Dr. Izabella Wentz, PharmD

Thyroid Pharmacist

Most Common Nutrient Deficiencies in Hashimoto's

The 7 Most Common Nutrient Deficiencies in Hashimoto’s

Medically reviewed and written by Izabella Wentz, PharmD, FASCP on January 9, 2020

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After my own Hashimoto’s diagnosis in 2009, I wanted to figure out what I could do to live the healthiest life possible. I wanted to know if there was anything I could do to address my symptoms and reverse my condition, or at least stop its progression. So, I set out on a journey to find the root cause of my disease.

I have learned that Hashimoto’s symptoms result from a combination of thyroid hormone imbalances, nutrient deficiencies, food sensitivities, an impaired ability to handle stress, an impaired ability to eliminate toxins, intestinal permeability, and one or more chronic infections.

Some of these root causes can be somewhat elusive and may take a lot of digging to uncover, but addressing nutrient depletions is usually pretty straight forward. Best of all, when we address nutrient depletions, we can feel better quickly, even when other underlying root causes are still present!

In this article, you’ll learn more about:

  • The top nutrient deficiencies in Hashimoto’s
  • Which nutrients require lab testing before supplementation, and which ones typically don’t
  • Recommended supplements to address nutrient deficiencies
  • How to understand your lab tests

Why Do We Have Nutrient Depletions?

While macronutrients — carbs, fats and proteins — are the three basic components of our diet, micronutrients are the vitamins and minerals that are vital to our wellbeing. Most people with Hashimoto’s have numerous micronutrient deficiencies. In fact, I would argue that due to our current farming practices and the Standard American Diet (S.A.D.), micronutrient depletions are a factor for most people!

Nutrient deficiencies can occur as a result of eating nutrient-poor foods, following a calorie-restricted diet, having inflammation from infections or food sensitivities, taking certain medications, or having an imbalance of gut bacteria.

Even people who are eating organic, nutrient-dense diets are at risk for micronutrient deficiencies, as factors like low stomach acid, fat malabsorption, and a deficiency in digestive enzymes will result in many of us not being able to properly break down the nutrients from the foods we eat.

A lack of sufficient thyroid hormones can also lead to nutrient deficiencies, as it makes nutrient extraction from food more difficult and less efficient.

These nutrient deficiencies contribute to the development of Hashimoto’s, as well as many of its symptoms. Restoring one’s nutrient levels through nutrient-dense foods, supplementation, and optimizing digestion are some of the fastest ways to feel better with Hashimoto’s and begin to restore the body!

The 7 Most Common Nutrient Deficiencies in Hashimoto’s

The most common nutrient deficiencies in Hashimoto’s are selenium, vitamin D, B12, ferritin (the iron storage protein), thiamine, zinc, and magnesium (in no particular order).

The Spectracell Micronutrient Test Panel can be used to test for thiamine and magnesium deficiencies; however, selenium and zinc levels are not reliably found via blood tests. All four of these supplements can be safely taken within recommended doses, without testing. Most people with Hashimoto’s have deficiencies in these nutrients, and I’ve seen very limited adverse reactions with supplementation. I’ve written separate articles for each supplement that summarize all of the related research, so you can dig deeper into each one — but I’ll give a brief overview of each of them, below!

The 4 Thyroid Supplements Safe and Helpful for Most

Thiamine

Thiamine, (also known as B1), is a vitamin that is responsible for converting carbohydrates into energy. It also helps with the digestion of proteins and fats. Thiamine is necessary for the proper release of hydrochloric acid in the stomach, which is required for proper protein digestion — essential for healing from Hashimoto’s. It has been found to often be deficient in people with Hashimoto’s and Crohn’s disease.

I wrote an article about thiamine a couple of years ago, and I still get hugs from readers at conferences, as well as messages from people who have turned their life around with using thiamine. I recently received a letter from a reader who started on disability due to her thyroid fatigue and, with the use of thiamine, was able to return back to work!

Thiamine helped me resolve my fatigue and the low blood pressure I battled for as long as I could remember. (It was sometimes as low as 80/50 mmHg!) My blood pressure has always tested normal after I started this supplement a few years ago.

Research has shown that a dose of 600 mg per day can turn fatigue around in 3 to 5 days, and 36 percent of my surveyed readers said B1 supplementation made them feel better.

Clues that you may have a thiamine deficiency include: having Hashimoto’s or another autoimmune condition, irritable bowel syndrome (IBS), fatigue, low blood pressure, low stomach acid, brain fog, or adrenal and blood sugar issues. You may also feel worse after drinking alcohol or after taking L-glutamine.

Recommended Supplement: Benfomax from Pure Encapsulations

Dose: 600 mg per day*

*Please note: All dosage recommendations in this article are intended for adults. Please consult with your pediatrician before giving supplements to children.

Expected Benefits: more energy, better brain function, stabilized blood pressure, and improved blood sugar tolerance

When to Expect to See Benefits: usually 3-5 days

How Long to Take: 3 months-2 years

Special considerations: If you have an adverse reaction to thiamine (which is rare), I recommend detoxifying the liver with a liver support protocol. Sensitivities to B vitamins are a symptom of “liver congestion,” a condition that can lead to multiple chemical sensitivities and numerous symptoms.

See my full thiamine article for more information on how this nutrient could benefit you.

Selenium

I used to have panic attacks… but they stopped after I started taking selenium (and balancing my blood sugar). I’ve seen this time and time again, and it makes me so happy to see improvements with this one inexpensive nutrient!

Selenium deficiency has been recognized as an environmental trigger for Hashimoto’s, and most people with Hashimoto’s are at risk for this deficiency, which can manifest as increased anxiety, fatigue, and depression. Other populations at high risk include those with IBS, celiac disease, and people who consume grain-free diets.

Numerous studies support using selenium in Hashimoto’s, Graves’, and pregnancy. In fact, selenium can help prevent postpartum Hashimoto’s.

A dose of 200 mcg per day has been found to reduce TPO antibodies by about 50 percent within 3 months! Additionally, 62 percent of my readers have reported increased energy levels with the same dose.

Recommended Supplement: Selenium Methionine from Pure Encapsulations

Dose: 200-400 mcg per day

Expected benefits: less anxiety, better T4 to T3 conversion, lower thyroid antibodies, more energy, less hair loss, fewer palpitations

When to expect to see benefits: usually 3-5 days for symptoms to start improving; 3 full months to see a reduction in thyroid antibodies

How long to take: 3 months-2 years

Special considerations: Selenium Methionine by Pure Encapsulations contains sulfur, which may cause an adverse reaction in those with a CBS mutation and are sulfur-sensitive. Selenium can also cause adverse reactions if you have an iodine deficiency. While iodine can be a trigger for, and can exacerbate Hashimoto’s, some people may be deficient in it and may benefit from a low dose iodine supplement. Up to 250 mcg of iodine has been well tolerated in people with Hashimoto’s, and most multi and prenatal vitamins will contain anywhere from 150-250 mcg. (Read more about this in my article on iodine and Hashimoto’s.)

For more information on possible selenium supplement interactions, please check out my selenium article.

