In 2017, while getting some routine bloodwork done to try to determine why I felt like my energy and vitality were rapidly declining, I was diagnosed with Hashimito's Thyroiditis, an autoimmune disease that affects millions of people worldwide. Current estimates say that Hashimoto's affects 1-2% of people in the U.S., and that it is the most common cause of underactive thyroid (hypothyroidism). Unfortunately, it often goes undiagnosed for years, and according to the American Thyroid Association, up to 60% of the 20 million Americans who have thyroid disease may be completely unaware.
I took this photo on a day when I felt absolutely terrible from a flare
I was first told that I had suboptimal thyroid function while undergoing testing for fertility treatments in 2012. At that time I was placed on thyroid hormone replacement therapy and told to go about my business with no additional guidance or suggestions for improving my thyroid function. It would be another 5 years before a naturopathic doctor would order the blood tests necessary to reveal that the underlying cause of that suboptimal function was Hashimoto's. Knowing what I know now about autoimmunity and the lifestyle modifications that can help manage the worst of the symptoms, I wish it hadn't taken so long to receive the Hashimoto's diagnosis.
The Basics of Hashimoto's Thyroiditis
Named after the Japanese physician who first described it in 1912, Hashimoto's Thyroiditis is a chronic autoimmune disorder primarily affecting the thyroid gland – a butterfly-shaped organ located in the neck, responsible for producing crucial hormones that regulate metabolism and energy levels. In this condition, the immune system mistakenly identifies the thyroid as a threat and launches an attack against it.
As the immune system attacks the thyroid gland, inflammation ensues, leading to the gradual destruction of the gland's tissue. At first, the thyroid may release excess hormones into the bloodstream, causing hyperthyroidism. However, as the disease progresses and the thyroid function declines, it often leads to hypothyroidism – a state where the thyroid doesn't produce enough hormones to meet the body's needs. Looking back, I can see that I lived in a hyperthyroid state for several years where I lost weight, had heightened anxiety, and felt, at times, almost manic. Once the hypothyroidism kicked in I started inexplicably gaining weight and feeling lethargic, which is what prompted me to ultimately seek the diagnosis that I received in 2017.
The Subtle Signs and Symptoms
Hashimoto's Thyroiditis is sometimes referred to as the "invisible illness" due to its subtle and diverse symptoms. Many of these symptoms can be easily attributed to other factors, making it challenging to diagnose, and often leading to delayed treatment. Some common signs and symptoms include:
Fatigue: Unexplained and persistent fatigue is a hallmark of Hashimoto's Thyroiditis, which can significantly impact a person's daily life.
Weight Changes: Unexplained weight gain is a common symptom of hypothyroidism, while hyperthyroidism can cause weight loss.
Cold Sensitivity: People with hypothyroidism often feel excessively cold compared to others. I was always the cold one!
Hair and Skin Changes: Brittle hair, hair loss, and dry skin can be linked to thyroid hormone imbalances. I couldn't understand why my skin was so dry all the time. It made sense in hindsight.
Muscle and Joint Pain: Muscle weakness and joint pain can occur, affecting mobility and causing discomfort.
Mental Health: Depression, anxiety, and mood swings are not uncommon among those with Hashimoto's Thyroiditis.
Menstrual Irregularities: Irregular or heavy menstrual periods are common. Unfortunately, as in my case, it can also lead to infertility.
Swelling of the Neck: A noticeable swelling in the neck, known as a goiter, can occur as the thyroid becomes enlarged.
The cause of Hashimoto's, and other autoimmune diseases, remains somewhat of a mystery. Scientists think they understand many of the mechanisms, but not exactly the why behind them. New research is showing that there are links between autoimmunity and gut permeability as well as past trauma. And some autoimmune diseases make you more likely to develop others. In my case, I also have GERD (Gastro-Esophageal Reflux Disease).
