Why Did I Get Thyroid Disease (and How Can I Prevent It)?

Across the globe, it’s likely that millions of people are asking themselves daily: “Why did I get thyroid disease?” And, it’s a completely fair question. If you can understand why something occurred, you can take steps to help manage it (or prevent it for those who don’t have it yet).

The truth is that thyroid disease, including hypothyroidism, hyperthyroidism, and autoimmune thyroid conditions like Hashimoto’s and Graves’ disease, are prevalent. Around 20 million Americans alone suffer from it, and cases are on the rise.

In this comprehensive guide, I want to explore the various factors that make some individuals more susceptible to thyroid disease, including genetics, gender, age, and iodine intake.

And, while it might feel frustrating that we can’t change our genetics, age, or gender, there is a silver lining:

We can easily change our iodine intake. Because you (and your thyroid) will do better with the RIGHT AMOUNT.

I’ll also share some action steps you can, starting today, to help with the causes of thyroid disease.

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Table of Contents

Thyroid Disease Is on the Rise
The True Causes of Thyroid Disease
Genetics and Thyroid Disease
Gender and Thyroid Disease
Age and Thyroid Disease
Iodine and Thyroid Disease
Medications and Thyroid Disease
Other Factors and Thyroid Disease
What Truly Causes Thyroid Disease?

Thyroid Disease Is on the Rise

If you’re newly diagnosed with thyroid disease, you’re not alone. Rates of nearly all types of thyroid disease have seen significant increases in recent years, including:

• Thyroid Cancer: Data from various sources, including the American Cancer Society and international cancer registries, indicate a significant increase in the incidence of thyroid cancer (those that go beyond simply better modes of detection).
• Hashimoto’s Disease – Studies suggest that the prevalence of Hashimoto’s disease is on the rise. In the United States alone, it’s been estimated that about 5% of the population has Hashimoto’s disease. More recent studies show that as many as 18% may test positive for Hashimoto’s antibodies¹.
• Graves’ Disease – Graves’ disease, which leads to hyperthyroidism, also showed an increasing trend in prevalence. In the United States, it was estimated that approximately 1.2% of the population had Graves’ disease before 2021.

The True Causes of Thyroid Disease

Estimates suggest that the leading cause of thyroid disease (79%) is genetics. An additional 19% of the risk is related to sex hormones and environmental triggers like iodine. The remaining 18% is related to unknown factors².

What does this tell us? Genetics are the main driver behind thyroid disease. And, that certain genes change how likely autoimmunity is and also change how enzymes work which regulate iodine metabolism in our bodies.

Let’s dive a bit deeper into the topic of genetics…

Genetics and Thyroid Disease

Studies have shown that if one or more family members have thyroid disease, your risk of developing thyroid disease increases significantly. But, it may not be of the same type.

The suggestion here is that certain genetic factors may predispose individuals to thyroid disorders. While specific genes are still under investigation, researchers have identified several genetic markers associated with thyroid conditions.

Most of the genes that create susceptibility to thyroid disease are not specific to any one type of condition. They can be uniquely present in Graves’ Disease, Hashimoto’s Thyroiditis, or other autoimmune diseases³.

Role of Deiodinase Genes and SNPs

Let’s talk a bit about the important role of deiodinases. These are enzymes that play a crucial role in the conversion of inactive thyroid hormone, thyroxine (T4), into its active form – triiodothyronine (T3).

When certain genes are different, the conversion process gets complicated. This leads to a fundamental imbalance in thyroid hormone throughout the body. This can often contribute to hypothyroidism or hyperthyroidism.

Gender and Thyroid Disease

After your genes, gender is often considered to be the second strongest indicator for thyroid disease. But, this is a bit of a tenuous distinction (because gender is also genetic).

