Each week, I get thousands of thoughtful questions from my readers. I’m so grateful for each and every one of them, but sometimes I feel like there is just not enough time in the day to respond to all of you personally, though I certainly do try. So, I thought I would share some of the most common questions I receive in the hope that someone else’s question might help others who are curious about the same thing.
Though our triggers may all be different, from a clinical perspective, there are universal things we can do to make ourselves feel better!
My mission is to spread awareness about lifestyle changes that can reduce or remove the autoimmune attack against the thyroid. I want to empower you to find answers to your root cause and reclaim your life once again. Your questions are an important part of my mission, so I’m pleased to be sharing them with all of you today!
In this article, I’ll address some of your most common questions:
- What is the difference between hypothyroidism, Graves’ disease and Hashimoto’s?
- How is Hashimoto’s diagnosed?
- Can hormonal changes lead to autoimmune disease?
- What diet is best for Hashimoto’s?
- How can I lose weight with a thyroid condition?
- And more…
What is the difference between Graves’ disease and Hashimoto’s?
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. About 95 percent of people with Hashimoto’s have elevated Thyroid Peroxidase (TPO) antibodies, while 80 percent will have elevated Thyroglobulin (TG) antibodies. (Read more about thyroid antibodies here.) Hashimoto’s results in hypothyroidism and is usually treated with thyroid hormone replacement medications.
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 thyroid hormone replacement medications as well.
Classical symptoms of Graves’ disease include weight loss, heart palpitations, anxiety, eye bulging, tremors, irritability, hormonal disturbances, fatigue, heat intolerance, diarrhea, and increased appetite. Patients will often also experience hair loss, muscle pain, irritability, and mood changes.
Hashimoto’s thyroiditis, on the other hand, is usually characterized by a slowed metabolism, weight gain, forgetfulness, feeling cold or cold intolerance, depression, fatigue, dry skin, constipation, loss of ambition, hair loss, muscle cramps, stiffness, joint pain, a loss of the outer third eyebrow, hormonal irregularities, infertility, and weakness.
Lifestyle interventions that address autoimmunity may be helpful in both conditions.
What is the difference between hypothyroidism and Hashimoto’s?
Hypothyroidism is associated with a lack of thyroid hormone that can occur as a result of a variety of different factors such as iodine deficiency, surgical removal of the thyroid, or damage to the thyroid.
Hashimoto’s is an autoimmune condition that results in the immune system damaging the thyroid, which leads to a lack of thyroid hormone production. Most cases of hypothyroidism in the United States and other countries that add iodine to their salt supply are caused by Hashimoto’s.
I am a proponent of not just using medications for hypothyroidism caused by Hashimoto’s, but also of rebalancing the immune system to prevent further attacks on the thyroid.
I’ve suffered from an underactive thyroid for many years—how do I know if it’s Hashimoto’s?
Ninety to 95 percent of cases of hypothyroidism in countries that add iodine to their salt supply, like the US, Canada, Europe, and Australia, are caused by Hashimoto’s. If you’ve been diagnosed with an underactive thyroid, which can be diagnosed when one has high TSH and/or low T4 and T3 levels, you may actually have an underlying autoimmune component causing your hypothyroidism. One way to diagnose Hashimoto’s is to test for Thyroid Peroxide (TPO) and TG (Thyroglobulin) antibodies. These antibodies are elevated for many years before a change in TSH is seen. Antibodies are elevated in most people with Hashimoto’s. You can have your physician order the antibody test, or you can order the test yourself through Ulta Labs.
I was tested for Hashimoto’s, and the antibody test came back negative, but my symptoms are consistent with Hashimoto’s. Does a negative antibody test mean that I don’t have Hashimoto’s, or do I need an ultrasound?
While about 95 percent of people with Hashimoto’s have elevated Thyroid Peroxidase antibodies and 80 percent will have elevated Thyroglobulin antibodies, about 5 to 10 percent of people with Hashimoto’s may not have any antibodies.
Research has shown that there is a variant of Hashimoto’s where the person doesn’t test positive for antibodies. This is known as seronegative Hashimoto’s, and is thought to be a less aggressive variant of the condition.
Additionally, some clinicians believe that some people with Hashimoto’s test negative for thyroid antibodies because their overall immune health is so weak, they do not produce enough antibodies. Now, I insist on a thyroid ultrasound to confirm a Hashimoto’s diagnosis. A thyroid ultrasound can be used to detect changes in the thyroid that are consistent with Hashimoto’s (such as a rubbery, shrunken, or enlarged thyroid; or a thyroid with abnormal growths). However, in some early stages of Hashimoto’s, changes may not yet be apparent on the ultrasound. In that case, I would work with an experienced practitioner to obtain a diagnosis based on symptoms.
If you do test positive for thyroid antibodies, it is possible to reduce or eliminate them through lifestyle interventions like eliminating infections and food sensitivities, addressing nutrient depletions, normalizing digestion, improving gut function, adrenal fatigue, and getting rid of toxins. By doing so, people have been able to reduce or completely eliminate their TPO antibodies.
You can test your TPO levels as often as monthly to look for antibody reduction as you go about finding your root causes and trying interventions. However, it will take a full three months to see the real impact following an intervention.
You can read more about thyroid antibodies in this article.
