Patient Question: “Does Hashimoto’s go away with treatment? I have Hashimoto’s and it seems to go away and then it comes back. It also seems to come in cycles: skin breakouts (hormonal acne, predominately on my chin and neck) followed by extreme dry skin/hair and water retention/weight gain/constipation.
I’m currently taking 100mcg of Synthroid and iron supplements. Are these types of flare-ups with Hashi’s normal? Or, should I be looking for a secondary diagnosis? I have tried cutting out gluten and it has had no impact.”
Response by Ridha Arem, MD
Texas Thyroid Institute
Ridha Arem, MD is a leading endocrinologist in the U.S., the Director of the Texas Thyroid Institute and Author of “The Thyroid Solution”. Read his bio below.
Hashimoto’s thyroiditis, the inflammation caused by the immune system attack on the thyroid gland, does not ever go away. It is a chronic condition in which the immune system is constantly attacking the thyroid gland.
The inflammation causes swelling of the thyroid gland and promotes a distortion of the architecture of the gland and impairs its functioning and that’s why hypothyroidism is a common consequence of Hashimoto’s thyroiditis.
When your immune system attacks your thyroid, that is called thyroid autoimmunity — meaning, your immune system is viewing your thyroid as not being part of your body. However, the intensity of this attack can wax and wane over time.
One of the main reasons of the flare-ups of intense inflammation is stress or inability to cope well with stress as I detailed in my book “The Thyroid Solution.” Of course, there are many environmental triggers, not only with the inflammation, but also with its course. These changes in intensity can affect the function of the thyroid gland over time and this is one of the reasons that symptoms can intensify at times.
You should know that dry skin is not a symptom of Hashimoto’s, but a symptom of low thyroid caused by Hashimoto’s. Make sure you take your iron late in the day so it will not interfere with thyroid hormone absorption.
Many times, taking Synthroid-only (T4-only) to treat the underactive thyroid is not enough. You may want to discuss with your doctor about other treatment options that will include a combination of the two hormones that the thyroid gland produces; T4 and T3. Synthroid is a T4-only medication which is synthetic and that may leave you with some deficit of T3, the most metabolically active form of thyroid hormone.
Ridha Arem, MD (www.texasthyroidinstitute.com) is the medical director of the Texas Thyroid Institute, a clinical professor of medicine at Baylor College of Medicine, and former Chief of Endocrinology at Ben Taub General Hospital. Dr. Arem is the author of more than forty peer-reviewed articles in the fields of thyroid disease, endocrinology, and metabolism. He is the author of The Thyroid Solution and the Thyroid Solution Diet and The Protein Boost Diet. Dr. Arem has lectured extensively worldwide and has been featured in numerous national publications.
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