As an avid researcher, I am always struck by the many inter-relationships between diseases of the body and the mind. A good example of this is the anxiety, mood swing, and OCD (obsessive-compulsive disorder) symptoms that can often be clues that a person may be having underlying issues with their thyroid.
As a pharmacist, I’ve been frequently dismayed that our modern medical solution to these mind-body connections, is to throw completely different prescription medications at the two. Not only does this often mean neglecting to “fix” the real root causes of both conditions, but many medications meant to address psychiatric symptoms often have unwanted side effects that make the physical health situation worse.
Looking for root causes is so important. In many cases, people find out that something as relatively straight-forward as a nutrient deficiency or a blood sugar imbalance, may be causing both their anxiety symptoms and their worsening thyroid condition.
Once you identify your root causes, you can usually feel better pretty quickly. For example, having people take therapeutic dosages of two nutrients, selenium and myo-inositol, as well as working to balance their blood sugar, can work wonders at reducing their anxiety and OCD symptoms, as well as reducing their thyroid antibodies and thyroid symptoms. Some people have even seen their TSH level drop, or have gone into remission, after supplementing with selenium and myo-inositol.
Blood sugar imbalance can be a root cause of Hashimoto’s and anxiety, and is also a co-occurring symptom of another condition that affects many women, polycystic ovary syndrome (PCOS). Myo-inositol has been found to improve symptoms of PCOS. It has also been found to be effective in increasing insulin-sensitivity, which results in improvements in reproductive health, including enhanced fertility.
As you can see, myo-inositol can be greatly beneficial for Hashimoto’s!
In this article, you’ll discover:
- What myo-inositol is and how it supports our health
- How myo-inositol can improve Hashimoto’s symptoms
- The connection between PCOS, Hashimoto’s and blood sugar levels
- The anxiety, depression, OCD and mood connection to Hashimoto’s
- Recommended dosage and precautions
What Myo-inositol Is and How It Supports Our Health
Myo-inositol is an important nutrient that serves key functions relating to hormone signal transduction throughout our endocrine system. As such, myo-inositol plays an important regulatory role relating to thyroid health (regulating the thyroid-stimulating hormone, or TSH) and reproductive health (regulating the follicle-stimulating hormone, or FSH). It also regulates glucose uptake and may be involved in serotonin uptake (our happy and calming hormone) (1).
Myo-inositol has been found to provide many valuable health effects, including anti-inflammatory, anti-oxidant, anti-diabetic, and anticancer effects (2).
Research has shown that myo-inositol supplementation reduces thyroid antibody and TSH levels, as well as improves symptoms associated with anxiety, mood swings, depression and OCD. Research has also found that myo-inositol improves PCOS symptoms such as menstrual irregularities, acne, insulin resistance, and weight (3). More will be discussed about each of these, further in this article.
So what exactly is myo-inositol? And why might you be deficient?
Myo-inositol is a form of inositol, a type of natural sugar alcohol that’s present in mammalian cells. Inositol was previously known as vitamin B8, as it used to be thought of as an essential nutrient, but it was later learned that it is actually made within our bodies, so it lost its official vitamin designation. However, just because we can make it internally, does not mean that we can’t be deficient!
There are actually 9 forms (referred to as isomers) of inositol, with the two most common being myo-inositol and D-chiro-inositol. These two forms are seen in much of the research relating to inositol, and in fact, they have been studied as a combination treatment relating to PCOS.
Myo-inositol is found in many plants and in the tissues of animals. Foods with the highest concentration of myo-inositol are fruits, beans, corn, and nuts. Blueberries, one of my favorite superfoods, are an especially rich source!
Research has shown that although it is synthesized in the body, some individuals may not be able to meet their body’s metabolic needs through its own synthesis alone (4).
While the human body (via the liver and kidney) can produce up to 4 g/day of inositol, it has been found that the overly processed, high glucose (and low fiber) Western diets that many people follow, only provide about 1 g/day of the compound (5).
People can be deficient due to their diet, poor nutrient absorption (common in Hashimoto’s), or perhaps even a genetic predisposition (such as having poor glucose metabolism) (6).
High glucose levels hinder inositol availability by increasing its degradation and by inhibiting both myo-inositol biosynthesis and absorption (7).
How Myo-Inositol Can Improve Hashimoto’s Symptoms
Blood sugar imbalance is a potential root cause of Hashimoto’s, and I’ll talk more about that in the next section. But first, let me talk about the importance of myo-inositol relating to thyroid stimulating hormone (TSH) signaling.
As I mentioned earlier, due to its key role in TSH signaling, myo-inositol supplementation has been shown to reduce thyroid antibodies, reduce TSH levels, and even achieve remission in people with Hashimoto’s.
TSH signaling is a very complex process, and there are two different branches of signaling that have an impact on TSH levels. One of these branches is inositol-dependent, so too little inositol causes TSH resistance, causing too much TSH to be produced (8). Myo-inositol improves TSH sensitivity, which in turn results in a reduction of TSH levels.
Think of it this way. If someone has earplugs in their ears, they can’t hear well, so you have to yell for them to hear you. But if they remove the earplugs, they can hear you without you having to speak at a loud volume. It is similar with TSH. Without adequate myo-inositol, the body has to be “louder” and generate greater levels of TSH. In my first book Hashimoto’s: The Root Cause, I discussed how an elevation of TSH, for whatever reason, may result in triggering or exacerbating the autoimmune process of Hashimoto’s. Providing myo-inositol in clinical studies appears to “remove the earplugs,” so to speak… resulting in less TSH being produced.
