Dr. Izabella Wentz, PharmD

Thyroid Pharmacist

Doing Everything for Your Thyroid but Still Not Well

Are You Doing Everything for Your Thyroid but Not Yet Well?

Medically reviewed and written by Izabella Wentz, PharmD, FASCP

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Whenever I meet a new person, and tell them about my mission of spreading awareness about lifestyle interventions and innovative treatments for Hashimoto’s, people always say, “Wow, that must be a really rare condition”, to which my response is, “It’s actually the leading cause of low thyroid function in Western countries, and most people who take thyroid medications actually have Hashimoto’s”.

The conversation always turns to, “Wow, I take thyroid medications,” or “My mom takes thyroid medications” or “My sister takes medications,” “Is this Hashimoto’s?” (As a side note, did you know that Synthroid was the bestselling medication in the United States in 2013??)

My answer: If you live in the United States, the UK, Australia, Europe and most developed countries that add iodine to the salt supply and take thyroid medications, there’s a high probability that you do have Hashimoto’s. Depending on the source, estimates are that between 90-95% of those with hypothyroidism have Hashimoto’s.

But most doctors will never tell people that they have Hashimoto’s, or that their immune system is attacking their thyroid. People are told that their “thyroid is sluggish,” and that these things happen with age and “Just take this pill, you’ll be fine.”

Why?

Because the conventional medical model treats autoimmune thyroid disorders in the same way as they would treat someone with a nutrient deficiency induced thyroid disorder, someone who was born without a thyroid or someone who had their thyroid removed or treated with radioactive iodine. But there is SO MUCH MORE to care for autoimmune induced hypothyroidism.

The Development of Autoimmune Induced Hypothyroidism

Based on my research over the last four years, here’s a general outline of how the mechanism behind Hashimoto’s hypothyroidism develops.

  1. The gut, which is the “home” of our immune system becomes imbalanced, (the early warning signs of autoimmune disease are often gut related, and may include gut distress, acid reflux, bloating, irritable bowel syndrome, diarrhea, constipation). This may also be the beginning stage where fatigue will be seen as the body stops absorbing nutrients properly due to the gut imbalance. The TSH test will likely be normal, but thyroid antibodies will be present. This is the best time to act on lifestyle interventions as it’s so much easier to prevent damage at this point!
  2. The immune system starts to attack the thyroid more aggressively (symptoms of anxiety, palpitations, irritability as the damaged thyroid releases hormone into the bloodstream). At this point, thyroid antibodies will likely be detectable, and a slight change in TSH may be seen.
  3. The thyroid becomes severely damaged and scarred and can’t produce more hormones, and thus the person becomes hypothyroid (symptoms of hair loss, fatigue, cold intolerance, depression, brain fog, inability to lose weight, a.k.a. the “typical” low thyroid symptoms). At this point, a change in TSH is more likely going to be seen.

Unfortunately, most people are not diagnosed until about the third stage of Hashimoto’s, that is, if their thyroid problem is uncovered at all!

At age 25, I was told that the extra weight, my forgetfulness, hair loss and fatigue were likely a result of “just getting older.” This seemed to make sense to me at the time, and I took my doctor’s word for it, and thus did nothing while my thyroid was under severe autoimmune attack. I don’t want you to make the same mistake, as it’s much harder to regenerate thyroid tissue than it is to prevent damage.

In the person with the right genetic susceptibility, there are triggers or root causes, that cause an immune system imbalance, which leads to nutrient deficiencies, many symptoms, and results in the destruction of the thyroid gland so it can no longer make enough thyroid hormones.

Opportunities for Intervention

There are three main opportunities for intervention. Giving supplemental hormone when the thyroid is no longer able to produce its hormone is the most common type of intervention. Of course, this intervention is crucial in those cases when the thyroid is so scarred that it can no longer make enough hormone on its own, as the body REQUIRES thyroid hormone for everything!

Taking hormones, in the right combination and at the correct dose, (read about Which Thyroid Medications are Best and What to do if Your TSH is Normal and for even more detailed information, you can download my eBook Optimizing Thyroid Medications for FREE) will help many of the hypothyroid symptoms such as hair loss, fatigue, cold intolerance, and losing weight, but will not get to the underlying cause of the condition.

Taking thyroid hormones should not be the only interventions for Hashimoto’s. I compare taking thyroid hormones to pouring more water into a leaky bucket but failing to plug up the leak. There’s a lot more to Hashimoto’s than just low thyroid function!

Thyroid Medications Aren’t Enough for Hashimoto’s Hypothyroidism!

Now trust me on this one- I’m a pharmacist, and I fully support appropriate medication use, but thyroid medications do not get to the underlying cause of Hashimoto’s.

So What Is the Underlying Cause?

The underlying cause is an imbalance of the immune system, and that will persist even when people get on thyroid medications, and even when the thyroid is taken out surgically or treated with radioactive iodine.

Many people will get on thyroid medications, thinking that’s all they need to do or will have their thyroids surgically removed, and years later will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc.

The immune system just finds a different target 🙁

We need to rebalance the immune system to prevent this -sometimes the autoimmunity can be reversed as well!

The second opportunity for intervention in Hashimoto’s, and in my opinion, the most important approach, is going after the root cause(s).

