The “Five R” Approach of Functional Medicine Summary
In January 2011, I made a specific resolution, to take charge of my health and my life.
I had been diagnosed with Hashimoto’s in 2009 and started to research complementary/alternative/functional medicine treatments in 2010. Unfortunately, despite my hours of research, I was stuck in a state of “paralysis by analysis,” there was just so much information about Hashimoto’s and autoimmune disease, I didn’t know where to start, who to trust, or if anything would help. As a pharmacist, I have been trained to be highly skeptical of non-FDA approved treatments, and a large part of me did not believe that myself, could figure out and fix something that hundreds of brilliant doctors were not able to. Despite my doubts, I finally decided that I needed to take action in 2011. After all, doing the same thing over and over while expecting different results is Einstein’s definition of insanity. Clearly what I had been doing during 2010 wasn’t working, and I needed to make a drastic change!
I decided to be the creator of my own universe!
I made a vision board with pictures of all of the things that I hoped would manifest for me that year…
- Getting my energy back (I was sleeping for 12+ hours each night)
- Getting my hair back (I had lost more than a third of my hair!)
- Regaining my health (reversing my autoimmune condition)
- Buying my first home
- A beach honeymoon/anniversary trip with my husband (postponed due to work obligations)
- Writing a book that would help and inspire others
I purchased numerous books on autoimmunity and thyroid disorders, scheduled a consultation with a reputable functional medicine clinic as well as an integrative doctor, and invested in food sensitivity testing, numerous supplements and started journaling.
One of my first successes was changing my diet! I had amazing results! You can read about my Hashimoto’s and Acid Reflux Journey.
But my journey didn’t end there. It took another year of trial and error to get my energy back, and two years to recover my hair and health.
There is a lot of conflicting information on the internet, and many of us will hear a variety of different explanations from various practitioners. (If you’re in need of a practitioner in your area, I’ve collected names of those who believe in the root cause approach to thyroid disease.) I decided to sort through all of the available information and do my testing and research.
In 2012, I started writing a Hashimoto’s patient guide to organizing my research and outline a roadmap with the hope that it would empower others with Hashimoto’s with the necessary knowledge to recover their health.
I’ve gone to great lengths to make the material in the book accessible and approachable for the patient. After all, we know ourselves best, and ultimately it’s up to us whether we will get better or not.
I hope you consider picking up a copy of Hashimoto’s: The Root Cause.
Starting Your Hashimoto’s Journey…
There are many of you that are just beginning your Hashimoto’s journey to find your own Hashimoto’s Root Cause! My aim is to empower you! Below you will find a summary of my approach; it’s very similar to the approach that I developed for myself in 2011.
You will 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 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.
The “Five R” Approach of Functional Medicine Summary
The complete approach to healing Hashimoto’s can be summarized through the Five R’s of Healing, an approach used by Functional Medicine Practitioners that I have tailored for Hashimoto’s patients.
REMOVE
REMOVE the things that may be irritating your thyroid and causing it to send out a stress signal.
Iodine excess (especially when other nutrients are deficient), fluoride, and toxins can cause thyroid inflammation as a result of oxidative damage, causing the thyroid to send out a stress response, which becomes picked up by the immune system.
Gluten and food intolerances promote intestinal permeability, making our immune system unable to recognize our cells.
Gut infections including bacterial, fungal and parasitic infections can weaken the intestinal lining, affecting the ability of our immune system to recognize self from non-self (the gut is home to most of our immune system)
Food that is poorly digested feeds the bad bacteria, making them stronger.
Stress weakens the thyroid through its actions on the adrenals and can help the negative bacteria proliferate.
REPAIR
REPAIR the intestinal permeability through an anti-inflammatory leaky gut diet, broths, and glutamine.
REPLACE
REPLACE the depletions that are present to help the body strengthen and jump back on a cycle of wellness. This includes thyroid hormone!
-> -> You can download my nutrient depletion chapter for free
REINOCULATE
REINOCULATE, giving the body enough beneficial bacteria to displace the pathogenic bacteria. Probiotics and raw Lacto-fermented foods are used.