There have been a number of studies focused on myo-inositol relating to Hashimoto’s, PCOS and OCD. Let’s first focus on Hashimoto’s.
In most of the studies relating to Hashimoto’s, myo-inositol has been evaluated in conjunction with selenium, likely because the research has already proven selenium to be effective at reducing thyroid antibodies. This is not surprising, as selenium deficiency is one of the most common nutrient deficiencies that I see in people with Hashimoto’s, and over 50 percent of them are likely deficient in it.
Selenium supplementation has been tied to a reduction in thyroid antibodies, improvements in thyroid symptoms, and a reduction in anxiety. I routinely recommend that my clients and readers try selenium to see if it helps them feel better. You can read much more about selenium here.
Given selenium’s well understood benefits for Hashimoto’s, studies have evaluated the incremental benefit of taking both selenium and myo-inositol over simply taking selenium alone. And the findings have shown there are benefits to taking both.
In one study done in 2013, patients with autoimmune thyroiditis were split into two groups, with one group being treated with 600 milligrams of myo-inositol and selenium (selenomethionine) per day for 6 months, and the other being treated with just selenium. While both groups showed a decrease in thyroid antibodies, the group treated with myo-inositol also experienced a 31 percent reduction in TSH levels. The selenium group showed no change in TSH levels (9).
The group taking the myo-inositol and selenium also showed a 44 percent reduction of thyroid antibodies, while the group taking selenium alone showed a 42 percent reduction in antibodies. Thyroglobulin was reduced by 48 percent with the myo-inositol/selenium combination, versus 38 percent with just selenium alone.
Some people actually went into remission after starting the myo-inositol. Improvements were seen in people’s assessment of their personal wellbeing. The authors of this study also pointed out that these two compounds were safe, with no side effects seen as part of their data collection.
In a more recent follow-up study in 2017, these results were confirmed and then expanded upon. Thyroid antibodies, TSH and quality of life were all significantly improved after administration of both myo-inositol and selenium. Interestingly, there was one case of hyperthyroidism included in this study, and in that single case, the supplementation increased TSH levels up to normal concentrations (10).
My own clinical results also support the improvements that may be seen when taking myo-inositol with selenium. I recommend this combination as a first step for people with mild elevations in TSH and thyroid antibodies, and sometimes it’s just enough to do the trick. I often recommend using myo-inositol powder instead of sweetner in tea!
The Connection Between PCOS, Hashimoto’s and Blood Sugar
In at least one study, it was found that up to 50 percent of people with Hashimoto’s have an impaired tolerance to carbohydrates, causing issues with blood sugar imbalances and insulin surges. I have found that many of my clients suffer from these types of surges, which can cause nervousness, anxiety, lightheadedness and fatigue.
In a 2017 study on insulin resistance and Hashimoto’s, the authors concluded that high thyroid antibody levels are related to high fasting blood glucose levels and high insulin levels. Their findings indicated a possible relationship between insulin resistance, autoimmune thyroiditis and TSH levels. They also concluded that patients testing with positive thyroid antibodies should be followed closely for diabetes mellitus and cardiovascular events (11). (Learn more in my article about blood sugar imbalances and Hashimoto’s.)
Blood sugar and insulin resistance are also a problem commonly seen in women with PCOS (12).
PCOS is an endocrine, reproductive and metabolic disorder, affecting at least 5 to 10 percent of reproductive-age women, worldwide (13). Women with PCOS are found to have a 50 to 70 percent incidence of insulin resistance, independent of body size and build (14). In those who are obese, the prevalence of insulin resistance rises to 80 percent (15).
Given these statistics, a common treatment for PCOS includes the insulin-sensitizing drug metformin. It has been shown to improve insulin sensitization and ovulatory function. Metformin does, however, have a number of negative side effects.
Remember when I said myo-inositol was involved in hormone signal transduction and helped regulate TSH, FSH and glucose uptake? Well, due to its similar regulatory role relating to addressing glucose intolerance, myo-inositol was identified as being a potential substitute for metformin in improving PCOS symptoms. Subsequently, there has been research focused on this, with that research confirming the positive results of myo-inositol supplementation.
Myo-inositol is the most abundant inositol form found within the ovary, with approximately 99 percent of the ovarian intracellular inositol being myo-inositol (16). Studies have shown that a high concentration of myo-inositol is required to ensure healthy oocyte (immature egg) maturation in the ovary (17).
So it is no wonder, then, that research has found myo-inositol to be beneficial to women with PCOS! One study found that after just 12 weeks of myo-inositol supplementation, there were improvements to insulin levels and LH/FSH levels, with both being significantly reduced. (These markers can be a potential signal of fertility challenges when elevated.) Menstrual cycles also normalized (18).
In another study, myo-inositol supplementation was found to improve the number of good quality oocytes, clinical pregnancies, and delivery rates in overweight women with PCOS. Insulin sensitivity improved as well (19).
Additionally, there are many studies that have focused on the benefits of pairing myo-inositol and D-chiro-inositol to reduce insulin resistance and improve ovarian function in women with PCOS.
In one of these studies, a myo-inositol and D-chiro-inositol combination therapy was found to improve oocyte quality, embryo quality, and pregnancy rates during in vitro fertilization (20).
In another study, the combined myo-inositol and D-chiro-inositol treatment was found to be better than myo-inositol alone at improving ovulation, endocrine and metabolic parameters (21). An additional study showed a significant improvement in insulin sensitivity as well as lipid profile in PCOS patients (22).
