From Genetics to Lifestyle: What’s Fueling the Increase in Hashimoto's Cases?
The following article on the rising prevalence of Hashimoto’s thyroiditis was created in part from Liz’s personal notes, which she shared with me after our recording in Episode 1413 of the Juicebox Podcast. In addition to Liz’s firsthand insights, I have incorporated supportive details from reputable medical sources and performed multiple layers of fact-checking to ensure clarity and accuracy. We’ll explore the key factors contributing to the apparent increase in Hashimoto’s—covering everything from genetic predispositions to lifestyle influences.
The observed increase in the frequency of Hashimoto’s thyroiditis appears to stem from multiple, overlapping factors—ranging from improved diagnostic practices to environmental influences, genetic predispositions, and lifestyle changes. While many studies highlight correlations between these factors and the disease, direct causation can vary among individuals. Below is a closer look at each potential contributor, as well as why ongoing research is crucial for clarifying the underlying mechanisms and risk factors.
1. Improved Diagnostic Techniques and Awareness
Advanced Medical Testing
Enhanced Detection
The development of more sensitive and specific diagnostic tools—such as high-resolution ultrasounds and precise antibody tests (anti-thyroid peroxidase and anti-thyroglobulin)—allows for earlier and more accurate detection of Hashimoto’s disease.Routine Screening
Increased routine screening for thyroid function has led to the identification of cases that might have gone unnoticed in the past.
Medical Community Awareness
Educated Healthcare Providers
Physicians are more aware of thyroid disorders and their varied presentations, leading to more frequent testing.Patient Advocacy
Greater public awareness encourages individuals to seek medical advice for symptoms like fatigue, weight gain, and depression, often associated with thyroid dysfunction.
2. Environmental Factors
Iodine Intake Variations
Dietary Changes
Global dietary shifts—including increased consumption of iodine-rich foods or supplements—can influence thyroid function. Both iodine deficiency and excess are linked to thyroid autoimmunity, but the degree of impact can vary by individual.Iodized Salt Programs
While these initiatives successfully reduce iodine deficiency disorders, they can occasionally lead to excessive iodine intake in certain populations.
Exposure to Environmental Toxins
Industrial Chemicals and Pollutants
Substances such as perchlorates, thiocyanates, and nitrates may disrupt thyroid function.Heavy Metals
Mercury and lead, among others, have shown correlations with autoimmune dysfunction, though ongoing studies aim to clarify whether these relationships are causal.Radiation Exposure
Increased exposure to medical imaging radiation and environmental radiation can affect thyroid health.
Infectious Agents
Viral and Bacterial Triggers
Certain infections may trigger autoimmune responses in individuals who are genetically susceptible.
3. Genetic Predisposition and Family History
Genetic Susceptibility
Hashimoto’s disease often runs in families, indicating a genetic component. However, not everyone with these genes will develop Hashimoto’s, highlighting the importance of additional triggers.Gene-Environment Interaction
Even with a genetic predisposition, individuals may remain asymptomatic unless environmental factors (stress, toxins, infections) activate the autoimmune response.
4. Lifestyle and Dietary Changes
Dietary Factors
Processed Foods and Additives
Increased consumption of highly processed foods may promote chronic inflammation and immune dysregulation. Research on the precise link, however, continues to evolve.Gluten Intake
Some studies suggest a relationship between gluten and autoimmune thyroid diseases, especially in those with celiac disease or gluten sensitivities.
Stress and Psychological Factors
Chronic Stress
Persistent stress can impact hormone levels and immune modulation, potentially triggering or worsening autoimmune conditions.
Sedentary Lifestyle
Physical Inactivity
A lack of regular exercise may impair overall health and immune regulation, indirectly increasing vulnerability to autoimmune issues.
5. General Increase in Autoimmune Diseases
Hygiene Hypothesis
Reduced Microbial Exposure
In highly sanitized, urban environments, limited exposure to various microorganisms in early life may lead an under-stimulated immune system to overreact to harmless triggers.
Inflammation and Immune Dysregulation
Systemic Inflammation
Lifestyle and environmental factors can contribute to chronic, low-grade inflammation, exacerbating immune system dysfunction.