REBALANCE
REBALANCE the adrenals, immune system, and our detoxification capabilities. The adrenals respond well to adaptogens. Some may require the use of further interventions such as the use of low dose hormones or glandulars.
The “Five R” Approach of Functional Medicine (in detail)
REMOVE
- Iodine excess
- Infections
- Fluoride
- Toxins
- Difficult to digest food
- Food intolerances
- Stress
REPAIR
- Healing diet
- Protomorphogens
- Broths
- Glutamine
REPLACE
- B12
- Zinc
- Selenium
- Ferritin
- Other vitamin and mineral depletions
- Thyroid hormone
- Digestive enzymes
REINOCULATE
- Probiotics
- Fermented Foods
REBALANCE
- Adrenal adaptogens
- Curcumin/Omega-3’s
- Green juices, smoothies, vegetables
Are there additional things you can do?
Create your 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.
Enter your email to Download your Sample Timeline below!
Journaling –Keep track of how you are feeling, the interventions you are making, and how they are impacting your well-being, and “numbers” (TSH, Free T3, Free T4, antibodies, etc.)
Embrace change, believe that you can heal, and listen to your body…
Implementation proved to be the hardest part for me, as many of us have been made to feel guilty about wanting to do something for ourselves, stories like: “it’s selfish to spend money on supplements,” “you should eat the same diet as everyone else”, “everyone feels tired”, “you’re not smart/strong/patient/good enough to get better,” “you’re wasting your time/money” often played in my head.
Through my journey, I have come to understand that I am powerful, smart, deserving of support and that taking care of myself is important. I hope that all of you believe the same. Now and then, a person such as an unsupportive doctor, friend or family member may come along and challenge your beliefs…don’t let them! You are the creator of your universe, and you know what’s best for you!
PS. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free by going to www.thyroidpharmacist.com/gift. You will also receive occasional updates about new research, resources, giveaways and helpful information.
For future updates, make sure to follow us on Facebook!
Anne says
Izabella Wentz, PharmD says
hope says
I am devouring your book! I am looking to do a liver detox (i have been following an autoimmune paleo protocol for over 90 days now) I was looking at Apex Clearvite b/c the program and the supplements seem good. it’s a pea protein…. then i read your chapter on detox and the juice/soup fast. I’m confused as to how to make the broth… can you please expand on how to do it? also, are smoothies as good as juice? or should i get a juicer? what about the clearvite? do i need extra supplements when i’m doing it… help! just looking for some advice 🙂 Thank you for ALL of your hard work and for sharing it with us! it is much appreciated. thank you again for any advice you can give me.
Izabella Wentz, PharmD says
Lucy says
Dr. Izabella Wentz says
Lucy- Here are a couple of articles about diet that you may find interesting or helpful.
TAILORING YOUR THYROID DIET
https://thyroidpharmacist.com/articles/tailoring-your-thyroid-diet-to-your-needs
BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism
Daniël Niks says
Dr. Izabella Wentz says
Daniel- Conventional cosmetics, potions and lotions are filled with petroleum by-products, phthalates, formaldehyde, hormone disruptors and other toxins, and as a pharmacologist, I can tell you that what you put on your skin definitely gets absorbed into your body! Here is an article you may find interesting! 🙂
ARE YOU SACRIFICING YOUR HEALTH FOR EXTERNAL BEAUTY?
https://thyroidpharmacist.com/articles/are-you-sacrificing-your-health-for-external-beauty
Wendy says
Dr. Izabella Wentz says
Wendy- Thank you so much for your support. I’m looking forward to hearing your progress on this page. Make sure to take the book slow, take notes, highlight, and establish a baseline when making changes. 🙂
Aasiya says
Dr. Izabella Wentz says
Aasiya- Thyroid tissue can regenerate, but the rate at which it does is not always predictable. Thus, some are able to stop the autoimmune attack on their thyroid and regain normal thyroid function. Others can reduce the dose of medications, and others will need to stay on the medications indefinitely. I’m currently working on some protocols to help with tissue regeneration.
