7 Common Triggers Of Thyroid And Autoimmune Flare-ups

by: S. Keestra, Prof. A. Alvergne, C. Tillekens, and Dr. V. Högqvist Tabor

As part of our collaboration with the University of Oxford, we asked people diagnosed with Hashimoto’s or an underactive thyroid to send us their top thyroid health questions.

We received a lot of inquiries about triggers of Hashimoto’s and thyroid flare-ups. Flare-ups are the worsening of one or more symptoms—causing discomfort and problems with your daily functioning.

We dug into peer-reviewed science research to determine the top causes of flare-ups, here’s what we found:

1. Low vitamin D levels

Vitamin D levels typically drop during the winter and spring. This can make you feel more tired and cause you more bone and muscle pain.

Vitamin D levels below 30 ng/ml (75 nmol/l) indicate you don’t have enough vitamin D, and less than 20 ng/ml (50 nmol/l) indicates a complete lack of vitamin D (1, 2).

Vitamin D3 supplements can be an excellent solution to compensate for the lack of sun, during winter months or even the whole year around depending on where you live.

It might take about eight weeks of treatment to reach the recommended blood levels of vitamin D (2).

Adequate levels of vitamin D are necessary to prevent flare-ups (3-7).

2. Low selenium levels

Selenium is an antioxidant. It prevents thyroid damage and inflammation (8, 9). Your body needs selenium to be able to convert T4 into the active T3 hormone (10).

Research has shown that taking 200µg of sodium in the form of sodium selenite reduces TPO antibody levels by more than half after six months of taking it (11, 12). It’s been shown that if you selenium intake drops, TPO antibody levels will go back up again (13).

3. Long-term stress

During periods of high or intermediate stress, many hormone-producing glands start producing adrenaline and cortisol. This activates the immune system (14-16).

Long-term stress leads to chronic inflammation, reduced sleep quality, changes in appetite, and makes people more prone to gaining weight (17,18).

8 out of 10 people with different autoimmune conditions reported experiencing emotional stress before flare-ups, which increases as people get older (19, 20). Your body copes less well with stress the older you are (21).

Mindfulness techniques, such as meditation, have been proven to reduce stress levels for many people (22).

4. Combination of foods you are sensitive to and a Western pattern diet

Although food sensitivities are individual, eating a Western diet is equally bad for everyone. A diet that’s high in processed and/or pre-packaged foods (high in salt, sugar, and bad fats) is a known trigger of autoimmune flare-ups (22).

Eating both foods that you are sensitive to and a Western pattern diet changes the balance of bacteria in your gut (aka the microbiome). The number of harmful bacteria increases—which can destroy your gut barrier, causing a leaky gut (23).

The best way to prevent diet-related flare-ups is to eat a wide variety of whole foods that you aren’t sensitive to (24, 25).

5. Menstrual cycle

It’s quite common for autoimmune diseases to appear around the time of puberty and menopause. Hormonal changes impact the immune system and can trigger flare-ups (26, 27).

The hormone estrogen is more present during the first half of the menstrual cycle (the follicular phase, ten days to two weeks after the period), which can cause flare-ups (28).

6. Insufficient sleep

Even just one night of bad sleep can mess up the immune system. A recurring pattern of poor sleep will cause flare-ups (29-33).

Flare-ups from lack of sleep can change the pattern of how your brain regulates sleep, which can lead to even worse sleeping patterns (34-35).

7. Bacterial or viral infections

Infections commonly trigger thyroid problems and flare-ups. This happens because viruses that infect your throat or intestine invade your thyroid as well, which causes an inflamed thyroid (36-38).

Triggers of flare-ups usually occur in combination. For example, lack of sleep and bad food choices and consumption of alcohol will prolong the length of a flare-up (39, 40).

In order to reduce your flare-ups, track your symptoms and your lifestyle in BOOST Thyroid. This will help you discover patterns of your triggers.

Sometimes it can take a while to figure out your triggers, as there are likely a few of them. Try tackling one trigger at a time and then move on to solve another one.

Tracking diligently will help you a lot when you analyze your health patterns weeks or months later. It also will provide a helpful overview for your next conversation with your doctor.