Help! I have just been diagnosed with Hashimoto’s. What do I do to get better?
There are several steps to take that will help you begin to get better once you’ve been diagnosed:
1. Test for thyroid antibodies. Hashimoto’s may be detected years before there is a change in TSH, by testing for thyroid antibodies. Early detection can increase the likelihood of improving symptoms and minimizing damage to the thyroid gland. The most common Hashimoto’s antibodies are thyroid peroxidase (TPO antibodies) and thyroglobulin (TG antibodies).
2. Consider the 5 R’s of thyroid medication use when consulting your doctor.
- Right Person – Are you the right candidate for thyroid medication?
- Right Medication – Which drug will be appropriate for you?
- Right Dose – What dose will put you in an optimal TSH range?
- Right Time – What time of day should you take your medication at?
- Right Way – Are you taking anything that could interact with your medication?
3. Allow time for your thyroid numbers to stabilize. After first starting a thyroid hormone medication, retest your thyroid function tests within 4-8 weeks, become familiar with the most important thyroid tests, and request a copy of your lab tests.
4. See an endocrinologist. It is important to get a thyroid ultrasound, which can give you a baseline of the condition of your thyroid and help determine if you have any nodules or tumors in your thyroid gland.
5. Know that the condition can be reversed. Lifestyle interventions and functional medicine, along with the proper medication, can lead to a reduction in symptoms and even a reversal of the condition for some people. Discovering one’s personal root causes and implementing effective interventions are key to recovering from Hashimoto’s.
6. Work with a functional medicine practitioner. Practitioners of functional medicine can help you implement lifestyle interventions and find hidden triggers that may be contributing to the development of your condition. I’ve put together a Recommended Thyroid Practitioners Guide to help you find these types of professionals!
7. Educate and empower yourself. Listen to your body. Advocate for yourself. The people with the best outcomes are educated and engaged patients. I developed the Thyroid Pharmacist website and wrote my books, Hashimoto’s: The Root Cause and Hashimoto’s Protocol, as a way for you to get a deeper understanding of what’s going on in Hashimoto’s, become empowered, and get to the root cause of your condition.
I have Graves’ disease. Will your recommended protocols help me if I’ve had radioactive iodine treatment to destroy my thyroid, or if I’ve had a thyroidectomy?
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. This can be caused by nutrient deficiencies, food sensitivities, toxins, a gut imbalance, poor stress response and/or a chronic infection.
Even when the thyroid is taken out surgically or treated with radioactive iodine, the autoimmunity still persists in most cases. People may develop additional autoimmune disorders including lupus, rheumatoid arthritis, and others. If you are not feeling well, have leaky gut, allergies, or infections, your immune system is not working properly. The gut determines your immune system. Therefore, I recommend working on balancing the immune system to prevent this from happening.
My book Hashimoto’s: The Root Cause focuses on restoring immune balance, as well as restoring optimal thyroid hormone levels though the use of individualized medications. (This is especially important if you have had your thyroid removed).
Can pregnancy be responsible for an immune imbalance?
Pregnancy can often be a trigger due to iron deficiency and an immune shift that occurs due to an increase in hormones. Oftentimes, lifestyle interventions, such as the ones found on my website and in my books, can help bring the immune system back into balance.
I wrote an article about my own pregnancy experience, and have also received a great deal of helpful advice from other moms with Hashimoto’s.
What are your thoughts on breast implants and autoimmunity?
Both the chemical toxicity in silicone implants and the biotoxicity often present in saline implants can trigger an autoimmune reaction in the body that can result in illness, including Hashimoto’s thyroiditis. Those that have a genetic susceptibility to autoimmune diseases will be at particular risk for developing symptoms after being exposed to the toxins present in breast implants.
If you have any type of breast implants in your body, have been diagnosed with Hashimoto’s, and are still digging for your root cause, there is a very real chance that your implants are to blame for your condition. I have written an article on breast implants as a trigger for Hashimoto’s, and the Breast Implant Illness website offers a list of symptoms associated with the condition, as well as resources to help heal.
What is the difference between the AIP and Paleo diet?
You may have heard of these diets, as they are often recommended as dietary interventions to reduce inflammation associated with autoimmune disease. The traditional Paleo diet eliminates grains and processed foods, and focuses on nutrient-dense foods like meats, vegetables, nuts, seeds, and eggs. In some cases, dairy may also be avoided. In my survey of people with Hashimoto’s, 81 percent reported that a Paleo diet made them feel much better, and some have even been able to eliminate thyroid antibodies by following this diet.
Unfortunately, not everyone gets better on the Paleo diet. In some cases, we need to dig deeper. Some people may have additional sensitivities that contribute to immune system dysfunction. That’s where the Autoimmune Paleo (AIP) diet comes into play. This diet goes beyond Paleo and removes additional foods such as nuts, seeds, and eggs. AIP is the starting point for many people—if you don’t remove the inflammatory foods, you can’t know if your other interventions are working or not.
I have found that diet is very much an individual intervention. What works for one person, may not work for another, as each individual may be different in their triggers and needs.
If you’re considering the Root Cause Autoimmune Paleo diet, I’ve developed a FREE, downloadable 2-Week Recipe Plan with many Root Cause Autoimmune Paleo diet recipes, meal plans, and customizable shopping lists to help you start.