Additionally, it is important to note that some foods and herbal supplements, such as those taken for lactation support, may be sources of selenium. These include Brazil nuts, burdock root, alfalfa, fenugreek, fennel seed, catnip, chamomile, garlic, cayenne, nettle, oat-straw, yarrow, peppermint, sarsaparilla, lemongrass, ginseng, hawthorn berry, rose hips and raspberry-leaf. Please consult with your practitioner to determine the most appropriate dosage for you, to avoid selenium toxicity.

You can find more information about selenium here.

Magnesium

Magnesium has often been called the “miracle nutrient,” and I couldn’t agree more! Magnesium is necessary for more than 300 biochemical reactions in the body: it supports the immune system, maintains normal nerve and muscle function, regulates the heartbeat, strengthens bones, keeps blood glucose levels steady, and plays a role in the production of energy.

Magnesium deficiency can cause migraines, headaches, insomnia, menstrual cramps, anxiety, joint pain, and a whole host of other symptoms (including an intolerance to loud noises), while supplementation can resolve them.

I have witnessed the miracle of magnesium for myself, personally, in the realm of menstrual cramps. I used to get cramps that were so horrific, I often had to miss school and work on the first day of my menses. I remember a time during my pharmacy internship where I had to physically lay down in the back of the pharmacy because my menstrual cramps were unbearable. With enough magnesium onboard, my menstrual cramps are thankfully a thing of the past!

Additionally, studies show that long-term use can help with normalizing the appearance of the thyroid gland on ultrasound tests, and magnesium may also help for thyroid and breast nodules.

Recommended Supplement: Magnesium Citrate Powder by Rootcology or Magnesium (glycinate) by Pure Encapsulations. Choose citrate if you tend to be constipated; glycinate if your stools tend to be on the looser side. (Please note that Rootcology supplements only ship to the U.S. at this time. International readers may consider Magnesium (citrate powder) by Pure Encapsulations.)

Dose: 100-400 mg daily, at bedtime (Note: Do not exceed 400 mg per day.)

Expected Benefits: reduced anxiety, reduced palpitations, more energy, improvements to the appearance of the thyroid during ultrasound tests (when used long-term), reduced menstrual cramps, better sleep, relief from constipation, migraines, cramps and pain

When to Expect to See Benefits: This really depends on the symptom(s) you may currently be experiencing. You may see benefits with anxiety, insomnia, and even migraines/headaches, within the first week. With menstrual cramps, they will reduce by 80-90 percent within the first month, and will lessen with continued use. With regard to normalizing thyroid appearances on ultrasound tests, this may take a few years of use.

How Long to Take: 3 months-lifetime

Special Considerations: Make sure to space your magnesium by at least 4 hours from thyroid medications, iron supplements, and calcium supplements, as magnesium can block their absorption. I prefer taking magnesium at bedtime because it promotes restful sleep.

Magnesium citrate can cause loose stools, which may be a good or a bad side effect, depending on which direction you tend to swing. Consider magnesium glycinate if you tend to experience diarrhea, or magnesium citrate if you tend to be more constipated. Keep in mind that, for some people, the glycinate version can worsen anxiety symptoms. If you are prone to anxiety, the citrate version would be a better choice.

For more information about the importance of magnesium, please see my full article.

Zinc

Zinc is involved as a catalyst in many different pathways in the body. It’s also very important for gut health, immune function, tissue healing, the conversion of T4 to T3, and the production of TSH. It can help tighten the intestinal junctions of those with intestinal permeability as well.

Symptoms of zinc deficiency include poor wound healing, impaired taste and smell, and thin, brittle, peeling, or white-spotted nails. Those low in zinc may also have a weakened immune system and suffer from allergies, frequent colds or respiratory infections. Low alkaline phosphatase (ALP) on a blood test can provide an indirect indication of zinc deficiency (the optimal range for alkaline phosphatase is 70-90 IU/L).

Depleted zinc levels can result in diarrhea, hair loss, impotence, loss of appetite, skin issues (acne, rashes, canker sores, foot fungus), depression, impaired vision, low sperm count, ADHD, unexplained weight loss, a lack of alertness, and open sores on the skin.

Over 52 percent of my surveyed readers reported feeling better after starting zinc supplementation.

Who is at Risk for Deficiency: Since zinc is needed to form TSH, those who are constantly producing TSH are more likely to develop deficiencies in zinc. If you have celiac disease or any other malabsorption syndrome that has caused intestinal damage, you may have an impaired ability to absorb zinc.

Recommended Supplement: Zinc 30 by Pure Encapsulations

Dose: 30 mg per day (larger doses require a doctor’s supervision)

Special Considerations: To ensure proper absorption, zinc supplements should be taken with food. I’ve also found that taking 500 mg of evening primrose oil, twice per day, improves the absorption of zinc. (Thanks to Trudy Scott for the tip!) Doses should be no more than 30 mg per day without your doctor’s supervision. This is because doses above 40 mg may cause a depletion in copper levels. Zinc supplementation can also deplete one’s iron levels.

To learn more about zinc and Hashimoto’s, please see my full article.

The 3 Most Important Thyroid Nutrient Tests

Vitamin D, B12, and ferritin are very common nutrient deficiencies in those with Hashimoto’s, but unlike the ones mentioned above, require testing before starting supplementation. Most doctors will order these tests for you if you ask, and the tests should be covered by your insurance. If you do not have a doctor who is willing to order the tests for you, or if you have a high-deductible insurance plan, I’ve provided links for self-ordering options for each of the tests below, as well as a guideline for your optimal reference range, and my preferred supplement choice.

Please note: The lab interpretation guide I provide below is based on functional labs. In some cases, doctors may consider your numbers “normal” when you are indeed deficient. Make sure to be an educated and empowered patient, and always ask for a copy of your own labs so that you don’t miss out on the life-changing effects of these important nutrients!

Vitamin D

Vitamin D deficiency is more commonly found in people with Hashimoto’s — 68 percent of my readers with Hashimoto’s reported also being diagnosed with vitamin D deficiency — and deficiency has been correlated with the presence of antithyroid antibodies. Research done in Turkey found that 92 percent of Hashimoto’s patients were deficient in vitamin D, and another 2013 study found that low vitamin D levels were associated with higher thyroid antibodies and worse disease prognosis.

According to my 2015 survey, 74 percent of my readers felt better after taking a vitamin D supplement! This isn’t surprising, as vitamin D supplements can improve our mood and help us reduce thyroid antibody levels.

Both Thyroid Peroxidase and Thyroglobulin antibodies were reduced in a Polish trial of 18 women who were supplementing with vitamin D, to reach a target level of 60 ng/mL. I’ve personally found that most of my clients who are in remission from Hashimoto’s keep their levels of vitamin D between 60-80 ng/mL.

Who is at Risk for Deficiency: Anyone who is not a full-time lifeguard in Southern California may be at risk. 🙂 Vitamin D deficiency is rampant, especially in most North Americans, Europeans, and Australians — and it affects a large number of people with Hashimoto’s. A low-fat diet or fat malabsorption increases the risk.

