From the practice · Praxis Dr. Romanos
Hashimoto's thyroiditis is an autoimmune disease in which the immune system attacks the thyroid gland. It is the most common cause of hypothyroidism in Switzerland. Many of my patients come to my practice with fatigue, weight gain, and depressive symptoms — and Hashimoto's is often the reason.
In Hashimoto's, the immune system produces antibodies against the thyroid. The most common are TPO antibodies and thyroglobulin antibodies. These antibodies slowly destroy thyroid cells. The process can take years before symptoms appear. That's the insidious thing about this disease — many people already have high antibodies without knowing it.
Fatigue is the classic symptom, but it's so much more. Weight gain despite normal diet, cold extremities, dry skin, hair loss — I see this all the time. The psychological component is particularly important. Depressive symptoms, anxiety disorders, and memory problems can be caused by Hashimoto's.
This is my major criticism of standard medicine. Many doctors only check the TSH value. That's not enough. I always order: TSH, free T3, free T4, TPO antibodies, and thyroglobulin antibodies. Only with this do I get the complete picture. A normal TSH does not rule out Hashimoto's!
Not all patients feel good on the same T4 values. The "normal range" is too broad. Some patients need a TSH just above zero, others feel better with a higher value. This is individualised medicine, not mass production. I work with my patients to find the optimal dose.
Selenium is an essential cofactor for glutathione peroxidase, an antioxidant that protects the thyroid. Patients with Hashimoto's often have low selenium levels. Zinc, vitamin D, and vitamin B12 are also important. This is part of my functional medicine — not just replacing the hormone, but correcting the underlying deficiencies.
There is a strong connection between gut health and Hashimoto's. A "leaky gut" can amplify the autoimmune reaction. Some patients benefit from a gluten-free diet, others from an elimination diet. This must be tested individually. Gut health is a key issue in Hashimoto's patients.
Hashimoto's is not a disease you diagnose once and then forget. Antibody titres can change, hormone values too. I recommend regular checks for my patients — not just checking the same TSH year after year. This is the essence of individualised, preventive medicine.
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