Dr. Z answers: What is the cause of Hashimoto’s Thyroiditis?

iStock_000000187667LargeWhenever a bacterium, virus, parasite, or grain of pollen enters the body, the white blood cells that make up the immune system mount an attack against the invader. That immune response happens when certain white blood cells form antibodies against the foreigner, while other white blood cells devour the bacteria or viruses, thus destroying them. These foreign invaders have proteins on their outer cell membranes that attract certain white blood cells called lymphocytes. The lymphocytes, through specific mechanisms, seek out and destroy foreign proteins like viruses, bacteria, and other aliens that come in contact with the body.

Autoimmunity occurs as a consequence of these same lymphocytes responding to proteins that make up our cells and tissues. Conditions such as Rheumatoid Arthritis, Celiac Disease, and Hashitmoto’s Thyroiditis are conditions of an autoimmune response. Hashimoto’s Thyroiditis more specifically occurs when the immune system goes after the thyroid. As a consequence of this the thyroid is impaired, producing less of the thyroid hormones T3, and T4. This autoimmune condition eventually creates hypothyroidism.

How does the immune system ‘all of a sudden’ go after its own body? What would cause such a response? Research states that many autoimmune conditions are triggered by previous infections, viral or bacterial. Viruses and bacteria are recognized by proteins found on their surfaces. The immune system produces antibodies to destroy the aliens, and then remain in circulation for some time. Unfortunately, certain cells and tissues in the body have similar proteins, which the antibodies identify as foreign, seek and destroy. 

Autoimmunity can also be caused by immune reactions to proteins found in certain foods. Again, the proteins in these common food sources cause the manufacturing of antibodies for those specific proteins, which also resemble the proteins found in and on our cells and tissues. The stress response also plays a role in autoimmunity, along with hormones, environmental toxins, and medications.

TH1 and TH2 immunity.
Most practitioners treat the thyroid in Hashimoto’s Thyroiditis, without addressing the autoimmune reaction. Unfortunately, this direction of treatment will perpetuate the disease. Shifting the immune system from a state of attack to one of surveillance is key to treating autoimmunity. This involves balancing the TH1 response and the TH2 response. TH1 cells notify the immune system that bacteria or viruses have entered the body. After the white blood cells seek and destroy the bacteria, the immune attack stops. TH2 cells produce antibodies against bacteria or viruses to overcome the infection. When bacteria or viruses come in, the antibodies are there to fight the infection. Under normal circumstances, the TH1 and TH2 response is balanced, switching back and forth according to the body’s need to deal with internal threats. 

In many autoimmune responses, the TH1 response becomes dominant; one example is Hashimoto’s Thyroiditis. The ideal treatment for Hashimoto’s is to balance the TH1 and TH2 response, instead of treating the tissue or organ targeted for the immune attack. Depending on the results of specific blood tests to uncover the imbalanced TH1 and TH2 response, a treatment plan should be implemented to normalize the response and help the areas of the body that have been the target for the autoimmune response.

References
Page, LM, du Toit, DF, Page, BJ, Understanding Autoimmune Disease—a review article for the layman, Division of Anatomy and Histology, University of Stellenbosch, Western Cape, RSA

BMJ volume 321 12 AUGUST 2000, Science commentary: Th1 and Th2 responses: what are they?

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