Recommended Test: I recommend testing for vitamin D deficiency with the Vitamin D 25-Hydroxyvitamin or 25(OH)D test, then retesting within 3 months once you start supplementing, to make sure that you are getting enough, but not too much. In contrast to most vitamins which are water-soluble and are excreted by the body in excess, vitamin D is fat-soluble and can build up.

Understanding Your Results: Vitamin D levels should be between 60 and 80 ng/mL for optimal thyroid receptor and immune system function.

Recommended Supplement: Vitamin D by Pure Encapsulations

Dose: I generally recommend a dose of 2000-5000 IU for my clients, with a recheck in 3 months.

Special Considerations: I also recommend spending time in the sunshine to get more vitamin D if you have Hashimoto’s. If you don’t live in a warm climate, get to one! You have an official prescription for a beach vacation from yours truly!

Take a look at my full article on vitamin D for more information on how important it is to thyroid health.

Vitamin B12

Vitamin B12 helps us with our energy production. Low levels are commonly associated with Hashimoto’s and may lead to fatigue, depression, neurological issues, impaired digestion, brain fog, tingling extremities, nerve damage, seizures, and anemia.

Who is at Risk for Deficiency: Vegans and vegetarians are at greatest risk, due to the fact that B12 is only found in animal foods and cannot be synthesized by the human body. Those with pernicious anemia (a type of autoimmune condition), H. pylori, and SIBO may also be susceptible.

In my survey of 2232 people with Hashimoto’s, 33 percent reported that they had tested as deficient in this all important vitamin, and 76 percent said they felt better after taking a B12 supplement.

Recommended Test: You can test your B12 (cobalamin) levels through your healthcare provider or through Ulta Labs. This is not a routine test but is covered by most insurance plans. Levels may be low, even if all other screening tests for iron and anemia come out within the reference range.

Understanding Your Results: Optimal B12 levels should be between 700-900 pg/mL. Please note: most labs will not flag low B12 levels unless they are under 200 pg/mL.

Recommended Supplement: B12 5000 Liquid (methylcobalamin) by Pure Encapsulations

Dose: 5000 mcg, sublingually, daily for 10 days; then 5000 mcg, once per week, for 4 weeks; then 5000 mcg monthly for maintenance

Monitoring: You can’t really overdose on B12, as it’s water-soluble, but I always recommend doing the initial test and retesting 3 months later, to track and monitor your progress.

Special Considerations: Be sure to use the sublingual version — swallowing B12 may result in inadequate absorption. Injections are also available and are highly effective; however, the sublingual form is just as effective, much less expensive, and is pain-free.

If you have pernicious anemia, please note that it’s often caused by H. pylori, which can trigger both Hashimoto’s and pernicious anemia. Treatment can reverse both conditions! Make sure to read my article on H. pylori to learn more about this gut infection.

If you have the COMT V158M gene mutation or mitochondrial issues, the Adenosyl/Hydroxy B12 Liquid supplement from Pure Encapsulations may work better.

Please see my full article on B12 for more information that may benefit you.

Ferritin

Ferritin is our iron storage protein. Low levels are commonly associated with Hashimoto’s and may lead to fatigue, difficulty breathing, and hair loss. According to my 2015 survey of readers, supplementation made 63 percent of them feel better.

Who is at Risk for Deficiency: Women who menstruate and/or are postpartum may be at increased risk due to blood loss. Additionally, SIBO, H. pylori, low stomach acid, vegan/vegetarian diets, manganese deficiency, and heavy metal toxicity (including copper toxicity) can cause low ferritin levels.

Recommended Test: Ferritin levels may be low, even if all other screening tests for iron and anemia come out within the reference range. You need to specifically test for ferritin. Ferritin level tests can be ordered by your doctor, or you can self-order one via Ulta Lab Tests.

Understanding Your Results: Normal ferritin levels for women are between 12-150 ng/mL. According to some experts, ferritin levels of at least 40 ng/mL are required to stop hair loss, while levels of at least 70 ng/mL are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/mL.

Recommended Supplement: OptiFerin-C by Pure Encapsulations

Dose: 1-3 capsules per day, in divided doses, with meals

Special Considerations: Ferritin can be deficient due to numerous root causes, including a lack of stomach acid that helps us absorb iron from iron-rich foods; so if supplementing does not address your levels, you will need to do some more digging. I have more information in the Advanced Protocols section of my book Hashimoto’s Protocol.

Be sure to retest your levels of ferritin, as ferritin can build up in the body and become toxic. If you have elevated ferritin levels, you may have iron overload and may benefit from blood donations.

Keep this supplement out of reach from children and pets!

You can read more about ferritin and Hashimoto’s here.

Lab Testing

All of the above labs can be ordered by your primary care doctor or endocrinologist, and are covered by most insurance plans. Research supports that they should be the standard of care for everyone that has Hashimoto’s, but oftentimes, you will need to request these tests from your doctor.

Please note: if you don’t have a doctor that can order the labs for you, you can order each of the labs separately, or you can order the full Root Cause Nutrition panel from Ulta Lab Tests. This is the first company that not only lets patients order their own labs (and receive the results), but also allows them to submit their receipts to their insurance for billing! Please be sure to check with your insurance, as each company has different rules.

Action Steps

In summary, the most important nutrient depletions to address in those with Hashimoto’s include thiamine, selenium, magnesium (citrate or glycinate), ferritin, B12, vitamin D, and zinc.

Thiamine, selenium and magnesium are safe and helpful for most people with Hashimoto’s, and most people will see a significant benefit from these supplements.

Hashimoto's and 7 Nutrient Deficiencies - Dr. Izabella Wentz

If you have Hashimoto’s, you should also request lab tests for ferritin, B12, vitamin D, and zinc, to see if you would benefit from supplementation.

As with all supplements, please be sure to consult with your healthcare practitioner to determine the dosage and duration that is right for you.

To further help you along your healing journey, my new cookbook, Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health, is available now! In addition to containing 125 delicious, nutrient-dense recipes that will help restore your depletions, this cookbook also includes information regarding how to tailor your diet to you, how to address specific symptoms with nutrition, how to use complementary nutrients to address symptoms, and when to dig deeper beyond nutrition.

I hope this information helps you on your journey toward better health!

Have you tried these nutrients? How have they helped? What other nutrients have you found to benefit you? Let me know in the comments below! 🙂

References

  1. Costantini A, Pala M. Thiamine and Hashimoto’s Thyroiditis: A Report of Three Cases. The Journal of Alternative and Complementary Medicine. 2014;20(3):208-211. doi:10.1089/acm.2012.0612.
  2. Gärtner R, Gasnier BC, Dietrich JW, Krebs B, Angstwurm MW. Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. J Clin Endocrinol Metab. 2002;87(4):1687-1691.

Note: Originally published in April 2017, this article has been revised and updated for accuracy and thoroughness.

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Comments

  1. funny you should mention glutamine sensitivity.i was taking large amounts of it about a year ago for leaky gut.it was recommended by several experts. i started getting an intense pain in my lower back on the right side but did not equate it with the glutamine.thought i had a kidney stone pain was so intense.had a ct scan .they found nothing. stopped the glutamine as it was the only new supplement i was taking.pain stopped within 3 days and never returned.so why the sensivity to glutamine.i do have a low thyroid and take all the supplements you mentioned but i was never able to find out why the bad reaction to glutamine

    Reply

    • William – thank you for reaching out. I am so sorry you experienced those side effects. <3 I wish I could give you more direct advice but, each person will react differently. I would advise you to discuss this with your clinician who’s care you are under.

