A Hashimoto’s Glossary...

Posted by Healthful Elements Staff

Wait, I’ve got what?…

Whether you’re newly diagnosed or Hashimoto’s is an old friend, the language of thyroid health and immune system function can feel opaque and technical.

Immune modulation sounds great, after all, but what does it mean?

And why do you need to care about your immune system in the first place?

Understanding all the key terms helps illuminate the bigger picture. It’s like a jigsaw puzzle. Disassembled, the picture makes no sense. Assembled, you can see how all the parts fit together.

To that end, here’s a glossary of the basic terms you’ll encounter when talking about Hashimoto’s. Instead of listing the terms in alphabetical order, I’ve arranged them in the order you might think of them in putting together the Hashimoto’s puzzle.

Endocrine system: The endocrine system makes, stores, and releases hormones. These hormones travel to every corner of the body and direct the activity of our cells. The thyroid gland is part of the body’s endocrine system. (You may have received your diagnosis from an endocrinologist, an MD who specializes in endocrinology.)

Thyroid: The thyroid is a butterfly-shaped gland in the neck. It’s about 2 inches long and weighs less than an ounce. Don’t let its small size fool you. The thyroid makes and releases hormones that affect almost every aspect of human physiology, including metabolism, cognitive function, cardiovascular function, nervous system function, body temperature, skin dryness, weight, muscle strength and, for women, menstrual cycles. Some experts claim it’s the least understood endocrine gland and doesn’t get the credit it deserves.

Thyroid hormones: The thyroid makes several hormones, with triiodothyronine (T3) and thyroxine (T4) being the most impactful to metabolism and cellular health. (The other hormones are RT3, T1, T2, and calcitonin.) T3 does all the heavy lifting – it’s the most metabolically active and nicknamed “the big daddy.” Free T3 (a different test than total T3) tells you what’s unbound and available to your cells. T3 is made from T4 by a conversion process that happens primarily in the liver, gut, and muscles.

Hashimoto’s disease: Hashimoto’s is an autoimmune disorder (the most common autoimmune disorder) in which the immune system creates antibodies that attack the thyroid. These antibodies damage the thyroid over time and interfere with its ability to make thyroid hormones. It’s important to know that some can have Hashimoto’s antibodies without tissue damage – but if the condition continues on, it’s unlikely that damage won’t occur.

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Immune system: The immune system is a web of cells, tissues, and organs that defend the body against germs and other pathogens like viruses and bacteria.

Autoimmune disease: When you have an autoimmune condition, the immune system — which normally guards the body against foreign invaders — mistakes healthy cells and tissues as the enemy and launches a seek and destroy mission. The immune system has lost its ability to differentiate between self and non-self. With Hashimoto’s, the immune system thinks the thyroid is “foreign.” This means that Hashimoto’s isn’t so much a thyroid problem as it is an immune system problem. The most effective treatment for Hashimoto’s addresses immune function and root causes, which is the basis of functional medicine vs. conventional medicine. Conventional medicine tends to prescribe supplemental hormones and immune-suppressive drugs, where the side effects are worse than the symptoms of the original condition.

Multiple autoimmune syndrome (MAS): As many as one in four people with an autoimmune condition are at risk for developing additional autoimmune conditions. Some experts claim that once you have one manifestation of autoimmunity, without immune modulation, the chances of developing another are greater than 50%. This is called multiple autoimmune syndrome (MAS) or the autoimmune cascade. The etiology of MAS is not entirely clear, but lifestyle medicine can help prevent MAS — it helps to quiet the symptoms of the primary autoimmune condition(s) and calm down a hypervigilant immune system. Yes, autoimmunity can be managed — it’s not something that you have to “live with.”

Immune modulation: Immune modulation is the most effective approach for easing the symptoms of autoimmunity and managing the condition. The goal of immune modulation is to slow down or stop a misguided immune response (e.g. when the immune system attacks the thyroid). Conventional approaches typically involve suppressing the entire immune system, which has its own set of problems. Immune modulation is largely achieved through targeted and personalized lifestyle medicine, where the goal is to train the immune system to stop the improper response without shutting it down altogether.

What other terms do you hear bandied about but aren’t quite sure what they mean? What has confused you in the process of learning about Hashimoto’s and autoimmunity? Let us know in the comments below. 

Posted by Healthful Elements Staff


This was interesting and helpful. My questions are:

1) I have several articles that give you the range of your test scores for T3, T4, FT3 and antibodies. What is the best range in your opinion?

2) I was able to stop my meds for 3 months since no antibodies showed. Now back on a low dose of synthetic meds after trying Armour. I was surprised that my body could not absorbe Armour. Is this common?

3) I am a little confused about foods. One article says eat fermented foods...another says stay away. What are your thoughts?

Thanks again

Hi Melinda,

Thanks for writing!

(1) Most conventional MDs use standard reference ranges that are wider than those used by functional medicine doctors. It can be helpful to see where you fall within that tighter range.

(2) Everyone is bio-individual and there can be so many (and varied) resasons that a person doesn’t respond to medicine (of all kinds, not just thyroid meds). Jill and I talk with people all the time who have had all different types of experiences with medication. Suffice it to say, it’s not uncommon to not react in the way you might expect. 

(3) Again, everyone is bio-individual – even when it comes to food! That’s why personalizing an approach is so critical. In general, fermented foods confer amazing health benefits, but it’s true that some people don’t respond well to them. The way to tell is to know a few key questions to ask about how your body responds to certain other foods and environmental triggers. 

Hope that helps a bit!

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