Can I recover from Hashimoto’s on a vegan or vegetarian diet?
Recovering from adrenal fatigue and hypothyroidism when following a vegetarian diet is very challenging, as vegetarian diets are often carbohydrate heavy. Vegetarian sources of protein such as legumes (beans), dairy, grains, soy and some seeds may be incompatible with trying to heal a leaky gut, which is almost always present with Hashimoto’s. Pea protein is an alternative that may be easier to digest and is less likely to cause food sensitivities.
Eggs, some seeds, and nuts would be the preferred sources of protein for vegetarians. However, some people with Hashimoto’s may be intolerant to those as well, especially in the early stages of starting a healing diet. Being a vegan is even more challenging, as nuts and seeds would be the go-to source of protein, which are usually too difficult to digest for many at the beginning of their thyroid healing journeys.
While vegan and vegetarian diets have been reported to be extremely helpful with autoimmune and chronic conditions, I haven’t been able to find reports of people recovering from Hashimoto’s by following a vegan diet. Even devout vegans who are nutritionally conscious still struggle with low body temperatures, hypothyroidism and Hashimoto’s.
Additionally, many former vegans have reported improved symptoms of Hashimoto’s following a transition to a Paleo diet. Based on this, I believe that animal proteins must play an important role in building back the health of people with Hashimoto’s.
That said, while meats and fats are important for healing, eating them exclusively will produce an acidic environment in the body, hindering healing. Therefore, the diet should be balanced with plenty of nutrient-rich vegetables.
Additionally, vegan and raw vegan diets can be extremely helpful for cleansing and detoxifying, especially for those with persistent protein digestion issues. A vegan diet could be followed for a few days to a few weeks and may help the body detoxify. B12 and iron or ferritin supplements often need to be utilized at this time to prevent deficiency. Please see my article on vegan diets and Hashimoto’s for more info.
I read somewhere that sensitivity to caffeine, green tea, grapes, and red wine indicates Th2 dominance. Sensitivity to mushroom and licorice indicates Th1 dominance. Is there some sort of chart to determine this?
If you’ve read my book Hashimoto’s: The Root Cause, you may be familiar with the Th1/Th2 Dominance Chart in it, which explains that certain foods and herbs may stimulate different branches of the immune system (Th1 or Th2). The theory is that if one branch is more dominant, the immune system may become imbalanced, so if you are either Th1 or Th2 dominant, you should avoid certain immune-stimulating foods that further the imbalance. Many people believe that those with Hashimoto’s have Th1 dominance.
While an increased number of Th1 cells has been associated with Hashimoto’s, and an increased number of Th2 cells has been associated with Graves’ disease and asthma, this is not the case for all people affected. Some people with Hashimoto’s may have an overabundance of Th2 cells or may not have a clear predominating pathway. Thus, I haven’t found Th1/Th2 dominance to be clinically relevant to Hashimoto’s.
In my experience, most causes of an immune system imbalance are linked to an infection. Avoiding Th1 or Th2 modulating foods will not be the most effective approach. Figuring out your triggers and reducing them is more important, as is increasing the number of T regulatory cells in your body. You can help your immune system by getting adequate amounts of vitamin C, taking a high quality probiotic, and making sure you’re getting sunshine and plenty of rest. Again, I’m not a big believer in trying to balance your immune system by tweaking your intake of Th1 or Th2 stimulating substances. However, if you have found that any of these substances make you feel unwell, I do not recommend that you continue consuming them.
What can I do if I’m gaining weight, or can’t lose weight?
Here are a few things to think about if you are having trouble losing excess weight:
- What were your recent TSH, Free T3, and Free T4 levels? 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 μIU/mL.
- What type of medication are you on? Some people report more weight loss with a T4/T3 combination versus T4 alone, as they may not convert T4 properly.
- What type of diet are you eating? 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” may 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 also to feel better. Some diets that have been helpful for those with Hashimoto’s include the Body Ecology diet, Paleo diet, 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 individuality. Check out my article on weight loss for more tips.
Can you explain what systemic enzymes do and how they help food sensitivities?
I often recommend systemic enzymes to those with Hashimoto’s. (You can read more about that in my article on using enzymes for Hashimoto’s.) They work in our blood to reduce Circulating Immune Complexes, or CICs (antibody complexes that are coupled with immune cells, which build up in our bodies when we have autoimmunity). When you take systemic enzymes on an empty stomach, there is a breakdown of those CICs. When you take them with food, they help with the digestive process. For the purpose of reducing the CICs and antibodies, I do recommend taking them on an empty stomach, one hour before you eat, or two hours after you eat.
I’ve tried EVERYTHING but can’t get better!
I often talk about how people with Hashimoto’s have a combination of food sensitivities, nutrient deficiencies, adrenal issues, gut issues, as well as an impaired ability to get rid of toxins. Any one of those things can prevent a person from getting better.
Hashimoto’s is very much an individual condition. While there are root cause commonalities, each person will have their own root cause, or in some cases, they’ll have several.
You will have to start with implementing the simplest modifications and removing triggers, followed by repairing the other broken systems, to restore equilibrium and allow the body to rebuild itself. You will 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 put 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.
