Question: Do you have a doctor you recommend in my area?
I believe that everyone needs to find a practitioner that will let him/her be a part of the healthcare team. I recommend working with a functional medicine doctor- functional medicine doctors approach the body as a whole, and not just the thyroid hormones. (Here is a blog post I wrote about the functional medicine approach to the thyroid)
We are currently building a list of doctors. You can view the list here.
Question: Do you provide consultations?
I do provide a limited number of consultations. However, most of the information required to get your health back is covered in my book, Hashimoto’s: The Root Cause. At the present time I am not accepting new clients, but for future updates on consultations and educational events, please sign up for my waiting list.
Question: Which supplements do you recommend?
As a pharmacist, I’m picky about my supplements. Some may have allergenic fillers; some are poorly absorbed, and others don’t have what they say the do. When looking for a supplement, be sure to pick one that is gluten and dairy free.
There are many excellent supplement companies; my favorite brand is the professional only line Pure Encapsulations. They have very tight quality control standards, so you know that the product you are getting in free of fillers that may delay absorption and free of gluten, dairy, and in most cases soy. I have set up an E-store with them and maintain a list of recommended supplements. You can learn more about this brand of supplements on the Pure Encapsulations website.
Question: You have a large number of supplements on your website. Do you recommend that everyone with Hashimoto’s should start taking all of them?
By all means no! Not everyone will need every single supplement! In fact, I believe that most nutrients should come from the diet, this is why I always list food sources for most of the nutrients, vitamins, minerals, and probiotics that are depleted in Hashimoto’s in the book and on the blog. However, some may require/prefer supplements and the supplements on the website are a resource for those that do. I recommend getting tested for deficiencies to determine your need for a supplement as instructed on 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.
Question: Why do you recommend a selenium supplement instead of Brazil Nuts?
Selenium appears to be a supplement with a narrow therapeutic index. A minimum dose of 200 mcg was required to reduce TPO antibodies in clinical trials (100mcg did not have an effect), and selenium can be toxic at doses >800mcg. Daily selenium dose for adults should be between 200mcg and 400mcg daily.
Selenium content of Brazil nuts is determined on the soil where the nuts are grown and can vary 10 fold depending on the origin of the nuts. Brazil nuts can have between 50-500 mcg of selenium per ounce of nuts, so unless a lab has analyzed the micronutrients, you don’t know if you are getting enough or too much selenium.
Additionally, may people with Hashimoto’s may have multiple protein sensitivities and may be sensitive to Brazil nuts.
Question: Can’t I just take a good multivitamin with iron, selenium, zinc, copper?
As a pharmacist, my concern with multivitamins is that they throw everything together in one batch, so the absorption of the nutrients can’t be guaranteed. Some vitamins are best absorbed on an empty stomach; others require food, an acidic environment, etc. Additionally, different minerals can inhibit each other’s absorption.
Question: I have been gluten free for 1 year and have not seen a difference in TPO’s. What should I do?
You are likely sensitive to other proteins. Consider an elimination diet. Additionally, you may have a gut infection. Please take a look at my book for more information.
Question: I read your story about dairy. I don’t suffer from such symptoms you mentioned. Is it possible that although being symptomless I may be allergic to casein too? Do you think we should have it tested?
Not everyone has the same symptoms after consuming dairy. The best way to find out is trying an elimination diet where you take dairy out for 2-3 weeks, and then trying it again and watching for reaction for 2-3 days. Dairy protein reaction is pretty common in Hashimoto’s, but it’s possible not everyone will react. I would recommend first an elimination diet, followed by IgA and IgG testing.
Question: You mentioned gut repair is the most important thing in Hashimoto’s, why is that when Hashimoto’s is a thyroid condition?
Hashimoto’s is an autoimmune condition that happens to affect the thyroid. The gut is where the immune system lives; so restoring gut function is key for overcoming autoimmunity.
Question: What’s your opinion about seaweed? Is it a good idea to take chlorella or spirulina to cleanse your body if you suffer from Hashi? Because I have read that you mustn’t consume any iodine if you have Hashimoto’s because it can, even more, damage your thyroid.
Spirulina and chlorella have immune stimulating properties and can worsen autoimmunity and even cause new onset autoimmunity. Additionally, the iodine is problematic and can cause further thyroid damage. So I am not comfortable recommending them. Instead, for cleansing, you can do green juicing (avoiding cruciferous vegetables)…
Question: Do you recommend spirulina/seaweed/kelp for cleansing?
I do not recommend any of the above for those with active Hashimoto’s due to their high content of Iodine and their propensity to modulate the immune system. Spirulina, in particular, has been associated with new onset autoimmune conditions. Additionally, excess iodine can perpetuate/worsen the autoimmune attack in Hashimoto’s and lead to additional thyroid cell destruction.