The gut determines your immune system. Food sensitivities and hidden gut infections are two of the most common causes of an imbalanced immune system. I often hear miracle stories of people who treated one infection (like Yersinia) or got rid of gluten and completely reversed their Hashimoto’s- their thyroid antibodies go away, and some are even able to regenerate thyroid tissue and get off medications.

These are easy cases, and everyone loves this kind of story, but the truth is, that it’s not that easy for most people. In my experience, most people with Hashimoto’s have a combination of nutrient deficiencies, food sensitivities, adrenal issues, infections and an impaired ability to get rid of toxins. Some also suffer from emotional issues that keep their immune systems on guard.

Most People Will Need to Make Multiple Changes to Feel Great Again

I often get messages from people who say they’ve tried everything, but still feel terrible. My answer is usually that you haven’t tried everything.

So if you are someone who has gone gluten free, but hasn’t seen improvement, perhaps you may want to try an elimination diet or food sensitivity testing to see if you have any other food reactions. If you feel worse going gluten free, perhaps you need to think about your blood sugar balance. If you are already eating a super clean diet, and have seen no improvements, perhaps it’s time to think about your gut… could you have a gut infection that is keeping your immune system confused? If you’ve done the gut thing and the food thing, perhaps it’s time to think about your detox capabilities or nutrient deficiencies. These interventions are the interventions that address the root cause of the condition. Read my post about 6 Different Hashimoto’s Root Causes. For additional root causes, please take a look at my Dig-At-It approach and my book, Hashimoto’s: The Root Cause.

Immune modulation is the third type of approach to Hashimoto’s… chemicals, nutrients, herbs medications and even our thoughts can modulate our immune system. Sometimes the triggers may be gone, but they immune system may still be imbalanced…

If you are doing all of the root cause things, but not feeling better, you may want to consider immune modulation like LDN (Low Dose Naltrexone)… And remember, in the end, your goal should be to feel your best. If you are stressed out about having the perfect numbers and ignoring your emotions, perhaps it’s time to evaluate the contribution of your emotions on your immune system. Are your emotions putting you in a sympathetic mode- stress, fight or flight- or are they putting you in a parasympathetic mode of rest, digestion, and healing?

Thyroid Still Not WellSome of you may be thinking… Why do all of this, why go through all of this trouble… why not just give up? My answer is… because you are worth it! Please know that there are many things that you can do to make yourself better.

You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free by going to www.thyroidpharmacist.com/gift. You will also receive occasional updates about new research, resources, giveaways and helpful information.

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Disclaimer: The information contained herein is for informational purposes only and should not be construed as medical advice. Please consult your physician for any health problems and before making any medical or lifestyle changes.

Lifestyle changes can result in improved thyroid function and/or an increased absorption of thyroid hormone medications, leading to a lower required dose and possible symptoms of hyperthyroidism at a dose that was previously stable. Please discuss lifestyle changes with your physician and ensure that your thyroid function is monitored every 6-8 weeks while making lifestyle changes. Symptoms of overmedication include, but are not limited to: rapid or irregular heartbeat, nervousness, irritability or mood swings, muscle weakness or tremors, diarrhea, menstrual irregularities, hair loss, weight loss, insomnia, chest pain, and excessive sweating. Do not start, change, increase, decrease or discontinue your medications without consulting with your physician.

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Comments

  1. Thank you so much for continuing to research and to post again! I have found out something I think is rather important: Just recently I had antibody tests performed. I have been monitoring my TPO and TGB (thyroglobulin) antibodies. However, recently LabCorp switched to a methodology for analyzing TGB antibodies that, instead of giving an exact number, says “>2250” which is the upper limit of the new methodology. I don’t know if this is true elsewhere, but it is vital information for me, since within the past year my TGB count (with their previous methodology) was around 18,000. So it is not possible to measure any improvements unless I’m under 2250. Please let your readers know about this, and if there is any way to address this problem!
    Reply

      • Yes, I have found this with some labs in Australia. They simply tell you that your antibodies are >1500. Not helpful! Very frustrating.

        Reply

        • Allyson – It is frustrating indeed. Perhaps you can call around and find a lab that uses a more accurate scale? Others in Australia may have found better options, so I always recommend asking others in the same situation.

          A couple of years after my diagnosis, I found Hashimoto’s 411, a closed Facebook group run by Alice Berry McDonnell. This group is amazing! It is comprised of an army of highly motivated, smart, supportive women and men (now 45,000+ strong), and each of them sharing ideas of what worked for them, things they were planning to try, and offering support to one another. The comfort I received from knowing that there were others going through the same challenges as I, was enormous.

          https://www.facebook.com/groups/hashimotos411/

          Reply

  2. Hi Dr. Wentz, I was just prescribed 1 grain of Thyroid. Medication was given/sold to me directly at the doctor’s office along with some other hormones and supplements. When I got home, I realized there was no pamphlet or any sort of information about this medication. The name printed on the bottle is just “Thyroid”. I searched online for it but could not find it. I don’t know who makes it and where. I don’t know what fillers are used. Doc told me it was a natural thyroid so I just assumed he gave me Armour. The imprint on the pill is TCL 023. It is a 2 grain pill which I was told to split in half. I called the doctor’s office but the staff is not very knowledgeable. They just say this is was the doc prescribes and it’s natural. My next appointment is not for another month. Do you have any idea what this may be? Any help would be greatly appreciated. Best regards, Anna
    Reply