There are four potential reasons for why gender affects the risk of thyroid disease:

1. Hormonal influences: Estrogen, a female sex hormone, has been shown to have an impact on thyroid function. During puberty, pregnancy, and menopause, when estrogen levels fluctuate significantly, women may be at a higher risk of developing thyroid problems (in addition to estrogen’s influence on autoimmune thyroid conditions).
2. Pregnancy and postpartum period: Many women experience thyroid dysfunction during and after pregnancy, known as gestational and postpartum thyroiditis. These are temporary conditions that can make women vulnerable on a long-term basis.
3. X-linked chromosomes and thyroid disease: Some thyroid disorders, particularly those related to thyroid hormone receptor function, exhibit X-linked inheritance patterns. Given that women have two X chromosomes, this can lead to potentially double the risk compared to men (who only have one).
4. Fetal microchimerism and thyroid disease: During pregnancy, small numbers of fetal cells can cross the placenta and enter the mother’s bloodstream. These cells can potentially affect the mother’s immune system – leading to autoimmune thyroid disease.

Age and Thyroid Disease

Moving on from gender, let’s talk about the role of age in the cause of thyroid disease. The truth is that thyroid disorders can affect individuals of all ages, but the likelihood of developing them varies throughout one’s life.

Let’s go through each stage to paint a clearer picture…

Childhood and Adolescence

Thyroid disorders may occur in children and adolescents, but they are relatively rare. If they are diagnosed and then managed promptly, these conditions can be effectively treated.

Adulthood

The risk of developing thyroid disease increases with age, with the majority of cases diagnosed in adulthood.

As people age, the likelihood of developing both hypothyroidism and hyperthyroidism rises, highlighting the importance of regular thyroid screenings, especially for those over 50.

Menopause and Perimenopause

During the brief transition years before and after menopause, a woman’s risk of Hashimoto’s disease increases fivefold.

Older Age

Once women reach their 80s, their cumulative lifetime risk of thyroid disease is greater than one out of four.

Iodine and Thyroid Disease

The final factor after genetics, gender, and age is iodine. Iodine is an essential mineral that plays a pivotal role in thyroid function. While iodine deficiency is known to contribute to thyroid problems, excessive iodine intake can also be a risk factor.

A Deep Dive on Iodine and Thyroid Disease

In the case of iodine and thyroid disease, all types of evidence converge. From biochemical models, we know that above a low threshold, iodine intake turns on a mechanism that lowers thyroid activity and induces free radical damage.

Leveraging population studies, we find that regions whose iodine intake is above 300 mcg per day have overall higher rates of thyroid disease. Populations develop more thyroid disease after fortifying their diets with iodine. This has happened in the United States and Denmark.

Lastly, we have what we know from clinical trials. Those have shown that regulating iodine intake can reverse thyroid disease for 78% or more of the participants within three months.

In this next section, I want to go deep into the evidence. Once we’ve covered all of that, I’ll also share how we all respond a little differently to iodine.

The Molecular Model of Iodine

Excess iodine can harm the thyroid slowly or all at once. A single high dose can cause thyroid disease. This reaction has been documented from topical iodine, iodine supplements, and even medications that feature iodine^4,5.

In some ways, iodine turns the immune system against the thyroid. In others, it shuts down the thyroid. The positive news is that when the extra iodine is gone, the thyroid may be able to work normally again⁶.

Iodine Activating the Immune System

Iodine is thought to start autoimmunity via three main processes:

• The formation of free radicals within the thyroid cells leads to cell damage and death.
• The activation of lymphocytes and mobilization into the thyroid.
• Molecular mimicry targets the lymphocytes against thyroglobulin, especially when it has a higher number of iodine atoms⁷.

Free Radicals from Iodine

The fact is that iodine is a highly unstable substance. In nature, it is almost always found in the more stable form of iodide.

The thyroid moves iodide inside small spheres that are lined by follicular thyroid cells. Think about pouring acid into a test tube. Inside this controlled space, iodide is turned into iodine.

Whereas iodide is an antioxidant, Iodine is a highly oxidative free radical. This change is made so that iodine can bind with a long protein called thyroglobulin and form thyroid hormones.

Iodine is so volatile that it can damage these cells. In fact, the thyroid cells make large amounts of antioxidants like glutathione to protect themselves against the free radicals from iodine. The more iodine that is present, the more free radicals emerge.

