Hashimotos – Case Study 2

Hashimotos balanced by diet

by Sue Kira, Naturopath & Clinical Nutritionist

Client name and identifying information changed

Every now and then as a practitioner, I would get what I called the real ‘doozies’ – those cases where I wasn’t sure where to start, or if I could even help those clients because they had already been everywhere and seemingly covered every angle about their condition.

In recent years, these clients became more the ‘norm’ than the odd one out, or perhaps I attracted them because of my repeated success rates.

My rule of thumb with difficult health situations is, if in doubt, treat the gut and sort out the diet and then go from there. This case was no different.

When Lydia first saw me she had a folder of information, test results, scans and a list of symptoms, supplements and things she had done over the previous two years with doctors, naturopaths and other ‘healers’.

Lydia’s thyroid problem started about 2.5 years before she saw me, after she gave birth to her second child and then put on an enormous amount of weight (25kgs/55lbs) onto her slightly framed body. She was very tired and foggy in the head, which was put down to childbirth, being a new mum and not getting enough sleep.

Eventually one doctor found that Lydia had an underactive thyroid and put her onto thyroid replacement hormone and she thought all her problems would be solved. She did in fact feel a little bit better with more energy for a few months, but then all came crashing down again.

Back to the doctors and her TSH (Thyroid Stimulating Hormone) was through the roof and antibodies were very high, so her medication was doubled and again, she felt a little better for several months – but then back to square one.

This time the doctor sent her to a specialist where she had more tests and her medication was further increased. However, instead of feeling better with the higher dose, she felt worse – her heart rate was rapid, she had anxiety, couldn’t sleep, felt restless and generally unwell.

These were symptoms of an overactive thyroid, as if her thyroid levels had gone too far the other way. Yet tests revealed that her TSH was nearly normal (a bit low) but her antibodies were higher than ever. The doctor tried to lower her medication but then she became so tired and put on even more weight, to the point where she just didn’t know what to do.

After more tests and specialist appointments, Lydia was getting nowhere, felt worse and fed-up. That’s when she saw me.

Folder in hand and exhausted, she wanted me to look at her situation differently and hopefully help her. She said, “You’re my last resort, I just don’t know what to do anymore”.

I have heard these words so often from clients, and I would answer, “Never, never give up or you will stay the same or get worse. If not me, then someone else will be able to help you.”

After an initial overview of Lydia’s situation I decided to investigate her gut health, as many diseases physically start in the gut. (I say physically, because most health conditions are emotionally based, but then physically manifest somewhere in the body, often in the gut, and then continue a path of destruction to other organs.)

From some in-clinic tests, it looked like Lydia’s gut was unhealthy, so we organised some lab tests and sure enough, her digestive system was a mess.

She had loads of inflammation, high markers for gluten sensitivity, high markers for putrification in her gut and terrible levels of good and bad bacteria – too many bad, not enough good. Leaky gut (intestinal permeability) was also present and she had intolerances to many foods. Tests also confirmed low levels of vitamins and minerals, which indicated she was not absorbing nutrients efficiently.

Interestingly, Lydia was totally oblivious to her digestive system being such a mess, because she felt so bad in many other ways that it was all a blur of discomfort.

Because Lydia had been to many practitioners, doctors and specialists, her funds were low, so she didn’t want to take any supplementary products initially, but she had a strong feeling that diet changes might help. She had experimented with diet by randomly choosing to eliminate certain foods like gluten or dairy but never the two together, or any other foods.

Essentially, it was too exhausting for her, particularly because of how she felt and looking after a family. She needed guidance – that was my job.

Knowing Lydia’s case was quite serious because she was not responsive to medication and her immune system was attacking her body, I put her onto the full Auto-Immune diet protocol. There was no beating around the bush or going in gently, we dropped her in the deep, so to speak, with a radical change to her diet as we needed to reduce the inflammation pronto.