  5. I just want to thank you for all you do. Your book is like my bible, especially when I go to the dr. Your posts are my reminder that it will get better.
    Reply

  7. So , what is the next step , switching meds how do I test these herbs , would be interested in setting up an appt ( live in NYC ) can you recommend anyone,,, I feel as if my yrs on synthroid and changes to my diet and exercise have left me sluggish and depleted !! Thank you
    Reply

      • Thank you Dr. Wentz for the clinician links! I’ve been watching your videos and feel I have overwhelming evidence that my past and symptoms make sense. My DO seems very caring and has performed a few screening tests but either lacks the experience or understanding to assure she has a game plan to get to the root. My scalp is continually to show and I am afraid it may not be recovered. After following your videos, I thank God that my prayers for understanding have been answered. I just need to either share the information with my doctor or find someone else. God bless you for making your experience a “life boat” to others.

        Reply

        • Anita – thank you for your support, and you are most welcome! <3

          When I was first diagnosed with Hashimoto’s, I felt so alone. My doctor didn’t think it was a big deal, and none of my friends or co-workers had it. It wasn’t until I started to research online that I found others who were going through the same thing.

          A couple of years after my diagnosis, I found Hashimoto’s 411, a closed Facebook group run by Alice Berry McDonnell. This group is amazing! It is comprised of an army of highly motivated, smart, supportive women and men (now 45,000+ strong), and each of them sharing ideas of what worked for them, things they were planning to try, and offering support to one another. The comfort I received from knowing that there were others going through the same challenges as I, was enormous.

          https://www.facebook.com/groups/hashimotos411/

          Ask questions. Post your thoughts. Scan the files. It is an absolutely amazing resource. Best of all it’s kept private from spammers.

          Reply

    • Dawn- Thank you so much for your support! Thyroid tissue can regenerate, but the rate at which it does is not always predictable. Thus, some are able to stop the autoimmune attack on their thyroid and regain normal thyroid function. Others can reduce the dose of medications, and others will need to stay on the medications indefinitely. I’m currently working on some protocols to help with tissue regeneration.

      Reversing Hashimoto’s means different things to different people. For some, it means a reduction in symptoms and for others it means a reduction in your antibodies. I had both. Here a few articles that might be helpful for you 🙂

      REVERSING AUTOIMMUNITY? AND THE PERFECT STORM
      https://thyroidpharmacist.com/articles/reversing-autoimmunity-and-the-perfect-storm/

      HASHIMOTO’S SELF CARE, GETTING AND STAYING IN REMISSION
      https://thyroidpharmacist.com/articles/hashimotos-self-care

      Reply

  9. Great read thank you. A good kick up the butt to be completely gluten free. Just wondering about iodine in prenatal/natal supplements and Hashimotos. Is there a danger there?
    Reply

  11. I had Graves. Had my thyroid removed after almost 20 years of feeling bad. My numbers are normal and I do feel better in some ways, but not in other ways. I am on disability and gluten free is very expensive, and not an option for me. I have been on levothyroxine since my surgery almost 2 years ago. I don’t know what to do. I’m 5’7″ and have to fight to stay 100lbs. I cannot be in the heat and live in Texas. Fight depression. Osteoporosis. Ibs. Lactose intolerant. Brain fog…and more. I don’t know what to do. I’m existing, but not living. Help
    Reply

  12. Hi Cindy, I read your post . I just want to say I feel for you. I had Craves for so long time, but my doc. tell me itś time for RAI, after these I feeld great for about 2 years, then come gluten intolerance, lactose intolerance, joint pain, carpaltunnel, Fibroids, my stomach was upset, acid ruflex….. I did cut glutens, dairy, I am trying not to eat processed food, take suplements B complex and Floradix for iron and doing T-tapp exercise, after two weeks I am feeling a lot better. I have energy, my stomach feel calm and don have so much joint pain. I pray for you.
    Reply

  13. Cindy, Gluten free is not expensive but takes discipline! You just eliminate anything with wheat, barley or rye from your diet. Breads, pastas etc are easy ti remember but watch soups, sauces, gravies etc as wheat is used as a thickener in many foods. If you go gluten free it has to be 100% just reducing gluten Will not reduce the effects. (Gluten protein that causes bloating inflammation and swelling)
    Reply

  14. Thank you I’m still struggling with grofaves even tho I had RAI not once but twice.
    I eliminated gluten can’t say I feel better
    Insomnia and stomach issues IBM still present
    my last Labs came back OK TPO was on the high end of normal. The anxiety is major and I’m sleeping all the time I’m on synthroid 100mcg .
    I’m about to go purchase Root Cause on amazon. . Hopefully it will help
    Reply

  15. Hi I’m in Scotland and on 150 mg per day of levothyroxine I cycle ten miles four days a week the other 3 I see a personal trainer I have bring doing this exercise 3 years plus always before I done heavy exercise , I donnot lose a single pound and often fall straight into bed sleeping hours and hours . I’d take armour if I could get it as I’m told that’s the best . I don’t no how much to take , my doctors here point blank refuse to test my T3 plz help me . Thank you . Dawn x
    Reply

