Table of Contents

• What are thyroid antibodies?
• Does having thyroid antibodies mean I have a thyroid problem?
• What should I do if I have thyroid antibodies?
• What causes, increases, or triggers thyroid antibodies?
  • Infections
  • Pregnancy
  • Menopause
  • Environmental toxin exposure
  • Leaky gut
  • Gluten
  • Stress and trauma
  • Vitamin D deficiency
• How to lower thyroid antibodies
  • Ensure healthy levels of thyroid support and immune-balancing nutrients
  • Eat a nutrient-dense AIP diet, avoiding gluten and dairy
  • Stress management
  • Exercise
  • Eliminating toxic exposures
• Conclusion

What are thyroid antibodies?

Antibodies are proteins that your immune system naturally produces to flag germs as the bad guy so other immune cells know what to attack. If you have a healthy immune system, it has many checks and balances to avoid attacking your own proteins. However, when those all fail, the immune system can produce antibodies flagging (anti) your own protein, such as protein in the thyroid gland. This can lead to autoimmune attacks against the thyroid.   

The two common antibodies in Hashimoto’s include:

Anti-thyroid Peroxidase Antibodies (Anti-TPO) – Thyroid peroxidase is an enzyme that produces thyroid hormone inside your thyroid gland. Anti-TPO antibodies destroy or block thyroid peroxidase, so you can’t make enough thyroid hormone. Basically, anti-TPO antibodies block thyroid hormone production. 90% of Hashimoto’s patients have Anti-TPO.

Anti-thyroglobulin Antibodies (Anti-TG) – Thyroglobulin helps transport and build thyroid hormones. Anti-TG recognizes thyroglobulin and may get the immune system to start attacking the thyroid. However, the roles of Anti-TG in Hashimoto’s development remain unclear, even though about 60% of Hashimoto’s patients have these antibodies.

The other type of thyroid antibodies are Thyroid Receptor Antibodies (TRAb). These don’t always cause autoimmune attacks against the thyroid, but they bind to your thyroid receptors. Some types of TRAb block the thyroid receptors, causing hypothyroidism. However, some TRAb stimulate thyroid receptors, causing Graves’ disease, an autoimmune hyperthyroidism. Basically, TRAb binds to thyroid receptors, sometimes blocking the receptors and other times stimulating them. 

How high do thyroid antibodies have to be to indicate Hashimoto’s? There is no antibody level that indicates Hashimoto’s, but above normal anti-TPO is an indicator that an autoimmune thyroid condition may be present.

Does having thyroid antibodies mean I have a thyroid problem?

The older you are, the more likely you are to have thyroid antibodies. Also, 5% of postpartum women have thyroid antibodies and experience postpartum thyroiditis, even though they had no thyroid problems during pregnancy [2]. 20% of these postpartum cases need long-term thyroid treatments [2].

Also, about 5% of autoimmune thyroid patients have no detectable antibodies [3]!

Having antibodies doesn’t mean you have Hashimoto’s. In fact, autoimmune disease can only develop when many things go wrong at once, including when your immune system [4]:

1. Cannot kill off all cells that produce antibodies against your tissues as they’re produced and in the bloodstream
2. Fails to ignore the self-antibodies flagging your own tissues
3. Loses its ability to balance itself and control the inflammation

What should I do if I have thyroid antibodies?

If you have thyroid antibodies and are trying to get pregnant, you want to address it appropriately. The presence of thyroid antibodies, even without thyroid disease or symptoms, can cause:

• Infertility
• Delayed pregnancy
• Premature birth
• Up to 40x higher risk of miscarriage [5,6] 

Treatment with levothyroxine decreases these risks [7–9]. 

If you have Hashimoto’s, lowering the antibodies typically results in a better prognosis.

What causes, increases, or triggers thyroid antibodies?

Autoimmunity requires genetics, environment, and a leaky gut to occur [10]. The following can contribute to the environmental and/or leaky gut trigger.

Infections

Many bacterial and viral infections can set off Hashimoto’s in people with a genetic predisposition. The infection can activate unchecked autoimmunity.

Almost all autoimmune diseases have been associated with one or more infections [11]. For example, components of hepatitis C virus, human parvovirus B19, coxsackie virus, and herpes virus have been detected in the thyroid of Hashimoto’s patients [12].In a case study of a 49-year-old woman, eradicating her Blastocystis hominis, a common intestinal parasite, reduced thyroid antibodies and normalized her thyroid hormones. Also, her hives and angioedema resolved [13].

Pregnancy

Pregnancy can trigger autoimmunity because your immune system needs to accommodate the fetus, and then shift back to normal after pregnancy. 

One way pregnancy may increase the chance of autoimmune disease is fetal microchimerism. This is when fetal cells enter the bloodstream of the mother and can still be present in the mother’s tissues for decades. When the mother’s immune system reacts to the fetal cells, it can trigger autoimmune processes [14].

Menopause

The hormonal changes in menopause have a strong influence on the innate and adaptive immune system. The estrogen and progesterone changes also cause a shift in the balance of inflammation in the body towards more inflammation[15,16]. 