This approach is detailed in full in my book, Hashimoto’s: The Root Cause, while my book Hashimoto’s Protocol contains a more step by step plan that streamlines the most effective interventions. It includes checklists to help you to identify your possible triggers.
Do you recommend testing for Reverse T3?
There is a test that checks Reverse T3 levels. This test is sometimes used to identify cases of poor T4 to T3 conversion, or thyroid symptoms that are due to adrenal stress, instead of thyroid malfunction or autoimmunity. The reverse T3 (rT3) test measures how much of the free, active T3 is able to bind to thyroid receptors. RT3 is produced in stressful situations and binds to thyroid receptors but turns them off instead of activating them.
When assessing your rT3 results, it is important to watch for trends of your levels going up. This usually indicates your body is reacting to a stressful situation. Your body produces rT3 to give it a break and to prevent you from becoming hyperthyroid. This is an evolutionary adaptation to slow your metabolism in times of famine. High rT3 due to stress has a snowball effect on hypothyroid symptoms. The adaptation by the body producing rT3 is not useful in our high-demand society when we must work and take care of our children, spouse, parents, etc. In cases where a lot of reverse T3 is produced, adding a thyroid medication that contains T3 ensures that the right hormone is getting to the right receptors.
When I work with clients, I don’t routinely order the rT3 test, as I normally make recommendations that make the testing irrelevant. In essence, the test results don’t change what I recommend. I always recommend focusing on adrenal health and recommend a T3 containing medication.
If I get into remission, but later I get stressed out or have kids, can the immune process start up again?
Hashimoto’s usually involves a whole system breakdown. Multiple parts need to be affected to have Hashimoto’s, or autoimmunity, manifest. If you are able to repair the damage done to your organs, one minor thing might not be an issue. I do know quite a few women personally who were able to get Hashimoto’s into remission and were able to stay in remission throughout multiple pregnancies. I would be concerned if you start experiencing a few different stressors happening at once, such as if you are pregnant, stressed, have prolonged sleep deprivation, family illness, catch a gut bug, start eating reactive foods, etc. That’s when you might start seeing the whole system begin unraveling again.
Is there another question you have been waiting to ask me?
I LOVE hearing from my readers! What are your top Hashimoto’s-related questions? Post them here and I’ll do my best to include them in future Q&A’s! I also invite you to become a part of our Facebook community where you can share your personal experiences and ask me questions about Hashimoto’s and thyroid health. I do my best to respond to all of your questions.
In the meantime, please consider picking up a copy of Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back and Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause.
PS. You can sign up for my weekly newsletter. I’ll send you updates on my latest research and answer my readers’ questions there!
Note: Originally published in November 2015, this article has been revised and updated for accuracy and thoroughness.
Hi. I dont understand where I stand. I gain weight very easily, hair r becoming thinner n thinner n they are also falling constantly n rapidly. I feel tired easily. Drained out in the morning after a good night sleep also. Feel lethargic always. Depressed at all times.
Doctors in Pakistan don’t tell us things clearly. I was told that I have 3 warm nodules of the size 2.8 on my right side which is also very visible to the naked eye dye to the bulge. And that I have another 2 or 3 nodules on the left. Now even my left side bulge is becoming visible. My TSH is .7 n my TLC came out to be 17.1
I have been suffering from sinusitis infection for more than a month n no medication seemed to have any effect initially but now it’s getting better.
Doctors say I should have a surgery done. But they don’t say why this problem has been caused. What’s the root cause. What exactly is wrong. How can I reverse my condition. What am I suffering from? Hypothyroidism or hashimotos?
Please help me n guide me. I’m too confused
Farheen – thank you for following this page. Please, understand that due to liability issues, I am unable to answer specific medical questions.
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
Hashimoto and breast enlargement has a connection? I read an article (in Portuguese) but I couldn’t find any medical article in English on the internet yet.
Do you have any case(s) in which that occurred?
I primarily blame menopause for that, since I went for 36C to 40D in four years (always on diet – vegetarian, gluten free and dairy free) and gained 60 pounds as well. Active a much as I can (yoga 3x week). Nothing helps to lose weight and have my shape and brain back. reading your book gave me some hope.
Rose – thank you for following this page. In general, most people with autoimmunity need to find their food sensitivities, heal from infections, and eat organic; however, bioindividuality is important, not everyone will respond to the same interventions. The foods that heal one person, may not be the same for another. It might seem like a lot to give up, but feeling your symptoms fade away can make it feel like it’s all worthwhile. And don’t forget it’s not forever! You will be reintroducing these foods once your gut heals.
WHAT’S CAUSING YOUR LEAKY GUT
https://thyroidpharmacist.com/articles/whats-causing-your-leaky
ELIMINATION DIET FOR HASHIMOTO’S
https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos
I have followed all your protocols and I feel awesome. The weird thing is that my TPO’s still range between 220-375 and my TSH is 7.5. I honestly am symptom free at the moment on a dose of 3/4 grain Nature-Throid. My ND is out of answers and just wants to raise my dose, but it doesn’t feel right. Is it possible that my TSH number is okay for my body?
Kyra – Thank you for following this page and for sharing. I am so happy you are feeling so well! <3 For questions pertaining to the protocols please contact my team at info@thyroidpharmacist.com and they will be happy to help you.
