Hashimoto’s affects 14 million people in the United States alone mostly woman,¹ and this autoimmune disease is triggered by elevated estrogen – also known as estrogen dominance. Elevated exposure to estrogen can place a woman at greater risk for Hashimotos autoimmune thyroid disease (Hashimoto’s thyroiditis). In the case of Hashimotos thyroid disease, the immune system is destroying the Thyroid gland, but the real problem lies with the immune system and the triggers behind the attack. In this case, high levels of estrogen are one of the culprits behind this attack and one of the reasons all woman with Hashimotos should have their estrogen levels properly tested. Unfortunately, most doctors don’t know how to properly treat Hashimotos, and don’t know how to properly test for estrogen dominance and if you are one of the 14 million people with Hashimotos, this spells years of symptoms and trips to your doctors office.

Overcoming Hashimotos

In order to understand how to overcome Hashimotos, we need to do two things. We need to think about the root cause(s) of this autoimmune disease (triggers) and we need to think about how to stabilize the immune system. If we fail to address these two critical questions, we won’t be very successful in overcoming the disease or the symptoms it causes. If you are reading this article and have a thyroid problem or think you have a thyroid problem, chances are very high that the cause of your thyroid problem is Hashimotos. Research has shown that Hashimotos is the number one cause of Hypothyroidism. You might be wondering if you have hashimotos so let’s first review how someone is diagnosed with hashimotos.

Currently, diagnosing Hashimotos is done by testing your blood for antibodies against the thyroid. The most common antibody tested for the diagnosis of Hashimotos is Thyroid peroxidase enzyme antibodies (TPOAb). I want to stress something that I believe is very important. Thyroid peroxidase antibodies (TPO Ab) are not the only antibody associated with Hashimotos Disease. There is another antibody, that when elevated, indicates Hashimotos as well. These are the Thyroglobulin antibodies (TgAb). Here is something so important that I don’t want you to miss. It is essential that both of these antibodies are tested. I have seen time and time again a person go to the endocrinologist whereby the endocrinologist/primary care doctor only tested the patient for one of the antibodies. Many times, I have seen that antibody come back negative while the other antibody when tested came back off the charts. So be sure that your doctor runs testing on both of these antibodies if you have symptoms of thyroid disease. The devil is always in the details. It is true that these antibodies can come back elevated in other autoimmune disease such as Sjogrens disease or Lupus or Rheumatoid arthritis. But for the most part these thyroid antibodies are very specific to Hashimotos thyroiditis.

Some doctors will say that the only way of truly diagnosing Hashimotos disease is through a fine needle biopsy which can look at the physical signs of thyroid tissue damage and if the thyroid has been infiltrated. Here’s the problem with this line of thinking. The presence of thyroid antibodies indicates that your immune system has been tagged by immune system cells. I explain it to patients by using a strobe light analogy. When thyroid antibodies have been detected by immune system cells, it is like a strobe light going off. Your immune system is being told that the thyroid is a foreign invader. At this point your immune system is no longer recognizing the thyroid as a friend but now as an invader. Any invader will now be attacked by the immune system, and this is how your thyroid gland is destroyed and your thyroid hormone levels eventually wind-up dropping. So, it’s not a matter of If the thyroid gland is going to be attacked it’s just a matter of when.

Earlier in today’s article, I said that to successfully overcome hashimotos disease we need to know two things.

1- We need to know What is triggering the immune system to attack the thyroid gland

2- We need to know How to stabilize the immune system.

So, let’s talk about one of the triggers of Hashimotos disease. There are three times that woman are most likely to be diagnosed with hashimotos. These three times are Puberty, Pregnancy and perimenopause-I call these the Three P’s. Not only is the incidence of Hashimoto’s thyroiditis in women higher than men, it’s 20 times higher. What’s happening to a woman during these three stages- the answer is estrogen Dominance. Not only can Thyroid problems cause estrogen dominance, but estrogen dominance can also bind up your thyroid hormones, leaving less thyroid hormones available to your tissue.

The end result is often a woman who has many thyroid symptoms but normal thyroid blood levels. Heres where things unfortunately get a bit more confusing for most doctors. Woman who are hypothyroid not only produce excess estrogen but also cannot detoxify or methylate the excess estrogen. Certain MTHFR mutations harshly affect the methylation cycle and therefore leads to hormone imbalances – such as in estrogen-dominant women with high oestrogen concentration cycles. Studies have shown that high levels of oestrogen may increase one’s risk (and progression) for cancer.