      Reply

  2. I will try these supplements the way it is suggested here. Nothing has helped so far. Many weird symptoms, many different Drs. Many different meds that dont help. I’ve given up for several months. Lets see what happens.

    Blessings

    Rosanne Zawisza

    Reply

    • Rosanne – thank you for sharing. I am so sorry to hear you are struggling with all of this. <3 Hashimoto’s is often a combination of food sensitivities, nutrient deficiencies, adrenal issues, gut issues as well as an impaired ability to get rid of toxins. Any of those things would 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 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 offers a 12-week program, Hashimoto's Self Management Program. Here are some resources I hope you find helpful.

      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

      • Hi my name is Lucas and I’m an 18 year old in Florida with Hashimoto being diagnosed when I was about 16 _ I think. I was wondering what would be the proper manner of taking all these supplements in one day, what order, and which ones can I take together? I already bought your book just today ??

        Reply

  3. Dear helpful one,

    I can not express enough how thrilled I am with this list. I will get the testing and am eager to see what develops. I wish the lab had the exact package nd the the thyroid tests you recommend…but I will get after them, just the same.

    Reply

  5. Hi Izabella. I have found your books an invaluable aid in understanding my Hashimotos – thank you! It has taken three years of following your advice and protocols for my anti TPOs to come down from 955IU/ml to 22, within normal range (here in UK). I am still needing to take 50mcg thyroxine daily, but hoping that my thyroid gland will be abke to recover without the antibody attack.

    I was wondering if you have researched neutropenia in Hashimotos? I am consistently neutropenic, (though don’t seem to have any problems nor recurrent infections as a result) and have been referred to a consultant haematologist twice now. On both occasions, after testing has ruled out malignancy, I have been told “this is just something we see with autoimmunity”. Do you have any suggestions why this may be the case please? Are there any steps you would recommend to correct this?

    Many thanks
    Barbara

    Reply

    • Barbara – thank you for reaching out. That’s a great question and unfortunately I don’t have any information to share with you at this time but, I will add this to my list of future article possibilities. While I only work with patients with Hashimoto’s, oftentimes patients will have additional autoimmune conditions. Most autoimmune conditions have common root causes, and a lot of times the things that are recommended for one autoimmune condition will help with others. Conditions that I have found to respond really well to the Hashimoto’s protocols have been rheumatoid arthritis, lupus, Celiac disease, irritable bowel syndrome, eczema, asthma, Graves’, premature ovarian failure, psoriasis, Alopecia Areata, and Sjogrens. I have also seen the protocols help with Fibromyalgia, chronic fatigue syndrome, PCOS, as well as Type 2 diabetes, Crohn’s, and Ulcerative colitis.

      Hashimoto’s Protocol
      http://amzn.to/2B5J1mq

      Hashimoto’s Root Cause
      http://amzn.to/2DoeC80

      Reply

    • Hi Barbara and Dr Wentz, I would be interested in hearing more about this as well as I have been seeing a functional medicine practitioner for about 6 months with a lot of my symptoms improving. However I still have a low white cell count as well as mild to moderate neutropenia. I have been tested for Rheumatoid arthritis, Lupus and Sjogrens and all tests have come back negative. We are at a loss as to what could be causing this.

      Reply

      • Marina – thank you so much for reaching out. <3 Oftentimes patients will have additional autoimmune conditions. Conditions that I have found to respond really well to the Hashimoto’s protocols have been rheumatoid arthritis, lupus, Celiac disease, irritable bowel syndrome, eczema, asthma, Graves’, premature ovarian failure, psoriasis, Alopecia Areata, and Sjogrens. I have also seen the protocols help with Fibromyalgia, chronic fatigue syndrome, PCOS, as well as Type 2 diabetes, Crohn’s, and Ulcerative colitis.
        A great place to start is with diet/nutrition: The diet I recommend for people with autoimmune conditions is the traditional Paleo diet which eliminates grains, dairy, soy, and processed foods and focuses on nutrient-dense foods like meats, vegetables, nuts, seeds, and eggs. It has helped a lot of people 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. People may have additional sensitivities that contribute to the immune system dysfunction. People with Hashimoto’s are especially sensitive to a multitude of foods, especially gluten, dairy, soy, and eggs.
        That’s where the Autoimmune Paleo (AIP) diet comes into play. This diet goes beyond Paleo and removes an additional couple of foods such as nuts, seeds, and eggs. AIP is the starting point - if you don’t remove the inflammatory foods, you can’t know if your other interventions are working or not. An elimination diet is the gold standard for determining the foods one is sensitive to.

        Here are a few articles related to diet that hopefully help you get started:

        IMPORTANCE OF GUT HEALTH
        https://thyroidpharmacist.com/articles/importance-gut-health/

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

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

        Reply

  6. Would you please provide optimal ranges for all the nutrients recommended? It would be helpful to know if supplementation is necessary, for those of us with access to testing.

    Reply

  7. Dear Izabella
    Thank you for all you do. I’m in England and the Primary Care system will not provide any lab testing for any of this. So I will do myself. If I can get my antibodies down when could I challenge a reduction in my levy thyroxine dose and at what point stop altogether. I want to be armed with this to have a proper conversation with my GP. Many thanks Chris

    Reply

  8. Can some of these supplements be replaced by real foods? I find the list of supplements to be a bit overwhelming and costly. I pick and choose due to financial limitations. I recently replaced my selenium supplement with eating 2 brazil nuts daily. And I take a bath with Himalayan or Epsom salt twice weekly, and use magnesium spray on the other days. Trying to balance the timing of supplementation can also be tricky. Can you give suggestions for food substitutions?

    Reply

    • Vicki – thank you for reaching out. I agree! 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. I do have a full supplements chapter in my books. Have you checked them out? Not everyone should be taking every supplement and any of these books will help uncover your root cause. This will help you figure out your supplementation. Here are the links

      Hashimoto’s Root Cause:
      http://amzn.to/2DoeC80

      Hashimoto’s Protocol (this is my latest book):
      http://amzn.to/2B5J1mq

      Reply

    • Judy – Thanks for your message! 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.
      I do have a full supplements chapter in my books. Have you checked them out? Not everyone should be taking every supplement and any of these books will help uncover your root cause. This will help you figure out your supplementation. Here are the links

      Hashimoto’s Root Cause:
      http://amzn.to/2DoeC80

      Hashimoto’s Protocol (this is my latest book):
      http://amzn.to/2B5J1mq

      Reply

  10. Hi Dr Izabella
    I really need your advise. I know you cure your thyroid naturally n I have faith in you. However I want to share with u about my condition. I have hypothroid n now just got to know hashimoto’s.. however doctor gave me levothyroxine low dosage. My T3 is in the normal range and T4 is also normal range according to the doctor but my TSH Levels are high. After stated medication although my tsh levels are lower now,  none of my symptoms improved.  Infact hair loss is worsen. My memory prblm is killing me. N my cold feet n hands are brutal. I dont feel good at all. When I told the doctor they just increased my dosage of levothyroxine.  But I cant do this anymore. My hair loss is do bad n I’m balding and causing myself into depression. I want to stop this medication . Pls help me which suppliments should I start taking. I understand what worked for u may not work for me. I watch most of your videos . I eliminated glutan dairy n soy to begin with.  Doctors r not helpin me. I’m in Canada..I can’t meet with specialist unless I have a referral from my family doctor. My general doctor thinks my case is not severe so they are not referring me to a specialist  .

