Causes of Hypothyroidism
I, as creator of this patient-to-patient site, have always been amazed at the amount of causes, even if some are far more common than others. Below is an outline of those potential causes of which some can be corrected and most others will need medication. ~Janie B. hypothyroid patient and creator of this site.
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Thyroid problems can simply run in families, perhaps due to specific genetic mutations which become expressed, and which you can discover via testing at 23andme.com. Those thyroid genes can include FOXE-1, FOXE-2 and TG. Genes related to the autoimmune Hashimoto’s are CTLA-4, PTPN22, MHC-DR3, and MHC-HLA C*07. The DIO1 and DIO2 mutations affect your ability to convert T4 to T3 (a reason some might do awful from the get-go on T4-only like Synthroid or Levothyroxine–that was Janie Bowthorpe, the creator of this site).
Autoimmune Hashimoto’s Disease (thyroiditis)
Also called “Hashi’s” or “Hashimoto’s thyroiditis“, this is an organ-specific autoimmune disorder in which one’s immune system attacks your own thyroid cells, causing inflammation and destruction, eventually resulting in hypothyroid. In many cases, a goiter develops because of the inflammation, but sometimes the thyroid gland can actually shrink. Patients with Hashi’s can vacillate between hypo (as thyroid is less effective) and hyper (as thyroid hormones dump into blood and cells). There is a genetic predisposition to autoimmune disease, so if you have one, you are more at risk to have others, on top of having Hashi’s.
Causes of Hashimoto’s taking root? From having an autoimmune vulnerability, here are some triggers:
- an uncontrolled infection
- low iodine
- too much iodine
- food sensitivities
- intestinal permeability caused by SIBO (small intestinal bacterial overgrowth) or uncontrolled candida
- any gut issues
- even parasites like Blastocystis Hominis and others!
Read more about triggers and treatment in the highly recommended is the patient-to-patient book Hashimoto’s: Taming the Beast
Other forms of thyroiditis
Thyroiditis is an umbrella term to describe several conditions concerning the inflammation, or the attack, of the thyroid gland, of which Hashimoto’s disease is just one. Those other forms include Seronegative, Post-partum, De Quervain’s Subacute, Acute, Silent, Drug-caused, Radiation, Reidel’s, Ord’s Atrophic. You can read more here.
Overtreatment for Graves Hyperthyroid or Hashi’s with Radioactive Iodine
If a person with Graves’ disease (or Hashimoto’s) is treated with radioactive iodine (RAI), the thyroid gland is usually rendered partially or fully inactive. Over time, from a few months to a few years, hypothyroidism usually occurs.
Thyroid Removal Surgery
If much of the thyroid gland is surgically removed, the result would be hypothyroidism. Some surgeons leave a small amount of thyroid, which would technically still give thyroid hormones. (And sadly, surgeons tend to put you nothing but T4 in the treatment of your hypothyroid state. Find out why it’s far better to have T3 in your treatment, too!)
Radiation of the face/neck/chest
Whether for treatment of acne, or for Hodgkins Disease, this treatment from the 1960s through the 80s and beyond can be a precursor to developing thyroid disease, especially if the thyroid area wasn’t protected.
Tumor on the Pituitary Gland
Also called Secondary Hypothyroidism, a tumor on the Pituitary gland interferes with the production of the messager hormone call Thyroid Stimulation Hormone (TSH), causing hypothyroidism as well as potentially adrenal insufficiency if the ACTH messenger hormone isn’t released either. Disorders of the hypothalamus gland in the brain may also cause thyroid hormone deficiency.
It’s strongly proposed that millions of individuals develop hypothyroidism due to the lack of adequate iodine intake, which in turn is due to soil depletion and lack of iodine in our diet. Since iodine is necessary in the synthesis, storage and secretion of thyroid hormones, a deficiency of iodine can result in hypothyroidism.
Trauma from Accidents or Surgery
Trauma, such as from automobile accidents, surgery, or severe uterine hemorrhage during childbirth can result in Sheeans Syndrome, which is hypopituitarism, and results in hypothyroidism. Cholecystectomy and Hysterectomy, as well as Tonsillectomy, can increase the risk of hypothyroid. Whiplash or neck trauma can cause hypothyroidism.
Prolonged acute stress
Long-term high stress can push cortisol high, and the latter pushes T4 to convert to the inactive Reverse T3, which causes hypothyroid symptoms. This is called Secondary Hypothyroidism and can be reversed once one moves away from the acute and chronic stress.
Pharmaceutical Drug Induced
Lithium, used in the treatment of bipolar manic-depressive disorder, inhibits thyroid hormone release and can also result in a goiter. The heart drug, Amiodarone, also increases your risk of hypothyroidism.
On the opposite side of the coin of insufficient iodine is taking too much from iodine-containing herbs such as kelp, bladderwrack, or bugleweed can increase your risk for hypothyroidism. Many multivitamins, glandular support formulas and combination products contain these supplements. Someone can even get hypothyroid from consuming too much soy. See right below.