    • Dawn- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

  16. Hi Dawn ,
    I am from the Netherlands. Here is also not Armour.
    But I think you exercise to much for your condition, so they told to me .
    I am doing almost two weeks T-Tapp and I am feeling a lot better, I lost my sugar craves and lost 4kg. and 2inches af my waist.
    I am taking Levotyroxine 150mcg and B complex , Vit.D3 and Floradix.
    I hope your doc. can help you with that.
    I was check for vit B12, and Vit D too, they was low.
    Reply

  17. Hi Dawn ,
    I am from the Netherlands. Here is also not Armour.
    But I think you exercise to much for your condition, so they told to me .
    I am doing almost two weeks T-Tapp and I am feeling a lot better, I lost my sugar craves and lost 4kg. and 2inches af my waist.
    I am taking Levotyroxine 150mcg and B complex , Vit.D3 and Floradix.
    I hope your doc. can help you with that.
    I was check for vit B12, and Vit D too, they was low.
    Reply

  18. Hi Dawn ,
    I am from the Netherlands. Here is also not Armour.
    But I think you exercise to much for your condition, so they told to me .
    I am doing almost two weeks T-Tapp and I am feeling a lot better, I lost my sugar craves and lost 4kg. and 2inches af my waist.
    I am taking Levotyroxine 150mcg and B complex , Vit.D3 and Floradix.
    I hope your doc. can help you with that.
    I was check for vit B12, and Vit D too, they was low.
    Reply

  21. So , all this being said, who do I go to? I’ve gone to my GP but feel like I need more help. Can you recommend someone?
    Thnx
    Reply

    • Faye- Did you know that reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients (gluten sensitivity in particular has been implicated in causing a Selenium deficiency, a well known risk factor for Hashimoto’s), and can also produce intestinal permeability whenever they are eaten?

      Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.

      FOOD SENSITIVITIES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply

  26. Ive been told i had hypothyroid took meds but was unable to see that same doctor due to no insurance. i went to the health dept and had very thing tested sgain. they said all was good. hair falls out and very thin. i stay tired all the time. is there anythin i can take over the counter to help this. my weight is not bad but cant lose the bit i need to. help if there is heral meds i can take daily . due to no insursnce
    Reply

  27. Thank you Izabella. I have Graves’. About a year before getting pregnant with my third child, I contracted a bacteria that was being spread somehow in well water supplies, circa 1991. I was diagnosed with IBS. What I later realized was dairy was a big trigger. Even when my son was born he had a dairy intolerance as well. It’s too bad I didn’t realize at the same time I probably had the gluten intolerance as well as soy and some nightshades. I just didn’t react as badly, or so I thought. Over time, I was on so many meds for allergies, acid reflux,osteo arthritis…the list goes on…my thyroid has been under active since 2000. I now eat paleo for AI except I seem fine with eggs. I follow the dirty dozen for organics if I don’t I sneeze and have watery eyes. I’m still on a quest. My doctor after I’ve asked three times now keeps giving me synthroid instead of a natural hormone. It’s very frustrating. As soon as my new insurance kicks in I will be switching to a new doctor, especially since it took an elimination diet to find out my intolerances and he never even checked knowing I have Graves’. He has never, even though I am 51 now, done a bone density test either. I had my Ortho do that. It is just appalling that they do not keep themselves educated and open minded anymore. I have learned a lot from you! Thanks again!
    Reply

    • Dawn- Thank you so much for sharing! You may be interested in checking out the Root Cause Recipe Portal. It is full of autoimmune paleo and paleo recipes. You’re able to organize weekly shopping lists, meal planning, etc. Hope you check it out.

      http://rootcauserecipes.com/

      Reply

  28. Good morning, I am here again trying to get through this allergy season wanting to just end it all. 4 years ago I turned 45 and was not feeling right. I went to the dr. And came away with fibroids (she said were as big as an 8th month pregnancy) and hashimotos .
    So a pill and in 3 weeks my uterus taken out. Now I have bad hot flashes and everything on the hashimotos list from hair falling out to not sleeping you know the rest. I go to the dr and they have no answers. What can I do?
    Reply

  29. Ms Izabella. Tremendously appreciating your life mission. Following every word of yours. Would you be able to kindly recommend a good specialist in Seattle area sharing your approach and expertise on severe (TSH 18-) hypothyrodism please. Sincerely, Inna.
    Reply

  30. Im not versed on this disease tyroid I really need a lot of help my doctor don’t even say anything to me about it I’m in the dark with this issue so if you can please help me to know what questions to ask my doctor my muscle mass is deteriorating a I don’t know why that’s happening im always so tires I have lots of medical issues COPD diverticulitis asthma. Went offhormone pills when I was around 42 now I’m 77.and need your help feel like im dieing. ..
    Reply

    • Shirley- Hashimoto’s is a complicated condition with many layers that need to be unraveled. While conventional medicine only looks at each body system as a separate category and is only concerned with the thyroid’s ability to produce thyroid hormone, Hashimoto’s is more than just hypothyroidism. I wanted to pass along these articles that I wrote. I hope they help 🙂

      WHERE DO I START WITH HASHIMOTO’S
      https://thyroidpharmacist.com/articles/where-do-i-start-with-hashimotos/

      OVERCOMING HASHIMOTO’S
      https://thyroidpharmacist.com/articles/overcoming-hashimotos-in-the-new-year/

      Reply

      • Shirley- When I was first diagnosed with Hashimoto’s, I felt so alone. My doctor didn’t think it was a big deal, and none of my friends or co-workers had it. It wasn’t until I started to research online that I found others who were going through the same thing.