    Pls help me by telin me which suppliments to buy to help me in my hypothroid n hair lost hashimotos

    Reply

  11. Hello!
    In taking these supplements, is there a time of day you would recommend or would you recommend taking them all at the same time?
    I enjoyed meeting you in Denver last year 🙂

    Reply

    • Kimberly – thank you for reaching out. 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. If you have more specific questions on how and when to take particular supplements under normal circumstances, please do reach out to my team by email, at info@thyroidpharmacist.com and they will be more than happy to help ?

      Reply

  12. I was wondering about calcium. My family doctor is pretty adamant about me not taking calcium supplements. He says they are not bio available, and since I have no signs of osteoporosis, I shouldn’t take them. However, I take Synthroid, which I just found out may cause bone loss long term. Also, thanks to your suggestion of elimination diet, I find that dairy causes sinus problems for me. I gave up dairy and have not had a sinus infection all year. So, how do we Hashimoto’s people get our calcium?

    Reply

  13. Hi Izabella,
    I had a total extraction of my thyroid 7 years ago, I just take synthoid 100 mg and vitamin D3, but my body aches, I am 42 years old, and want to feel myself again. Which supplements are best for people with thyroidectomy? Since my teen years I have had low pressure, fatigue, thin hair, brittle, peeling, or white-spotted nails and after the surgery poor wound healing (slowly). Which are the most important nutrient depletions to address with thyroidectomy are they still the same of above or their is any rectriction?

    Reply

  14. Hi Dr Izabella,
    Do you also recommend taking Thyro-forte with these supplements? Or will just these supplements work for hashimoto’s? My TPO is elevated along w my thyroid antibodies due to the EBV… curious what all I should be on…
    Thanks!

    Reply

    • Tami – thank you for reaching out and sharing. <3 I wish I could be more helpful but, I can't provide any direct personal medical or supplement guidance outside of what I have published in my books and articles. You deserve the care of a skilled practitioner who can test and monitor your progress on an ongoing basis. I hope you find these resources helpful:

      CLINICIAN DATABASE
      https://thyroidpharmacist.com/database-recommended-clinicians/

      FIND A FUNCTIONAL MEDICINE CLINICIAN
      https://ifm.org/find-a-practitioner/

      Here is some information about EBV I hope you find helpful as well.
      Without going into too much detail, the first of the crucial defining moments in my disease development may have started during my undergraduate studies at the University of Illinois. Due to the communal living setting of dormitories (and less than stellar hygiene habits of most college students), I had recurrent strep throat infections and even contracted mononucleosis, a viral infection caused by the Epstein-Barr Virus (EBV), which is implicated in triggering many autoimmune conditions. I received multiple courses of antibiotics as well as flu shots (which may be associated with EBV infections) and started birth control for menstrual cramps. Animal fats, broths, soups, and stews support the body’s ability to suppress the viruses. Monolaurin or lauric acid, one of the components of coconut oil, has been found to be active against the Epstein-Barr virus. Replication of many viruses including Epstein Barr is inhibited by glycyrrhizic acid, an active component of licorice root. Quercetin, Co-Enzyme Q10, N-Acetylcysteine, and glutathione were also reported to be helpful in chronic fatigue syndrome because of their anti-viral properties. It is my belief that this combination had a profound impact on my gut flora, and thus my immune system.
      I have an entire protocol dedicated to eradicating EBV in my new book, Hashimoto’s Protocol, starting on page 329, that you may want to check out!

      HASHIMOTO’S PROTOCOL
      http://amzn.to/2B5J1mq

      Reply

  15. Hi Izabella,

    I just gave birth 5 months ago and have just been diagnosed with Hashimoto’s. It manifested as a goiter on my thyroid and that’s how they diagnosed it so quickly. Is selenium safe to supplement while breastfeeding? Thank you

    Reply

    • Julie – thank you for reaching out. <3 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.
      I do have a full supplements chapter in my books. Have you checked them out? Not everyone should be taking every supplement and any of these books will help uncover your root cause. This will help you figure out your supplementation. Here are the links

      Hashimoto’s Root Cause:
      http://amzn.to/2DoeC80

      Hashimoto’s Protocol (this is my latest book):
      http://amzn.to/2B5J1mq

      Reply

  17. Hi Izabella,

    I was recently diagnosed with Hashimoto’s disease after a goiter formed on my thyroid. I had a baby five months ago and I’m still breastfeeding. Are these supplements safe for breast feeding moms? Thank you! Helen

    Reply

  18. I found out I had thyroid cancer and had my thyroid removed a year before finding out I had Hashimoto’s the whole time. Since my thyroid has been completely replaced by Levothyroxine, would everything you recommended in this article still apply to me?
    Thanks!

    Reply

    • Alicia – thank you for following this page. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. 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, it’s an autoimmune disease that needs to be managed. Whether you have all, part or no thyroid, the autoimmunity still persists in most cases. We need to re-balance the immune system which begins in the gut. With the exception of discussing proper thyroid medication dosing, the majority of my website and book’s focuses on balancing the immune system. The info I present is based on my own research and journey overcoming my autoimmune thyroid condition.

      Here are some articles I think you might find helpful:
      IMPORTANCE OF GUT HEALTH
      https://thyroidpharmacist.com/articles/importance-gut-health/

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

      Reply

  19. Hi Izabella,
    I was diagnosed with Hashimoto 3 years ago right before I got pregnant. The pregnancy went great, but since then (also during pregnancy) I have had low ferritin. During pregnancy I got supplements but not after. Got my lab tests today and ferritin was 43 (range 13-150). My doctor said it is still ok but on the lower end so he suggested to eat more iron containing foods, but didn’t prescribe any supplements. I should also mention that 4 months ago I resulted positive for h.pylori and it is still not entirely cleared out (still haven’t got the test results but I’m sure it has not cleared out since I still have stomach pain every morning before breakfast). Could h.pylori be the root cause of all my problems?
    Maybe I should mention that I’m gluten free and mostly dairy free (occasionally have some home made greek yoghurt) since 3 years. My TSH went up to 60 after pregnancy but since half a year has been stable to ~1 on 75ng l-thyroxine.

