Can Hashimoto’s Disease Be Reversed?

Hashimoto's disease, also known as chronic lymphocytic thyroiditis or Hashimoto’s thyroiditis, is an autoimmune disease that affects the thyroid gland. As with other autoimmune diseases, there is currently no cure for Hashimoto’s disease, and it cannot be reversed. There is evidence, however, that a proactive approach to diet and lifestyle may help reduce many symptoms. 

What is Hashimoto’s Disease?

Hashimoto’s disease is a chronic medical condition in which the immune system attacks healthy thyroid cells and gradually destroys the thyroid gland. This affects the thyroid’s ability to produce hormones that help control metabolism, growth, development, and maintenance of many bodily tissues and functions.

In the earliest stages of Hashimoto’s the inflamed thyroid gland may produce excessive amounts of thyroid hormones, causing hyperthyroidism, or high levels of thyroid hormones. Eventually Hashimoto’s may damage the thyroid gland enough to cause hypothyroidism, in which the gland can’t produce enough thyroid hormones to maintain normal metabolic function. When this happens, the treatment includes supplementation with levothyroxine, a synthetic thyroid hormone. (Source) 

What Is the Thyroid Gland?

The thyroid is a small gland in the front of the neck shaped something like a butterfly. The thyroid is an endocrine gland, meaning it produces hormones that travel to, and have influence on, other parts of the body. The thyroid produces two hormones, triiodothyronine (T3) and thyroxine (T4), that regulate metabolism — the complex chemical reactions that power all the work our bodies do. (Source, Source)

The role of the hypothalamic-pituitary-thyroid axis

How does the thyroid gland know how much of its hormones to produce? Like other endocrine glands, the thyroid participates in a feedback loop, in which hormone levels are monitored and adjusted as needed. The other members of the thyroid’s feedback loop are the hypothalamus and the pituitary gland. (Source)

The hypothalamus

The hypothalamus is an almond-sized area of the brain that is responsible for keeping all of the body’s systems in balance, a condition known as homeostasis. (Source)

When the hypothalamus senses a need for T3 and T4 hormones, it releases a hormone of its own called thyrotropin-releasing hormone (TRH). This hormone doesn’t work directly on the thyroid, however; it is destined for the pituitary gland.

The pituitary gland

The pea-sized pituitary gland is located very near the hypothalamus. In fact, the two are physically connected by a structure known as the pituitary stalk. (Source) 

The pituitary gland produces several different hormones, including thyroid stimulating hormone (TSH). When the pituitary gland receives TRH from the hypothalamus, it releases TSH. The TSH then makes its way to the thyroid gland, stimulating it to produce T3 and T4. (Source)

Hashimoto’s disrupts the hypothalamic-pituitary-thyroid axis

In Hashimoto’s disease, the thyroid gland is impaired and cannot respond properly when it receives TSH from the pituitary gland. When this happens, lab results will usually show elevated TSH levels — that’s the pituitary gland trying to signal the thyroid to release its hormones — and low T4 levels. (Source)

Signs & Symptoms of Hypothyroidism

Hashimoto’s disease usually progresses very slowly, and may not cause noticeable symptoms for many years. Eventually, if the thyroid gland is damaged enough, it will stop producing adequate amounts of its hormones permanently. The resulting hypothyroidism will begin to interfere with normal metabolic function, producing predictable symptoms. 

Those symptoms may include:

• Fatigue and insomnia 
• Muscle and joint pain, aches, or weakness
• Heaviness or feeling as if your body is weighed down
• Dizziness
• Sensitivity to cold
• Switching between feeling extremely hot and cold
• Weight gain
• Constipation
• Hair loss
• Brittle nails
• Pale, dry skin
• Slow heart rate (bradycardia)
• Enlarged thyroid (goiter)
• Irregular or heavy menstrual periods
• Heart palpitations

Neurological and mental symptoms that may arise include:

• Brain fog
• Migraines
• Difficulties with memory
• Mood swings
• Irritability 
• Anxiety
• Depression

(Source)

Reversing Hashimoto’s Disease Symptoms

Hashimoto’s disease is irreversible, and the treatment for hypothyroidism caused by a damaged thyroid gland is supplementation with levothyroxine, a synthetic thyroid hormone. 

