This article will cover the science behind Hashimoto’s inflammation and how you can manage it.
What is inflammation?
Common inflammation symptoms are redness, swelling, heat, and pain. It also involves proteins like antibodies and cytokines that help your immune cells communicate.
Acute inflammation causes temporary damage to meet an end goal of healing. Once this initial reaction does its job, inflammation should subside and usually does.
When inflammation is prolonged, it is called chronic inflammation. It can happen when your immune system fails to shut off after responding to an acute cause that has gone away. But in some cases, chronic inflammation happens due to ongoing causes such as chronic infections, leaky gut, or toxic exposure. The chronic inflammation can damage your tissues, prevent healing, and overall make you miserable.
How does inflammation play a role in Hashimoto’s?
This happens because:
- Your immune system fails to recognize that the thyroid gland is not an outsider
- Your immune system fails to shut off when it should
- You have other ongoing inflammation triggers
For #1 and #2, your genes loaded the gun and your environment pulled the trigger. Whereas, #3 is purely the environment. The environmental part, which you can control, can make Hashimoto’s worse or better.
Even without Hashimoto’s, chronic inflammation can reduce thyroid function in different ways . The inflammation from all 3 sources together can make you feel worse, increase the autoimmune attacks on your thyroid, and make you more likely to develop more autoimmune diseases.
How to know if you’re inflamed
Chronic systemic (whole-body) inflammation can cause :
- Muscle and joint pain
- Brain fog
- Depression, anxiety and other mood disorders
- Gut problems like constipation, diarrhea, and acid reflux
- Unhealthy weight gain or weight loss
- Frequent infections
- Elevated thyroid antibodies
There are no perfect tests for chronic inflammation. High-sensitivity C-reactive protein is often useful to monitor inflammation levels. But even if your labs are normal, symptoms are often the best measure of inflammation. Refer to our Normal thyroid labs but still have hypothyroid symptoms article for the inflammation labs and their reference ranges.
How to manage inflammation with Hashimoto’s
Hashimoto’s Diet and Healing the Gut
In a 2019 clinical study, 17 women with Hashimoto’s underwent a health coaching program including the autoimmune protocol diet for 10 weeks. At the end of the program, their hsCRP decreased by 29% and their quality of life significantly improved .
The AIP diet helps to heal the gut by removing common gut irritants and inflammatory foods that can increase inflammation or trigger autoimmunity . It also limits refined carbohydrates that can throw off your blood sugar and cause inflammation.
Intermittent fasting (IF) can help reduce inflammatory cytokines and monocytes, a type of inflammatory white blood cells. Women with thyroid issues need to be careful with prolonged fasts, but I’ve personally worked up to 16 hours daily with no issue. Even a couple of days a week can be helpful for Hashimoto’s.
I also advise seeing a functional medicine doctor to address infections and other factors that can contribute to chronic inflammation and leaky gut.
With a lack of sleep, acute blood markers of inflammation increase and the brain does not appropriately regulate the immune system .
Quality sleep comes down to falling asleep easily, staying asleep throughout the night, and waking feeling refreshed. You want to work to optimize your sleep through sleep hygiene, exercise, cutting out alcohol, and more.
Chronic stress and traumas can throw off the immune system and cause chronic inflammation . Many of us got diagnosed with Hashimoto’s after a major life stressor. Stress can set off the disease, worsen symptoms, or trigger flares .
Aside from exercise, consider mindfulness practices, meditation, biofeedback, and therapy.
Fat loss, resistance training and muscle building
Belly fat can be inflammatory, worsening many symptoms and health risks associated with Hashimoto’s. It can also be the hardest fat to lose. Aside from diet, you also want to lift weights and build muscles.
Exercise can be slightly inflammatory at first. That’s why you may feel sore during the few days following the exercise, especially after long and intense sessions. But in the long term, any amount of exercise can reduce your overall inflammation and make your immune system more resilient .
For this reason, resistance training is one of the most important lifestyle changes you need to make with Hashimoto’s.
Beginning a muscle building program and getting fit can feel daunting at first, especially if you’ve never worked out to that level before. That’s why I created the Thyroid Strong program.
Mold Remediation and Detox.
If you suspect mold exposure, hire a professional to come and inspect. If you discover you have mold exposure, the first step is to move to a safe home and/or get professional mold remediation.
Then, work with a mold-literate practitioner like Dr. Jill Crista, ND to safely detox from mold.
Supplements to reduce thyroid and systemic inflammation in Hashimoto’s
Nutrients for inflammation
Magnesium deficiency is associated with increased inflammation and oxidative stress . Very low serum magnesium levels are associated with a higher risk of thyroid antibodies . In an animal model, magnesium supplementation along with levothyroxine improved chronic inflammation levels .
Vitamin D deficiency is more common in people with Hashimoto’s than those without. Low vitamin D is a factor in all autoimmune diseases Supplementation with vitamin D may also decrease thyroid antibody levels . Many studies find that healthy blood vitamin D levels correlate with lower markers of inflammation .