2-Methoxyestradiol, an endogenous estrogen metabolite, induces thyroid cell apoptosis. (2)

“Prolonged exposure to 2-ME led to apoptosis and to increased release of the autoantigen thyroid peroxidase (TPO).

The process of methylation exists primarily for the function of breaking things down and removing them from the body. Estrogen is no different. What happens if our bodies do a poor job at methylation? obvious…. you can’t get rid of all that excess estrogen and hence we develop the all too familiar symptoms of estrogen dominance. Learn how to support Methylation for better thyroid function.

There is more to this story- This estrogen dominance is often missed on routine blood testing because estrogen is accumulating in the tissues not in the blood. Have you gone to your doctor thinking you were estrogen dominant only to have your doctor look at you like your crazy? Many times when woman get their estrogen levels tested, blood levels are normal or low normal while tissue level can be 50 times higher. This excess estrogen now increases production of TPO antibodies.

Hashimotos, Peri Menopause and Estrogen- Understanding the Connection to Hypothyroidism

Perimenopause is the transitional period before menopause. During perimenopause, levels of estrogen, a key female hormone, start to decrease.

but the aging ovaries tend to produce unpredictable levels of the reproductive hormones progesterone and estrogen. During this time, many women experience various symptoms, including mood swings, irregular periods, and sleep disturbances. Most women experience fluctuating hormonal symptoms in the eight years to ten years leading up to menopause.

Women should be aware of the connection between their bodies and hypothyroidism.

Irregular estrogen levels may also affect thyroid function. Specifically, estrogen affects the thyroid gland’s ability to produce enough triiodothyronine (T3) and thyroxine (T4) to meet the needs of the body. In response, the pituitary gland releases more TSH into the bloodstream in an attempt to stimulate the thyroid.

It is well-documented that estrogen levels can have both direct and indirect effects on thyroid function. too much or too little estrogen has far-reaching effects. Your body requires just the right amount of estrogen, and any deviation can affect the subtle relationship between estrogen, progesterone, and thyroid function.

How Estrogen Effects Thyroid Health.

High levels of estrogen signal the liver to increase the production of thyroid-binding globulin (TBG). This protein (when too much is made) binds to the thyroid hormones, which in turn reduces the amount of T3 and T4 available for use by cells. That’s a bad things that can cause many of typical hypothyroid symptoms. But now the body becomes even more confused. Because the thyroid proteins are binding up available thyroid hormones, the body believes that the thyroid hormone levels are low. In response, the thyroid gland cranks up production of thyroid hormones to compensate for what it believes to be a deficit. Read this article on 5 Ways To Reduce Estrogen Dominance

Hashimotos, Goiters, Estrogen Dominance- 4 Ways Estrogen Dominance Affects Your Thyroid.

Estrogen stimulates the growth of the thyroid gland. As a consequence, excess estrogen can lead to an enlarged thyroid (goiter).
Estrogen influences thyroid Binding Globulin levels (TBG). Elevated TBG levels leads to low levels of thyroid hormones.
Estrogen stimulates thyroglobulin production. Thyroglobulin is a protein made by the follicular cells of the thyroid gland. It is used by the thyroid gland to produce T3 and T4.
Estrogen can cause chronic stimulation and buildup of thyroid hormones within the thyroid, and this can lead to goiters and nodules.

Other Triggers for Hashimoto’s Thyroiditis

While today’s article focused in on one of the culprits behind Hashimotos disease, keep in mind that there is no one singular reason (Root Cause) of Hashimotos (check out the other articles on this topic)

In my office, we often test our patients for a number of these autoimmune triggers as I believe that the only way to stabilize the immune system is to identify what the root causes include. Learn more about Hashimotos Causes, Treatment, who’s at risk here.

When To Consult a Functional Medicine Doctor.

If you have thyroid problems alongside the hormonal imbalances often referred to as Estrogen dominance, I suggest you work with not only with your primary care doctor but also a doctor who is certified and experienced in functional medicine. A doctor who has become certified in functional medicine, is a doctor who is focused on getting to the root cause. These doctors are problem solvers, we are capable of thinking outside the box and putting all the pieces of the puzzle together. We approach problems like estrogen dominance and Hashimotos with a concern to understand the cause.

If you’re experiencing any of the symptoms of hypothyroidism and/or estrogen dominance, contact our office today. We can help put the pieces of the puzzle together for you.

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References

(1) Hashimotos Facts-https://www.endocrineweb.com/conditions/hashimotos-thyroiditis/hashimotos-thyroiditis-facts-tips

(2) 2-Methoxyestradio http://www.ncbi.nlm.nih.gov/pubmed/10940494

(3) https://jamanetwork.com/journals/jama/fullarticle/2728926