1HASHIMOTO THYROIDITIS Hashimoto’s Thyroiditis (HT) is an autoimmune inflammatory disease. The antibodies that are produced in this disease are in response to the thyroid antigens that ultimately results in the elimination of thyroid gland. Thus, it also destroys the necessary precursors for the production of thyroid hormone. Hypothyroidism is mainly caused due to HT. However, for a patient suffering from HT, the symptoms can suggest the possibility of fluctuationbetween that of hyperthyroidismorhypothyroidism as well (Trbojevic & Djurica, 2005; Xue et al. 2015). The most common symptoms of hypothyroidism include excessive weight gain, feeling fatigued, drying up of skin, loss ofhair and increased intoleranceto cold, brain fog, muscle and joint pain as well as depression. Constipation can also be a common symptom suggesting hypothyroidism(Crowley 2004; Kumar & Clark, 2009). Studies has shown that HT is also associatedwitha large amount of other autoimmune diseases such as pernicious anemia, vitiligo, lupus, primary adrenal autoimmune disease, celiac disease, myasthenia gravis, rheumatoid arthritis and type 1 diabetes (Trbojevic & Djurica, 2005). The diagnosis of the disease is done on the basis of elevated levels of TSH or Thyroid Stimulating Hormone along with lower levels of T3 and T4. According to Gruner (2017) the treatment of thyroid includes replacement of thyroid hormone and the prescription of certain precursors, cofactors and stimulants that will lead to the synthesis of thyroid hormones. The major causes of HT is not very clearly known but it is assumed to be a multifactorial facet that involves a large number of variables. HT is thought to be caused by a combination of factors involving genetic, environmental, immune and hormonal factors (Hechtman, 2012). According to Cusick, Libbey & Fujinami (2013) the prolonged proinflammatory responses to infections by both virus and bacteria have been associated with the initiation as well as theexacerbation of Hoshimoto’s Thyroiditis’auto immune condition. Studies have shown that stress plays an integralrole in the deregulation and obstruction with the synthesis of hormone by triggering the release of corticotrophin-
2HASHIMOTO THYROIDITIS releasing hormone, noradrenaline and cortisol. The roles played by these hormones are inhibitory in nature as they hinderthe secretion of TSH. Thus, it becomes a contributing factor in the suppression of thyroid functioning (Tsigo & Chrousous, 2002). The digestive system also plays a critical role in the homeostasis, because of its linkage to the immune system via the GALT or Gut- Associated Lymphoid Tissue. Thus, the disbalance between the microbes present in the gut micro-biota and the disturbances in GIT causes the infection of the GIT andincreases the permeability thereby causing impairing of the immune system (Shuichi et al, 1999).