Omega-3 fatty acids, especially EPA and DHA, are potent modulators of inflammation and the immune system . Many autoimmune patients benefit from omega-3 supplementation, likely due in large part because of the inflammation balancing effects .
N-Acetyl Cysteine (NAC) provides building blocks for glutathione, a potent natural antioxidant made by your body. NAC protects the thyroid from oxidative damage, including DNA damage, even after exposure to radiation. It also helps to balance systemic inflammation .
Quercetin is a yellow-colored flavonoid found in many plants and foods. Quercetin, along with other flavonoid compounds, are antioxidants that promote whole-body immune balance . Foods rich in quercetin include onions, dark berries, citrus, apples, parsley, and sage . You can also take quercetin supplements.
Alpha-lipoic acid (ALA) is an antioxidant made in the mitochondria and is an easy supplement to obtain. It also helps to regenerate other antioxidants in your body, like vitamin C and E, and helps increase glutathione . ALA can also turn off inflammatory genes .
Herbs for inflammation
Turmeric curcumin (Curcuma longa) is a common yellow spice with antioxidant and inflammation modulating effects. Research suggests that it can be beneficial for thyroid health and protective for the thyroid [25,26].
Frankincense (Boswellia serrata) is a plant resin that balances inflammation and has antioxidant properties. It blocks the enzymes cyclooxygenase 1 and 2, and regulates immune functions .
Ginger (Zingiber officinale) is an easily accessible culinary herb with well-established inflammation modulating effects. It is also an antioxidant that may protect the thyroid against oxidative damage, as well as the associated disruption in thyroid hormone levels.
Garlic (Allium sativum) is somewhat of a panacea of health benefits. In inflammation, garlic can reduce serum inflammatory proteins including CRP and TNF-alpha .
Reishi mushroom (Ganoderma lucidum) has been used in Asian medicine for thousands of years. It has powerful flammation-modulating properties [31,32]. It is available in capsule, tincture, and tea form.
Thyroid Strong focuses on three key lifestyle components, diet, resistance training, and supportive community to help you manage inflammation and put Hashimoto’s into remission.
2 Abbott, R. D., Sadowski, A. and Alt, A. G. (2019) Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis. Cureus 11, e4556.
3 Irwin, M. R. (2019) Sleep and inflammation: partners in sickness and in health. Nat. Rev. Immunol. 19, 702–715.
4 Liu, Y.-Z., Wang, Y.-X. and Jiang, C.-L. (2017) Inflammation: The Common Pathway of Stress-Related Diseases. Front. Hum. Neurosci. 11, 316.
5 Mizokami, T., Wu Li, A., El-Kaissi, S. and Wall, J. R. (2004) Stress and thyroid autoimmunity. Thyroid 14, 1047–1055.
6 Calle, M. C. and Fernandez, M. L. (2010) Effects of resistance training on the inflammatory response. Nutr. Res. Pract. 4, 259–269.
7 Fortunato, A. K., Pontes, W. M., De Souza, D. M. S., Prazeres, J. S. F., Marcucci-Barbosa, L. S., Santos, J. M. M., Veira, É. L. M., Bearzoti, E., Pinto, K. M. D. C., Talvani, A., et al. (2018) Strength Training Session Induces Important Changes on Physiological, Immunological, and Inflammatory Biomarkers. J Immunol Res 2018, 9675216.
8 Strickland, J. C. and Smith, M. A. (2014) The anxiolytic effects of resistance exercise. Front. Psychol. 5, 753.
9 Cerqueira, É., Marinho, D. A., Neiva, H. P. and Lourenço, O. (2019) Inflammatory Effects of High and Moderate Intensity Exercise-A Systematic Review. Front. Physiol. 10, 1550.
10 Kraft, S., Buchenauer, L. and Polte, T. (2021) Mold, Mycotoxins and a Dysregulated Immune System: A Combination of Concern? Int. J. Mol. Sci. 22.
11 Brown, R., Priest, E., Naglik, J. R. and Richardson, J. P. (2021) Fungal Toxins and Host Immune Responses. Front. Microbiol. 12, 643639.
12 Nielsen, F. H. (2018) Magnesium deficiency and increased inflammation: current perspectives. J. Inflamm. Res. 11, 25–34.
13 Wang, K., Wei, H., Zhang, W., Li, Z., Ding, L., Yu, T., Tan, L., Liu, Y., Liu, T., Wang, H., et al. (2018) Severely low serum magnesium is associated with increased risks of positive anti-thyroglobulin antibody and hypothyroidism: A cross-sectional study. Sci. Rep. 8, 9904.
14 Abbas, A. M. and Sakr, H. F. (2016) Effect of magnesium sulfate and thyroxine on inflammatory markers in a rat model of hypothyroidism. Can. J. Physiol. Pharmacol. 94, 426–432.