Besides metformin, myo-inositol is now considered a further insulin-sensitizing supplement which could benefit women with PCOS (23). Side effects that can occur with metformin have not been seen.
Interestingly, there is also a connection seen between women with PCOS as well as hypothyroidism. Perhaps this can be partly explained by shared root causes, such as both having blood sugar imbalances as well as having deficiencies in myo-inositol (resulting in a less than optimal inositol-dependent signaling pathway).
In one study, it was found that 22.5 percent of women with PCOS also had hypothyroidism, compared to just 8.75 percent in controls (24). The same authors also found TPO antibodies present in 27 percent of patients with PCOS, versus 8 percent in controls. More recently, a study found a higher prevalence of Hashimoto’s, higher antibody levels and elevated TSH levels, in PCOS patients (25).
In view of its recognized insulin-sensitizing activity, myo-inositol is used today to prevent and/or treat a number of metabolic disorders related to insulin resistance, such as metabolic syndrome, gestational diabetes mellitus and PCOS.
The Anxiety, Depression, OCD and Mood Connection to Hashimoto’s
Research has shown that anxiety, depression, mood fluctuations, OCD behaviors, and a general feeling of being “unwell”, are early signs of an autoimmune attack on the thyroid, and can be correlated to thyroid antibodies, even when the TSH level is still “normal.”
Many new clients come to me after being prescribed anxiety and mood-related medications, including SSRIs (Selective Serotonin Reuptake Inhibitors), lithium, antipsychotics, dopamine, and benzodiazepines. They don’t feel well, and may have other thyroid symptoms, but in many cases are still being told their TSH level is normal, so their thyroid is fine (oh, and “just keep taking those anxiety meds!”). Sometimes the term hypochondriac is thrown about. I’ve had way too many clients who were told they were bipolar, when in fact the thyroid was out of balance.
Yet, there is research that concludes with the recommendation that people presenting with these types of psychiatric symptoms be initially screened for underlying thyroid issues (26).
Anxiety and mood disorders are very common thyroid symptoms. A study in 2004 found that there is an association between the presence of an anxiety or mood disorder, and the presence of TPO antibodies. (You can read more about mood disorders and Hashimoto’s.)
The most common type of anxiety disorder reported in people with thyroid antibodies is obsessive-compulsive disorder (OCD).
I myself used to have issues relating to OCD (which interestingly is very common in pharmacists and those with Type A personalities, like yours truly!) and anxiety, which seemed to rear their ugly heads when my Hashimoto’s was least controlled by diet and other interventions.
But, I have seen the positive effects of successful interventions (like removing reactive foods, reducing stress, and treating Streptococcal-based gut imbalances which have been tied to OCD), as well as addressing various nutrient deficiencies. Two that I recommend most often, relating to OCD, are selenium and myo-inositol.
Several studies have found that daily treatment with inositol resulted in improvements to OCD (measured as a reduction on the Yale-Brown Obsessive-Compulsive Scale).
In one small study, thirteen patients with obsessive-compulsive disorder were given either 18 g of inositol or a placebo, daily, for 6 weeks. The subjects had significantly lower scores on the Yale-Brown Obsessive-Compulsive Scale when taking inositol. The authors concluded that inositol is effective for depression, panic, and obsessive-compulsive disorders, a spectrum of disorders responsive to selective serotonin reuptake inhibitors (27).
Just like myo-inositol regulates TSH, FSH and glucose uptake, research has shown that it may be involved in the modulation of serotonin uptake, too (29). I think it is a much more natural solution to anxiety and OCD behaviors versus some of the psychiatric prescription medications that so many people are on today!
Along with anxiety and OCD, depression is also associated with Hashimoto’s.
In a meta-analysis done comprised of 19 studies, with a total of 36,174 participants (34,094 for anxiety and 35,168 for depression), patients with AIT (autoimmune thyroiditis), subclinical hypothyroidism, or overt hypothyroidism had significantly higher scores on standardized depression and anxiety tests. The authors concluded that patients with AIT exhibit an increased chance of developing symptoms of depression and anxiety or receiving a diagnosis of depression and anxiety disorders (30).
The study found that approximately 23.8 percent of patients with AIT experience depression, and approximately 41.6 percent of patients with AIT experience anxiety disorders.
To learn more about depression and Hashimoto’s, please see my article.
It makes sense that mood swings, anxiety, OCD and even depression can be so intertwined with Hashimoto’s. Fluctuating thyroid hormone levels (due to any number of root causes), stressed out adrenals, and even the autoimmune process itself can be common culprits. The good news is there are a lot of interventions that can help, including addressing the nutrient deficiencies and blood sugar balancing issues we’ve been discussing.
One other strategy that I often discuss with clients having these types of anxiety and mood related symptoms is changing up their thyroid medication to a T3-containing medication like Nature-Throid, WP Thyroid, Armour, or compounded T4/T3. In my survey of Root Cause readers, around 60 percent reported improved mood after switching to a T3-containing medication.
Recommended Dosage and Precautions
Given the research and the results in my own clinical practice, I typically recommend that people with Hashimoto’s try supplements such as selenium and myo-inositol. Generally, you do not need to test your own levels of these nutrients. They have been shown to be safe (with noted precautions) in the research, so my philosophy is to try them and see if they result in improvements.