Activation of Immune Cells

The first step of autoimmunity is damage to the follicular cells and a higher than normal rate of cellular death. This occurs before lymphocytes start to target the thyroid gland⁹.

High-dose iodine has been shown to cause such types of injury in the thyroid cells in numerous lab animals.

We know iodine is the culprit because when animals are given an antioxidant that prevents iodine from forming free radicals (Ethoxyquin), thyroid disease does not develop¹⁰.

Molecular Mimicry

The immune system can be activated by Pathogen-Associated Molecular Patterns (PAMPs) or by Damage Associated Molecular Patterns (DAMPs).

A normal molecule like a thyroid protein mimics the molecule of an infectious organism. Soon the immune system treats that molecule as foreign.

In this process, PAMPs and DAMPs produce high amounts of cytokines and chemokines which turn immune cells against the body’s own tissues^11,12.

As part of the final step, lymphocytes that have moved to damaged thyroid cells learn to attack thyroglobulin¹⁴. Mature thyroid hormones that are released from the thyroid gland consist of thyroglobulin with three or four iodine atoms.

Essentially, thyroglobulin in earlier stages of development will have higher numbers of iodine atoms attached which become pared down as the final hormone is produced.

In low-iodine states, early-stage thyroglobulin may have as few as 13 iodine atoms. In high iodine diets, this can be as many as 60 atoms.

The more iodine in the diet, the more of a surplus there is on thyroglobulin. The more iodine on thyroglobulin¹⁵, the more likely the lymphocytes will attack it¹⁶.

Ultimately, cellular studies have shown that thyroglobulin with fewer iodine atoms is unable to become a target of immune cells. In the same setting, highly iodinated thyroglobulin readily became the source of autoimmunity¹⁷.

Iodine Blocks Hormone Production

The thyroid has a protective system that is meant to keep it from overproducing hormones in times of iodine excess. This is called the Wolff-Chaikoff effect.

It was first documented as early as the 1950s¹⁸. When too many tires get unloaded the conveyor belt breaks. Too much iodine stops hormone production.

If you didn’t have this protection, an excess of iodine could cause your heart to stop. In a lot of ways, it would essentially short-circuit your entire body.

One of the most dangerous situations in thyroid disease is called a hyperthyroid storm. This is a complication of Graves’ hyperthyroidism where the thyroid levels are so high they can be lethal.

The strongest way to stop the thyroid in this situation is mega-dose iodine. This is thanks to the Wolff-Chaikoff effect.

This effect is also why high-dose iodine is used to protect against radioactive iodine exposure. After the Fukushima nuclear disaster, many companies sold high-dose iodide as a preventive measure. The goal is to use the mechanism to stop the thyroid from absorbing iodine for a few weeks so that it won’t absorb any radioactive iodine that could lead to cancer later on.

After several weeks of inactivity, Wolff-Chaikoff’s second stage, known as the escape or adaptation phenomenon kicks in. This stage allows for normal iodine absorption and thyroid hormone production to resume.

Good News: Iodine Response is “Transient”

This part is really good news. The latest research has found that thyroid autoimmunity may be what is known as a transient phenomenon – meaning it can go away²⁰!

The solution can be as simple as getting the right amount of iodine. When used intentionally and with respect, iodine can be a powerful agent to help reverse thyroid disease.

The Iodine Fortification Paradox

Interestingly, the relationship between iodine and thyroid disease is incredibly complex. While iodine deficiency can lead to thyroid issues, countries that have implemented iodine fortification programs in recent decades have reported increased rates of thyroid disease, including autoimmune thyroid conditions.

This phenomenon, known as the “iodine fortification paradox,” suggests that iodine intake needs to be carefully monitored and adjusted to avoid potential negative consequences.

The Effects of Radiation

Radiation exposure can indeed lead to thyroid disease, and the risk varies depending on the level and duration of exposure, as well as individual susceptibility factors.