    Thanks a lot for your insight
    Ana

    Reply

    • Ana – thank you for reaching out and sharing your your journey. <3 Pregnancy can often be a trigger for developing Hashimoto's or for an autoimmune flare – iron deficiency and immune shift, as well as potentially the baby’s thyroid cells that circulate in the body, may be a trigger. H. pylori is a stubborn infection. I’ve found that some clients are successful in treating their H. Pylori by using a combination of herbal products such as Mastic Gum, DGL, S. Boulardii, and Rootcology Amino Support, among other products. You might also appreciate my book, Hashimoto’s Root Cause. The book has an entire section dedicated to infections and the various options for treatment. This 380-page guide helps people figure out their own root cause. It covers birth control, gut infections, the thyroid, adrenals, hormones, toxins, food sensitivities, medications, diet, tests/assessments you can do, etc. It will save you a lot of time and frustration, and so far it has helped a lot of people to feel better. You may also want to check out my new book Hashimoto’s Protocol, a more step by step in-depth plan that streamlines the most effective interventions. ? Here are the links to my books as well as some articles you may find helpful as well:

      Hashimoto’s Protocol
      http://amzn.to/2B5J1mq

      Hashimoto’s Root Cause
      http://amzn.to/2DoeC80You might find these articles interesting.

      Hashimoto’s Food Pharmacology
      https://www.amazon.com/Hashimotos-Food-Pharmacology-Nutrition-Protocols/dp/0062571591?tag=thyroipharma-20

      ESTROGEN DOMINANCE AS A HASHIMOTOS TRIGGER
      https://thyroidpharmacist.com/articles/estrogen-dominance-as-a-hashimotos-trigger/

      WHY WOMEN HAVE MORE THYROID DISORDERS
      https://thyroidpharmacist.com/articles/women-thyroid-disorders/

      Reply

  20. I would love recommendations for a water system that removes fluoride and chlorine from tap water, both on the counter, and a full reverse osmosis system for the whole house.
    Also, if I need bottled water (in plastic) are any of them safe? Not sure I should trust the water reviews online to guide me.
    YOU I TRUST!
    I’ve recommended your books to everyone. Finally, someone who can guide us.
    Thank you!

    Reply

    • Mary – thank you so much for your support! <3 Fluoride and chlorine can potentially be problematic in Hashimoto's. I have found fluoride in particular to be a trigger for Hashimoto's and recommend getting an under sink reverse osmosis filter, or a counter top filter, as well as getting fluoride-free toothpaste, to avoid being exposed to it in such high amounts.
      Here is an article that you might find helpful and it includes my recommendations for filters as well:

      FLUORIDE AND YOUR THYROID
      https://thyroidpharmacist.com/articles/fluoride-and-your-thyroid/

      The bottled water brands with the lowest amount of fluoride are Aquafina, Calistoga, Dasani, Avian, and Propel Fitness water. The link to that list is here: http://fluoridealert.org/content/bottled-water/.

      Reply

    • Eva – thank you for reaching out. <3 I am not able to advise on whether these supplements 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

  22. Thank you for the information. Do you happen to have a table that summarizes the supplement names, doses, frequency, special instructions, etc. for the supplements discussed in the article? It would be nice to have a table that compacts the information all in one place for reference.

    Reply

  23. You recommend many of the Pure Encapsulations products.
    I see that they offer a Thyroid Support Complex, but it also contains 150mg of iodine. I’m trying to watch my budget and buying all these supplements individually gets costly. Plus, I don’t want to be popping pills all day long.
    Is this thyroid complex one you would recommend as well?
    Please let me know. I value your opinion and have been making great strides with my health due to your advice. I just finished 120 days on the AIP diet and lost 16 pounds (which was the only that worked for me for weight loss), and also increased my energy and cleared the brain fog.
    Thank you for all you do!!!

    Reply

    • Carolyn – thank you for reaching out. I am very hesitant in recommending iodine in Hashimoto’s. Although iodine serves as fuel for our thyroid and is very important in iodine deficiency hypothyroidism, Hashimoto’s is a different mechanism. It’s like pouring gas into an engine that’s on fire… that’s essentially what’s happening in Hashi’s, thyroid inflammation. Adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, in animal and human studies.

      I have spent 4 years researching about this issue, and have seen too many people suffering the consequences of adding iodine too soon. My approach is, let’s fix the engine first (usually a gut issue), and then add the fuel once we know that the engine is no longer on fire. Hope that you will check out my books. I do have a chapter on the iodine controversy that references numerous studies as well as the work of Abraham and Brownstein. Here is an article where I discuss Iodine and safe supplementing.

      IODINE AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/iodine-hashimotos/

      Reply

  24. Hi Dr. Wentz,
    I have a LOW tsh ranges from 5-right now 7.1
    I ahe lost 25 pounds this year. not good. feel racy all the time. muscle weakness. hae an adrenal problem. wondering if your writings could serve my situation as well as the hypo peole. tx linda.

    Reply

    • Linda – thank you for reaching out. <3 Conditions that I have found to respond really well to the Hashimoto’s protocols have been rheumatoid arthritis, lupus, Celiac disease, irritable bowel syndrome, eczema, asthma, Graves’, premature ovarian failure, psoriasis, Alopecia Areata, and Sjogrens. I have also seen the protocols help with Fibromyalgia, chronic fatigue syndrome, PCOS, as well as Type 2 diabetes, Crohn’s, and Ulcerative colitis.

      A great place to start is with diet/nutrition: The diet I recommend for people with autoimmune conditions is the traditional Paleo diet which eliminates grains, dairy, soy, and processed foods and focuses on nutrient-dense foods like meats, vegetables, nuts, seeds, and eggs. It has helped a lot of people 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. People may have additional sensitivities that contribute to the immune system dysfunction. People with Hashimoto’s are especially sensitive to a multitude of foods, especially gluten, dairy, soy, and eggs.

      That’s where the Autoimmune Paleo (AIP) diet comes into play. This diet goes beyond Paleo and removes an additional couple of foods such as nuts, seeds, and eggs. AIP is the starting point - if you don’t remove the inflammatory foods, you can’t know if your other interventions are working or not. An elimination diet is the gold standard for determining the foods one is sensitive to.

      Here are a few articles related to diet that hopefully help you get started:

      IMPORTANCE OF GUT HEALTH
      https://thyroidpharmacist.com/articles/importance-gut-health/

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

      ARE YOUR ADRENALS SABOTAGING YOUR HEALTH?
      https://thyroidpharmacist.com/articles/are-your-adrenals-sabotaging-your-health

      Reply

  25. Hello there and thank you for the useful information. I’m curious about magnesium and your suggestion to space it by at least 4 hours from calcium. A supplement I’ve been taking for years is Vegan Cal-Mag Plus (it also has Zinc, D, K, Boron++). Am I to understand now that this is ineffective? Yelp!

    Thanks!

    Reply

    • Kenda – thank you for reaching out. <3 As a pharmacist, I can tell you that many supplements are ineffective, and some are even downright unsafe. The truth is that most supplement companies do not undergo the same scrutiny and testing that pharmaceutical products do. This is because many of the tests required of pharmaceutical companies are voluntary for supplement companies and most companies do not take the extra steps to test their products to ensure safety and purity. I also prefer to start supplements one at a time, as there is a potential of reacting to some of the ingredients. There are about 20 different types of magnesium and the Magnesium glycinate and Magnesium citrate are the ones that I've seen people have the most success with. Here is an article I hope you find helpful.