However, some studies have suggested establishing a normal thyroid level may not relieve all Hashimoto’s symptoms, and some persistent symptoms may be related to the presence of autoantibodies. (Source) 

This means it may well be possible to mitigate Hashimoto’s symptoms through diet and lifestyle changes that are focused on reducing inflammation and avoiding autoimmune triggers.

Measures that may help reduce Hashimoto’s symptoms include:

• Eating a paleo, autoimmune protocol (AIP), or gluten-free diet to reduce inflammation and identify foods that trigger the immune response. A study published in 2019 found that while these diets didn’t improve thyroid function in people with Hashimoto’s, lab results showed reduced inflammation and more balanced immune function. (Source) 
• Following a vegan diet, or emphasizing plant-based foods over those derived from animal sources. Part of the advantage is thought to be due to phytosterols (plant sterols, similar to cholesterol), which have been shown to reduce inflammation and modulate immune response. (Source, Source)
• Supplementing the diet with vitamin D, selenium, and zinc. People with Hashimoto’s tend to be deficient in vitamin D, and supplementation may slow the progress of the disease. (Source, Source). Supplementing with selenium has been shown to decrease levels of anti-thyroid antibodies. (Source) Zinc deficiency, often overlooked in people with hypothyroidism, has been shown to interfere with T3 action; zinc supplementation may improve thyroid function. (Source)
• Eating foods high in Omega-3 to heal inflammation and improve gut health. It is thought that intestinal inflammation allows antigens in the gut to interact with the immune system and stimulate an autoimmune response. Poor gut health may also impair absorption of nutrients needed for healthy thyroid function. (Source, Source)
• Maintaining a low-iodine diet. The thyroid gland needs small amounts of iodine to produce its hormones, but research suggests taking in excessive amounts of iodine leads to overproduction of thyroid hormones and an autoimmune response. Iodine occurs naturally in seafood and dairy products, and is often added to salt; if you don’t eat these foods anyway, you’re already on a low-iodine diet. You don’t necessarily need to avoid dietary iodine if you have Hashimoto’s, but you certainly shouldn’t take iodine supplements.  (Source, Source)
• Enjoying moderate alcohol consumption. Studies show that consuming moderate amounts of alcohol (1 to 10 units per week) may help prevent autoimmune hypothyroidism. Heavy drinking, however, is not more protective and carries additional risks. (Source)
• Taking probiotics. Small studies of the effects of probiotic, or synbiotic, supplementation in patients with hypothyroidism, as well as patients with rheumatoid arthritis, have shown some promise. More research is needed, though, to confirm the benefits of probiotics on autoimmune disorders. (Source, Source)
• Minimizing mental, emotional, and physical stress. Stress has been implicated in disruption of the feedback loops that maintain homeostasis, including regulation of thyroid hormones. Stress management is a safe way to enhance quality of life in general, in addition to possibly reducing action of anti-thyroid antibodies. (Source, Source)
• Treating anxiety and depression. People with autoimmune disorders often suffer depression and anxiety, and there is some evidence these mental health issues may sometimes be rooted in autoimmunity themselves. Whether depression and anxiety are related to Hashimoto’s or not, treating them can make living with the disease less stressful. (Source, Source)
• Taking the thyroid medication levothyroxine, a synthetic form of thyroid hormone, to balance thyroid hormone levels. As discussed previously, levothyroxine alone may not be enough to alleviate all Hashimoto’s symptoms, but it is essential to treatment of hypothyroidism. (Source)

The Bottom Line on Reversing Hashimoto’s

While there is currently no way to reverse or cure Hashimoto’s thyroiditis, it may be possible to reduce symptoms with an anti-inflammatory diet, lifestyle changes, and stress reduction. When Hashimoto’s progresses to a permanent decrease in thyroid function, though, the standard treatment is supplementation with levothyroxine, a synthetic thyroid hormone.