Question: Do you recommend eating kelp, dulse, spirulina, chlorella or seaweed?
I do not recommend any of these for Hashimoto’s due to potential immune modulating properties and because of the high iodine content, which can be problematic and can cause further thyroid damage.
Question: Is Anatabloc helpful for Hashimoto’s? If I start taking Anatabloc, do I have to take it for life long? Or how long?
Anatabloc blocks inflammation and is effective at reducing thyroid antibodies and damage to the thyroid. However, Anatabloc blocks the inflammation only as long as someone is taking it. At the same time of taking Anatabloc, I recommend working to reduce inflammation; otherwise, it will just come back up when you stop taking the Anatabloc. As inflammation and gut issues can take a long time to change, taking Anatabloc may be helpful in preventing further damage while you work to fix the inflammation!
Question: What is the difference between Graves’ 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. 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 thyroid replacement hormones.
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 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 replacement hormones as well.
Lifestyle interventions that address autoimmunity may be helpful in both conditions.
Question: I have had a thyroidectomy due to thyroid cancer or Graves’ disease. I take thyroid medications but still have many symptoms. Any suggestions?
Most thyroid conditions (Hashimoto’s, Graves’, thyroid cancer) result from an immune system that 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 immune imbalance still persists in most cases, and a person may go on to develop additional health conditions and still feel unwell.
The Hashimoto’s Root Cause book focuses on restoring immune balance, as well as restoring optimal thyroid hormone levels through the use of individualized medications (this is especially important if you have had your thyroid removed). Many people post thyroid thyroidectomy have been helped by the book, and we hope that the book will help you as well.
Question: 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?
5-10% of those with Hashimoto’s may not have antibodies. An ultrasound of the thyroid will help you see if your thyroid has changes consistent with Hashimoto’s. There is also a test called reverse T3, that tells you if you are having thyroid symptoms because of other reasons not related to Hashimoto’s, such as stress or adrenals. I don’t have a blog about it yet, but more info is in my book.
Question: I’ve suffered from an underactive thyroid for about 7 years, how do I know if it’s Hashimoto’s?
90-95% of cases of hypothyroidism in countries that add iodine to salt are caused by Hashimoto’s (US, Europe, Canada, Australia). The best tests are the thyroid peroxidase (TPO) antibodies and the TG (thyroglobulin) antibodies. These antibodies are elevated for many years before a change in TSH is seen. Antibodies are elevated in 90% of people with Hashimoto’s. You can have your physician order the antibodies, or you can order the test yourself through www.mylabsforlife.com. Please check out my blog about Hashimoto’s and TPO antibodies.
Question: How often should the antibodies be retested?
You can test the TPO as often as monthly to see a trend in antibody reduction. However, it will take a full three months to see the real impact following an intervention, such as a gluten-free diet.
Question: Help! I have just been diagnosed with Hashimoto’s! What do I do to get better?
The three keys to feeling well are:
- Diagnosis (which you have)
- Appropriate medication – this is where the TSH, FT4, FT3, would come into play. You want to make sure those are under control and not causing further inflammation and damage.
- Addressing the immune imbalance.
Question: Is it possible to eliminate TPO antibodies?
Yes, through lifestyle interventions like eliminating infections, intolerances, nutrient depletions, normalizing digestion, improving gut function, adrenal fatigue, and getting rid toxins people have been able to reduce or eliminate TPO antibodies.
Question: Which protein should one eat?
Everyone is different, but protein from animal meat is usually less reactive than dairy, gluten, soy, nuts, or eggs. Some people have found that they tolerate pea protein, hemp protein, and chia protein well. I recommend ALCAT testing to figure out your unique sensitivities.
Question: How do I lose weight with Hashimoto’s/hypothyroidism?
Here are a couple of things to think about:
- 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.
- What type of medication are you on? Some report more weight loss with T4/T3 combination vs. T4 alone. Some do 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” 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 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 individuality.
Question: Help! My doctor won’t test my thyroid! What can I do?
I recommend that you find a doctor that will let you be a part of your healthcare team! You can also order your labs tests via direct to patient lab testing via UltaLabs.
Question: Help, I have a high deductible and lab testing costs a lot of money! Are there cheaper tests I can get?
Yes! I have direct to patient testing options set up through Ulta Labs, for discounted bloodwork.
Question: Help! I don’t have insurance and can’t afford to get thyroid tests done! What do you suggest?
Please go here for a list of free and sliding scale clinics in your area.
You can also take charge of your own health my looking at your diet. I believe humans do not thrive on processed and packaged foods. The best foods for us are meat and vegetables. If it wasn’t food 200 years ago, I don’t eat it, and this has made a world of difference in my life.