Reversing Hashimoto’s means different things to different people. For some, it means a reduction in symptoms and for others it means a reduction in your antibodies. I had both. Here a few articles that might be helpful for you 🙂
IS IT POSSIBLE TO RECOVER THYROID FUNCTION IN HASHIMOTO’S
https://thyroidpharmacist.com/articles/is-it-possible-to-recover-thyroid-function-in-hashimotos
REVERSING AUTOIMMUNITY? AND THE PERFECT STORM
https://thyroidpharmacist.com/articles/reversing-autoimmunity-and-the-perfect-storm/
HASHIMOTO’S SELF CARE, GETTING AND STAYING IN REMISSION
https://thyroidpharmacist.com/articles/hashimotos-self-care
Hannah says
Dr. Wentz- Have you had any success in creating a supplement that assists in tissue regeneration? That would be amazing. Thanks! – Hannah
Dr. Izabella says
Hannah – thank you for reaching out. I’m currently working on some protocols to help with tissue regeneration. Reversing Hashimoto’s means different things to different people. For some, it means a reduction in symptoms, and for others, it means a reduction in your antibodies. I had both. Here a few articles that might be helpful for you:
IS IT POSSIBLE TO RECOVER THYROID FUNCTION IN HASHIMOTO’S
https://thyroidpharmacist.com/articles/is-it-possible-to-recover-thyroid-function-in-hashimotos
REVERSING AUTOIMMUNITY? AND THE PERFECT STORM
https://thyroidpharmacist.com/articles/reversing-autoimmunity-and-the-perfect-storm/
Adriana says
Dr. Izabella Wentz says
Adriana- Thyroid tissue can regenerate, but the rate at which it does is not always predictable. Thus, some are able to stop the autoimmune attack on their thyroid and regain normal thyroid function. Others can reduce the dose of medications, and others will need to stay on the medications indefinitely. I’m currently working on some protocols to help with tissue regeneration.
Reversing Hashimoto’s means different things to different people. For some, it means a reduction in symptoms and for others it means a reduction in your antibodies. I had both. Here a few articles that might be helpful for you 🙂
IS IT POSSIBLE TO RECOVER THYROID FUNCTION IN HASHIMOTO’S
https://thyroidpharmacist.com/articles/is-it-possible-to-recover-thyroid-function-in-hashimotos
REVERSING AUTOIMMUNITY? AND THE PERFECT STORM
https://thyroidpharmacist.com/articles/reversing-autoimmunity-and-the-perfect-storm/
HASHIMOTO’S SELF CARE, GETTING AND STAYING IN REMISSION
https://thyroidpharmacist.com/articles/hashimotos-self-care
Brenda Phillipd says
Dr. Izabella Wentz says
Brenda- 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, is ‘dead’, 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 re-balance the immune system to prevent this (sometimes the autoimmunity can be reversed as well). The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.
Hashimoto’s Root Cause
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Hashimoto’s Protocol
https://smile.amazon.com/Hashimotos-Protocol-Reversing-Thyroid-Symptoms/dp/006257129X/ref=sr_1_1?ie=UTF8&qid=1482698453&sr=8-1&keywords=Hashimoto%27s+Protocol
Isaura Pérez says
Dr. Izabella Wentz says
Isaura- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.
The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.
Hashimoto’s Root Cause
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Hashimoto’s Protocol
https://smile.amazon.com/Hashimotos-Protocol-Reversing-Thyroid-Symptoms/dp/006257129X/ref=sr_1_1?ie=UTF8&qid=1482698453&sr=8-1&keywords=Hashimoto%27s+Protocol
Amy says
Dr. Izabella Wentz says
Amy- Thank you so much for your support. I’m looking forward to hearing your progress on this page. Make sure to take the book slow, take notes, highlight, and establish a baseline when making changes.
Debi Stuber says
Dr. Izabella Wentz says
Debi- Thyroid tissue can regenerate, but the rate at which it does is not always predictable. Thus, some are able to stop the autoimmune attack on their thyroid and regain normal thyroid function. Others can reduce the dose of medications, and others will need to stay on the medications indefinitely. I’m currently working on some protocols to help with tissue regeneration.
