The thyroid is one of the more underrated, yet complex organs in the body. Many individuals, specifically women over 40, are diagnosed with a "hypoactive thyroid" or even hashimoto's thyroiditis. This simply means your thyroid is getting old, and has been overworked. That can come from many factors, be it autoimmune thyroid disease, or just a lifetime of bad diet. In this article we are going to discuss hashimoto's with normal levels of TSH.

What is TSH?

TSH or thyroid stimulating hormone is secreted by the pituitary gland in the brain in response to an underactive thyroid. This hormone simply tells the thyroid to kick it into gear. On labs or panels, I find a lot of patients get confused when looking at their TSH levels, so let me break down what they tell us.

High TSH is indicative of a low functioning thyroid, which is contrary to normal belief. High levels of a substance must mean a high function, right....?

Unfortunately, the thyroid likes to be confusing. For the sake of this article we are going to assume TSH is normal, but if we see an elevated TSH level (over 1) that is a separate conversation.

How is Hashimoto's Thyroiditis Diagnosed?

Almost always this condition is diagnosed based on lab or serum levels. Specifically lab results associated with anti-thyroid peroxidase or anti-thyroglobulin antibodies. Those are a mouthful, so we will refer to them as TPO antibodies and TgAb.

High levels of these antibodies in combination with a diagnostic ultrasound are key in a good diagnosis of autoimmune thyroid diseases, but is it really autoimmune?

Autoimmune Disease, and What It Means?

To answer this question, we must first have a definition of what an autoimmune condition is.

Autoimmune conditions are a disorder where the bodies immunes system attacks itself. Sound crazy?

Autoimmune conditions are on the rise in the developed world, and modern medicine cant tell you why. In my opinion, it has to do with all the toxins that surround us. Bad air, bad food, and high prescription medicine count are confusing the body. This confusion is a one way trip to an autoimmune disease diagnosis.

How do TPO Antibodies Factor In?

TPO antibodies or thyroid peroxidase autoantibodies are a reflection of a food allergy of some kind. When I see high levels of TPO but no rise in TSH, I immediately pivot treatment for hashimoto's with normal tsh to food allergy testing and diet regulation. Something you are eating is causing the thyroid to panic.

For example, gluten is a very common allergen, but why. People ate bread for thousands of years and no one had issues. To understand why we see a lot of gluten allergy, we have to understand the wheat grain. Wheat has been hybridized to be the most hearty, drought resistant, wind resistant granule. This is a huge boon to the farmer, but not so much for the consumer. It can be quite difficult to break down in the stomach.

Wheat is also no longer left to dry on the stalk the way it used to. Rather than let the wheat naturally die and dry up on the stalk, wheat plants are sprayed with roundup to kill it and dessicate it quicker so less waste is seen. The wheat berry is then harvested, processed and that roundup will be seen in any product containing wheat.

One last major reason gluten is becoming an issue for people is due to the way it was baked. Bread used to be leavened through a sourdough process, that took time and pre-brokedown the gluten strands prior to it ever getting into your mouth. Now, we use instant rise yeast to accomplish the rise, but no fermentation takes place.

To wrap up my saga on wheat, you are now eating a very resistant granule of wheat that has been covered in roundup, and starved of fermentation. No wonder it is difficult for our bodies to break down.

This is just one common example I see in my patients, there are other allergens that can fire up TPO antibodies.

What This Means For You

You got diagnosed with Hashimoto's thyroiditis, but your TSH is normal, what are you going to do. I would start with a food allergy test, even if TPO is not elevated. Once you eliminate toxins from your diet, your body will self regulate. God made our bodies perfectly, and if we treat them right, they will self heal. Contact our office to start diving into your food allergies and heal your thyroid.

Common Questions

Can you have thyroid issues with normal TSH?

Yes, TPO antibodies can be a large part of a hashimoto's thyroiditis diagnosis. Normal TSH levels are variable from practitioner to practitioner, get a second opinion if you don't feel taken care of. Our doctors are happy to order labs and explain them to you! Give us a call for more info.

Can you have a normal TSH and abnormal TPO?

You bet. It all depends on what food allergies or avoidances your body is dealing with.

Can you have TPO antibodies and not have Hashimoto's?

Yes, the thyroid is rather resilient and having high TPO antibodies, but no autoimmune thyroid disease is common. Over time, your body will develop an autoimmune thyroid disease, so stay on top of your health.

What is the best way to treat Hashimoto's thyroiditis?

This is a loaded question. We can treat for high TSH or a high antibody count. To fully answer the question I would need to know if we are seeing high TSH or high TPO antibodies.

Is treatment for Hashimoto's different than hypothyroidism?

Yes and no. Hashimoto's thyroiditis is hypothyroidism, but hypothyroidism is not always hashimoto's thyroiditis. Generally treatment will look similar, it just depends on your lab work.