        A couple of years after my diagnosis, I found Hashimoto’s 411, a closed Facebook group run by Alice Berry McDonnell. This group is amazing! It is comprised of an army of highly motivated, smart, supportive women and men (now 45,000+ strong), and each of them sharing ideas of what worked for them, things they were planning to try, and offering support to one another. The comfort I received from knowing that there were others going through the same challenges as I, was enormous.

        https://www.facebook.com/groups/hashimotos411/

        Ask questions. Post your thoughts. Scan the files. It is an absolutely amazing resource. Best of all it’s kept private from spammers.

        Reply

  31. Shirley, I was so touched by your comment as I’m nearly 70 with a lifetime of health issues & history of auto immune diseases through my family. I know just how despondent one can become. So here are some thoughts which I hope help.
    1. Buy Izabella’s Book and also one called ‘Stop the Thyroid Madness’. They will make you realise you are not alone and give you an outline of what to put to your doctor.
    2. Don’t stay with or listen to any doctor who belittles you or is sarcastic toward your complaints. Find an Integrative Doctor who understands auto immunity and is willing to help you get the right testing. As you have muscle mass deterioration, I would also request a test for MTHFR gene issues. Diverticulitis indicates an irritation of the bowel which has probably been caused through a lifetime of eating grains.
    3. work at your diet. You CAN do it. Try gluten free to start with, and dairy free. Once you get to handle that, cut down on the sugar. Find out what triggers the diverticular attacks. You are possibly also celiac. Not much is written by or for people of our age who are now very damaged. I’m not so sure that really good health can be achieved in such cases, but there can be definite improvement. Also, tune in to the various health webinars that are on line these days. You need to know MORE than your doctors! ..and that’s not as hard as you might think!!
    My advice is not from a medical background, but from vast experience, both personally and with family. Lastly, perhaps for us, it is too late, but we owe it to our little ones to keep working at finding the answers. There is quite a growing movement out there, as you will realise. I’m connecting with you from Australia.
    oh, and don’t forget to keep up the B vitamins and antioxidants!
    I wish you well.
    Reply

  32. I am 43 have had right side of thyroid removed. Now they say I need the left side removed. I am a diabetic for 12 yrs. Had my gallbladder also removed. I have gerd. Very bad. I am always very tired. Could sleep 14 hours a day. Am on 88mcg of Levoxel. Dont know where to go from here! Going crazy because doctors dont help me. Oh I have had a heartattack 2 months ago too! Please help!!!
    Reply

  33. Just some food for thought. Hashimoto’s, thyroid problems, auto-immune problems ect… can all also be attributed to mercury poisoning. There is a reason many countries have banned silver amalgams. Tons of people have thyroid issues-tons of people of mercury laced amalgams. Many people will need to start there before ever getting their health on track.
    Reply

  35. I am 47 and I was diagnosed with graves disease 16 years ago been on levothyroxine for all this time and legs have been killing me muscle spasms and no doctor would help so I just recently figured out it was a side affect.don’t know what to do
    Reply

    • Terri- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
      Hashimoto’s Protocol
      https://smile.amazon.com/Hashimotos-Protocol-Reversing-Thyroid-Symptoms/dp/006257129X/ref=sr_1_1?ie=UTF8&qid=1482698453&sr=8-1&keywords=Hashimoto%27s+Protocol

      Reply

  36. Ask for Armour thyroid, also try a magnesium supplement also potassium being deficient in these will also cause muscle cramps. Liquid supplements with added chloride are absorbed best.
    Reply

  37. I am very interested in your report that I have read and have been on thyroid meds 17 years with a hypoactive thyroid I am taking 0.125 mcg. You had described many of the symptoms that I live with of which my doctor says it has nothing to do with my thyroid. I am also going through menopause and live with the symptoms. ( I am not taking anything)
    With one of the symptoms you have mentioned which was loosing weight. I would like to know if you have any suggestions in helping me with this.
    Reply

    • Teresa- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

  38. Thank you, Izabella, for making sense in a world gone mad! (Sense of humor required…) I’m a nurse, a psychotherapist, and a traveler in the Hashimoto jungle… So appreciate you bringing the compass and lantern to this journey.
    Reply

  39. I’ve been on levothyroxine or synthroid for 54 years. My thyroid has NEVER functioned. My problem is I am so weary; I now have a problem of very dry mouth and my voice has changed and is dry, very itchy skin. But the doctors here in Alberta, Canada only follow the TSH levels; refuse to give T3 and, as we’ve heard over and over, if you think you still have a problem when your TSH is fine, then you got a mental problem. We have no functional doctors here and I guess I just have to live feeling low and nobody cares.
    Reply