I recommend taking 700 mg daily of the Rootcology Myo-Inositol Powder, which contains the myo-inositol form, for reducing TSH and thyroid antibodies (ideally, in conjunction with selenium). As a side bonus, if you are trying to replace sugar or other sweeteners in your tea or coffee, myo-inositol has half of the sweetness of table sugar and may just do the trick for you. However, varying doses may be needed for helping to address other conditions.
Precautions
Myo-inositol should not be taken by people who have kidney disease or who may be already taking supplements, such as cleavers (a diuretic herb), that can affect the kidneys or the lymphatic system. Myo-inositol may not be properly cleared when the kidneys are overworked, such as in kidney disease or while taking diuretics.
Myo-inositol is also not recommended if you are pregnant or lactating. People with diabetes taking myo-inositol, should watch for signs of low blood sugar (hypoglycemia), as myo-inositol may lower blood sugar and hemoglobin A1c levels.
Rarely, myo-inositol has been associated with nausea, headaches, dizziness, or fatigue. If you experience these effects, then I’d discontinue taking it. Some people have reported increased bleeding with the use of myo-inositol, so I would not recommend it with a history of heavy bleeding, or in those taking blood thinners. If you experience any of these effects, I would discontinue taking it.
While research has shown that myo-inositol seems to have a normalizing effect on testosterone in women with PCOS, myo-inositol has been shown to increase testosterone in men with low levels of this hormone. Thus, myo-inositol can be used by both men and women. However, a word of caution for men who are sexually active: myo-inositol can increase sperm quality, leading to surprise pregnancies in partners of men who were previously thought to be infertile.
As always, I suggest you work with a good functional medicine practitioner and consult with him or her before trying myo-inositol. If you are on psychiatric medications, please do not go off of them without working with the prescribing practitioner.
What You Can Do Today
If you have Hashimoto’s, you likely have one or more nutrient deficiencies. And while it’s important to investigate and correct any underlying root causes (such as food sensitivities, blood sugar imbalances or gut issues), in the meantime, myo-inositol supplementation could help you feel better.
Remember, much of the research relating to Hashimoto’s has shown myo-inositol can increase the effectiveness of selenium. Both have been found to reduce thyroid antibodies and anxiety. Myo-inositol has also been shown to reduce TSH levels and balance blood sugar, as well as help with depression, mood swings and OCD. It can encourage a healthy mood, emotional wellness and less stressful behaviors.
For those with PCOS, myo-inositol may help to support a healthier reproductive system, as well as improve ovulatory function.
Even those who haven’t yet been diagnosed with thyroid disease, due to having a “normal” TSH level, could still have thyroid antibodies, and I recommend testing for those. It is easy and inexpensive, and antibody testing provides you with “early warning” information that can help you prevent further damage to your thyroid. Remember, you can have thyroid antibodies for years – even a decade – prior to testing abnormal for TSH.
I hope this helps you on your healing journey! Let me know how taking myo-inositol and selenium together works for you.
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References
- Unfer V, Facchinetti F, Orrù B, Giordani B, Nestler J. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrine Connections. 2017;6(8):647-658. doi:10.1530/EC-17-0243.
- Dinicola S, Minini M, Unfer V, Verna R, Cucina A, Bizzarri M. Nutritional and Acquired Deficiencies in Inositol Bioavailability. Correlations with Metabolic Disorders. International Journal of Molecular Sciences. 2017;18(10):2187. doi:10.3390/ijms18102187.
- Formuso C, Stracquadanio M, Ciotta L. Myo-inositol vs. D-chiro inositol in PCOS treatment. Minerva Ginecol. 2015 Aug;67(4):321-5.
- Berdanier C. Is Inositol an essential nutrient? Nutrition Today. 1992.
- Dinicola S, Minini M, Unfer V, Verna R, Cucina A, Bizzarri M. Nutritional and Acquired Deficiencies in Inositol Bioavailability. Correlations with Metabolic Disorders. International Journal of Molecular Sciences. 2017;18(10):2187. doi:10.3390/ijms18102187.
- De Leo V, Musacchio M, Cappelli C, et al. Genetic, hormonal and metabolic aspects of PCOS: an update. Reproductive Biology and Endocrinology. 2016;14:38. Doi: 10.1186/x12958=016-0173-x.
- Dinicola S, Minini M, Unfer V, Verna R, Cucina A, Bizzarri M. Nutritional and Acquired Deficiencies in Inositol Bioavailability. Correlations with Metabolic Disorders. International Journal of Molecular Sciences. 2017;18(10):2187. doi:10.3390/ijms18102187.
- Nordio M, Pajalich R. Combined Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Subclinical Hypothyroidism Patients with Autoimmune Thyroiditis. Journal of Thyroid Research. 2013;2013:424163. doi:10.1155/2013/424163.
- Nordio M, Basciani S. Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis. International Journal of Endocrinology. 2017;2017:2549491. doi:10.1155/2017/2549491.
- Ceyhun V, Tezcan K, Perihan V, et al. Insulin resistance in the patients with euthryroid Hashimoto thyroiditis. Biomedical Research. 2017;28(4).
- Unfer V, Nestler JE, Kamenov ZA, Prapas N, Facchinetti F. Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials. International Journal of Endocrinology. 2016;2016:1849162. doi:10.1155/2016/1849162.
- Unfer V, Facchinetti F, Ora B, Giordani B, Nestler J. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrine Connections. 2017;6(8):647-658. doi:10.1530/EC-17-0243.
- DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril. 2005 May;83(5):1454-60.