      NEW STUDIES ON MAGNESIUM AND THYROID HEALTH
      https://thyroidpharmacist.com/articles/new-studies-on-magnesium-and-thyroid-health

      Reply

  26. Dr. Wentz,

    I have been following you for awhile now. I think you saved my life. I have read your books, I have been researching for so many years. Your article on supplements that Hashimotto patients can be deficient in was just what I needed. I tested positive for h pylori and I got it under control with antibiotics , but when I ordered these supplements I could feel the results in 3 days. It was helping my energy! And I just felt better overall. I told my girlfriend that has Cushins and she had the same result. Thank you for helping us. I’ve learned how to get what I need from my doctors. I ordered the food sensitivity test. I share your articles on Facebook every chance I get

    Thank you thank you thank you
    S. Jackson

    Reply

    • Sharon – that’s amazing!!! <3 Thank you so much for sharing! I'm so glad you enjoyed the Hashimoto's Root Cause book. I would love it if you and your girlfriend would share what protocols you did and what symptoms improve. My mission is to collect 10,000 success stories with the hope of submitting them to a medical journal in the future. Understandably, you are probably very busy, but if you have some time, please do you mind sharing your full story with me here at this link? https://thyroidpharmacist.com/testimonial/
      These stories will go a long way in helping others who are going through a similar journey to yours. Thank you for your consideration! <3

      Reply

  27. Dr. Izabella,
    I was diagnosed years ago with hypothyroidism. Recently, after a head and chest cold with antibiotics, I was hit with a panic attack. It progressively worsened, to the point where I cannot drive. I had my doctor (after several phone calls) test for all things thyroid and hormonal. The tests say Hashimotos, as well as the beginning of menopause (slightly low estrogen/progesterone levels). I am 42, and early menopause runs in my family. My question is concerning treating both of these, in high hopes of eliminating panic. The doc wanted to try birth control pills, but it was not a pleasant experience. I don’t believe she tested for selenium even though I requested it. Will these supplements, if needed, help or hinder peri menopausal symptoms? I do take a probiotic faithfully, but it could be gut health related as well. I love this information, and am grateful you have done such extensive research!

    Reply

    • Margaret – thank you so much for reaching out. <3 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. 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

      Reply

  30. Hi there, I have a daughter 28 who has always had issues with ADHD, and when she was 15 we discovered she had hemochromotosis… since then she has developed symptoms of pyroluria, and Hashimoto.. at one stage she started to put on excessive weight now about 40kg and chronic fatigue. She is anemic has low muscle tone – despite massive amount of zinc she still has low levels…she has been to many doctors been on restrictive diets but still is getting bigger with massive weight gain and fluid. Despite exercising and limiting foods and amounts – no idea what to do now! What tests should she ask for and who should she see? So depressing for her. Sure hashi is a main cause!

    Reply

    • Judy – thank you so much for reaching out and sharing your daughters journey. My heart goes out to you both. <3 We know that intestinal permeability (aka leaky gut) is present in every case of autoimmunity and often precedes the development of Hashimoto’s. Symptoms of leaky gut may include bloating, diarrhea, constipation, stomach aches, acid reflux and irritable bowel syndrome. According to the Institute of Functional Medicine, many people develop IBS 5-10 years before an autoimmune diagnosis. I was one of them and didn’t take my gut health as seriously as I should have. Gut problems are often caused by infections like H. pylori, parasites like Blasto, SIBO, an imbalance of bacteria, and enzyme deficiencies or food sensitivities (especially to gluten, dairy, and/or soy). Even stress can be a factor in gut permeability.

      6 DIFFERENT ROOT CAUSES
      https://thyroidpharmacist.com/articles/6-different-hashimotos-root-causes/

      You also may find this article helpful where I discuss pyroluria as well.
      https://thyroidpharmacist.com/articles/hashimotos-and-zinc-deficiency/

      Reply

  31. I was on cytomel and told by my doctor that I should take magnesium without ever doing a blood test. Eventually I started to have symptoms of a heart attack. Much later I found out that cytomel can store magnesium so I was actually getting an overdose. This has greatly affected my wellbeing and something readers should be aware of as the information on cytomel was not made public. I would imagine that some of your readers are on cytomel or as I was, a generic liothyronine.

    Reply

    • Linda – thank you so much for sharing this with me. I’m so sorry you had to experience this! My heart goes out to you. <3 I hope your thyroid healing journey is going better now. <3

      Reply

  32. What about Iodine? Should someone with a slightly hi TSH try Iodine? At what level of TSH should you consider Synthoid and what other test should be done before?

    Reply

    • Barbara – thank you so much for reaching out. <3 I am very hesitant in recommending iodine in Hashimoto's. Although iodine serves as fuel for our thyroid and is very important in iodine deficiency hypothyroidism, Hashimoto's is a different mechanism. It's like pouring gas into an engine that's on fire... that's essentially what's happening in Hashi's, thyroid inflammation. Adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, in animal and human studies.

      I have spent 4 years researching about this issue, and have seen too many people suffering the consequences of adding iodine too soon. My approach is, let's fix the engine first (usually a gut issue), and then add the fuel once we know that the engine is no longer on fire. Hope that you will check out my books. I do have a chapter on the iodine controversy that references numerous studies as well as the work of Abraham and Brownstein. Here is an article you might find interesting:

      IODINE AND HASHIMOTO'S
      https://thyroidpharmacist.com/articles/iodine-hashimotos/

      Reply

  33. Hi Dr Wentz,
    What can you recommend for someone who has an optimal ferritin level (105), but low iron (39)?
    Also, thank you for all your research ?

    Reply

    • Eunice – thank you for reaching out. <3 Hashimoto's and low iron do go together as leaky gut makes it hard to absorb iron from your diet. These are the ferritin levels from my book, page 83. Normal ferritin levels for women are between 12 and 150 ng/mL. Ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml. This article does discuss iron: 12 STRATEGIES TO OVERCOME HASHIMOTO'S FATIGUE https://thyroidpharmacist.com/articles/12-strategies-overcome-hashimotos-fatigue/

      Reply

  34. I appreciate your articles so much! I have a question. You suggested taking selenium up to 2 yrs. My Dr suggested selenium when I was diagnosed with Hashimotos 5 yrs ago and I have taken it ever since. Should I quit? Also, my daughters are both taking selenium as I hoped it would help prevent Hashimotos. My oldest daughter was recently diagnosed with hypothyroid (in her mid-twenties), my other daughter as a teen had a test that showed high throid antibodies. Is it beneficial to keep taking selenium long term?

    Reply

    • Tere – thank you so much for reaching out and sharing your journey as well as your daughters. <3 I'm so happy to hear you are finding my research helpful! My best advice is to work with your practitioner to determine the appropriate dosage for you and your daughters as wells discuss the long term use.

      Reply

  35. I have followed you for so long. What you do for this community is amazing so thank you. Can you help me figure out what prenatal is best? Btw we are still struggling to get my thyroid at optimal levels. I jump from 5.7 up and down every test. Right now I’m on both synthroid and nature thyroid in hopes we can get my levels optimal so we can start IVF. I am also turning 40 so need help ASAP! Any help with a prenatal or even idea on how to get my level normal enough to have a baby would be amazing!!!