Many autoimmune conditions, including Hashimoto’s, are linked to the hormonal transitions in menopause[15].

Environmental toxin exposure

Many different chemicals have been associated with the development of autoimmune conditions, each in its own way. For example, mercury, aluminum, dioxin, pesticides, asbestos, and trichloroethylene may kick off autoimmunity.

Some toxins disrupt hormone systems or damage your DNA. Others activate the immune system and throw off the checks and balances against autoimmunity[17]. 

Consistent exposure to mold toxins is associated with autoimmune diseases, including Hashimoto’s [18]. Also, endocrine disruptors containing chlorine, bromine, and iodine, such as polychlorinated biphenyls and many pesticides, can directly disrupt thyroid function [19]. Iodine, including in food and salt, can also make the immune system more likely to attack the thyroid, especially in the presence of thyroid antibodies.

Leaky gut

The gut acts as a barrier between the inside and outside worlds. With 60-80% of our immune system residing in our gut, there are large implications for the gut’s contribution to autoimmunity. 

If food particles and pathogens can breach the gut barrier and be exposed to the gut immune system, it can increase inflammation that results in autoimmunity [20]. Current evidence suggests that healing a leaky gut barrier can mitigate the effects of genetic and environmental factors that would otherwise cause autoimmunity [20].

Gluten

Gluten can trigger autoimmunity in people with a predisposition. Gluten can throw off the gut bacteria and open the gut barrier. Also, it is pro-inflammatory and can trigger immune responses in humans [21]. 

Gliadin, the protein in gluten, has a structure that is very similar to proteins in the thyroid gland. If the immune system sees gliadin and recognizes it as foreign, it may also make antibodies to the thyroid by mistake due to the similarity.

For these reasons, functional medicine and naturopathic doctors commonly recommend that anyone with Hashimoto’s completely eliminates gluten from their diet, even if they have no digestive symptoms from gluten.

Stress and trauma

Stress can cause a leaky gut and increase unhealthy gut bacteria [22]. Also, it can throw off the immune system, leading to autoimmunity [22].

Vitamin D deficiency

Vitamin D regulates the immune system so that it can fight off germs strongly, but also stay balanced. It also helps to maintain the gut barrier [23]. Not surprisingly, vitamin D deficiency is linked to Hashimoto’s and all other autoimmune diseases [24].

How to lower thyroid antibodies

Ensure healthy levels of thyroid support and immune-balancing nutrients

These nutrients include:

• Vitamin D
• Selenium
• Zinc
• B vitamins
• Magnesium
• Iron

Eat a nutrient-dense AIP diet, avoiding gluten and dairy

I recommend that people with thyroid antibodies, with or without autoimmune symptoms, eat an autoimmune protocol diet. The diet supports healthy gut flora and contains anti-inflammatory foods.

Avoiding gluten is an important part of decreasing thyroid antibodies as well, due to its negative gut and immune system effects [25]. Dairy sensitivity is also common among women with Hashimoto’s. If this is you, I recommend that you eliminate it, as it may increase gut inflammation and contribute to a leaky gut.

Stress management

It’s essential to keep your stress levels managed because it will improve Hashimoto’s symptoms by decreasing inflammation and helping the immune system regain its balance.

Stress management techniques are those that put you in the rest and digest nervous system mode. Meditation and paced breathing with 5 seconds inhales and exhales accomplish this well.

Exercise is one of my favorite stress management tools.

Exercise

Physical activity significantly increases T-regulatory cells, which as their name implies, regulate the adaptive immune system [26]. They are responsible for keeping balance and avoiding autoimmune cell growth. So, exercise is beneficial for autoimmunity and reducing antibodies.

Exercise also helps with Th1/Th2 balance, which helps manage autoimmunity [26]. In Thyroid Strong, I teach women with Hashimoto’s the right way to do resistance training to reap the above benefits, as well as the anti-inflammatory effects of increasing muscle.

Eliminating toxic exposures

We are all exposed to toxins every day. It’s unavoidable in the world we live in. The best thing you can do is be conscious and eliminate your primary exposures with these steps.

• Use a high-quality water filter
• Buy organic and pasture-raised produce whenever possible
• Avoid processed foods
• Avoid drinking or eating out of plastics
• Don’t touch receipts. They are very high in BPA. Handling receipts with hand sanitizer on your hands is the worst combination as the sanitizer can greatly increase BPA absorption through your skin [27].
• Take shoes off at the door to avoid tracking chemicals into your home.
• Dust your home often. Heavy metals and other chemicals get carried around on dust particles.
• Make your own cleaning products.
• Avoid living near a golf course or train tracks, as they both get sprayed with pesticides frequently

Conclusion:

In Thyroid Strong, I guide you through all the steps in getting fit, improving body composition, and experiencing the benefits of resistance training on your immune system. Join a community of women just like you who are taking their health into their hands through the Thyroid Strong program.

Cheers to you and your health,

Dr Emily Kiberd

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