Hashimoto’s Thyroiditis
Understanding Autoimmune Thyroid Dysfunction and Root-Cause Contributors
Hashimoto’s thyroiditis is the most common autoimmune thyroid condition and a frequent contributor to chronic fatigue, brain fog, weight changes, and cold intolerance. Yet for many individuals, a diagnosis of Hashimoto’s raises more questions than answers—especially when symptoms persist despite standard thyroid treatment.
At Keystone Total Health, individuals navigating Hashimoto’s thyroiditis are evaluated through a root-cause, functional framework guided by Dr. Martin Hart, DC, and Dr. Koji Aoki, DC. Our clinic is located in Columbia, Tennessee, serving the greater Nashville area and welcoming clients from across the United States seeking clarity around complex autoimmune and chronic inflammatory conditions.
Reviewed by Dr. Martin Hart, DC & Dr. Koji Aoki, DC
What Is Hashimoto’s Thyroiditis?
Hashimoto’s thyroiditis is an autoimmune condition in which the immune system produces antibodies that target thyroid tissue. Over time, this immune activity can impair the thyroid’s ability to produce hormones needed to regulate metabolism, energy, temperature, digestion, and neurological function.
Hashimoto’s often develops gradually and may be present for years before thyroid hormone levels fall outside conventional reference ranges. This is one reason many individuals experience symptoms long before receiving a formal diagnosis.
What Does the Thyroid Do?
The thyroid gland plays a central role in regulating:
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Metabolic rate
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Energy production
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Body temperature
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Heart rate
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Digestion
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Cognitive function
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Hormonal signaling
When autoimmune activity interferes with thyroid signaling, the effects are often system-wide, not limited to the neck or thyroid alone.
Common Symptoms of Hashimoto’s Thyroiditis
Symptoms of Hashimoto’s can vary significantly between individuals and may fluctuate over time.
Energy & Metabolic Symptoms
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Chronic fatigue
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Weight changes
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Cold intolerance
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Exercise intolerance
Cognitive & Neurological Symptoms
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Brain fog
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Memory difficulties
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Slowed thinking
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Mood changes
Hormonal & Systemic Symptoms
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Hair thinning
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Dry skin
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Menstrual irregularities
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Sleep disruption
Digestive & Immune Symptoms
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Constipation or slowed digestion
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Food sensitivities
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Bloating
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Heightened immune reactivity
Many of these symptoms overlap with chronic fatigue, autoimmunity, and gut dysfunction, which is why Hashimoto’s rarely exists in isolation.
Why Hashimoto’s Thyroiditis Develops
Hashimoto’s is not caused by a single factor. Instead, it reflects chronic immune dysregulation influenced by multiple internal and external stressors.
Common contributors may include:
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Immune system imbalance
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Gut barrier dysfunction
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Chronic inflammation
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Environmental exposures
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Infections or immune triggers
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Nutrient and mineral depletion
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Nervous system stress
Understanding why the immune system is targeting the thyroid is a key part of root-cause evaluation.
Hashimoto’s, Gut Health, and Immune Signaling
The gut plays a major role in immune regulation. Increased intestinal permeability (“leaky gut”), dysbiosis, or chronic gut inflammation can contribute to immune activation and autoimmune signaling.
This gut-immune connection is one reason individuals with Hashimoto’s often experience:
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Food sensitivities
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Digestive symptoms
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Nutrient absorption issues
Addressing gut health is often an important part of clarifying autoimmune patterns.
Hashimoto’s and Mold Illness or Lyme Disease
In clinical practice, Dr. Hart and Dr. Aoki frequently observe Hashimoto’s thyroiditis overlapping with mold illness (CIRS) and Lyme disease.
Both mold biotoxins and chronic infections can:
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Drive immune activation
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Increase inflammatory burden
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Disrupt hormonal signaling
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Lower immune tolerance thresholds
When these conditions coexist, thyroid-related symptoms may become more persistent and complex.
How Hashimoto’s Thyroiditis Is Evaluated at Keystone Total Health
At Keystone Total Health, Hashimoto’s thyroiditis is evaluated through a root-cause functional approach, not solely based on antibody levels or thyroid hormone numbers.
Evaluation may include:
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Comprehensive health and symptom history
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Assessment of immune and inflammatory patterns
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Thyroid-related functional markers when appropriate
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Evaluation of gut health, detoxification capacity, and nutrient status
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Consideration of overlapping conditions such as mold illness or Lyme disease
Many individuals pursue this process through the Keystone Root Cause Intensive, which provides a structured and immersive evaluation for complex chronic illness.
Why Hashimoto’s Is Often Misunderstood
Hashimoto’s is frequently misunderstood because:
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Symptoms may appear before labs change
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Antibody levels do not always correlate with symptom severity
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Focus is often placed solely on hormone replacement
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Root contributors are rarely addressed together
A systems-based approach helps explain why symptoms may persist even when lab values appear “managed.”
Serving Columbia, TN, Nashville, and Clients Nationwide
Keystone Total Health is located in Columbia, Tennessee, serving individuals from the greater Nashville area and welcoming clients from across the country who travel to work with Dr. Hart and Dr. Aoki for comprehensive autoimmune and thyroid evaluation.
Hashimoto’s Thyroiditis FAQ
The following questions address common concerns about Hashimoto’s thyroiditis, including symptoms, causes, and why many individuals experience persistent issues despite treatment.
What is Hashimoto’s thyroiditis?
Hashimoto’s thyroiditis is an autoimmune condition in which the immune system attacks thyroid tissue, gradually impairing the thyroid’s ability to produce hormones that regulate metabolism, energy, and many body systems.
Can you have Hashimoto’s with normal thyroid labs?
Yes. Many individuals have thyroid antibodies and symptoms long before standard thyroid hormone levels fall outside reference ranges. This is one reason Hashimoto’s is often missed early.
What are the most common symptoms of Hashimoto’s?
Common symptoms include chronic fatigue, brain fog, cold intolerance, weight changes, hair thinning, dry skin, constipation, and mood changes. Symptoms vary widely between individuals.
Is Hashimoto’s linked to gut health?
Yes. Gut health plays a major role in immune regulation. Increased gut permeability and dysbiosis are commonly seen in individuals with autoimmune thyroid conditions.
Can mold illness or Lyme disease affect Hashimoto’s?
Yes. Mold illness and Lyme disease can increase immune activation and inflammation, which may worsen autoimmune thyroid patterns and contribute to persistent symptoms.
Why do symptoms persist even with thyroid medication?
Thyroid medication may help normalize hormone levels, but it does not address immune dysregulation, inflammation, or other root contributors driving Hashimoto’s.
How is Hashimoto’s evaluated from a root-cause perspective?
Evaluation focuses on immune patterns, inflammatory contributors, gut health, environmental exposures, nutrient status, and overlapping conditions—not just thyroid hormone levels
Who should consider a root-cause evaluation for Hashimoto’s?
Individuals with ongoing symptoms, overlapping autoimmune or chronic conditions, mold exposure, Lyme disease, or unexplained fatigue may benefit from a broader evaluation.
Resources & Further Reading
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): https://www.niddk.nih.gov
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American Thyroid Association: https://www.thyroid.org
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Wentz I. Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause
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PubMed: Autoimmune Thyroid Disease Reviews
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Cleveland Clinic: Hashimoto’s Thyroiditis Overview