Over consumption of Goitrogenic Foods
When eaten in large quantities, this class of foods can promote goiters and resulting hypothyroidism. They are mostly only a concern when served raw as cooking may minimize or eliminate goitrogenic potential. The most common goitrogenic foods include brussel sprouts, rutabaga, turnips, kohlrabi, radishes, cauliflower, African cassava, millet, babassu, cabbage, kale and soy products.
Over consumption of Soy Products
Soy products have a definite antithyroid and goitrogenic effect. Long term consumption of soy products can promote formation of goiters and development of autoimmune thyroid disease.
Severe under consumption of Carbohydrates
Yes, some patients have reported that severely limiting carbohydrates…so severe that one is in constant ketosis, can cause hypothyroidism and even adrenal issues.
Gut dybiosis/leaky gut
One could see hypothyroid symptoms due to gut problems, especially from the overgrowth of bad bacteria in the intestines.
Unfortunately, tobacco smoke contains cyanide, which is converted to thiocyanate, and which adversely acts as an anti-thyroid agent, inhibiting iodide uptake and hormone synthesis. The enlargement of the thyroid can occur due to smoking, which is a clue that the thyroid is negatively affected. On the other side of the coin, ceasing to smoke has caused hypothyroid symptoms to appear in some, probably due to the withdrawal of the nicotine–the latter which hid the problem.
Some doctors estimate that as many as 5 to 10% of women develop a thyroid problem after delivery. Childbirth can be a hormonal trigger for Hashimoto’s Disease. The owner of this site noticed this additional possibility, as well, for her own hypothyroidism, even though her main cause most likely was her exposure to mold at that time.
Sex Hormone changes
Surging estrogen is known to cause a hypothyroid state in some women, since excess estrogen can bind thyroid hormones. This could especially occur at puberty for some, and menopause for others.
Thyroid problems are known to surface at periods of hormonal upheaval and are more common just prior to or during menopause. (The owner of this site noticed her thyroid got a bit worse as she started to enter meno.)
Congenital means what one is born with, and though not common, it definitely happens. Usually, it’s due to either a missing thyroid gland, or a poorly-developed thyroid gland–the latter called dysgenesis and the most common cause of congenital hypothyroid. Or sometimes the gland is fully developed and placed in the neck, but simply doesn’t make enough thyroid hormones for the need of the baby–this is called dyshormonogenesis and the least common form of congenital hypo
Down Syndrome (DS)
It appears that having Down Syndrome greatly increases the risk of having accompanying hypothyroidism, and primarily the autoimmune version. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683266/ Sadly, some patients of Down children report a delay in the diagnosis of hypothyroidism due to the widespread use of the TSH lab test which, which can be so-called “normal” while the child is truly hypothyroid.
Hypothyroidism becomes increasingly common as we age, particularly in women, and appears to be so due to problems of converting T4 to T3. Ten percent of all women over the age of 50 show signs of a failing thyroid. The percentage rises to 20% in women over 65. The owner of this site saw her 90+ year old father-in-law ease into hypothyroidism which the doctors didn’t treat.
There are proposals that viruses like EBV (Epstein Barr Virus) or HHV 6 could precipitate Hashimoto’s disease, but the cause and effect is not as strong as other causes listed on this page. Here’s a study on EBV as a potential cause. And here’s one for HHV-6.
I, Janie Bowthorpe, found out many years later that the reason I probably got hypothyroidism is because I was HEAVILY exposed to mold for three years in a house we lived in…and at the same time I was starting to experience hypothyroid symptoms. It was so bad that the shoes in my closet would gather mold on them! And mold exposure is very toxic to your thyroid.
Some patients have experienced the fact that fluoride and chlorine can interfere with proper thyroid conversion and result in hypothyroidism. Another concern is mercury, a component in dental fillings, which can disable the thyroid’s ability to convert T4 to T3, resulting in hypothyroidism. This especially becomes a problem if one has the MTHFR defect. A chemical found in plastic bottles and canned food linings and known as BPA (Bisphenol A) is linked to thyroid hormone changes in pregnant women and newborn boys. Contra Costa Times, California. 4 October 2012. Another study finds lower thyroid hormones in baby boys exposed to BPA. Pregnant women exposed to higher levels of the chemical bisphenol A gave birth to baby boys with lower thyroid hormones, according to a new study published in Environmental Health News. 4 October 2012. Read about Endocrine Disruptors.
Perchlorate and Other Toxic Chemicals Exposure
Perchlorate (ammonium perchlorate or perchloric acid) blocks iodine from entering the thyroid, and prevents further synthesis of thyroid hormone. It is found in various water supplies around the nation, particularly in areas near rocket fuel or fireworks plants. There is strong evidence that exposure to certain toxic chemicals increase the risk of developing thyroid disease. Those that are of concern are dioxins, MTBE, and others that act as “endocrine disrupters”.
von Willebrand syndrome type I disease
Acquired von Willebrand syndrome type I (AvWS), which is a blood coagulation disorder causing bleeding, seems to go hand in hand with hypothyroidism. And the interesting aspect is that once the hypothyroidism is correctly treated (and we know that “correctly” means also having T3 in one’s treatment, NOT just T4), von Willebrand can be reversed.
And more in the updated revision STTM book here.
Do YOU have a cause not listed here? Use this form to let me know.
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