  40. I am 55 and have taken thyroid medicine for 40 years. Never really thought about all my problems until the last year b/c I just feel bad all the time. I had goiters on my thyroid gland 2times and the 2nd time had thyroid gland removed. My levels are up and down. I have all the symptoms for Sjorgrens syndrome but not officially diagnosed. I am taking 188mcg of synthesis. I have been following a low carb diet and still gain weight (30 lbs) in 2years. Just want to feel better.
    Reply

  41. I have been dealing with under active thyroid for 20 years. I had to keep bugging my doctor to do the tests each time I was in the office. Which was a lot with sinus infections related to allergies or asthma attacks leading to pneumonia. I think I was part of her bank roll toward her vacation home. After testing she finally sent me to a specialist who got my levels under control but still had the allergy and asthma issues until 3 years ago when I found a nutrition supplement that was made from the Moringa oleifera tree. The mix helped me get some of the nutrients I was missing in a form that my body could absorb. It is shade dried and the enzymes are alive. Every one needs to take charge of their own health and take research with them to doctor and if doctor won’t listen, it is time for a new doctor. I am now off my allergy medicine and have asthma medicine to use as needed. Thank you for sharing your information so I can continue on the journey to better health. I’m learning about fermenting foods to help heal my gut so I can have better absorption of nutrients that help feed my thyroid.
    Reply

  42. Dear Dr Wentz,
    Thank you for all the information you put together to help others like me. I was diagnosed with Hashimoto’s thyroiditis when I was 19. Given some meds and no other info. I am now 62 and have had breast cancer, osteoarthritis etc. I was recently diagnosed with hyperparathyroidism. Never knew I could try to help myself with diet changes etc. So I consider this the beginning of my journey to help myself. They want to give me IV meds for the osteoporosis. I want to hold off until I have given these AIP diets etc a chance to work. Am I being foolish? I feel I should take charge first and try to let my body heal with all I’m learning about root causes.
    Reply

  43. I have been on several medications & doses of synthroid for 28 years now. I have been pricked & poked every off stage & nearly bled to death during perimenopause. Still, my levels come up in the NORMAL range taking me on the yoyo battle between .125mcg & .150mcg daily. Allergic to generics & Synthroid is expensive on my health insurance. Seriously not feeling any different each dosage change but knowing the difference when I miss a day. I have been organic & GF for over 3 years now, which has helped me with joint pain & headaches. Honestly, I am lost in the brain fog & just plain exhausted all the time. I would LOVE a REAL answer to regulating my levels naturally.
    Reply

  44. Dr. Wentz,
    I have read your book, ‘Root Cause’ and listened to you during the thyroid summit because I was convinced I had a thyroid problem. I also relate to you since you had an EBV infection and slept through much of your 20’s. I also had an EBV infection since I was 19, one year after I had my spleen removed due to untreatable ITP. I am now 48. I have been sick in bed for two years after working endless hours due to clean up the Super Storm Sandy mess (I’m in NY) and being exposed to toxins. My EBV infection became active again and has led to chronic fatigue. I’ve been taking valcyclorair (3g/daily) for a year. Recently I was tested for carnitine which came back very low. I am supplementing with Levocarnitine and the fatigue and weakness is diminishing. So, since both carnitine and thyroid, T3 produce energy maybe that’s why I felt I may have a thyroid problem. My thyroid numbers T4 and T3 are low normal or just below, TSH varies between 1.5 – 3.5 and I have no antibodies ever. My reverse T3 is on the high side from what I calculate, but not too high. I am celiac and have been gluten free since 6/2011. I have decided to try LDN since I have had a history of immune problems and viral infections. Are there nutrients that become depleted from taking valcyclovair, levocarnitine(3g/day – last 3 months) and LDN? I take many supplements already but I do not know which ones are affected by the medicines I have mentioned. Any advice you provide would be greatly appreciated.
    Reply

  45. You can search tcl 023 , medicine identification and it will tell you about that pill. You should also be able to call your local pharmacy and give them that info and they will tell you. That’s what I do.
    Reply

  46. I was diagnosed 30 years a go whit hashimoto desiase now I fell tyre the all time I have you book they take me off levotiroxine they now put me back on 25 milligrams again I have depression insomnia brain fog ,Gi issues bloated the all year constipation I don’t now where the go no more?I live in Fl now before I leave in Germany they say everything it’s normal I have a goiter what I suppose to do?
    Reply

  48. Hi! I just wanted to add that I was diagnosed years ago with Hashimotto’s and have been on T-3 compounded specifically for me. I am now going down on the dosage since I have been avoiding wheat, gluten and soy completely from my diet. I have energy and feel almost 100% better but some days I still have foggy mind and can’t figure out what that is about.
    Reply