- Nestler JE. Role of hyperinsulinemia in the pathogenesis of the polycystic ovary syndrome, and its clinical implications. Seminars in Reproductive Endocrinology. 1997;15(2):111–122. doi: 10.1055/s-2007-1016294.
- Unfer V, Carlomagno G, Papaleo E, Vailati S, Candiani M, Baillargeon JP. Hyperinsulinemia alters myoinositol to d-chiroinositol ratio in the follicular fluid of patients with PCOS. Reproductive Sciences. 2014;21(7):854–858. doi: 10.1177/1933719113518985
- Kalra B, Kalra S, Sharma JB. The inositols and polycystic ovary syndrome. Indian Journal of Endocrinology and Metabolism. 2016;20(5):720-724. doi:10.4103/2230-8210.189231.
- Genazzani AD, Lanzoni C, Ricchieri F, et al. Myo-inositol administration positively affects hyperinsulinemia and hormonal parameters in overweight patients with polycystic ovary syndrome. Gynecol Endocrinol. 2008 Mar:24(3):139044 doi: 10.1080/09513590801893232.
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- Colazingari S, Treglia M, Najjar R, Bevilacqua A. The combined therapy myo-inositol plus D-chiro-inositol, rather than D-chiro-inositol, is able to improve IVF outcomes: Results from a randomized controlled trial. Arch Gynecol Obstet. 2013;288:1405–11.
- Nordio M, Proietti E. The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. Eur Rev Med Pharmacol Sci. 2012;16:575–81.
- Minozzi M, Nordio M, Pajalich R. The combined therapy myo-inositol plus D-Chiro-inositol, in a physiological ratio, reduces the cardiovascular risk by improving the lipid profile in PCOS patients. Eur Rev Med Pharmacol Sci. 2013 Feb;17(4):537-40.
- Unfer V, Facchinetti F, Ora B, Giordani B, Nestler J. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrine Connections. 2017;6(8):647-658. doi:10.1530/EC-17-0243.
- Sinha U, Sinharay K, Saha S, Longkumer TA, Baul SN, Pal SK. Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital based cross-sectional study from Eastern India. Indian Journal of Endocrinology and Metabolism. 2013;17(2):304-309. doi:10.4103/2230-8210.109714.
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Note: Originally published in October 2018, this article has been revised and updated for accuracy and thoroughness.
I want to try this for my 12 year old son who suffers from OCD. Is this combo just for women?? Thanks!
Kate – thank you for reaching out. My heart goes out to you and your son. I recommend that you work with a functional medicine doctor that is familiar in working with children (I only works with adults). I hope this helps!
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
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Hi-Do you provide consultations? I have been dealing with hashimotos and for the last 3months many other symptoms . My doctors tell me to take anti-anxiety meds and I am somewhat reserved about taking them. Besides I really think something else is going on and it is almost debilitating dealing with these symptoms: Frequent headaches daily anxiety loss of memory loss of concentration overall sense of helplessness don’t feel normal increase digestive issues pelvic pain joint pain. I could go on also my metabolism is extremely slow I could eat clean and balanced but never lose a pound. Thanks in advance for listening.
Jenny – thank you for reaching out. I understand how frustrating this can all be. 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. There are a few requirements that you should pay attention to before enrolling to this course, like reading my book. Here is the link to the program:
Hashimoto’s Self-Management Program
https://thyroidpharmacist.com/enroll-in-hashimotos-program/
Hi Dr Izabella,
I am seeing a Naturopath doctor and I just found out that although my blood sugar is at a normal level when fasting (81mg/dl) I have a low Hemoglobin Alc (4.3). She told me to eat every 2 hours and avoid meals that contains only carbohydrates and combine it with fat and protein. I was wondering if myo inositol would be good to regulate my blood sugar imbalance, since I am way far from being diabetic at this point.
Thank you so much, I love your books and your supplements. It has lowered my T4 dosage in only a month going without gluten, soy and dairy (My tsh was 2.67 in December and now it is 0.3)
Very grateful to have found you!!!
Sibelle – thank you so much for reaching out and sharing. <3 I'm so happy to hear you finding my research helpful and that you have found a practitioner! Please understand, I am not able to advise on whether the Myo-inositol would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your practitioner.
Hi Dr. Wentz,
Thank you for the wealth of information.
What do you think can be a contributing factor to unbearably itching toes, if sugars of all kinds have been removed from the diet(for a long time) as well as all grains, and dairy ?
K. – you are very welcome! 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. I would advise you to discuss this with your clinician.
My blood sugar drops frequently, and often have to get up in the middle of the night for a snack. I have hashimotos. Would this product help with drops in blood sugar? The article mentions to watch for hypoglycemia as a side effect and I already struggle with this. Thanks!
Tara – thank you for reaching out. I am not able to advise on whether this supplement would be appropriate for your specific health needs without a comprehensive health assessment. <3 I recommend that you discuss the use of this supplement with your personal doctor. Here is a link which might help as well: https://thyroidpharmacist.com/articles/blood-sugar-imbalances-and-hashimotos
I am excited to add myo-inositol to my supplement regime. Your books and website have been a wealth of information and support on this journey to healing my hypothyroid, thank you for all you do and share with us!
I have been gluten-free and dairy-free for about a year, but have been slowly reducing grain (and carb) consumption and it has helped me tremendously. I am eating mostly “primal” now, working to heal my gut and bring down my A1C level , which was pre-diabetic.
Cate – thank you so much for sharing your journey! <3 I am happy to hear you are taking charge of your health and I hope you will keep me posted on your progress here.
can you take these supplements if you are on depressants and benzo’s?