Reversing Hashimoto’s means different things to different people. For some, it means a reduction in symptoms and for others it means a reduction in your antibodies. I had both. Here a few articles that might be helpful for you 🙂
IS IT POSSIBLE TO RECOVER THYROID FUNCTION IN HASHIMOTO’S
https://thyroidpharmacist.com/articles/is-it-possible-to-recover-thyroid-function-in-hashimotos
REVERSING AUTOIMMUNITY? AND THE PERFECT STORM
https://thyroidpharmacist.com/articles/reversing-autoimmunity-and-the-perfect-storm/
HASHIMOTO’S SELF CARE, GETTING AND STAYING IN REMISSION
https://thyroidpharmacist.com/articles/hashimotos-self-care
Tracie says
Dr. Izabella Wentz says
Tracie- You may like to check out the doctors that other patients recommend on this list:
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
vineeta anand says
Dr. Izabella Wentz says
Vineeta- In my book I also give different brands that I like to use. The chapter starts on page 329! 🙂
Corine De Jonge says
Dr. Izabella Wentz says
Corine- You may find this article interesting as well! 🙂
THIAMINE AND THYROID FATIGUE
https://thyroidpharmacist.com/articles/thiamine-and-thyroid-fatigue
Ellen says
Dr. Izabella Wentz says
Ellen- Thank you so much for your support. I’m looking forward to hearing your progress on this page. Make sure to take the book slow, take notes, highlight, and establish a baseline when making changes. You may like to check out the doctors that other patients recommend on this list:
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
Karen says
Dr. Izabella Wentz says
Karen- Fatigue was the most debilitating symptom I experienced with Hashimoto’s. It actually started 8 years before I was finally diagnosed in 2009, after I got Mono (Epstein-Barr Virus) in college. I needed to sleep for 12 hours each night to be able to function, and by “function” I mean after hitting the snooze button on my alarm clock for two hours (ask my poor husband), I would drag myself out of bed and then had to drink 4-6 cups of caffeine everyday to keep myself awake. I often had Red Bull and Pepsi for breakfast, and was the epitome of “wired but tired”. I hope my articles help you get started 🙂
OVERCOMING THYROID FATIGUE
https://thyroidpharmacist.com/articles/top-10-tips-for-overcoming-hashimotos-fatigue
THIAMINE AND THYROID FATIGUE
https://thyroidpharmacist.com/articles/thiamine-and-thyroid-fatigue
Gabi says
Thank you for this helpfull advices. I have Hashimoto since 2012 and realiced during this time: it changed – food which was ok. last year is unbearabel this year. So I make a selftest from time to time, to find out, what I can bear today – knowing it can be diffrent just next week. The list of unbearable food becomes longer and longer… too sad that my body dont looks like this 🙂
Dr. Izabella Wentz says
Gabi – thank you for following this page. Did you know that reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients (gluten sensitivity in particular has been implicated in causing a Selenium deficiency, a well known risk factor for Hashimoto’s), and can also produce intestinal permeability whenever they are eaten?
Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.
FOOD SENSITIVITIES AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos
AUTOIMMUNE PALEO DIET
https://thyroidpharmacist.com/articles/autoimmune-paleo-diet
Paxton says
Hello, I was recently diagnosed with hypothyroidism, something I’d been suffering from for many years and trying to figure out. I’ve also had vitiligo for many years and was wondering if it is safe to assume that I have Hashimoto’s, considering that many consider them associated Auto Immune disorders? With that being said, I randomly stumbled across your web page, just purchased your book too, and had no idea that I should be doing more than just taking the thyroid suppliment. At the same time of being diagnosed with hypothyroidism I also discovered numerous food intolerances and the combo of their elimination from my diet and the L-thyroxene has left me feeling much better finally. My question to you now is if these foods are the cause, will my vitiligo potentially disappear in time?
Dr. Izabella Wentz says
Paxton- Thank you so much for your support! These are the recommended labs from my book, page 32.