6. Hormonal and Reproductive Factors
Gender Differences
Higher Incidence in Women
Hashimoto’s disease occurs more frequently in women, potentially due to estrogen’s influence on immune response.
Reproductive Hormones
Estrogen Effects
Estrogen can alter immune regulation, increasing susceptibility to autoimmune conditions in some cases.
7. Vitamin D Deficiency
Immune System Modulation
Role of Vitamin D
Adequate vitamin D levels are crucial for normal immune function. Studies link deficiency to higher rates of autoimmune disorders, including Hashimoto’s, though research is ongoing to pinpoint cause-and-effect pathways.
8. Obesity and Metabolic Factors
Chronic Inflammation
Impact of Obesity
Excess body fat is associated with a chronic inflammatory state, potentially influencing autoimmune processes.
Hormonal Changes
Adipokines Production
Adipose tissue releases hormones (adipokines) that affect immune responses, possibly increasing or aggravating autoimmune activity.
Conclusion
Rising Hashimoto’s disease rates reflect a multifactorial interplay rather than a single driver. Enhanced diagnostic methods and heightened awareness undoubtedly capture more cases. Simultaneously, environmental changes, lifestyle factors, genetic predispositions, and broader autoimmune trends shape the overall picture—though exact causal pathways vary from person to person.
Clinical Considerations
If you suspect thyroid dysfunction, seek professional evaluation. Typical assessments include TSH, T4, T3, and antibody tests. Not everyone with a genetic susceptibility or specific lifestyle factors will necessarily develop Hashimoto’s; presentation is highly individual, and personalized treatment is often required.
Ongoing Research
Scientists continue investigating how genetics, environment, and lifestyle converge to influence disease onset. Identifying modifiable risk factors—like dietary habits, vitamin D levels, and stress—may help reduce the incidence of Hashimoto’s in the future.
Disclaimer
This post was prepared with the assistance of an AI language model. To help ensure its reliability, we cross-referenced medical literature, double-checked factual statements, and included insights drawn from Liz’s experiences featured in Episode 1413 (available at https://www.juiceboxpodcast.com/episodes/jbp1413). Nevertheless, the information provided here is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized guidance regarding your health and any medical tests or treatments.
Suggested Resources
European Thyroid Journal (various articles on environmental triggers and autoimmune thyroiditis)
Low-Dose Naltrexone: Is it right for you?
This article on Low-Dose Naltrexone (LDN) was inspired by conversations with Liz, who shared her personal notes and experiences after appearing in Episode 1413 of the Juicebox Podcast (available at https://www.juiceboxpodcast.com/episodes/jbp1413). To ensure its accuracy, we compared her insights with existing medical literature and performed multiple rounds of fact-checking. The goal is to provide balanced, up-to-date information for those curious about LDN’s potential role in managing autoimmune conditions, chronic pain, and metabolic issues.
If you’ve been struggling with autoimmune issues, chronic pain, or insulin resistance, you may have heard about Low-Dose Naltrexone (LDN). Originally used at much higher doses to treat opioid and alcohol dependence, LDN at lower doses is gaining attention for potentially reducing inflammation, modulating the immune system, and easing chronic pain.
What Is LDN?
LDN is a reduced-dose version of naltrexone, a medication initially developed for opioid and alcohol dependence. When used at doses around 1.5 to 4.5 mg, LDN has shown preliminary benefits in smaller studies and anecdotal reports for autoimmune and inflammatory conditions, chronic pain, and metabolic issues such as insulin resistance. Larger clinical trials are still needed to confirm these findings.
How Does It Work?
Although the precise mechanisms aren’t fully understood, two main hypotheses have emerged:
Endorphin Production
By temporarily blocking opioid receptors, LDN may prompt the body to increase its own endorphins—natural painkillers and immune modulators.Immune System Modulation
LDN might help calm overactive immune responses, potentially reducing inflammation and autoimmunity.
Who Might Benefit from LDN?