Normally I suggest to ease into these protocols by starting with a gluten, dairy and sugar free diet, but with so many intolerances and so much going on in Lydia’s body, we also included the second and third phase of the auto-immune protocol.

This involves avoiding all grains (not just the gluten ones), all nightshade family of fruits/vegetables, eggs, all fruits, nuts and all legumes. She was also placed on a low ‘FODMAPs’ diet combined with a low histamine diet. We also removed any foods that tested sensitive. All of this was combined.

This left Lydia with a very basic diet of proteins from meats, poultry and fish (all to be very fresh, thus low histamine) along with certain vegetables that are low FODMAPs and low histamine.

By taking away all potential inflammatory foods and aggravants to her body, within only three weeks Lydia felt much better. We still had a long way to go, but it was a good start. After another three weeks at this intensity. Lydia felt quite normal, but we needed to see her markers again.

Her thyroid (still on medication) was now within the normal reference level and her antibody levels had halved so we knew that even though she felt so much better, we still had work to do. Lydia was so pleased with how things were going that she was happy to continue with this restricted diet for another three months, after which we retested her antibodies and her gut.

Her antibodies were now within normal levels, so that meant no more auto-immunity for her thyroid and her TSH was dropping low enough for the doctor to drop her medication by half (he was very surprised).

She wanted to continue longer with this diet, but I felt it was time to re-introduce some of the foods that had been removed to see if any caused issues. It was time to ‘challenge’ her body.

I advised Lydia to gradually re-introduce only one food every three days and really feel if her body responded negatively to any foods. I suggested to commence with some of the foods she missed the most but leave out the foods on her reactive list till last.

Over the next three months Lydia managed to reintroduce many of the foods. She only reacted to three foods challenged and these were tomatoes, tinned tuna and chocolate. At this stage, we hadn’t challenged the more potentially dangerous foods like gluten, dairy, grains or eggs.

After 12 months on the less restrictive diet, we tested again and it looked like her thyroid condition had never existed and by this stage she was off medication. Her weight was normal, her energy good, she was sleeping well and she was so pleased that she found something to help her ‘get her life back’.

There were only three foods she hadn’t challenged which were grains, dairy and eggs. Before doing anything about these foods I asked her to get another food intolerance and allergy test done. Gluten, dairy (both casein and lactose) and egg whites all still came up reactive (yolks were ok).

I suggested to Lydia it would be best for her not to ever eat these reactive foods again. I would like to add that once we knew Lydia was fine with histamine foods, we also introduced gut healing foods like fermented probiotic rich foods and bone broths to help heal her gut and re-establish good bacteria.

It’s quite possible that the stress of her second childbirth, poor eating habits and potential intolerances, set off a leaky gut that cascaded into her initial auto-immune disease spiral of ill health.

However, along the way when Lydia came in for check-ups, we also discussed potential emotional triggers for her condition. We spoke about how thyroid conditions can be linked to holding back something we need to express and how we over-ride what we feel is best. Also, the intestines are generally about self-worth.

With these cues, she told me that when she gave birth to her second child, a feeling of dread came over her when she was to go home, because she knew she wasn’t going to get any support from her husband. It was bad enough with the first child but worse now there were two children. She didn’t respect herself enough to voice her concerns and she bottled it all up inside, only to be expressed through her body going into self-destruct mode.

She was right about not getting the help needed, but the worst part was that she didn’t even ask for help. Many women tend to ‘martyr’ themselves, thinking that their loved ones should just know to offer help. Meantime, their partner thinks all is well and each has their different roles in the house. I’ve made the same mistake myself in the past, so I could share how I managed to change this situation.

Lydia’s situation could have ended in divorce, so she needed to resolve it or risk creating another disease. Thankfully her husband was very open to do more in the home; he actually thought that Lydia was happy to do everything. He did need a nudge every now and then, but they were both much happier with improved communication.

Does this mean that all Hashimoto’s disease cases can be reversed by diet and talking to your partner (or whoever)? Not necessarily…but it’s worth a try.

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