Question: Is there anything I can do dietary wise to feel better?
Absolutely! Eliminating food sensitivities can eliminate many symptoms and can sometimes result in remission. Limiting processed foods, sugar, sweets, grains, caffeine and carbohydrates makes a huge difference. Balancing blood sugar can also help, by eating good fats and protein with every meal. You can try the autoimmune paleo diet that focuses on foods like non-starchy vegetables, low glycemic index fruits, and meats.
Question: What is the difference between hypothyroidism and Hashimoto’s?
Hypothyroidism is 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. Most cases of hypothyroidism in the US and other countries that add iodine to their salt supply are caused by Hashimoto’s, an autoimmune condition. 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 attack on the thyroid.
Question: I have Graves’ disease, I had radioactive Iodine treatment to destroy my thyroid, or have had a thyroidectomy. Will your book help me?
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. People may develop additional autoimmune disorders including lupus, RA, and others. Thus I recommend working on balancing the immune system to prevent this from happening.
If you are not feeling well, have leaky gut, allergies, infections; your immune system is not working properly. The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my book focuses on balancing the immune system.
Question: Should I take my thyroid medication on the morning of my thyroid blood work?
It depends! If you are taking a T4 only medication, you can go ahead and take your medication in the morning before the test. T4 medication has a long half-life, and your levels will be stable regardless of when you take it. If you take a T3 medication on the other hand, or a combination of T3/T4, T3 has a shorter half-life so your blood work may not be reflected accurately. It will appear that you have more thyroid hormone on board than you do. Thus it may be helpful to delay your morning dose of a T3/T4 medication until after you do the test to see (try to schedule the test in the morning).
Question: If I have had a thyroidectomy or radioactive iodine, will the information on this site and in your book still apply to me?
Yes. Even when the thyroid is removed, an immune system imbalance may still remain. My mission is to spread awareness about lifestyle changes that can reduce or remove the autoimmunity, such as eliminating food intolerances, eliminating infections and balancing the gut environment.
Question: What is your opinion on vaccines for people with Hashimoto’s?
Unfortunately, I cannot give any straightforward guidance about vaccinations. As with any drug, we each have to make our own informed decision about this and ultimately, it’s up to you, your family, and a doctor you trust to assess personal risk and benefits, and decide if a vaccine is the right thing for you and/or your family member.
Question: What could cause a suppressed TSH (0.01) and low normal Free T4 (0.9) & Free T3 (2.9)? I’m feeling good and am taking Levothyroxine and Cytomel.
Sometimes this can be due to pituitary suppression. It can be due to adrenal support, steroids, glandulars taken at bedtime. This effect may also be seen with T3 medications in some people.
Question: Would you recommend taking Saccharomyces Boulardii in addition to a super dose of probiotics?
I often do recommend combining them. One is a beneficial yeast, one a beneficial bacteria. They work in synergy.
Question: Have you heard of the theory that pregnancy can be the start of immune imbalance? My allergies certainly began when my child was a few years old with a reaction to metals.
Pregnancy can often be a trigger – iron deficiency and immune shift, as well as potentially the babies’ thyroid cells that circulate in the body, may be a trigger. You can bring it back to balance with lifestyle interventions.
Question: Is betaine with pepsin okay if I have a beet sensitivity?
While some companies source their betaine from beets, the Rootcology brand of Betaine is synthetic and is not sourced from beets. Patients sensitive to beets will be able to tolerate the Betaine HCl Pepsin. Synthetically derived ingredients can be made to be bio-identical (acting in the body identically to naturally derived compounds). This limits the potential for allergy/sensitivity in the highly sensitive customer population.
Question: I would like to know your thoughts about breast implants & autoimmune?
Breast implants can be a potential trigger. I have seen this happen in a few cases. You would want to think about if your problems started, or worsened after the procedure. They can potentially be seen as a foreign invader and promote autoimmunity. They can also be the host of infections. We risk rejecting any foreign material that is implanted into our bodies. Silicone implants seem to be more commonly implicated.
Here are some articles on the subject.
Question: Which supplements do you recommend for Hashimoto’s?
I recommend high-quality supplements that are tested for purity and content and that are free of gluten, dairy, soy, pesticides, and toxins.
I like the Pure Encapsulations brand and has the most experience using it. Other high-quality brands she knows and uses are:
- Designs for Health
- NOW Foods
- Vital Nutrients
- Douglas Labs
- Allergy Research Group
Click here to view my recommended supplements for Hashimoto’s:
Click here to view Protocol specific supplements for Hashimoto’s.
Ordering outside of the United States? Click here.
Unfortunately, she is not able to comment and recommend specific products for people who are not clients. If you’d like to work with her, you can sign up for her consultation waiting list.