  49. Please help!!! I am 44 years old. Have suffered from 3 miscarriages. All 3 times I bled very heavily throughout. I was diagnosed with endometriosis the 2nd time and lost the baby in the 7th month. I am too scared to try fall pregnant now and doubt whether I am able to. I started losing my hair in my early 20’s and was told it was due to an iron deficiency. An On/Off vegetarian for ethical reasons but my body craves red meat especially when pregnant. My hair has an overall general thinning and has got to a point where I may have to have a fitted integrated hair piece to disguise the loss (it’s that bad). I battle to lose weight and my breasts have gone from a C cup to a DD/E cup. I’ve gone from a size 12 to 16 dress size. I have had my thyroid checked numerous times and the levels are always normal. I have had my hormones checked and need to see my doctor for the results. (She seems to think falling pregnant will sort everything out)??? I eat healthy and do regular detoxes. At the moment I am doing a parasite, liver and kidney detox. I have serious fatigue…brain fog…anxiety attacks…body aches…dry/itchy/burning/sensitive skin…sore aching eyes/eye sight deterioration/weepy and burning eyes…hair loss with tiny scalp scabs…weight gain…sore muscles…dry mouth…frequent urination…always thirsty…stomach aches…increased food intolerances and severe allergies. It feels as though I have aching kidneys/constant lower back pain. I am battling to work (earn a living) and function normally. Please can you help???
    Reply

  50. I want to take a moment to thank you. When I was told the same “you’ll just have to live with it” and “It happens to a percentage of every woman after pregnancy” by my doctor and “there is no cure” “natural remedies are dangerous” I was floored. I believe in the body’s natural healing capabilities and firmly believed even then that this doesn’t have to be permanent. A year and six months later? I’m still hopeful but not sure I’ll be able to stop the spiral and reverse the condition. Your site and book have given me renewed hope and fresh anger that my doctor either doesn’t know about your research – or worse, doesn’t care. I saw an immune specialist and he was clueless. Thank you.
    Reply

  51. (My english is not the best so i hope you can understand my question) Thanks for this wonderfull artical. I would love to know more about a diat or best nutrition for this condision.
    Reply

  53. I have Hyperthyroidism
    I had nodules on one side and half my thyroid removed. I also have Graves Disease. I am still having constant tummy issues,extreme tiredness etc.
    My doctor says it can’t be my thyroid but I suspect it is.
    I’m not sure what I can do.

    Reply

  54. I read your “Root Cause” book late last year and my first step was to eliminate gluten and dairy. Within weeks, all my patches of eczema (they looked like psoriasis to doctors) totally dissapeared. Even bumps on my upper arms. Amazing! My IBS symptoms have also gone. My antibodies are down to 115 as of Dec. 2016. Taking Selenium daily took away my constant anxiety. Life is so much better now after ~30 years of symptoms. I still have some symptoms and can’t lose weight but I hope to resolve them soon after trying more suggestions from your book and perhaps doing the 12-week protocol. Thank you a thousand times.

    Reply

    • Keryn – thank you for following this page and for your kind words. <3

      When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as "healthy" contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

  55. Newly diagnosed with Hashimotos over the summer. My antibodies were at 220 now they are at 6. I’ve been taking LDN on and off for six months. Even though my antibodies are better my symptoms are worse. I am exhausted but not where I can fall asleep just exhausted. I know tiredness is a symptom but this is not a relaxed tired it’s pure head exhaustion. Is that a symptom? I have an appt with a doctor that I got off of your list tomorrow. I

    Reply

  56. I am considering LDN and would like to know if you have to stay on that medication or is it only used till your thyroid normalizes,
    Thanks

    Reply

  57. I love reading your articles. Thank you for all your research. I’m 53. I was diagnosed with hyperthyroidism at the age of 14. I have been taking Synthroid ever since. I have constipation, hair loss, trouble losing weight and brain fog all my teenage and adult life. Could it be possible that I don’t have hashimoto? I don’t know how to feel any other way.

    Thank you,
    Mary

    Reply

    • Mary – thank you for following this page and for sharing.

      Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually, people with Graves have hyperthyroidism, and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own, and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.

      We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Hashimoto’s Protocol
      thyroidpharmacist.com/protocol

      Reply

  58. After I twisted my do to get more test done I have found pretty much I am dealing with an autoimmune disease. Most likely hashimotos or crohns.

    I am very worried and now need to find somebody who can evaluate my labs since my doctor was lost. He innitially just wanted to put me on meds and after debating with him he called out for more labs, yet not all that was suggested to me.

    Anyway, after thinking about things I think I have been dealing with this for the better part of my life… 25 years maybe.

    This article has been very helpful is tracing my history and progression.

    Now I have to go to sleep because I am exhausted as usual.

    Please let me know any suggestions as to who I might seek out to look at these labs? Unfortunately too going to all these doc visits, labs, supplements and diet is draining my pocketbook adding even more stress.

    Thanks for all you do.

    Reply

  59. I suffer from fatigue almost daily. I need to lie down for 45 minutes and concentrate to help me relax. Today I fell asleep and woke up after one hour and 30 minutes. Before I attend a dance our go out socially, I lie down for one hour and it works.

    Reply

  60. Thank you for helping me understand this. I have had mild hypothyroidism since I was pregnant with my first baby a couple years ago. I have been in Levothyroxine but just switched to Armour Thyroid. I had no idea I probably have Hashimotos disease. Should my next step to be to go to my doctor and have them test me for Hashimotos? If I do have Hashimotos then would you recommend me trying to be gluten free?

    Reply

  61. I read your book Optimizing Thyroid Medications and it is so helpful! The switch between medications and synthroid and all that is so damn difficult. But your book had the answers I needed! I can’t wait to get into my doctor and get these worked out.

