It's All ONE Disease...

[This post received some minor updates on October 2, 2017.]

I was diagnosed with Hashimoto’s thyroiditis (the most common autoimmune condition) in early 2008 and have since built my practice on helping others manage their autoimmune hypothyroidism (and adrenal dysfunction, which I also suffered from). As they say, “We teach what we most need to learn.”

And something interesting happened along the way. I’ve become just as (if not more) passionate about autoimmunity as I am about hormones. (With most of my clients, we’re addressing both – their dysregulated immune system as well as their hormonal imbalances.)

Many people diagnosed with Hashimoto’s (or any other form of autoimmunity) have more than one autoimmune condition, whether they know it or not. 

There can be a co-occurrence or “kaleidoscope of autoimmunity,” which was certainly my situation, including the female members of my family (Hashimoto’s, alopecia (two types: universalis and areata), and Celiac – and these are just the ones we know of).

Multiple Autoimmune Syndrome (MAS) is “the combination of at least three autoimmune diseases in the same patient.” 

In fact, some people can have Graves’ disease (autoimmune hyperthyroidism) and Hashimoto’s (autoimmune hypothyroidism) at the same time. Weird, right? Another common scenario is Graves’ that morphs into Hashimoto’s.

(We’ve received a great deal of inquiries about whether our Essential Thyroid Cookbook will be helpful for people with Graves’ disease. Given that, at its core, it’s a whole foods cookbook, yes, it can be helpful, but more importantly, we sleuthed out the most immune-supportive nutrition to highlight in our recipes, so from that standpoint, yes, it can be helpful. Our recipes certainly wouldn’t cause a hyper flare!)

[Now available: the #1 best selling: The Essential Thyroid Cookbook: Over 100 Nourishing Recipes for Thriving with Hypothyroidism and Hashimoto’s.]

Once the immune system has gone rogue and crossed the line from attacking non-self (pathogens, viruses, bacteria) to self (normal tissue), all tissues are up for grabs. And once you develop one manifestation of autoimmunity, if it goes unaddressed, the chances of developing another autoimmune condition are greater than 50 percent.

According to Dr. Datis Kharrazian, “Eighty percent of those with a diagnosed autoimmune condition have antibodies to other tissues.”

No Fear
This post isn’t meant to be alarmist or to use scare tactics. In fact, it’s meant to provide comfort and assurance. 

Autoimmunity is one disease, not 90-some separate diseases treatable with symptom management alone.

I need to repeat this – autoimmunity is one disease.

When you turn your attention to the root of the imbalance – a hypervigilant, confused immune system – any and all manifestations of autoimmunity can be addressed.

Notice that I don’t say “cure” or “treat” or “heal.” I’m not a doctor, so I don’t claim to cure, treat, or heal anyone, but I’m confident saying that autoimmunity can be “managed” and “addressed.” You can live symptom-free.

(With Type 1 diabetes, it’s understood that people with this condition need to be insulin-dependent for life.)

Even though most of my autoimmunity clients come to me with Hashimoto’s (I recently discovered that I’m referred to as “The Hashimoto’s Lady” by a local holistic nutrition study group), many of my clients have another known autoimmune condition, such as psoriasis, scleroderma, Sjogren’s syndrome, rosacea, or Raynaud’s and are thrilled to hear that what we do to simply focus on the Hashimoto’s can largely, if not completely, address their other autoimmune condition(s).

While autoimmunity is one disease (there, I said it again), I don’t claim to be an expert in each and every type of autoimmune condition, given that there’s a spectrum of autoimmunity – a more advanced type is multiple sclerosis (MS), for instance. Each type needs immune modulation, most importantly, but also symptom management, depending on how the autoimmunity is expressed. 

In addition to their Hashimoto’s, nearly half of my clients also have an autoimmune skin condition such as psoriasis, rosacea, or eczema (eczema is now thought to be autoimmune in nature). Like alopecia (autoimmune hair loss), these are all visible expressions of autoimmunity, so any improvement in immune function (or lack thereof) is easily seen.

I’m not a dermatological expert, but the majority of the time, these skin conditions are gone by the time our work together is done. Gone, as in…completely cleared. And if they’re not cleared, they’re greatly reduced in appearance.

I’ve had clients get very emotional and say things like, “I’ve had psoriasis for years – I never thought it would go away. I’ve tried everything and nothing has worked. Now, you can’t even see where it was – I don’t even have any scarring.”

No Silos
Given that autoimmunity is skyrocketing and it’s not uncommon to have more than one autoimmune condition, it’s easy to get overwhelmed with it all and think of these different manifestations of autoimmunity as silos, as in, “I have multiple illnesses that I need to manage.”

Again, there are always considerations for how different types of autoimmunity present themselves, but underneath it all, it’s one disease.

And this disease can be managed by: optimizing digestive function, reducing toxic body burden (including assessing heavy metal exposure), managing stress, keeping blood sugar stable, addressing any infections (such as Epstein Barr), and living healthfully for optimal gene expression (epigenetics).

Unfortunately, conventional medicine isn’t adept at helping people with these things which, by the way, can also be considered preventative measures if you happen to have autoimmunity in your family and haven’t yet been diagnosed with an autoimmune condition. 

With Hashimoto’s, for instance, the go-to “treatment” for Hashimoto’s is thyroid hormone replacement. I’m not completely against thyroid drugs, especially when symptoms are so unmanageable that they’re greatly affecting someone’s quality of life.

But man, this approach is really barking up the wrong tree – it allows the autoimmune antibodies to smolder on, advancing the Hashimoto’s and making people sitting ducks for other tissue attacks.

I recently returned from vacation and on my way home, sat next to a lovely woman on the plane who struck up a conversation. She asked what I did for a living and when I told her, she said, “Yeah, I’m just waiting for the hammer to fall. Autoimmunity is rampant in my family – I guess I’ll just wait and see how it shows up for me.”

Meanwhile, she drank three Diet Cokes, ate a bunch of gluten-filled pretzels, ate a small Snickers bar, and slathered her hands not only antibacterial gel, but also toxin-filled lotion.

No judgment here – she’s likely ignorant of how these things are affecting her immune system and drawing that hammer closer and closer to her.

She was the inspiration for this post.   


Perhaps if she had asked what steps you could recommend she take to avoid what she thinks is inevitable, you could have advised her to start by changing those simple (and simply devastating) habits which you observed during the flight.  Since she did not ask, even for free advice, your best response was no response.  Condensed version of an old adage is, "Horse/water"!  Sad but wise to move on.  We want to help everyone but it is not possible.

I  have been diagnosed with hoshimotos more than 10 years ago. I have managed it with Westhroid 65 mg daily. I am just now learning about controlling this with diet and am interested to see where this takes me. What is your opinion on taking Westhroid daily? I've been told it's "natural". 

I have congenital toxoplasmosis, and severe eye damage.  Since i turned to get differen diagnosis for inmune system related deseases.  psoriasis and psoriatic arthritis, IBS, endiometrosis and recently Hashimoto and reactive hypoglysemia.

Due to my Toxo, i cannot take any medicine that supresses my inmune syste. I read in your book you have helped people with psoriasis and psoriatic arthritis, and i really would like to know if you can help me too.  I have been following your recipes in the book and i love them, i am learning how to eat and cook healthy food. 

What can i do to aleviate my psoriatic arthritis? I am worry about the damage in my joints and how will this affect me in several years.

Thanks in advance,


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