    Reply

  36. I am doing pretty much everything to help with my hashimoto’s and my numbers keeps rising instead of going down. I had a doctor that I loved who had me on naturthroid for so long,even while pregnant, and felt great.That doctor moved ,so I found a new doctor who likes to prevent things beforehand through diet.Unfortunately,he told me that new research shows that natural thyroid medication does not work for hashimoto’s, so I need to get synthetic compounded slow release t4+t3.I begged him to prescribe the same thing I was on,but he kept telling me that he can’t, as he might lose his license (I know it is not true).
    5 years later and keep getting worse ,my medication keeps getting higher (185 mcg t4+I believe close to 40 or 45 t3) and my tsh is 13.5,thyroglobulin antibody 394 and tpo <9.My thyroglobulin keeps going above 700,to 500 to 300 and so on,but never below 300
    Also,I just started developing skin rashes,cyst pimples looking like,on my face,back,chest,neck and around my hairline .I know I developed sensitivities or allergies to some foods ,but not sure what.I am already gluten free due to celiac, and been off dairy for a very long time.I also have alopecia areata, carpal tunnel syndrome and mctd.Since December I am medication free.Instead of prescribing something new at my last appointment, he blamed the compounding pharmacy and recommended a new one in California,which by the way I already tried and had the same experience. He did try to persuade me saying that they changed, but I am done with compounding.
    I am truly lost and have no idea where to go from now on.I tried and tried to find a new doctor to no avail. Illinois really sucks.Also,does anyone knows about a reliable food allergy/sensitivity test?
    I had my son do the mrt for his eczema and now he is eczema free.Unfortunately this test is 700$ now (was 350 back then),so I feel is a bit expensive especially when you have 3 kids .
    I would appreciate any advice. Thank you.

    Reply

    • Ann – thank you for following this page and sharing your journey. <3 I am so sorry you are struggling with all of this. I understand how frustrating it can be. <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 are some articles I hope you find interesting.

      ELIMINATION DIET
      https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos

      HOW THE DOSE OF YOUR THYROID MEDICATION CAN UNCOVER YOUR ROOT CAUSE
      https://thyroidpharmacist.com/articles/the-dose-of-your-thyroid-medication-can-uncover-your-root-cause/

      I also suggest that you join one of the Hashimoto’s groups that are out there. Being able to share ideas of what has worked with one another and offer support for each other can be very helpful. 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. Ask questions. Post your thoughts. Scan the files. It is an absolutely amazing resource. Best of all it’s kept private from spammers.

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

      Reply

  37. Hello how are you, I appreciate your articles so much. I have been diagnosed with Hashimoto since 2016, I have had all the symptoms and my levels of antibodies and TSH were high, since then I read your articles every time. I have removed gluten and sugar, milk from the diet, but not cheese because many foods are lacking in our country and I am afraid that I may be missing calcium, even though I have pain, acid reflux, bloating, fatigue, brain fog sometimes. But lately I have had back, neck and left leg pain, I have tested the values ​​of calcium, thiamine, vitamin B12, magnesium which have been in normal values ​​as well as vitamin D which have been in low values ​​but I am treated and values ​​now are normal. My doctor prescribed me supplements(calcium, magnesium and zinc) in 2018, I have read that people who have Hashimoto’s may not use calcium, cabbage and broccoli. Is it true that calcium is not allowed to be used or allowed to be used as it is not taken with food. I’m fearing that I may have osteoporosis symptoms by the time. Thank you so much for understanding, wish you all the best.?

    Reply

    • Fjolla – thank you for reaching out and sharing your journey. <3 Dairy is a common reactive food in people with Hashimoto’s and can directly increase our thyroid antibodies. Some people may have a primary dairy sensitivity, while others may develop a secondary dairy sensitivity due to the gluten-induced damage to the gut. You may have heard of lactose intolerance, a lack of enzymes that prevent a proper breakdown of the milk sugar lactose. This is just one type of dairy reaction, but it is not the same as dairy sensitivity, which, like gluten sensitivity, is mediated by the immune system. People with Hashimoto’s usually have sensitivities to the proteins found in dairy: casein and whey. All cow milk products including milk, cheese, yogurt, ice cream, and even butter should be avoided. If you are sensitive to casein in conventional cow’s milk, you will likely react to the casein in raw milk, goat milk, sheep milk, and lactose-free milk. Some protein powders containing whey protein also need to be eliminated. Some non-dairy cheeses may contain casein, the most problematic of the dairy proteins. Many processed foods also may contain dairy proteins and are best avoided.
       
      Camel milk is an alternative that most will be able to tolerate. Camel milk isn't for everyone as some casein-sensitive people may still react to it, I recommend looking into it as an alternative to milk, if you can tolerate it. Good dietary sources of calcium include canned salmon and sardines, broccoli, and kale. If you are not following a Paleo or AI Paleo diet, legumes such as black-eyed peas and white beans would be other options for dietary calcium.

      Did you know vitamin D affects about 3,000–30,000 genes in our bodies? It’s necessary for helping our body to absorb calcium and strengthen our bones, but it also plays an important role in our immune system health. Many diseases have also been connected to low Vitamin D levels, including heart disease, autoimmune disease, depression, and recently, thyroid conditions and Hashimoto’s. There are also quite a few options for thyroid medications. In my experience, what works for one person may not work for another. I hope you find these article helpful:

      GOING DAIRY FREE TO REVERSE HASHIMOTO’S
      https://thyroidpharmacist.com/articles/going-dairy-free-to-reverse-hashimotos/

      GOT ACID REFLUX?
      https://thyroidpharmacist.com/articles/got-acid-reflux/

      Get Some Sunshine for your Thyroid
      https://thyroidpharmacist.com/articles/get-some-sunshine-for-your-thyroid/

      Reply

  38. What will it take to have a telephonic or email consultation with Dr Izabella Wentz? I am so desperate for help and the doctors here in SA just don’t have the experience with Hashimoto’s and I am not getting the help I need. I really need to speak to someone who knows and understands my illness. South African doctors JUST DON’T GET IT!

    Reply

    • Irene – thank you so much for reaching out and sharing your journey. I’m so sorry you are struggling to find a practitioner. I understand how hard this is. <3 I do provide a limited number of consultations, however, my consultative schedule is all full at the moment. I have a 12 week online program called Hashimoto’s Self-Management Program, that covers all of the strategies that I go through with my one-on-one clients, in a self-paced format, so that participants have access to all of the things I’ve learned about Hashimoto’s without having to schedule costly consults with me or another practitioner. Here is the link to the program so you can check it out:

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

      Reply

  39. Hello, I have been diagnosed with hashimotos for almost 3 years now. I love this article and have since purchased selenium vitamin b1 zinc and vitamin e I’m just not sure when I should take them., do I split them up?

    Reply

  40. Hi Izabella
    Do you have any products you can recommend for Australians? I’m finding it very hard to source Pure encapsulations from here. I have got my blood tests back and very low in iron is , ferritin is 15, active b12 is low (39), zinc is 7 I think these deficiencies would explain my hair loss. DHEAS is 3300 which is very high can this just be from Stress? I don’t know if I have hashimotos but def have had high stress for some time and keen to get this sorted. I am on so many supplements for hair and for my dry eyes its hard to know what will actually work.

    Reply

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