Nana – thank you for reaching out. I am not able to advise on whether this supplement would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss the use of this supplement with your personal doctor.
Thanks for you in-depth article on myo-inositol. It was very helpful. I know it’s better to take myo-inositol on an empty stomach for better absorption. I’ve always been told to try not to take any supplements within four hours of your thyroid medications. Would this still be the case with myo-inositol? I’d rather take it in the mornings on an empty stomach when I usually take my thyroid meds. Any input would be helpful.
Thanks!
Brian – thank you for reaching out. I wish I could give you more direct advice but, each person will react differently. I recommend that you ask your personal pharmacist or a trusted clinician who’s care you are under. <3
Thank you for the information,I am unclear with the selenium dosage to go with 600mg of inositol.Can you clear that.Thank you
Nicole – thank you for reaching out! I am happy to hear you found this article helpful. I recommend Selenium Methionine at 200-400 mcg per day.
Here is an article you may find helpful!
NUTRIENT DEFICIENCIES – SELENIUM
https://thyroidpharmacist.com/articles/nutrient-depletions-in-hashimotos-part-i-selenium
Here is a link to the one I recommend in the article:
https://www.purerxo.com/thyroidpharmacist/rxo/products/product_details.asp?ProductsID=177
Hello, dr Izabella! You recommend to take the selenium on an empty stomach. Should myo-inositol be taken on an empty stomach together with selenium too? or should myo-inositol be taken with food to avoid stomach upset? Thank you very much for the reply!
Kasia – thank you for reaching out. You should start with the directions on the bottle and adjust from there. I cannot tell you specifically what you can and cannot do over the internet as I could be held liable for what would happen to you. 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, they will be more than happy to help 🙂
Thank you!
What great information, especially as it pertains to carb intolerance.
I believe I have developed a carb intolerance, more so a sugar intolerance. I have noticed that added sugars either make me feel dizzy or give me a headache almost instantaneously, even as little as three grams in an apple cider vinegar beverage that I tried a couple of times. The same happens with honey and with low glycemic sweeteners such as coconut palm sugar. Is this an issue that accompanies Hashimoto’s for some?
I am allergic to Selenium. Each day Hashimoto’s is taking a little bit out of me. How can I reduce my antibodies without Selenium?
Beth – thank you for reaching out. For questions about the supplements please email my team at info@thyroidpharmacist.com and they will be happy to help you. <3
Thank you for all of this valuable information. I saw that you had recommendations for the selenium, is there a brand you recommend for the myo-inositol? Also, will this help with hair loss? I have Hypo with my Hashimotos but I am have a lot of hair loss, even with my
AIP routine and added supplements. Will myo-inositol help with the hair loss at all? If not do you have any suggestions?
Thank you
Sarah – you are very welcome! I recommend taking 600 mg daily of the Pure Encapsulations Inositol powder, which contains the myo-inositol form, for reducing TSH and thyroid antibodies (ideally, in conjunction with selenium). Hair loss is a distressing symptom experienced by women with Hashimoto’s. For women, our hair represents our femininity, and losing our hair is a constant reminder that something is off and that we are not well.
Here are some articles which might help:
PURE ENCAPSULATONS INOSITOL
https://www.purerxo.com/thyroidpharmacist/rxo/products/product_details.asp?ProductsID=1203
HAIR LOSS AND YOUR THYROID
https://thyroidpharmacist.com/articles/hair-loss-and-thyroid/
HASHIMOTO’S AND GETTING YOUR HAIR BACK
https://thyroidpharmacist.com/articles/hashimotos-and-getting-your-hair-back/
I read a study that showed Myo inositol and selenium reduced thyroid antibodies. I have started both, but I alternate. I find that I am not able to tolerate many supplements daily, but a lesser dose helps. Not sure about the selenium, but I must say the inositol makes me feel better in that I feel happier and not stressing about things I have no control over. I have read though, that it can be a problem with bi polar conditions.
Jane – thank you for sharing. <3
I have read the article on myo-inositol. I have had hashimoto’s for over twenty years. And now my daughter has it as well as lupus. I would like to start the myo-inositol supplements but I read that it is derived from rice bran. I am avoiding rice as I have read that it has arsenic in it. Is this a possibility with the myo-inositol?
S – thank you for reaching out. My heart goes out to you and your daughter. Please email my team at info@thyroidpharmacist.com and they will be happy to help you. <3
I had been taking selenium alone for about 6 months. About one month ago, I added myo-inositol to my regimen and I’m please to report I feel great! I started feeling good enough to start brisk walking again! I’m taking 200 mcg of Selenium and my multi-vitamin has another 125 mcg. I’m taking 2 scoops (4.2 g) of myo-inositol. I’m curious to know if it would help to take myo- and D-chiro-inositol as I’ve seen them combined. Also, is that too much Selenium? Thank you so much for this article!
Patti – thank you so much for reaching out and sharing your journey! I am so happy to hear you are feeling good! <3 For questions about the supplements please email my team at info@thyroidpharmacist.com and they will be happy to help you.
You mentioned caution using myo inositol with diabeties, as it may cause low blood sugar. While my A1c and glucose are still below prediabetic values, I am being monitored due to some GAD 65 antibodies and am not on any diabetic meds. Does the reference to myo inositol and blood sugar apply only if diabeties meds are being taken? I have been doing gluten, dairy free, selenium and myo inositol (although at a lower dose as EVERYTHING seems to bother me) and other protocols. Much to my endo’s surprise, my TSH has dropped consistently over the past year and I have gone from 88mcg to alternating 50 and 75 mcg of Synthroid. He is baffled. I feel wonderful. Not much movement on the antibodies yet. Thank you!!!!