Coping with Hashimoto's Thyroiditis Living with Hashimoto's Thyroiditis can be challenging, as the symptoms often fluctuate, leading to good days and bad days. These symptoms can be triggered by food sensitivities (of which I have many), and stress. If I accidentally (or on purpose) eat something that is a known trigger, then it can cause a flare that can last several weeks. Coping requires understanding and support from family, friends, and my amazing team of healthcare professionals. Self-care becomes paramount – learning to listen to your body, getting adequate nutrition and rest, and managing stress.
How I deal with a Hashimoto‘s Flare:
1. Nourish myself: During these flares, I have to take extra time to feed myself well, and by that I mean preparing whole nutritious foods from scratch, according to the Autoimmune Paleo Protocol. This takes a lot more time and is way more inconvenient than buying prepared foods from the grocery store, going out to a restaurant, or getting takeout, but the end result is so much better. It also means making sure that I am getting enough nourishment. After many years of living in the toxic diet culture mentality of eating less, restricting calories, and working out more, the net effect is systemic depletion. And if there’s one thing, autoimmunity has taught me, it’s that depletion is not sustainable. Living in a state of depletion and trying to do my best in the world is not a recipe for success. So when I have a flare, I batten down the hatches and prepare all of my food at home.
2. Declutter my life: Oftentimes, because I am an outgoing people lover, I love the idea of doing lots of things with lots of people. But the reality is that when I am having a flare, I simply don’t have the energy to do all of the things I wish I could. That’s when I look at my calendar and figure out what I can release, which also means releasing FOMO (fear of missing out) and embracing JOMO (joy of missing out). While I might miss out on some incredible opportunities to see my favorite people, it also means that I am able to rest and restore my energy so that when I do see those people and do those activities I can do it with my whole self and really be present to enjoy the experience.
3. Declutter my home: Years ago I worked as a professional organizer in Seattle. Seeing firsthand the deleterious effects of not being able to let go of possessions or living in a more-is-more mentality, I was able to really internalize the idea that what you own owns you. At this point in life, I love living a little bit simpler and having just a few well-chosen items. When I look at my home, it’s not what I would call bare, but it’s not overly maximalist either. "Decluttered" means something different to each individual, so find what that means to you and embrace it. Don’t be afraid to seek the help of a professional organizer if figuring this out on your own feels too daunting or overwhelming. It’s what they’re trained to do. The benefits of spending less time maintaining your stuff are priceless.
4. Move my body. When my symptoms are in remission, I have a big capacity for physical movement. You’ll find me strength training with heavy weights 2 to 3 days a week, getting to a dance class once a week, getting out into the wilderness and hiking, riding on my mountain bike, and doing stretching workouts. When I’m in a flare, I’m lucky if I can go for a short walk on an easy trail and do 10 to 15 minutes of stretching. During these times I treat my body extra gently and also give myself permission to take naps, go slowly, and do less, which is perhaps the most challenging thing of all.
5. Forgive yourself. There is much speculation about what causes autoimmunity. What there is not is consensus. It appears to be a complicated mix of physical and emotional issues and that one's toxic burden may also play a part. Trying to understand it can send you to a dark place and also it may lead you to blame yourself for your flare and the disease itself. This is not helpful at all. How you feel about your ability to heal and recover from a flare will actually impact your ability to heal and recover from the flare. Flip the script and write a love letter to your body thanking it for everything that it does for you, for everything that it’s gotten you through, and for everything that is yet to come. This, too, shall pass.
6. Embrace natural. I referenced toxic burden above. What once used to be relegated to the halls of woo is now widely excepted to be a real factor in influencing disease and autoimmune disease in particular. Give your personal atmosphere a long look. Are your beauty products free from potential endocrine disruptors? What about your cleaning products? Are they free from artificial fragrance and other toxic chemicals? These are low-hanging fruit in a world where there are now so many excellent nontoxic alternatives. How about your clothing? Opt for natural fibers and natural dyes over synthetic ones. The more of these swaps that you can begin to make in your life, the more you will reduce your overall toxic burden and begin to allow your body to do what it knows how to do, which is to heal itself for your benefit.
I learned all of the above after years of doing everything wrong. If you find yourself in a flare and don't have the energy for all this, just remember to give yourself the grace to feel whatever you need to feel and get more rest. And if you need to commiserate, drop me a note!
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