Research into LDN is ongoing, and while initial results are promising, the evidence is not yet conclusive. Areas of interest include:
Autoimmune Diseases
Multiple Sclerosis (MS)
May help alleviate fatigue, spasticity, and nerve pain based on small-scale studies.Rheumatoid Arthritis (RA)
Early data suggest it could reduce joint inflammation and pain.Hashimoto’s Thyroiditis
Some case reports show a possible reduction in thyroid antibodies and improved energy.Inflammatory Bowel Disease (IBD)
Pilot studies indicate it might help with Crohn’s disease and ulcerative colitis.Lupus
May lower systemic inflammation and fatigue in certain patients.Psoriasis and Psoriatic Arthritis
Possible benefits for skin lesions and joint pain.
Chronic Pain
Conditions such as fibromyalgia, nerve pain (neuropathy), or Complex Regional Pain Syndrome (CRPS) may respond to LDN’s proposed impact on neuroinflammation, although more robust data are required.
Insulin Resistance
Some emerging research suggests LDN might improve insulin sensitivity by reducing inflammation linked to metabolic dysfunction. This is of interest for managing Type 2 Diabetes or prediabetes in conjunction with lifestyle changes, but larger-scale trials are still needed.
Why Consider LDN?
Generally Well-Tolerated
Most reported side effects (e.g., vivid dreams, mild insomnia, occasional nausea) tend to be mild and temporary.Non-Immunosuppressive
Unlike certain traditional treatments, LDN generally does not weaken your immune system.Cost-Effective
LDN often costs less than many other therapies.Potential Broad Benefits
It may offer advantages across different conditions, though individual responses can vary significantly.
How to Start LDN
LDN must be prescribed by a healthcare provider familiar with off-label dosing and should be prepared by a compounding pharmacy. Typical guidelines suggest:
Low Starting Dose
Many begin at 0.5–1.5 mg at bedtime to minimize side effects.Slow Titration
The dose is gradually increased every 1–2 weeks based on tolerance and therapeutic response.Maintenance Dose
Many individuals find 4.5 mg (or slightly lower) works well after several weeks of careful titration.
Things to Keep in Mind
Off-Label Use
LDN is not FDA-approved for autoimmune or chronic pain indications; medical professionals prescribe it off-labelbased on emerging (but not definitive) evidence.Opioid Caution
Because LDN blocks opioid receptors, it should not be used if you are currently on opioid medications, as it may trigger withdrawal or negate opioid pain relief.Compounded Medication
LDN must be prepared by a compounding pharmacy; ensure you use a reputable source.Potential Side Effects
Vivid dreams, insomnia, headaches, or mild GI upset are the most common. Serious adverse effects are rare, but always report concerning symptoms to your doctor.Medical Supervision
Regular check-ins with a healthcare provider are important for monitoring progress and adjusting the dose.Individual Variation
Responses to LDN can vary widely. Some people experience notable symptom relief, while others see minimal change.
The Bottom Line
Low-Dose Naltrexone is an intriguing option for individuals with autoimmune conditions, chronic pain, or metabolic challenges. Early evidence and anecdotal reports suggest it may help some people by reducing inflammation and supporting the body’s natural healing mechanisms. However, LDN is not a guarantee and works differently for each person. If you’re curious, consult a healthcare provider who is knowledgeable about LDN’s off-label use to discuss whether it aligns with your unique medical situation.
Disclaimer
This post was prepared with the assistance of an AI language model. Every effort was made to ensure its accuracy by reviewing medical literature, comparing insights from Liz’s personal notes (featured in Episode 1413 of the Juicebox Podcast), and performing multiple rounds of fact-checking. However, this article is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always seek a qualified healthcare provider’s guidance before trying any new treatment, particularly if you currently use opioid medications or have complex health conditions.
I Don’t Understand Social Media
🎙️ Juicebox Podcast: Why Does Social Media Feel So Unreal?
In the latest episode of the Juicebox Podcast, Scott and Arden dive deep into a question we've all thought about: Why does the internet feel so different from real life?
Arden: "Every day I get up and take the same route, see the same people, and nothing ever happens. But on the internet? Every five seconds, there's some insane video."
Scott: "It's an odds thing, right? Billions of people with cameras, sooner or later, something crazy is going to get caught."
They also discuss hate-watching, the internet’s obsession with Capuchin monkeys, and the power of viral content.
Scott: "I hate-watch TikTok. Arden sends me a video, and I immediately think, 'I hate this.' But I keep watching it. Why?"
Arden: "Because you like complaining."
