Can Hashimoto’s Really Go Away – Or Is It Stuck With You Forever?

One of the biggest questions women with Hashimoto’s ask is: “Is this a lifelong thing, or can it ever get better – like, really better?”

From a regular doctor’s view, Hashimoto’s is often seen as chronic. You manage it with thyroid meds forever, because the immune attack damages the thyroid over time.

But in functional medicine, where we look for the root cause of your condition, we see it differently – and the answer is hopeful:

Yes, Hashimoto’s can go into remission for many people!

It’s not always “forever.” Lots of women lower their antibodies (sometimes to zero), feel amazing, and even reduce or stop meds (with doctor help, of course).

What Does “Remission” Mean for Hashimoto’s?

It’s not a full “cure” (your body might still have the tendency), but it’s like the fire goes out:

• Antibodies (like TPO) drop way down or become undetectable.

• Thyroid works normally (good TSH, Free T3, etc.).

• Symptoms like fatigue, brain fog, weight struggles, and cold hands disappear.

• Some people need little or no thyroid medicine.

• Thyroid ultrasound shows less inflammation or damage stopping.

A 2025 review showed about 20% of people get spontaneous remission with no big changes to their life. But with changes to diet and lifestyle you have way higher chances!

The Paper Basics

Title: "New insights into the phenomenon of remissions and relapses in autoimmune diseases and the puzzle of benign autoantibodies in healthy individuals"

Published: May 9, 2025 (open access on PubMed Central)

Main Idea: It explores why some autoimmune diseases flare and calm down. The key is the balance between how fast your body destroys tissue (from the immune attack) and how fast it recovers/regenerates.

For Hashimoto’s there is slow thyroid cell turnover – cells divide only about once every 10 years, so remission is possible but is rare compared to disease in faster-healing tissues.

What It Says About Remission Rates in Hashimoto’s

The paper highlights some studies:

In one group of 92 adults with Hashimoto’s treated with levothyroxine, 24% went into remission. That means they stayed euthyroid (normal thyroid function) for 1–8 years after stopping meds. (from a study by Takasu et al.).

In kids with overt hypothyroidism from Hashimoto’s (followed for about 8 years), 16% stopped therapy and stayed in remission.

These aren’t fully “spontaneous” (no changes at all) – treatment helped lower the attack enough for recovery to win. But it shows remission happens more than people think.

The authors say true spontaneous remission - meaning there was no treatment,  is rare in Hashimoto’s because thyroid recovery is slow. But if inflammation drops naturally or from diet and lifestyle changes then surviving thyroid cells can ramp up and make up for the losses.

Immunosuppressants (like corticosteroids) might help mild cases of Hashimoto’s by decreasing destruction, giving recovery a chance. This would be a last resort in my opinion. I’ve mentioned before that I had to go on LDN in 2025 because my immune system took a hit from covid and it has improved my quality of life significantly. There is no shame in that- sometimes you need the prescription meds to get you better.

This backs the hopeful view: Calm the immune fire with diet, nutrients, gut healing, and give your thyroid a chance to recover.

Why Remission Is Trickier in Hashimoto’s

The thyroid is a slow healer! Thyroid cells (thyrocytes) divide about once every 10 years, only around 5 times in an adult lifetime. That means low natural regeneration.

In Hashimoto’s:

The main damage comes from T-cells (immune attackers), not antibodies. Antibodies like TPO are more like markers – common even in healthy people with up to around 30% having them without issues or symptoms.

Remissions/Relapses Explained

High-recovery diseases (e.g., alopecia areata/hair loss patches, early multiple sclerosis/RRMS, inflammatory bowel disease, autoimmune pancreatitis): Fast tissue healing allows full remissions and relapses. Symptoms come and go.

Low-recovery diseases like advanced Type 1 diabetes, severe Graves’/Hashimoto’s, androgenic alopecia/balding all have slow or no regeneration – damage is permanent, no true cycles.

Hair follicles regenerate fast (alopecia areata often remits). Thyroid cells? Super slow (divide once every ~10 years) – harder remission.

Benign Autoantibodies in Healthy People

Why do healthy folks have autoantibodies (like in Hashimoto’s) without disease?

If tissue recovers fast, low-level attacks don't cause symptoms (autoantibodies are “benign" meaning they don’t cause any damage to the tissue. ). T regulatory cells create a balance that keeps these antibodies benign. When this changes is when triggers like stress, gut issues, toxins, poor diet break the tolerance and the T cells go rogue, antibodies rise and damage to tissue begins.