Hi,
I’ve had a complete thyroidectomy, and I’m trying to apply the HSM protocol as best I can since August 2017 and feel so much better than before. However, I have been on natural thyroid extract for a year now but I am finding it rather difficult to get my TSH levels up – it’s at 0.02. FT3 and FT4 levels have stabilized.
What are your thoughts on this?
Mary – Thank you for following this page. Please, understand that due to liability issues, I am unable to answer specific medical questions, but I highly recommend that you work with a functional medicine clinician. It’s an entire medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms. Here are some links which might help:
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://www.thyroidpharmacistconsulting.com/clinician-database.html
MY RECENT CHALLENGES AND FINDING DR. RIGHT
https://thyroidpharmacist.com/articles/my-challenges-and-finding-dr-right/
My daughter has been fighting for years fatigue, her right eye buldging and weight gain, as well as her hair falls out. She has been tested for everything and it all comes back normal. She was just tested again for Hyperthyroidism and it came back negative. She has migraines as well. They have scheduled her for an MRI of her head. My question is should they run a thyroid antibodies test on her? She thinks that she has a thyroid issue, but everything they test for comes back normal.
HELP!
Michelle – thank you for following this page and my research. Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
Top 10 Thyroid Tests and how to Interpret them.
https://thyroidpharmacist.com/articles/top-6-thyroid-tests
I’ve had a very noticeable enlarged thyroid ever since I can remember (like 30 years) Complete strangers used to notice it, yet my GP (whom i’ve been seeing since I was 5) has never looked into the cause as my levels have always been ‘normal’ I have almost every symptom of Hashimoto’s (except for thin hair, I have zero problem there). My diet is very healthy, but I have struggled with weight loss despite eating veg and meat 99% of the time.
Just recently I started to see a naturopath, and she is the one who checked the antibodies and T3 and TPO is 10x normal and T3 is <3. I know its crazy to say, but i'm glad theres something wrong with me,,,,,,i've felt everything from very, very, poor to 'normal' for my whole life.
I plan to follow your page for some guidance and I'd like to get your root cause book soon!
Cheers!
Heather – thank you so much for sharing your journey with me. I am so sorry you had to go through that for all those years. I am happy to hear you have found a practitioner and are taking charge of your health! Please keep me posted on your progress. <3
Hello,
I was wondering what you think of Acoustic Cardiography as a way of determining deficiencies and also the Carroll Method for food sensitivities or if it would be more accurate to do blood or stool tests.
Thank you,
Catherine
Catherine – thank you for reaching out. Unfortunately I don’t have any information to share with you about acoustic cardiography at this time but, I will add this to my list of future article possibilities. The gold standard or the most accurate test for uncovering reactive foods and individual food sensitivities is actually the elimination diet. In contrast to other diets that simply exclude common problematic foods, an elimination diet is done to determine what particular food intolerances the individual may have. An elimination period of at least 2-3 months is a good starting place, but you may want to continue if you feel that you still have more healing to do. Then you can try a new food every 4 days and monitor yourself for reactions. Going through an elimination diet will help you figure out your own individual food triggers and your specific response to each trigger food. Here is an article I hope you find interesting!
https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos
Thank you
Hi, despite following most of the protocols & a healthy lifestyle, my main concern still remains recurring acne and breakouts. Could you ple throw light on it, what could be the possible causes? Ple suggest a regular course of action for the cure.
Thank you!
Pooja – thank you for reaching out. I am sorry to hear you are struggling with this. Our skin is a window to our internal health. It is the body’s largest elimination organ, and also a canvas where toxicities, nutrient deficiencies, food sensitivities and hormonal imbalances can show up. Women with Hashimoto’s and autoimmune conditions are more likely to have dry, dull skin, rashes, hives, pre-menstrual acne and facial swelling, especially if their thyroid levels are not optimized and they are not absorbing vitamins and nutrients correctly. Here are some articles you might find helpful. <3
THE THYROID AND SKIN
https://thyroidpharmacist.com/articles/the-thyroid-and-skin
ZINC DEFICIENCY
https://thyroidpharmacist.com/articles/hashimotos-and-zinc-deficiency/
I was diagnosed with Hashimoto’s in 2005 and have been on medication since. My numbers are always perfect but my symptoms have never gone away. I have pretty much every symptom in the book you could have with the disease with no relief. I have tried various recommended diets to fix the disorder. In addition, I had an enlarged goiter that was actually choking me, so I had a complete thyroidectomy in 2017 where they discovered that I had thyroid cancer. I was hoping for some relief after the surgery but my numbers are still perfect and my symptoms are still present.
Sara – thank you for reaching out and sharing your journey. I am sorry to hear you are struggling. 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. Here are the links to my books:
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Dear Isabela, thank you! I got diagnosed 3 months ago and it was just a coinidence – i have no symptoms yet.
Firstly I got depressed after reading all the awful stuff on the internet and you are just a source of light in this black hole. You make me believe that maybe mh life is not over and it will not only be getting worse and worse. Thank you for sharing your knowledge with us!
Aga – you are very welcome! I understand how overwhelming it can all be. Going gluten-free is always the first step that I recommend. Through my research, I’ve found that a good percentage feel better off gluten. About 20% will actually go into remission by doing so. Some researchers have found that three to six months on a gluten-free diet can eliminate organ-specific antibodies.
