Dr. Weyrich's Naturopathic Functional Medicine Notebook is a collection of information on topics of interest
to Dr. Weyrich that may be of interest to the world wide audience.
Due to limitations of time, not all information that Dr. Weyrich knows or would like to further research is
Dr. Weyrich welcomes financial contributions to support specific research topics, as well as copies of
non-free access journal articles for him to review on a topic.
Constructive criticism is also welcome.
Overview of Hashimoto's Thyroiditis
Hashimoto's thyroiditis is an autoimmune condition in which the cells of the
thyroid are destroyed.
Initially the destruction of the thyroid cells causes a release of larger
than normal amounts of thyroid hormone, resulting in transient
As destruction of the thyroid cells continues, eventually too few cells will
remain to produce normal amounts of thyroid hormone and the patient will
develop a hypothyroid state.
Hashimoto's thyroiditis is associated with other autoimmune conditions, such as:
Adrenal insufficiency (Schmidt's syndrome)
Inflammatory bowel disease
Diabetes Mellitus type I
Complimentary and alternative treatments for Hashimoto's thyroiditis that are considered below include:
Immune System Balancing
Low Dose Naltrexone
Signs and Symptoms of Hashimoto's Thyroiditis
Chronic hypothyroid signs/symptoms: fatigue, weakness, cold
intolerance, decreased memory, constipation, muscle and joint pain,
hoarseness, weight gain, dry skin and sparse hair, depression, carpal tunnel
syndrome, decreased sweating, swollen tongue, eyes, hands and feet,
burning, prickling, itching, or tingling sensations, and hearing impairment.
Slow heart rate, decreased pulse pressure, low body temperature,
delayed relaxation of deep tendon reflexes.
Acute hyperthyroid signs/symptoms: Nervousness and emotional distress, shortness of breath,
increased sweating and heat intolerance, night sweats, rapid heart rate, heart palpitations,
fatigue, weakness, weight loss despite increased appetite, tremors or inward trembling [Kharrazian2010],
atrial fibrillation, loss of bone density, bulging eyes (exophthalmos).
Physical Exam: Thyroid gland is usually non-tender, diffusely
enlarged with fine nodularity, possibly asymmetrically.
Etiology of Hashimoto's Thyroiditis
The exact cause of the autoimmune condition is unknown, but
leaky gut syndrome,
are thought to play an important
role both in initiating and maintaining the autoimmune process.
Diagnosis of Hashimoto's Thyroiditis
Hashimoto's thyroiditis may present as either an acute hyperthyroid or
chronic hypothyroid condition in the standard thyroid screening panel (TSH, free T4).
Elevated antithyroperoxidase levels (95%).
Elevated antithyroglobulin antibodies (60%).
Thyroid gland nodularities upon palpation merit further evaluation
(to rule out concomitant cancer) with ultrasound or fine needle biopsy,
especially if isolated or unilateral, or patient has history of head/neck
Naturopathic, Complimentary and Alternative Treatments
Treat adrenal insufficiency first, if present (supplementing T4 or T3 in
the presence of adrenal insufficiency is contraindicated).
Hormone replacement therapy: Start with 1.6 mcg/kg/d levothyroxine
(T4, Synthroid, Levothyroid) and titrate up 25 mcg/d every 4-6 weeks until
TSH is normalized. Some patients get better results with a T4/T3 blend
from a compounding pharmacy).
Drug interactions with thyroid HRT requiring dosage adjustments:
oral anticoagulants, insulin, oral hypoglycemics, estrogens and OCP,
cholestyramine, iron and calcium supplements.
Start with 33% lower doses in the elderly.
[McCulley2018, pp 28, 35, 61, 89] reports that Hashimoto's thyroiditis is a
autoimmune disorder, and proposes an approach to treating this disease, which should be
supervised by a properly trained medical professional.
Dr. Weyrich has considerable interest in this topic, and has
treated several cases of Hashimoto's thyroiditis
with Immune System Balancing.
According to the Low Dose Naltrexone home page [LDN], LDN has been seen to benefit
Hashimoto's thyroiditis, which is considered to be an autoimmune disease.
Dr. Weyrich has been trained in the use of Low Dose Naltrexone (LDN) and offers these
protocols as a complement to other therapies; however at this time Dr. Weyrich has only
treated one confirmed case of Hashimoto's thyroiditis using LDN (in addition to
thyroid hormone replacement therapy).
The patient reported significant improvement in symptoms, and auto-antibody markers were
seen to be substatially reduced.