In low-recovery tissues, autoantibodies are rare in healthy people and linked to progressive disease.

For Hashimoto’s: Anti-TPO/Tg antibodies are common in healthy women (30%) but mostly harmless – real damage is from T-cells, not antibodies. Antibodies when high, show active autoimmunity and are predictors for progression to hypothyroidism. Sometimes their job is to flag bad cells for other cells to come in and clean them up or get rid of them and sometimes they signal the T- cells to start destruction. The antibodies themselves are not what is destroying tissues. The cytotoxic or cell toxic T cells are what go into the thyroid tissue and directly damage or kill off the cells. Other T cells called helper T cells (Th1 or Th17) cause inflammation, recruit more attackers, and amp up the whole process of destruction.

Key Takeaways for Us

This paper says Hashimoto’s is "low recovery" – so full relapse-remission cycles (like in MS or rheumatoid) are unlikely. But reducing the immune fire by finding your root cause and working on diet, nutrients, and gut fixes can tip the balance toward remission by protecting remaining cells.

It's hopeful science backing what many experience with root-cause work!

The Big Balance: Destruction vs. Recovery

Think of your thyroid like a garden being attacked by weeds (immune cells).

If weeds grow faster than the garden regrows → damage builds (hypothyroidism worsens).

If weeds slow/stop and plants recover → garden heals (remission).

Thyroid cells grow super slow (divide only once every 8–10 years in adults). That's why full regeneration is tough – slower than in other tissues like skin or liver.

Remission often comes from stopping the attack so remaining healthy cells compensate (make enough hormones). In kids or early cases, some real regrowth happens (seen on ultrasound).

Calming the Immune Attack

Functional medicine shines here: Remove triggers to lower antibodies and inflammation.

Drop in antibodies (TPO/TgAb) → Less destruction. Gluten-free diets, selenium, and gut healing often cut antibodies fast.

Restore immune balance → More "regulatory" cells (like peacekeepers) calm overactive attackers. Stress relief, nutrients (vitamin D, zinc), and fixing leaky gut help this.

Helping Remaining Thyroid Cells Work Better

Even without new cells, survivors can ramp up:

Better T4-to-T3 conversion most of which happens in the liver, some in your gut, and in other tissues. When you have good conversion you will have no brain fog, you will be warm, and your metabolism is ramped up. 80% of your T3 comes from converting T4 to T3.

Stress, inflammation, nutrient deficiencies and liver or gut problems can affect conversion - something else that affects conversion is fasting or calorie restriction as well as cold exposure and aging. Making diet and lifestyle changes may not be enough here - you may need a T3 medication as well.

Less oxidative stress (damage) from antioxidants.- the biggest culprit here can be the actual peroxide that your thyroid makes when it makes T4 and T3. We also make enzymes that neutralize it but in active autoimmunity or stress or inflammation or all three, the immune attack creates a demand for more thyroid hormone creating more peroxide and oxidative stress.

Inflammation also adds more free radicals to the picture causing more cell damage or rust in the cells, the mitochondria (our energy factories in the cell) and the enzymes needed to make things happen around thyroid hormone production and conversion. This leads to fewer healthy cells making hormones, poor conversion from T4 to T3, more inflammation ( a vicious cycle), higher levels of antibodies and more damage to the thyroid gland.

Less oxidative stress means less cell damage and more cells survive the autoimmune attacks, it boosts energy production, improves thyroid conversion,  calms inflammation, supports recovery.

In studies, 16–24% of treated adults (and more kids) recover enough function to stop meds temporarily.

Emerging Ideas (Future Stuff)

Stem cells → Might help regenerate tissue (early research exciting but currently mostly animal studies exist.). There is some thought that these stem cells could regenerate thyroid tissue  which has been done in mice but not in humans yet. There are some human studies in thailand and the Cayman islands that have reported improved symptoms, lower antibodies and improved thyroid function in Hashimoto’s. There has been some lab studies done where they have used pluripotent stem cells from skin cells that were reprogrammed to make working thyroid follicles so that provides some hope for the future that we may be able to regenerate our own thyroid tissue.

Drugs like low-dose naltrexone → Calm immunity in some.

Bottom line: Remission works best early, by slowing destruction and supporting recovery. Functional fixes (diet, nutrients, lifestyle) boost your odds big time!