10 MOST HELPFUL DIY INTERVENTIONS FOR HASHIMOTO’S
https://thyroidpharmacist.com/articles/10-most-helpful-diy-interventions-for-hashimotosaccording-to-my-clients
TOP 9 TAKEAWAYS FROM 2232 PEOPLE WITH HASHIMOTO’S
https://thyroidpharmacist.com/articles/top-9-takeaways-from-2232-people-with-hashimotos/
I was diagnosed with Hashimoto’s in 2010 – after I started taking the hormone Levothyroxine, I started to feel much better and was able to lose weight and have more energy. That didn’t seem to last very long and later I started Cytomel in addition to the Levothyroxine. My test numbers are GREAT yet I still feel somewhat lousy most days. In August of 2016 I was diagnosed with Parkinson’s disease. I read somewhere that people with Hasimoto’s are at a greater risk of developing Parkinson’s. I asked my endocrinologist but was told she never heard of it. Do you know anything about this?
Sandy – thank you for reaching out and sharing your journey. I am so sorry to hear about this. <3 Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it's important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones. Here is a research article which might help further:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
I have had a thyroid problem since 1992 when I went into heart failure as they didn’t recognize what was wrong with me. I had iodine treatment and have been on Thyroxine ever since. I suffer with palpitations and irregular heartbeat and certain foods seem to trigger it. I am now taking a magnesium supplement to try and stabilise it. My doctor does not agree it is food related and put me on a beta blocker which I am not really happy about. I know it is related to my thyroid but in your opinion could they be food related
Sandra – thank you for reaching out. I am so sorry you are struggling with this. <3 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. Here are the links to my books:
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
I am one of those few “vegans” with Hashimotos. It works for me, as of now at least. So for any of you interested in a vegan diet here’s my story( for anyone else my most important point is that everyone(especially if you have an autoimmune disease), regardless of the specific diet should be eating abundant amounts of greens, legumes(beans), other vegetables, fruits(berries)) :
I’ve been a vegetarian since I was about 12, 13. And even before that I rarely ate dairy because it made me sick, and I didn’t really like eggs or meat. I was diagnosed with Hashimotos at 18. Following the advice of my doctor and nutritionist I changed my diet to include a regular intake of meat, dairy and eggs, few grains and fruit, no soy. This made me in short sicker. I got really bad digestive issues, symptoms i never had before, and i was getting infection after infection. I was told that basically Hashimotos was just naturally progressing and everything was “normal”. Then i stumbled across this book and website and stopped eating dairy and gluten, which definitely helped a lot with the digestive issues. I then reintroduced gluten through whole grains and soy and found I actually felt better. The same was not true for dairy though. To make a long story short I experimented a lot with my diet( I tried Paleo, low carb, aid..), i eliminated and reintroduced certain foods many times and after a couple years I basically got back to square one and found that a plant based diet works best for me. Whenever i eat meat or eggs I find I have a lot harder time digesting it. I’m a lot less energetic, I get sluggish. I honestly usually fall asleep right after the meal. The same doesnt happen when i eat plant based. Maybe that’s because I was never much of a meat eater and my body just can’t digest it as well. Anyway now I’m basically vegan, occasionally eating fish( like once a month or less). What i did find is that not every vegan diet works. High carb( especially simple carbs from a lot of sugar and processed foods) didn’t work for me. Low fat as well. For optimal energy I eat a moderate amount of fat and carbs and a good amount of protein(mostly from beans and soy). Beans and oats I found are key to a healthy vegan diet. I more or less follow the daily dozen dr Gregger program with few variations. For example I make sure to eat a good amount of nuts and seeds. So the results: I personally don’t believe you can reverse Hashimotos but i am in some sort of remission at the moment. My hormone levels are stable, my symptoms are few and far between and dont really affect my quality of life. For reference only a year ago I was sleeping 12-14h a night, a 20min walk was too much for me, I couldn’t work or exercise, headaches, digestive issues, weight gain all the symptoms, you name it, I had it. Now I sleep 8 hours a night, exercise regularly, work and I’m not on hormone replacement therapy etc. I’m not saying the vegan diet cured me, it was just a part of the puzzle. I’m sure it won’t work for most people, as it is difficult to maintain( in a healthy way), especially if you have gluten or soy sensitivities( which I don’t, or at least I think so). Most people don’t have trouble digesting meats, so it would be unnecessary anyway imo. But I would definitely recommend everyone start including a lot more fruits and vegetables(especially beans), as well as nuts and seeds, and oats. I think that’s a vital dietary change that helps with supplying essential nutrients, that people with autoimmune diseases often lack. Usually it is only highlighted what food to avoid and not which ones to eat more of. The foods to eat more of specifically are:legumes, beans, greens, cruciferous vegetables, berries, nuts and seeds and should be eaten every day imo. They have all been proven time and time again to be very beneficial in healing. They are full of essential nutrients and minerals. All plants also have anti inflamatory effects, while meats and dairy have the opposite. I believe that inflammation is one of the triggers for Hashimotos and even if it isnt lowering the inflammation certainly helps with symptoms and overall wellbeing. Sorry for the long post, I hope at least someone reads it
Maria – thank you for sharing your journey. I am happy to hear you are doing well and I appreciate you sharing what works for you! Recovering from adrenal fatigue and hypothyroidism when following a vegetarian diet is very challenging, as vegetarian diets are often carbohydrate heavy. Vegetarian sources of protein such as legumes (beans), dairy, grains, soy and some seeds may be incompatible with trying to heal a leaky gut, which is almost always present with Hashimoto’s. Pea protein is an alternative that may be easier to digest and is less likely to cause food sensitivities.
