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90 Percent of Hypothyroidism is Hashimotos

author avatar Dr. Eric Berg 08/31/2023

Did you realize that the great majority of hypothyroid cases - between 90-95% - is Hashimoto’s?

Let’s talk about what Hashimoto’s is, along with the why behind the diagnosis.

In this article, I will cover:


Understanding Thyroid Function

Before you can understand Hashimoto’s, we have to discuss basic thyroid function. It all starts with the hypothalamus. This is the master gland of the brain. It talks to the pituitary, which can be considered the middle man, and the pituitary gland ultimately talks to the thyroid. There’s a communication network between the three components, and there is a negative feedback loop (which you can see illustrated below by the green and red arrows).

The negative feedback loop between the hypothalamus, pituitary gland, and thyroid

Now, the pituitary gland releases something called thyroid-stimulating hormone (TSH). That has two purposes. First, it will tell the thyroid to release more hormone. It will also increase the growth of the thyroid itself.


Hypothyroidism: Causes

When you have hypothyroidism, two main issues could be happening with this negative feedback loop. First, there could be a low T3/T4 going on somewhere in the body that is resulting in a failure to send signals back to the pituitary or the hypothalamus. This would cause the pituitary and hypothalamus to tell the thyroid to make more hormone and get bigger. This generally causes “standard” hypothyroid symptom like:

  • General loss of energy
  • Slowed metabolism
  • Weight gain
  • Bradycardia
  • Dry skin and hair
  • Constipation
  • Cold intolerance
  • Puffy skin
  • Hair loss
  • Altered cognition
  • Hyporeflexia
  • Menstrual irregularities/infertility in women
  • Stunted growth in children

Alternatively, there could be an immune problem that’s creating inflammation and interfering in this feedback loop. This inflammation is being caused by antibodies that are actually attacking the thyroid itself. This is Hashimoto’s thyroiditis.


Understanding Hashimoto’s

Hashimoto’s hypothyroidism autoimmune disease

Hashimoto’s is an autoimmune condition, which means that your own immune cells are attacking the thyroid. That keeps the thyroid inflamed. Hashimoto’s, then, is more of an immune problem than a thyroid problem.

The best way to test for Hashimoto’s is to test for thyroid peroxidase antibodies (TPO Ab) or thyroglobulin antibodies (TGA b). If either result is positive, then chances are that you have a Hashimoto’s problem.

The three main symptoms for this are:

  • Stress
  • Anxiety
  • Depression

That said, you can pretty much have any typical hypothyroid symptoms. What’s weird is that, when you have Hashimoto’s, you can also have symptoms of hyperthyroidism (which is an overactive thyroid). These symptoms could include:

  • Hot flashes, sweating
  • Tachycardia
  • Anxiety, nervousness
  • Weight loss
  • Hair loss
  • Difficulty sleeping, restlessness
  • Tremors in the hands
  • Weakness
  • Diarrhea
  • Emotional instability, irritability or fatigue
  • Goiter
  • Moist, sweaty skin
  • Exophthalmos, lid lag

The important thing to know here is that some people with Hashimoto’s hypothyroidism don’t really present with the symptoms that you would normally see with hypothyroidism. People with Hashimoto’s could be really thin, maybe they don’t have problems with their hair, but they may have the above symptoms. This is different from standard hypothyroidism, which presents with weight gain, hair loss, etc.

Also, this condition can often take a long time to develop. You may show positive for TPO Ab and TGA b and not show any symptoms for 10-15 years.


What Causes Hashimoto’s

The big question here is what is causing this immune problem? There are a couple of interesting things to keep in mind here.


First, a high percentage of people with Hashimoto’s develop it 3-8 months postpartum. Also, there are 5-8 times more women who develop it than men.

This tells us that there’s a problem with estrogen. So what is it about estrogen that’s related to this? Well, estrogen is a very powerful antioxidant. That’s one of the reasons why women live longer than men; since women have higher concentrations of antioxidants in their bodies, they have fewer free radicals (and thus, less free radical damage).

Many times, postpartum women are going to have a drop in their estrogen levels. This could create a weakness and set them up for getting this autoimmune condition.


Another reason why people develop an autoimmune condition involves gluten. Gluten tears up the colon lining and allows for leaky gut and for proteins to get into the immune systems and cause a reaction.

You can develop an autoimmune condition just from that.

Other Contributing Factors

A couple of other things that contribute to this problem:

  • Zinc deficiency: Zinc is one of the most important trace minerals for the immune system. It protects people from all sorts of immune problems. If you’re deficient in zinc, then your risk of getting sick goes way up. Also, your chances of having viruses come out of remission go up as well.
  • Low vitamin D: Vitamin D is involved in the immune system, so if you’re low on vitamin D, you’re at risk for Hashimoto’s.
  • Selenium: Selenium is the last and most important piece of the puzzle. Selenium has a tendency to reduce these antibodies. It also is a very powerful antioxidant and it helps the conversion from T4 to T3. Consuming enough zinc can really benefit someone with Hashimoto’s.

Ultimately, though, it’s important to note that Hashimoto’s can often come from a combination of low estrogen (which means low antioxidants), low nutrients, and perhaps something that triggered it.


What Can You Do?

Keto with intermittent fasting will help

I would recommend taking around 300 mcg of selenium a day. It’s often recommended that people with hypothyroid concerns take iodine, but you don’t necessarily need iodine unless you’re deficient (so go get a test and find out either way).

Keep in mind, too, that If you take too much iodine, that could aggravate things, especially since Hashimoto’s isn’t really an iodine deficiency problem.

The other thing that’s really important is to do healthy keto and intermittent fasting. Why?

When you do intermittent fasting and you lower your carbs, you drop inflammation. If you can get rid of the inflammatory response from Hashimoto’s, you get rid of the complications from Hashimoto’s. That way, you can actually feel much better.

Give it a try and let me know how you feel.

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Disclaimer: Our educational content is not meant or intended for medical advice or treatment.

Editor’s Note: This post has been updated for quality and relevancy.

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