Jane – thank you so much for sharing your journey. <3 I am not able to advise on whether Myo-inositol 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. I very happy to hear you are feeling well and I hope you will continue to keep me posted on your progress.
I just started taking metformin for PCOS and also have Hashimotos. Can I take myo-inositol with the Metformin or should I only take one or the other?
Thanks.
Danielle – thank you for reaching out. I wish I could give you more direct advice but, each person will react differently. I would advise you to ask your personal pharmacist or a trusted clinician who’s care you are under. <3
I have tried myo-inositol a few times over the years for OCD, and it always gives me severe diarrhea, gas and bloating, so much so that I need to stay home or be near a bathroom the whole day. Very disappointing results with this supplement and no change in OCD. It’s not very palatable, like a chalky sweetener, so I had to mix with juice. I used the Pure Encapsulations brand. Even in smaller doses I have similar side effects.
I have noticed less hair loss, but am also using Seriphos at the same time, which lowers cortisol. My doctor said my high cortisol is to blame for much of my health issues, so we are working on blood sugar control with diet, and fixing my sleep apnea with corrective jaw surgery. Really getting diet, stress, weight and sleep normalized is the key to healing the body, not introducing tons of supplements which really are just natural drugs.
Pogo – thank you so much for sharing your journey. I am so happy to hear you have found a practitioner. Please keep me posted on your progress. <3
Under Supplement Facts, it says 2 scoops=4.2g. How many scoops are 600mg of inositol powder?
Chelsea – thank you for reaching out. In this article I recommend taking 700 mg daily of the Rootcology Myo-Inositol Powder, which contains the myo-inositol form. If you have any other questions about the supplements please email my team at info@rootcology.com and they will be happy to help you. <3
I see your reply message to Sarah Whitney on December 28, 2018, saying
“I recommend taking 600 mg daily of the Pure Encapsulations Inositol powder, which contains the myo-inositol form, for reducing TSH and thyroid antibodies (ideally, in conjunction with selenium).”
Chelsea – thank you for reaching out. I am sorry for the confusion. This article was recently updated to include my Rootcology brand of myo-inositol. You should start with the directions on the bottle and adjust your dosage from there. If you have more specific questions on how and when to take the Myo-inositol 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 ?
https://rootcology.com/collections/supplements/products/myo-inositol-powder
I have gained so many blessings from you and your newsletters over the years. My Hashimotos has been in remission (very low antibodies at every blood test) for a long time, too! My diet has been AIP strictly for almost 8 years now. I recently started using your Adrenal Support and now Myo-Inositol, together 4 times daily with excellent results!!! Do you know of a functional medicine practitioner who has had successful experiences helping patients to very gradually taper off their antidepressants after many years? I have been prescribed one for 25 years for an anxiety disorder, and the medication actually doesn’t even work to solve the anxiety.
C.B. – thank you so much for sharing you journey with me! <3 I am so happy to hear you are doing so well. I believe that everyone needs to find a practitioner that will let him/her be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It's a good idea to ask some standard questions when contacting a new doctor for the first time and let them know that your goal is to taper off the antidepressants. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
COMPOUNDING PHARMACIES
https://thyroidpharmacist.com/database-recommended-compounding-pharmacies/
So, this article makes since. I go online to check out the product and you have so many products. I have no idea what products I need without spending 3000.00 a month. Can there not be just a couple of products that can help with everything? Yes, OCD, Anxiety in this message. I know I got issues but trying to buy a product with 50 products does not help!
Jennifer – thank you so much for reaching out and sharing. I understand how overwhelming this can all be. <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:
http://amzn.to/2B5J1mq
Hashimoto’s Food Pharmacology (this is my latest book):
https://www.amazon.com/Hashimotos-Food-Pharmacology-Nutrition-Protocols/dp/0062571591?tag=thyroipharma-20
I have had my thyroid removed but have increasing anxiety and depression with OCD tendencies. Would taking either of these supplements help me and improve the stagnant ‘I don’t want to do anything ‘ mood I am constantly in?
Vicki – thank you for reaching out. I am so sorry you are struggling with all of this. Please understand, I am not able to advise on whether myo-inositol would be appropriate for you and your specific health needs without a comprehensive health assessment. Depression is a common symptom of Hashimoto’s and a consequence of chronic illness. 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. Depression is a common symptom of Hashimoto’s and a consequence of chronic illness. I recommend you read these articles as well:
ROOT CAUSES OF DEPRESSION AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/root-causes-of-depression-and-hashimotos/
HASHIMOTO’S AND ANXIETY
https://thyroidpharmacist.com/articles/hashimotos-and-anxiety/
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/
Thank you for this research! I have no idea where to begin, I have Hashimoto’s, PCOS, Insulin Resistance, high blood pressure, DDD, and 4 back surgeries waiting on another. I just want to feel better! I’m 50 years old.
I was diagnosed in late teens with PCOS and I have been on 1000 mg of Metformin 2x/day since then and continuous birth control. Also, been taking synthroid for about 10 years. I’m always tired and overweight. Anyway, I really want to get this weight off and I can’t exercise much right now. Where do I begin to know what supplements to take, I take some now like Selenium.
Thank you!