I have created my own line of supplements, which also includes an Organic Pea Protein. Here’s the link: https://rootcology.com/collections/supplements/products/copy-of-purepaleo-protein-vanilla
Eggs, some seeds, and nuts would be the preferred sources of protein for vegetarians. However, some people with Hashimoto’s may be intolerant to those as well, especially in the early stages of starting a healing diet. Being a vegan is even more challenging, and nuts and seeds would be the go-to source of protein, which are usually too difficult to digest for many in the beginning of their thyroid healing journeys.
While vegan and vegetarian diets have been reported to be extremely helpful with autoimmune and chronic conditions, I have not been able to find reports of people recovering from Hashimoto’s by following a vegan diet. Even devout vegans who are nutritionally conscious still struggle with low body temperatures, hypothyroidism and Hashimoto’s.
Many former vegans have reported improved symptoms of Hashimoto’s following transitioning to a Paleo diet. Based on this, I believe that animal proteins must play an important role in building back the health of people with Hashimoto’s. That said, while meats and fats are important for healing, eating them exclusively will produce an acidic environment in the body, hindering healing, and thus the diet should be balanced with plenty of nutrient rich vegetables (suggested ratio may be 20% meat/80% veggie).
Additionally, vegan and raw vegan diets can be extremely helpful for cleansing and detoxifying, especially for those with persistent protein digestion issues. A vegan diet can be followed for a few days to a few weeks and may help the body detoxify. B12 and iron or ferritin supplements should be utilized at this time to prevent deficiency. Please know that I’m a big proponent of bio-individuality which honors the distinct nutritional needs of every human being. I’m not saying everybody needs to eat meat, but I am saying to listen to your body if it needs meat. Here are a few articles which might help:
AUTOIMMUNE PALEO DIET
https://thyroidpharmacist.com/articles/autoimmune-paleo-diet
ELIMINATION DIET FOR HASHIMOTO’S
https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos
Hello,
I consider myself so lucky to have been working with a functional doctor. He did all the food testing and what I have to eliminate is simply overwhelming (gluten, dairy, soy, rice, stabilizers and thickeners, etc etc) for about 6 months. He says I’m starting to lose oral tolerance. I just can’t do this diet right now. Is there another path or alternative I can try that would give me at least some success? I’m stuck between (not being able to do) this restrictive protocol and doing nothing. We’ve already addressed infections, and I’ve done most of your modules, too. Thanks for all you do!
Elle – thank you for reaching out. I am happy to hear you found a practitioner. <3 The gold standard or the most accurate test for uncovering reactive foods and individual food sensitivities is actually the elimination diet. In contrast to other diets that simply exclude common problematic foods, an elimination diet is done to determine what particular food intolerances the individual may have. An elimination period of at least 2-3 months is a good starting place, but you may want to continue if you feel that you still have more healing to do. Then you can try a new food every 4 days and monitor yourself for reactions. Going through an elimination diet will help you figure out your own individual food triggers and your specific response to each trigger food. Here is an article I hope you find interesting.
https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos
Thank you, that’s something I can tackle. However, I was under the impression that sometimes you can have a food sensitivity with no symptoms (I’ve read this particularly with gluten). I think this is why I haven’t done an elimination diet for fear of reintroducing a food that is “bad” for me clinically but with no noticeable effects (bloating, skin irritation etc). Thoughts?
Elle – you are very welcome! <3 I understand how hard this is. Until you eliminate the foods from your diet, it will be nearly impossible to correlate your symptoms with a food. This is because food sensitivities can take up to 4 days to manifest. You will only notice that you are reacting to the food if you withdraw it for a time-period of at least 3-4 days. I always recommend going gluten-free. In my study of 2232 people with Hashimoto’s, 88% of them felt better gluten-free, while only 3.5% of them had celiac disease. <3 Here are some resources you might find helpful.
https://thyroidpharmacist.com/articles/gluten-root-cause-thyroid-condition/
ELIMINATION DIET
https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos
FOOD SENSITIVITIES AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos
Hi! Are there any contraindications to dental implants being placed in individuals with one or more diagnosed autoimmune diseases? Thank you for your time and expert information.
Lacy – thank you for reaching out. <3 I don't have an article specifically about implants but, you might find this article interesting. https://thyroidpharmacist.com/articles/carries-dental-procedure-triggered-her-hashimotos/
Dr. Izabella,
This is such a great, insightful article. I was diagnosed as hypothyroid long before my doctors thought to check my antibodies. Only when Hashimoto’s was confirmed did I receive suggestions that started to help, such as dietary (gluten free and dairy free diet – I’ve only implemented the gluten free diet (I love milk and cheese so much!)) and supplement changes.
What are your thoughts on adding fish oil and vitamin D daily?
