According to the November 2007 issue of Endocrine Today, in 1912, Hakaru Hashimoto discovered a condition called lymphocytic thyroiditis. This condition is otherwise known as Hashimoto's disease. In the process of his discovery, Hashimoto examined the tissue samples of four middle-aged women who had enlarged thyroids or goiters.
Hashimoto discovered that the tissue samples he examined had many white blood cells. White blood cells are usually not found in common goiters, which have no change in thyroid function. He also discovered that two of the four women had hypothyroidism.
This article will explain Hashimoto's disease and explore a possible connection between Vitamin D and Hashimoto's disease.
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Hashimoto's disease (also known as lymphocytic thyroiditis or autoimmune thyroiditis) is an autoimmune disorder that consists of white blood cells attacking the thyroid and affecting its function.
The thyroid is a gland in the front of the neck which releases thyroid hormones. The hormones help regulate weight, energy levels, internal temperature, skin, hair, nail growth, and metabolism.
When the white blood cells attack the thyroid, this prevents it from producing the thyroid hormones your body needs, creating hypothyroidism.
When your thyroid underproduces the hormones your body needs, you can develop symptoms such as:¹
Joint and muscle pain
Dry hair that is thinning
Slowed heart rate
Problems enduring cold temperatures
People with other autoimmune disorders, such as rheumatoid arthritis or lupus, are more likely to develop Hashimoto's disease.¹
The depletion of stomach acid is another symptom of Hashimoto's or hypothyroidism. Stomach acid is essential because it helps absorb nutrients, such as amino acids, iron, zinc, protein, calcium, B12, and more. So, the less stomach acid present, the fewer nutrients you absorb.²
Also, even though the thyroid uses iodine to produce thyroid hormones, having Hashimoto's disease may make ingesting excess iodine more harmful to the thyroid, causing hypothyroidism or worsening it.
Foods containing iodine include:³
Fish, such as cod or canned tuna
Shellfish, such as oysters or shrimp
iodized table salt
Dairies, such as milk, cheese, or yogurt
Avoiding high-protein foods because of their iodine content can cause nutrition depletions. For example, lacking fish or fish oils, dairy products fortified with vitamin D, beef liver, and egg yolks can deplete vitamin D.⁴
There are two types of vitamin D: vitamin D2, which comes from plants and supplements, and D3, which comes from animals. It's not proven if one is better than the other regarding nutritional value. Still, the absorption of both types will increase vitamin D levels in the bloodstream.⁴
A healthy amount of vitamin D in the bloodstream increases the absorption of calcium, magnesium, and phosphate, which is essential for normal bone development and maintenance.
Osteoporosis in adults can occur when the body is deficient in vitamin D. Some recent studies have indicated that a vitamin D deficiency might be associated with autoimmune diseases.⁵ ⁶
Knowing why vitamin D is essential will help you understand the link between vitamin D, thyroid disease, and Hashimoto's disease.
There are many causes of thyroid disease. For example, the medications you take, miscommunication between the pituitary gland and the thyroid gland, or an autoimmune issue with the thyroid gland can cause thyroid disease.
Both vitamin D and thyroid hormone bind to similar steroid hormone receptors. A separate gene in the vitamin D receptor could show a predisposition to autoimmune thyroid disease, such as Hashimoto's disease.
There is a clue that vitamin D deficiency correlates with thyroid hormone levels. However, the direct correlation between how vitamin D deficiency affects the thyroid is still a mystery.
Therefore, researchers conduct studies to discover if vitamin D deficiency causes the development of hypothyroidism or if it is a consequence of the condition.⁶
The pituitary gland produces thyroid-stimulating hormone (TSH), which stimulates the thyroid gland to produce thyroid hormones. Levels of TSH increase when the thyroid gland does not manufacture enough of the thyroid hormones T3 and T4, causing hypothyroid conditions. Too many thyroid hormones circulating will decrease the production of TSH, a condition called hyperthyroidism.
Some studies have been conducted on the correlation between vitamin D deficiencies and calcium blood levels because, through bone absorption, vitamin D regulates calcium levels in the blood. Researchers conducted studies to try and find a correlation between an increase and decrease in calcium blood levels, TSH levels, and T3 and T4 levels.⁶
Studies have shown that thyroid diseases caused by autoimmune issues can most likely be associated with vitamin D deficiency. When vitamin D deficiency was present, a high amount of thyroid antibodies, antibodies that are developed when the immune system attacks the thyroid tissues and cells, was detected.⁷ ⁸
In addition to vitamin D deficiency, the other most common nutrient deficiencies in Hashimoto’s are:⁸ ¹⁰
In the case of iodine, too much or too little iodine can be a liability for Hashimoto's disease, and here's why.
The thyroid gland needs iodine to produce thyroid hormones T3 and T4. Too little iodine equals an iodine deficiency that can increase the production of thyroglobulin (Tg). This protein is another critical component of the thyroid hormone production process. Too much production of Tg can result in hypothyroid conditions or an enlargement of the thyroid gland called a goiter. Your body does not produce iodine, so your diet must include it.⁹
Excessive iodine over time can produce autoimmune thyroiditis or Hashimoto's disease because Tg produces more immunity response antibodies when bombarded with iodine.¹⁰
Iron deficiency can cause impaired thyroid metabolism. Thyroid peroxidase (TPO), another enzyme important in thyroid hormone production, is iron-dependent. So, iron-deficient TPO can drive the development of hypothyroidism.¹⁰
However, iron deficiency is sometimes not the cause of Hashimoto's disease but the result. For example, iron deficiency can result when the body has problems absorbing iron because of an autoimmune condition.