RECOMMENDED THYROID FUNCTION TESTS
TSH
TPO Antibodies
Thyroglobulin Antibodies
Free T4
Free T3
Reverse T3 (Optional)
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
TOP 6 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Ina says
Thank you for your informative articles- I have recently started following you on Facebook and will try and get your books to get more knowledge. I have diabetes type I ( dx in 2000) and Hashimoto’s ( dx in 2010 while pregnant with my second child). I have tried gluten-free and no results. I am currently on synthetic rx. And at times too much release is happening as my heart rate goes up in the 100s. I am thinking about trying the Paleo diet.
momna says
Hello
I have few questions, which i want to ask from you:
1. How to Approach you for consultation, i mean your Office is in which Country and is it possible to consult you?
2. I have thyroid Problem, even i don’t know that i have or not because my doctors are good enough to find out the cause. Still i am following your Posts and pages and Research papers. I Diagnosed with Hypothyroid in 2014 not doubt i had some symptoms like hair falling dizziness and something feeling in my brain. From that time till now my TSH is fluctuating but not T3 or T4 , they are every time under the range. And doctor is not telling me proper medication , when he will see it is high , he will high the dose of Levothyroxin and when it is low then he will say now take 50 mg instead of 75mg . so I want to know what should I do ?
3. I stated selenium last two months back and I was begging these people to check my TPO but they said once you diagnosed that you have Hashimoto’s then there is no need to check after 3 months. Is it true?
4. Sometimes I think that my root cause is my GUT, because after diagnosed I got 18 kg and then I lost 12 Kg but my abdominal part is getting back to its normal position then I started Probiotic, I saw little bit changes in the size of my abdominal. So how to go for lab test for GUT or acid reflux and other things related to it.
Waiting for your response.
Thanks in advance for your corporation.
Monica Campanaris says
Hi Dr Wentz,
I just wanted to say thank you so much for your informative help. I have suffered with Hashimotos for many years, doctors were no help and was at my lowest point of desparation when someone gave me your name and told me to look you up on facebook. I am now more understanding of my condition and the triggers, and am feeling better than I have in years. The pain, fertility issues, insomnia etc has significantly subsided, oh I could go on. I do have a couple of questions for you;
1. Can Menieres disease be connected to hashimotos?
2. I have included the daily use of a pro biotic and have a green smoothie every day but now I’m finding that I wake up ravenous in the morning and craving a green smoothie before breakfast. Is this common?
3. Why do I get nausea when I eat eggs?
Once again, thank you so much for your help. We need more experts like you!
Kind Regards
Monica.
Dr. Izabella says
Monica – you are very welcome! I appreciate you sharing your journey with me. Vertigo or dizziness can be common symptoms seen in people with thyroid disease. In one research study, 52% of Hashimoto’s patients showed an alteration of Vestibular function, which can affect balance and lead to vertigo and nausea. Getting your thyroid antibodies down will, of course, help vertigo. You may want to discuss your sensitivity to eggs with your practitioner.
Reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients (gluten sensitivity, in particular, has been implicated in causing a Selenium deficiency, a well-known risk factor for Hashimoto’s), and can also produce intestinal permeability whenever they are eaten? Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts, and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.
FOOD SENSITIVITIES AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos
AUTOIMMUNE PALEO DIET
https://thyroidpharmacist.com/articles/autoimmune-paleo-diet
Ellen Storment says
When you take your prescribed thyroid medication, does it stop antibodies from further attacking your thyroid, or are they continually attacking it, but the medication helps your TSH levels be in a normal range. I am worried that over the years my thyroid will only get worse and worse and I will be more and more dependent on medication. (I understand to avoid gluten and dairy) I am in search for a new doctor, I am not getting clear answers on any of this, and when I do a google search it comes up with nothing about this specific question. Thank you so much for your time 🙂
Dr. Izabella says
Ellen – thank you for reaching out. If your thyroid hormone levels are not optimal, thyroid medications can help you optimize them. Taking thyroid medications can also help reduce symptoms and thyroid antibodies. I’m a big fan of using everything we can to get ourselves better. That said, many people find that thyroid medications do not eliminate all of their symptoms, and they need to address their personal root causes of Hashimoto’s in order to feel better. It’s important to note, however, that some people are able to wean off thyroid medications once they figure out their triggers and address them. Here are a couple articles you might find helpful:
TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/
WHICH THYROID MEDICATION IS BEST?
https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/