Lyndsy – thank you for reaching out and sharing your journey. I believe that most nutrients should come from the diet. This is why I always list food sources in the book and on the blog, for most of the nutrients, vitamins, minerals. and probiotics that are depleted in Hashimoto’s. However, some may require or prefer supplements. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm. Here are some article links which might help:
WHICH SUPPLEMENTS ACTUALLY HELP HASHIMOTO’S
https://thyroidpharmacist.com/articles/which-supplements-actually-help-hashimotos/
I was diagnosed with Grave’s about 20 years ago. Eventually, I underwent radioactive iodine and have been on levothyroxine since – about 18-19 years ago. Over the years I have had the typical thyroid symptoms of fatigue, depression, emotional outbursts, hair falling out, etc. Over the last year my symptoms have become worse. Fast forward to today and my symptoms are in full force. I was diagnosed with Celiac Disease last month and have removed gluten from my diet. I am still having issues and am wondering if part of my issues are thyroid related. My question is, can have hashimoto’s with my thyroid history? I had a GP tell me that it’s not possible for me to have hashi’s if I had radioactive iodine, but I’ve had another doc tell me that it is possible and ran blood work – that came back negative. I’m so confused. All of my doctor’s either tell me it’s in my head, or push me off on another doctor. Please help! I just want to know if it’s still possible for me to have hashi’s. I need to know if it’s somehting that I should pursue.
Thank you!
Deanna – thank you so much for reaching out. I am so sorry to hear you are struggling with all of this. <3 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. Here are the links to my books:
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
What about extreme flares, where TSH is over 20? About every year/every other year I flare pretty badly, and so far I’ve not found my root causes enough to prevent it. I have had Hashimoto’s for the majority of my life, over 15 years. My flares start with extreme fatigue and afternoon low-grade fever, maybe 99.5-100.0, then get worse. T3/T4 are always within range, but like I said, my TSH gets extremely high, up to 30 once. What is the reason, medically, for this and how can I feel better when I flare, since this seems to have a separate root cause?
Emily – thank you for reaching out. I am so sorry you are struggling with this. I‘ve found that an inability to manage stress is often at the core of the condition. Most people can trace back the development of Hashimoto’s and autoimmune conditions to a particularly stressful time period. Stress is inherent, and it’s how we handle our stress that matters. I recommend self-management stress-reducing habits like mindfulness, yoga, and meditation.
Meditation has specifically been found to be helpful in building resilience to stress. If you have a history of childhood trauma like I do, your stress response could be severely impacted, leading you to overreact and get into a ‘fight or flight’ state at the easiest provocations. I recommend therapies like the self-guided tapping, self-help books, neurofeedback or therapist guided EMDR to reset your stress response.
ARE YOUR ADRENALS SABOTAGING YOUR HEALTH?
https://thyroidpharmacist.com/articles/are-your-adrenals-sabotaging-your-health
ADRENAL FATIGUE SALIVA TEST
The test I recommend is https://www.thyroidpharmacistconsulting.com/collections/labs/products/hpa-stress-profile-201a
I have Hashimoto’s and been on Levothyroxine for almost 15 years now. If I reverse my autoimmunity, does that mean that I could stop taking my thyroid meditation? Will Hashimoto’s then be healed?
Eva – thank you for reaching out. 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. 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:
IS IT POSSIBLE TO RECOVER THYROID FUNCTION IN HASHIMOTO’S
https://thyroidpharmacist.com/articles/is-it-possible-to-recover-thyroid-function-in-hashimotos
REVERSING AUTOIMMUNITY? AND THE PERFECT STORM
https://thyroidpharmacist.com/articles/reversing-autoimmunity-and-the-perfect-storm/
Are there any essential oils that stimulate Th1 and Th2?
Susuan – thank you so much for following! ❤️ I don’t currently have information to share on essential oils that stimulate Th1 and TH2. but, I will add it to my list of possible future articles to research.
Dear Izabella, your books, website and newsletters have helped me immensely to understand my thyroid issues and the things that will help, so thank you so much. My situation puzzles all the practitioners I have seen, including endocrinologists and functional health practitioners. I have had constantly heightened TSH for six years (it sits around 5 when im not on thyroxine for pregnancy) and I have some hypothyroid symptoms when not medicated, but my antibodies are always negative and a recent ultrasound indicated my thyroid looked normal. My mum has overt Hashimoto’s. I am currently on T4 medication to prepare for pregnancy but my TSH is sitting in the 3s even when my T4 is at the very upper end of the range and T3 is sufficient (in the high 4’s when im on meds). I recently got my RT3 tested for the first time and it is high at 570, but my doctors don’t want me to start T3 medication before/for pregnancy. I know you can’t provide medical advice, but any thoughts you may have on my situation and what I should try next will be greatly appreciated!
Warmly
Simone
Simone – thank you for reaching out.❤️ I’m so glad to hear you are finding my research helpful. In general, when reverse T3 is elevated, that’s a sign of underlying adrenal issues at play. Getting on adrenal supporting supplements can sometimes help with that. Rootcology Adrenal Support contains a great combination of adrenal adaptogens that I like, and that can make a big difference. Here is an article you might find helpful:
https://thyroidpharmacist.com/articles/are-your-adrenals-sabotaging-your-health/