The autoimmune condition, Hashimoto's disease, causes antibodies to attack the thyroid or, precisely, TPO. Selenium can reduce the number of antibodies attacking the TPO and simultaneously reduce hypothyroidism.¹⁰
Results from studies have indicated that groups with patients with Hashimoto’s thyroiditis had lower vitamin D levels than the control groups with healthy people who were not on vitamin D supplements. For example, one study found that 96% of patients with Hashimoto's thyroiditis had a vitamin D deficiency. In contrast, 56.1% had severe vitamin D deficiency.¹¹
The levels of vitamin D deficiencies depend on the severity and degree of hypothyroidism. For example, as the severity of hypothyroidism increases, the more significant the amount of vitamin D deficiency happens in patients with Hashimoto's disease.
Some symptoms that may present themselves if there are vitamin B-12 and vitamin D deficiencies and hypothyroidism are:¹¹
Using vitamin D supplements to correct existing vitamin D deficiency will not reverse Hashimoto's. Still, some studies suggest that robust supplementation regimens can potentially reduce the blood markers for Hashimoto’s.¹²
A study conducted on patients with autoimmune thyroid disease (AITD) was randomized into two groups. One group received 60,000IU of 25(OH)D3 weekly and 500mg/day of vitamin D for eight weeks. The other group received just 500mg/day of calcium. After three months, researchers re-evaluated the patients and found a significant decrease in thyroid antibodies in the group who received vitamin D.
Incorporating more physical activity into your lifestyle and having a diet rich in nutrients is sometimes enough to improve symptoms and quality of life, not to mention it limits thyroid damage. However, those who have severe nutrient deficiencies can benefit from the help of multivitamins and supplements.
B complex vitamins
Vitamin D will not only prevent the deterioration of your bone health but also help suppress autoimmune antibodies from attacking the thyroid. The fewer antibodies attacking the thyroid, the less severe your hypothyroidism symptoms will be.
Selenium supplements help vitamin D supplements further decrease the number of antibodies attacking the thyroid, improving mood and quality of life.
Because vitamin B-12 deficiency and hypothyroidism symptoms are similar, taking vitamin B-12 supplements may alleviate symptoms that are thought to be solely from hypothyroidism.
Iodine can be a nutrient that helps thyroid health too. But remember that an excess of iodine can be just as harmful as a deficiency.
Vitamin D regulates calcium, phosphorus, and bone metabolism levels. Because of this, bone weakness and decreases in bone mineral density (BMD) are the most common issues with vitamin D deficiency.¹³
According to the National Institutes of Health (NIH), the recommended daily intake for people without thyroid problems or Hashimoto's disease varies according to age:¹⁴
Birth to 12 months: 400IU
Children, teens, and adults 1-70 years: 600IU
Adults 71 years and older: 800IU
However, suppose you have hypothyroidism or Hashimoto’s thyroiditis. In that case, you will have to take significantly more than the average daily intake. The recommended daily intake of vitamin D is 1000IU to 10,000IU.¹⁵
Some Hashimoto patients can regulate their hypothyroidism symptoms simply by incorporating more vitamin D foods into their diet. Here are some foods that are rich in vitamin D:⁴
Cereals fortified with vitamin D
Dairy or plant milk fortified with vitamin D
Orange juice fortified with vitamin D
Fatty fish like salmon, tuna fish, sardines, and salmon
Fish liver oils, such as cod
Some experts recommend vitamin D3 supplements, not D2. If the supplement is in liquid form, that's even better. Liquid supplements may be better absorbed rather than capsules or tablets.⁴ ¹⁵
The recommended dosage for Hashimoto's patients is 1,000 to 10,000IU daily. Have your vitamin D levels tested every three to six months? If your vitamin D levels aren't where they should be, try a higher dosage and repeat testing until levels are acceptable.¹⁵ ¹⁶
Before adding supplements to your recommended daily intake of vitamins and minerals, get your vitamin D, B-12, and other mineral levels tested that relate to your thyroid problem. Once the results are available, talk to your doctor. If your levels are low, your doctor will recommend what to eat and what supplements to add, if needed, to get your levels where they need to be.
Understanding the correlation between vitamin D and Hashimoto's disease will help you better care for yourself and your condition.
Because studies have shown that 96% of Hashimoto’s patients had a vitamin D deficiency, vitamin D deficiency is almost a certainty when a patient is inflicted with Hashimoto's disease and should be taken very seriously. Getting your vitamin D levels up to where they need to be will make you feel better and prevent further damage to your thyroid, bone, and heart health.
Hashimoto's disease | NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Thyroid function and nutrient extraction: How nutrient extraction affects everyone with Hashimoto’s | Dr. Izabella Wentz, PHARMD
Iodine | Harvard T.H. Chan
Vitamin D | Harvard T.H. Chan
Vitamin D deficiency (2022)
The 7 most common nutrient deficiencies in hashimoto’s | Thyroid Pharmacist
Iodine and thyroid function (2014)
Vitamin D | NIH: National Institute on Health
Vitamin D and Hashimoto’s: How much should you take? | Dr. Childs
The benefits of Vitamin D for your thyroid | Thyroid Pharmacist
Hakaru hashimoto: 1881-1934 | Healio