Latest infographic: Hashimoto's thyroiditis and the gut-immune interface

Hashimoto’s thyroiditis (HT) is the most common cause of hypothyroidism, characterised by immune-mediated destruction of thyroid tissue and disruption to thyroid hormone production. Central to this process is a loss of immune tolerance to thyroid antigens, including thyroid peroxidase (TPO) and thyroglobulin (Tg), leading to autoantibody production and chronic inflammation.

Activation of T-helper cells, particularly Th1 and Th17 pathways, promotes pro-inflammatory cytokine release and drives ongoing thyroid tissue damage. This is compounded by oxidative stress, reduced antioxidant capacity, and apoptosis of thyrocytes, further amplifying antigen presentation and immune activation.

The gut-immune interface plays a critical role in disease progression. Intestinal permeability allows luminal antigens to enter circulation, where molecular mimicry and immune activation contribute to cross-reactivity with thyroid tissue. Dysbiosis and reduced regulatory T cell (Treg) activity further perpetuate immune imbalance and systemic inflammation.

Conventional management typically focuses on thyroid hormone replacement; however, this may not fully address the underlying immune and inflammatory drivers in a significant proportion of patients.

Targeted nutritional and herbal strategies offer a complementary approach by supporting immune regulation, reducing oxidative stress, improving thyroid hormone metabolism, and restoring gut barrier integrity.

This infographic outlines the pathophysiology of Hashimoto’s thyroiditis and highlights key therapeutic interventions including selenium, vitamin D, magnesium, myo-inositol, probiotics, and CoQ10/ubiquinol, which support immune balance, antioxidant defence, and thyroid function.