😂 Don't miss this candid and hilarious conversation—plus, stick around for some talk about the ethics of filming strangers and why your TikTok feed is probably out to get you.
🎧 Listen now: https://www.juiceboxpodcast.com/episodes/jbp1419
Navigating College with Type 1 Diabetes – A New Podcast Series to Guide You!
Heading off to college is a monumental step for any young adult, but for those with type 1 diabetes, it comes with unique challenges. That’s why we created a comprehensive three-part series on The Juicebox Podcast to equip students and their families with the tools, strategies, and insights they need for a successful transition. Whether it's managing accommodations, handling medical supplies, or dealing with the dreaded low blood sugars, this series has you covered.
Part 1: The Essentials of College Accommodations
In the first episode, Andrea Lafleche, a diabetes advocate and former higher education professional, unpacks the world of college accommodations. Learn about navigating FERPA (the HIPAA of education), advocating for reasonable accommodations, and setting up systems to support your diabetes management on campus. From fridge policies to the importance of ADA-protected stop-the-clock testing, this episode is your roadmap to setting a strong foundation. - Listen on your favorite audio app or online.
Part 2: Building Self-Advocacy and Communication Skills
College is about independence. In this episode, we focus on empowering students to take the reins of their care while navigating complex relationships with parents and college staff. Andrea shares invaluable advice about working with disability services, communicating with professors, and even prepping peers or roommates about emergency protocols like glucagon use. - Listen on your favorite audio app or online.
Part 3: Staying Safe and Prepared on Campus
Finally, we tackle the everyday realities of living on campus with diabetes, including low blood sugar management, food challenges in dining halls, and navigating late-night emergencies. From stocking glucose tabs to ensuring roommates understand critical signs of trouble, Andrea offers practical advice to ensure safety without compromising the college experience. - Listen on your favorite audio app or online.
This series isn't just about tips—it's about fostering confidence. Whether you’re a parent sending your child off for the first time or a student wanting to conquer campus life with diabetes, this series provides actionable insights for everyone. Listen to these episodes now and share them with anyone you think could benefit from this life-changing advice.
Caregiving, Connection, and Coping – Inside the Juicebox Podcast's Caregiver Burnout Series
Caring for someone with type 1 diabetes is an incredible act of love, but it’s also a journey marked by stress, isolation, and emotional weight. The Juicebox Podcast, hosted by Scott Benner, dives deep into these challenges in a compelling new series on caregiver burnout. In partnership with Erika Forsyth, a licensed therapist and long-time advocate for the type 1 diabetes (T1D) community, this series offers an honest exploration of the emotional toll caregiving takes—and practical tools for navigating it.
The first episode sets the stage with stories of connection, vulnerability, and validation. Erika recalls speaking at a T1D conference and witnessing the powerful bond between caregivers who finally felt seen and understood. These moments inspired the series, which aims to create a similar safe space for listeners through the podcast.
A major focus is the concept of "chronic sorrow", a grief unique to caregiving for a chronic illness. Erika explains how this sorrow ebbs and flows, often resurfacing during life’s milestones or challenges, like a child’s first birthday party after diagnosis or navigating TSA with diabetes supplies. These moments can isolate caregivers and leave them stuck in cycles of frustration and sadness.
Scott and Erika tackle heavy topics with warmth and relatability, balancing hard truths with hopeful insights. The episode doesn’t shy away from asking tough questions: How do we grieve without a timeline? How can caregivers avoid burnout while supporting their loved ones? And what tools can turn moments of despair into opportunities for growth?
Through shared stories and research-backed strategies, this series empowers caregivers to redefine self-care. Erika introduces tools like the "Dear Diabetes Letter," a reflective exercise to release pent-up emotions, and emphasizes the importance of finding community—whether through local groups or the Juicebox Podcast’s thriving online network. These spaces remind caregivers they’re not alone, offering emotional validation and practical guidance.
This episode is more than a podcast—it’s a lifeline for anyone caring for someone with T1D. Whether you’re new to caregiving or a seasoned pro, Scott and Erika’s thoughtful discussion provides clarity, comfort, and actionable advice. Tune in to hear stories that will resonate deeply and tools that will help lighten the load. Caregiving isn’t easy, but with the right support, it doesn’t have to be lonely.