[Ask Inna] Your Thyroid and Hashimoto’s Questions Answered

I recently opened the door to questions about thyroid conditions and Hashimoto’s on my Instagram page. And, wow, was I flooded with really great questions. In this episode, I answer as many as I can.    The Question - How do you Shrink Your Thyroid Nodules? This was the question I got the most from my Instagram followers. Before I answer, I want to clarify a few things. There are many different types of growths on the thyroid. Many people confuse enlargement of the thyroid with nodules or inflammation. If the thyroid is enlarged in one spot, that is a nodule. However, if the whole thyroid is enlarged it’s either a goiter or thyroiditis. A goiter is caused by iodine deficiency (uncommon in the US), consumption of too many goitrogenic foods, or thyroiditis. This swelling is often painless (pain may indicate that inflammation is from a virus).  Goiter growth is fed by a high TSH (Thyroid Stimulating Hormone) and also by high hCG (human chorionic gonadotropin) which is present during and after pregnancy. Eventually the hCG will go back down but if the TSH level is not treated, it can continue to feed the goiter and it will continue to grow.  The first step in reducing a swollen thyroid is to get TSH levels in balance and to reduce goitrogenic foods.  As for nodules on the thyroid, these could be solid or cysts filled with fluid. About 50% of people have these and many are benign. Someone with Hashimoto’s may experience nodules during a flare up. However, it’s important to have them checked because they could lead to thyroid cancer. The good news is if the nodules are due to Hashimoto’s, addressing the root cause of Hashimoto’s can help shrink the nodules as well. For more on this, refer to past episodes 32 - Solving the Autoimmunity Mystery, and 68 - Ask Inna: Hashimoto’s Questions.   The Question - Do people with Hashimoto’s have a compromised immune system? This is a question that has popped up a lot more since the start of the pandemic. People want to know if having Hashimoto’s means your immune system is weakened.  Inna’s Response  This might seem logical but it’s actually the opposite.  Hashimoto’s makes the immune system hyper-vigilant. The problem is that the immune system is confused so it’s extra-active. But this extra activity means that it attacks your own tissue - in this case, your thyroid. So, it’s not weak in that sense but because it’s so hyper-vigilant and attacking your tissue, it can actually weaken its response to bacteria and viruses.    The Question - My antibodies are still high. Is there something else I should look at? This question came with quite a bit of backstory. She explained that she had switched from taking just Synthroid (a prescription synthetic thyroid hormone replacement) to adding Cytomel. However her hashimoto antibodies continue to be high despite adhering to the autoimmune protocol (AIP) diet (with the exception of eggs). She wondered if the eggs could really cause that much of an issue. An ultrasound also revealed that she has two nodules on her thyroid. So, the real question is, what’s the root cause and what else can she do? Inna’s Response  Finding the underlying cause can be tricky. It seems like she’s already looked at the food angle by doing a mostly AIP diet. It is possible that the eggs are a trigger because every person is different but it’s hard to say. A really good food sensitivity test (like the comprehensive panel test done at Vibrant America), and find out conclusively if eggs are an issue for you.  After that, you want to make sure you look for other underlying causes like stress, infections, and toxins. Keep in mind that you want to give new medication combinations a couple of months to shift your antibody response.    The Question - My TSH levels are very erratic as is my weight gain. What are the best diet plans, supplements and essential tests? Inna’s Response  In this case it sounds like it may be Hashimoto’s and the swings are caused by flare ups. TSH can go up and down erratically with Hashimoto’s.  For tests, you want to make sure to get a TSH a total T for the total T3 free, a T4, free T3, reverse T3 and (very importantly) both thyroid antibodies for Hashimoto’s - thyroglobulin and thyroid peroxidase.  As for the diet plan, the best one to start with is the AIP plan where you take out grains, dairy, nuts, eggs and processed foods. If this feels too restrictive at first, you can start with removing gluten and dairy. You should also look at underlying causes like infections, toxins and stress.   The Question - I’ve been diagnosed with Hashimoto’s but my tests are now normal and I don’t have any symptoms. Do I still have Hashi’s? This Instagram follower has seen her test results move into normal range lately with TSH at 1.5 and antibodies consistently below the threshold of 35 (from 17 to 34). And, without any mood or energy symptoms it has her feeling like she’s in a gray zone.  Inna’s Response  The answer here depends on when and how the dia...