15 Jamka, M., Ruchała, M. and Walkowiak, J. (2019) [Vitamin D and Hashimoto’s disease]. Pol. Merkur. Lekarski 47, 111–113.
16 Cannell, J. J., Grant, W. B. and Holick, M. F. (2014) Vitamin D and inflammation. Dermatoendocrinol. 6, e983401.
17 Mori, T. A. and Beilin, L. J. (2004) Omega-3 fatty acids and inflammation. Curr. Atheroscler. Rep. 6, 461–467.
18 Li, X., Bi, X., Wang, S., Zhang, Z., Li, F. and Zhao, A. Z. (2019) Therapeutic Potential of ω-3 Polyunsaturated Fatty Acids in Human Autoimmune Diseases. Front. Immunol. 10, 2241.
19 Kurashige, T., Shimamura, M. and Nagayama, Y. (2017) N-Acetyl-L-cysteine protects thyroid cells against DNA damage induced by external and internal irradiation. Radiat. Environ. Biophys. 56, 405–412.
20 Tenório, M. C. D. S., Graciliano, N. G., Moura, F. A., Oliveira, A. C. M. de and Goulart, M. O. F. (2021) N-Acetylcysteine (NAC): Impacts on Human Health. Antioxidants (Basel) 10.
21 Salehi, B., Machin, L., Monzote, L., Sharifi-Rad, J., Ezzat, S. M., Salem, M. A., Merghany, R. M., El Mahdy, N. M., Kılıç, C. S., Sytar, O., et al. (2020) Therapeutic Potential of Quercetin: New Insights and Perspectives for Human Health. ACS Omega 5, 11849–11872.
22 Quercetin. Mount Sinai Health System.
23 Shay, K. P., Moreau, R. F., Smith, E. J., Smith, A. R. and Hagen, T. M. (2009) Alpha-lipoic acid as a dietary supplement: molecular mechanisms and therapeutic potential. Biochim. Biophys. Acta 1790, 1149–1160.
24 Li, G., Fu, J., Zhao, Y., Ji, K., Luan, T. and Zang, B. (2015) Alpha-lipoic acid exerts anti-inflammatory effects on lipopolysaccharide-stimulated rat mesangial cells via inhibition of nuclear factor kappa B (NF-κB) signaling pathway. Inflammation 38, 510–519.
25 Shakeri, F., Bibak, B., Safdari, M. R., Keshavarzi, Z., Jamialahmadi, T., Sathyapalan, T. and Sahebkar, A. (2022) Cellular and Molecular Mechanisms of Curcumin in Thyroid Gland Disorders. Curr. Med. Chem. 29, 2878–2890.
26 Abdelaleem, M. M., El-Tahawy, N. F. G., Abozaid, S. M. M. and Abdel-Hakim, S. A.-B. (2018) Possible protective effect of curcumin on the thyroid gland changes induced by sodium fluoride in albino rats: light and electron microscopic study. Endocr. Regul. 52, 59–68.
27 Efferth, T. and Oesch, F. (2022) Anti-inflammatory and anti-cancer activities of frankincense: Targets, treatments and toxicities. Semin. Cancer Biol. 80, 39–57.
28 Mashhadi, N. S., Ghiasvand, R., Askari, G., Hariri, M., Darvishi, L. and Mofid, M. R. (2013) Anti-oxidative and anti-inflammatory effects of ginger in health and physical activity: review of current evidence. Int. J. Prev. Med. 4, S36–42.
29 Mohammed, E. T., Hashem, K. S., Ahmed, A. E., Aly, M. T., Aleya, L. and Abdel-Daim, M. M. (2020) Ginger extract ameliorates bisphenol A (BPA)-induced disruption in thyroid hormones synthesis and metabolism: Involvement of Nrf-2/HO-1 pathway. Sci. Total Environ. 703, 134664.
30 Mirzavandi, F., Mollahosseini, M., Salehi-Abargouei, A., Makiabadi, E. and Mozaffari-Khosravi, H. (2020) Effects of garlic supplementation on serum inflammatory markers: A systematic review and meta-analysis of randomized controlled trials. Diabetes Metab. Syndr. 14, 1153–1161.
31 Bhardwaj, N., Katyal, P. and Sharma, A. K. (2014) Suppression of inflammatory and allergic responses by pharmacologically potent fungus Ganoderma lucidum. Recent Pat. Inflamm. Allergy Drug Discov. 8, 104–117.
32 Suarez-Arroyo, I. J., Rosario-Acevedo, R., Aguilar-Perez, A., Clemente, P. L., Cubano, L. A., Serrano, J., Schneider, R. J. and Martínez-Montemayor, M. M. (2013) Anti-tumor effects of Ganoderma lucidum (reishi) in inflammatory breast cancer in in vivo and in vitro models. PLoS One 8, e57431.