    Reply

  62. Thank you for all the resources and work you’ve done to help so many. My dr ordered the tests and confirmed Hashimotos. I also began the protocol and got allergy tested. I’m significantly allergic to wheat, oat, soy, beef and mildly reactive to a longer list of other foods and environmental substances. I’ve noticed a big difference in most of my symptoms with my levothyroxine and diet change. However, one of the symptoms I have that upsets me most is facial flushing. When I get warm or even mildly excited or stressed my face and neck are so red. It is not only embarrassing, which makes it flush more because of my stress response, it changes the texture of my skin and I fear long term damage or disfiguring of my face. This has been going on for years. Is there any advice you have for determining root cause of this? Or supplement that can help with facial flushing? ( I actually have a biopsy scheduled for a thyroid nodule today. But my dr said most often they are benign. )

    Reply

    • Oh. Along with the facial flushing. My eyes are very red. My opthomologist said it is uveitis and have a drop of steroids which helps for a few days and the red returns. I can’t help but feel as though they are related

      Reply

    • Kristine – thank you for sharing your journey! I am so sorry to hear you are struggling with this. <3 Gut healing is a journey; you may need various interventions like removing reactive foods and infections, taking enzymes and probiotics, and balancing nutrients. It can seem daunting when you have a lot of restrictions and some people may have to take it a step further and incorporate a rotation diet, a low-histamine diet, or low-oxalate diet. You can find more information on these helpful protocols in my latest book Hashimoto’s Protocol. These changes are not permanent, so do not be discouraged! The Autoimmune Paleo diet is meant to be short-term; it solves the problem of leaky gut and is not just a band-aid. These variations in diet give you the power to improve how you feel and isolate your root cause(s). Using an elimination diet can help to show you if you are reacting to the foods you commonly eat. Remember, be kind to yourself and learn to listen to your body so that you can support and feed it properly! These articles should give you some further pointers:

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      SIBO
      https://thyroidpharmacist.com/articles/sibo-prevent-remission-hashimotos/

      Reply

  63. I have been on synthroid 100 mcg tablets a day for over 30 years. It works very well for me. Now, in my early 70s, I am very healthy, not on any other medications. I’m active, yoga, gardening, a good weight, only eat organic, and take supplements. I would like to take moringa organic leaves in the dried form. Is it safe to take with my synthroid?

    Reply

    • Caroline – thank you for reaching out and sharing your journey! I am happy to hear you are doing well! <3 I am not able to advise on whether this supplement or any other supplement would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you disuss this with your personal doctor or pharmacist.

      Reply

    • Sonya, thank you for reaching out. I am not able to advise on whether Moringa would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your personal doctor.

      Reply

  65. Hello! I have been following and emailing you for years. I’ve spent countless hours and dollars hacking away at my Hashimotos. I eat from farmers markets, have home cooked meals with my family every night, exercise (I actually ran my first marathon last year!), I sleep well, and am happy with my life. I consume very little gluten and if I do it’s my fermented sourdough, and I refrain from soy and other hard to digest processed foods. I have done the elimination diet, stool test, allergy test, and have generally been feeling great. Last week I got labs back that showed a low white blood cell count, and some strange red blood cell counts too. I know it’s just telling me (because I’ve dealt with this before) that I have an autoimmune disease. I guess I’m writing because I feel like I’m at the end of my rope. I’m frustrated at my body, I don’t understand. There aren’t more lifestyle changes I can make. I do have stress – so I started headspace this week. But I’m just at a loss. What more can I do. Should I keep spending 100’s of dollars and see a functional doc? I’ve been with a naturopath for years. Thank you so much. I really just want a consult with you! I’ve been on your waiting list for years. Thanks so much for all you do!!!

    Reply

    • Meera – thank you so much for reaching out and sharing your journey. I understand how frustrating this can be. <3 Hashimoto's is very much an individual condition. While there are root cause commonalities, each person will have their own or in some cases, more than one root cause. You will have to start with the simplest modifications, by removing triggers, followed by repairing the other broken systems to restore equilibrium, allowing the body to rebuild itself. You will need to dig down to why the immune system is imbalanced in the first place and this will tell you how you begin to finally feel better, reduce your thyroid antibodies and even take your condition into remission.

      You will have to create your own health timeline. Look back at your overall history as far back as you can remember. Look for infections, periods of severe stress, the use of medications (especially antibiotics, antacids, and oral contraceptives), accidents, and exposure to toxins. These are events that may have contributed to Hashimoto's. Once you do, you will know what types of changes you need to implement to make yourself feel better.

      If you need further support, please check out the list of lab tests inside the “Testing” chapter of my book, Hashimoto’s Root Cause. I also offer a 12-week program, Hashimoto's Self Management Program. Here are some resources I hope you find helpful as well.

      BUILDING YOUR OWN HEALTH TIMELINE
      https://thyroidpharmacist.com/sample-health-timeline/

      Hashimoto’s Self-Management Program
      https://thyroidpharmacist.com/enroll-in-hashimotos-self-management/

      Reply

    • Angie – thank you for following! ❤️ I am not able to advise on whether this supplement would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend discussing this with your practitioner.

      Reply

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