Sheryl – thank you so much for reaching out. I’m so sorry to hear you are struggling with all of this. <3 My heart goes out to you. 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
Hi Dr ,
I am from Malaysia.
May I know where can I get the Myo Inositol ?do they ship to Malaysia?
Albert – thank you so much for your interest in my Rootcology products. <3 Unfortunately, we cannot currently sell or ship our Rootcology supplements outside of the United States due to complicated regulations. However, I do have an alternate recommendation,for Rootcology's Myo-Inositol Powder for my international customers, available here:
Inositol Powder by Pure Encapsulations https://www.amritanutrition.co.uk/inositol-powder-250g
Hi, I have insulin resistance, high cortisol and high dhea/ PCOS
I’m 25 and deal with severe anxiety and depression as well, which I take medication for. One of my doctors recommended Inositol for my hormones which I took for a month straight but it made me have a full on period or spot the whole month, i stopped taking it and my next period which I’m having right now is awful, severe severe anxiety and depression etc. Is it common to bleed a lot in the beginning and does it sort itself out or should I maybe not take it as often or a lower dose? Thank you.
Kristen – thank you for reaching out. I’m so sorry you had this experience! <3 I recommend you discuss this issue with your practitioner. If you purchased this product from my Rootcology supplement line please email my team and they will be happy to help you.
Dear Isabella, I would also like to share my experience with myoinositol. I was treated with myoinositol as part of a clinical study. My health problems started after experiencing what I thought was a long term burn out and later also being treated for several months for infection with wrong antibiotics. A cascade effect followed – to make a long story short – I was diagnosed last summer with Hashimoto´s (TSH 3.9 but aTPO over 400), had a severe vit.D deficiency, histamine intolerance, extreme fatigue… I was treated with myoinositol for 9 months as part of a trial where my weight, sleep, sweat, different sensations, anxiety, menstruation etc was being monitored and went on a FODMAP diet. I started feeling better almost immediately, all thyroid symptoms gradually improved, lost a bit of weight and after 9 months I was taken off myositol with TSH 2.2 and aTPO 70, and was told to continue just with moderate levels of selenium until next check-up in 4 months. In this period I gained the weight back, menstruation cycle got a bit shorter and more heavy, I had mood swings, skin got worse. Finally I went to the planned check-up, and my TSH was 7!!! The highest ever. During this 4-month period without myositol I had to be treated with tetracycline for severe boreliosis for 3 weeks (will go for blood tests again soon to see if the infection is gone). I wonder if this could have had an impact at the higher TSH as well. Anyways my doctor put me on Euthyrox 50mg and said I do not have to take myoinositol anymore. To me, this sounds a bit odd. We have allergies, histamine intolerance and diabetes 2 in the family (I am not aware of any Hashimoto’s), and after experiencing the many benefits of myoinositol, I would like to continue taking it anyways as, what I understood from your article, it helps to heal the root cause which in my case might be deficiency (low vit D levels and tendency to gain weight, histamine intolerance…). I would like to know, what is your opinion on taking myoninositol together with Euthyrox? I am 35, not pregnant but would like to have children…
Eva – thank you for reaching out and sharing your journey with me. Please understand, I am not able to advise on what would be appropriate for you and your specific health needs without a comprehensive health assessment. I do understand how hard it is to find the right practitioner. I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and prevent serious chronic disease rather than treating individual disease symptoms. I believe that everyone needs to find a practitioner that will let him/her be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It’s a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
COMPOUNDING PHARMACIES
https://thyroidpharmacist.com/database-recommended-compounding-pharmacies/
Dear Dr. Wentz,
I find all your information so informative and helpful.
If I buy the myo-inositol do I also need to supplement with the other B vitamins?
thanks
Susan – thank you so much! <3 That is something I recommend you discuss with your practitoner. I believe that most nutrients should come from the diet. This is why I always list food sources in the book and on the blog, for most of the nutrients, vitamins, minerals. and probiotics that are depleted in Hashimoto’s. However, some may require or prefer supplements. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm. Here are some article links which might help:
WHICH SUPPLEMENTS ACTUALLY HELP HASHIMOTO'S
https://thyroidpharmacist.com/articles/which-supplements-actually-help-hashimotos/
USING ENZYMES TO OVERCOME HASHIMOTO’S
https://thyroidpharmacist.com/articles/using-enzymes-to-overcome-hashimotos/
THE FOUR BEST PROBIOTICS FOR HASHIMOTO’S
https://thyroidpharmacist.com/articles/the-four-best-probiotics-for-hashimotos/
Dear Izabella, I am 44 and have been diagnosed with Hashimoto 15 years ago. Since then I am on constant treatment with Euthyrox or Letrox. Last 6 months I am taking 100 mg. My TSH is 7,5 and my Anti TG are more then 2000 and Anti TPO more then 1000 (results from May). Last 2 years I have sleeping disorder and after testing my adrenals 4 months ago (saliva test) it turned out that my night cortisol is too high. I have eliminated gluten and dairy products 5 months ago, reduced carbohydrates and have also started to use supplements: selen, C, B, E, D. Now I would like to introduce Ashwagandha and Myo-Inositol. Would you be so kind to suggest when to use all that supplements during the day (in which order) to be the best absorbed and what is the best dose? I live in Croatia and to find functional doctor here is almost mission impossible. Thank you very much in advance. I deeply appreciate your work:)
Ana – thank you for reaching out and sharing your journey with me. <3 For questions about my supplements please email my team at info@rootcology.com and they will be happy to help you.