Certain populations may be at higher risk of radiation-induced thyroid disease:

• Survivors of nuclear incidents: Individuals who were exposed to radiation during nuclear accidents, such as Chornobyl or Fukushima, are at an elevated risk of thyroid problems.
• Patients receiving radiation therapy: Those undergoing radiation therapy for head and neck cancers may experience thyroid damage due to the proximity of the thyroid gland to the treatment area.
• Occupational exposure: Workers in certain industries, such as nuclear power plant employees or nuclear medicine technicians, may face occupational radiation exposure.
• Children and fetuses: Children and fetuses are more vulnerable to radiation-induced thyroid disease. Pregnant women exposed to radiation should be closely monitored to protect both their health and the developing fetus.

To mitigate the risk of radiation-induced thyroid disease, it is crucial to follow safety protocols, limit radiation exposure when possible, and maintain a balanced diet with sufficient iodine intake.

Additionally, individuals with a history of significant radiation exposure should undergo regular thyroid screenings and follow medical recommendations for managing thyroid disorders if they arise.

Medications and Thyroid Disease

After our deep dive into the fascinating world of iodine, let’s talk about medications! Medications can potentially cause thyroid disease or disrupt thyroid function, but this is a relatively rare occurrence.

The most common way medications affect the thyroid is through drug-induced thyroid disorders. Here’s an overview of how medications can cause thyroid disease and who might be at risk:

• Hypothyroidism: Some medications can interfere with the production or conversion of thyroid hormones, leading to hypothyroidism. This can result in symptoms such as fatigue, weight gain, cold intolerance, and depression. Medications that may cause hypothyroidism include lithium (used to treat bipolar disorder), amiodarone (used for heart arrhythmias), and interferon-alpha (used in the treatment of hepatitis C).
• Hyperthyroidism: In some cases, medications can trigger hyperthyroidism. This can lead to symptoms such as rapid heartbeat, weight loss, and anxiety. Medications that may induce hyperthyroidism include amphetamines, iodine-containing contrast agents used in medical imaging, and certain herbal supplements.

Other Factors and Thyroid Disease

Countless other factors have been talked about as being possible positive agents for thyroid disease. Yet our best evidence shows that they may be associated, or contributors contributing, but not causal.

What this means is that if someone is already prone to thyroid disease by better-established mechanisms, other factors may make it more apt to come on sooner than it would have otherwise.

Furthermore, these other purported causes are not leverageable. This means that changing them has not been shown to change the course of thyroid disease.

Other proposed causes include:

• Infections like Hepatitis C, EBV, or H.Pylori
• Environmental pollutants – numerous
• Intake of goitrogens
• Gluten

What Truly Causes Thyroid Disease?

The final takeaway for today is to understand that thyroid disease is extremely nuanced. It can be influenced by genetics, gender, iodine levels, age, and other risk factors.

Understanding these factors is the first step. It can help in early detection, prevention, and management of thyroid disorders.

As research continues to uncover new nuances, it’s important to craft personalized strategies that can help you keep your thyroid under control.

Right now, the only clinically proven strategy to reverse thyroid disease is through iodine regulation. I wrote the Thyroid Reset Diet based on that research, to help people maintain healthy levels of iodine to reverse thyroid disease. I’d love for you to take a look.

Additionally, if you want to learn a bit more about your thyroid, I would definitely advise taking The Thyroid Quiz. It can help you learn where you stand and some of the things you can do to bring things under control. I hope it helps.

P.S. Whenever you are ready, here is how I can help you now:

1. Schedule a Thyroid Second Opinion with me, Dr. C, Click Here for Details
2. Need A Thyroid Supplement Recommendation? Take My Thyroid Specific Formulations Quiz Now
3. Need a Personalized Supplement? Check out My Thyroid Specific Formulations
4. Download and use my Favorite Recipes Cookbook Here
5. Check out my podcast Medical Myths, Legends, and Fairytales Here

Dr. Alan Glen Christianson (Dr. C) is a board-certified Naturopathic Endocrinologist, and the author of The NY Times bestselling Adrenal Reset Diet, Metabolism Reset Diet, Thyroid Reset Diet, and the Healing Hormone Cookbook.

Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, diabetes, and regain energy. Learn more about the surprising story that started his quest.