In Part 1 of this article, How to Reduce Thyroid Antibodies, I discussed why thyroid antibodies are so important as an early warning for Hashimoto’s, what their significance is in Hashimoto’s, how to test for them, and how to properly monitor them.
In my view, knowing your antibody numbers early on is a better screening test than knowing your TSH level. Thyroid antibodies are going to be the first indication of a thyroid problem in many cases. They can be elevated for as many as 10-15 years before a change in TSH is even detected.  The presence of thyroid antibodies also means that there is an active destruction going on against your thyroid. The antibodies test is an easy test to do. Part 1 tells you what test you need to do and how to interpret the results.
I also discussed a tool you can use to help determine the aggressiveness of your condition. The Thyroid Event Amsterdam (THEA) Score is a score that can help assess how quickly Hashimoto’s can progress to hypothyroidism (or if you’re already there, to other kinds of autoimmune conditions).
The best way to reduce the aggressiveness of the condition is to reduce your thyroid antibodies.
I wanted to mention that in the last few years, I have seen various professionals claiming that thyroid antibodies don’t matter because they don’t actually destroy thyroid tissue; rather, they are markers for destruction. I respectfully disagree and do think thyroid antibodies matter, and we should measure them, track them, and use strategies that reduce them.
Even if they don’t directly destroy the thyroid cells, there are many additional health impacts when thyroid antibodies are elevated, including to well-being, fertility, mood, cognitive functioning, and metabolic health!
Studies have shown that antibody positivity is associated with physical and physiological symptoms that interfere with the quality of patients’ lives, independent of thyroid function. 
This means they may have normal levels of thyroid hormone and their doctor may tell them their thyroid is just fine, so they’re left with no answers and no treatment. This is why it’s so important to test for thyroid antibodies!
One that I find especially devastating is that thyroid antibodies appear to be directly pathogenic to reproductive organs and can impact egg implantation. It’s been shown that thyroid antibodies can pass through the blood-follicle barrier and create a cytotoxic environment that can damage the maturing egg, as well as reduce its quality and its fertilization potential.
In a study of 31 women undergoing IVF, 14 had thyroid antibodies.  In this group of women, oocyte fertilization, embryo quality, and pregnancy rates were lower, while their early miscarriage rate was higher.
Another interesting study connected fluctuations in TPO antibody levels to psychiatric symptoms in a hospitalized person diagnosed with borderline personality disorder. The symptoms were much worse when thyroid antibodies were elevated, and symptoms improved when antibodies lowered. 
Thyroid antibodies also have the potential to impact our cognitive functioning. In a study done on mice, the presence of thyroid antibodies was shown to produce hippocampal-dependent learning and memory dysfunction, regardless of thyroid function.  I know personally that even when my TSH was “within normal limits,” but I had super high thyroid antibodies, I felt like I was losing my memory.
Furthermore, levels of antibodies over 1000 IU/mL may lead to higher insulin levels and less protective HDL cholesterol. 
Some people may say that correlation doesn’t mean causation, but at the same time, I see that the same things that help our well-being, fertility, mood, cognitive function, and metabolism also tend to help reduce thyroid antibodies! One simple example is myo-inositol, which not only improves fertility outcomes, OCD, anxiety, and insulin resistance, but also, drumroll… reduces thyroid antibodies.
In my functional medicine work with clients, I have also seen a correlation with lowered thyroid antibodies (and lots of symptoms) through addressing triggers!
People can feel better and even dramatically reduce their thyroid antibodies by removing their triggers. This is my favorite corrective action to take, as it is truly addressing root causes. It involves recognizing and removing the antigens or triggers that are setting off the autoimmune process in the first place. In the case that root causes can’t be found or eliminated, there are other strategies that can be used to modulate the immune response against the thyroid, that will be discussed in this article.
So, let’s begin with discussing triggers as the initial corrective action to take to reduce thyroid antibodies.
There is a lot of research that identifies common triggers of Hashimoto’s, as well as anecdotal evidence (triggers that I have personally seen). I’ll review the most common culprits and how addressing these triggers may make you feel better, as well as reduce your thyroid antibodies.
After I discuss common triggers, the next corrective action I’ll talk about will be reducing oxidative stress — specifically, utilizing antioxidants to reduce the oxidative stress in the thyroid gland. This is going to be very helpful for most people with Hashimoto’s.
The third action I’ll discuss is going to be oral tolerance. This is a strategy to help make a person’s body become a little more tolerant of itself (which it is not when someone has an autoimmune condition).
The fourth action I’ll cover is taking advantage of immune modulation. We know that the immune system is out of balance in Hashimoto’s and that there are certain substances that we can give to people to help balance things out a bit.
Finally, I’ll talk briefly about immune suppression and target removal.
Note that the further you get down this list of 35 actions, the more advanced some of the interventions can be — in particular, some of the immune modulation and suppression actions, but I included them for your information.
The mechanisms of corrective actions to reduce thyroid antibodies are:
- Trigger reduction
- Oxidative stress reduction (with antioxidants)
- Oral tolerance
- Immune modulation
- Immune suppression
- Target removal
Let’s begin with the first one: trigger reduction.
There are many antigens which have been identified as key triggers of Hashimoto’s, including:
Numerous environmental toxins have been found to be triggers for Hashimoto’s and thyroid antibodies. Reducing your exposure to these toxins, and opting for liver support, will be key for reducing antibodies. Toxins to be aware of include: 
- Iodine excess
- Copper toxicity
- Mercury, like the kind commonly found in dental fillings (amalgams)
- Other heavy metals
- Medications, including lithium, birth control, PPIs, interferon, accutane, and more (check out my article on this topic to learn more)
- Endocrine disruptors found in personal care products and household cleaners
- Nickel toxicity
- Breast implants
- Mesh implant surgery 
Infections are common triggers for Hashimoto’s and often are the issue if dietary interventions are not making you feel better.  These are oral and gut infections, as well as a number of bacterial and viral infections, that are commonly seen in Hashimoto’s.
Infections that may be triggers of Hashimoto’s include:
- Mouth infections like tooth abscesses, infections in root canals, and periodontitis
- Blastocystis hominis
- H. pylori
- Bacterial infections
- Epstein-Barr virus
- Hepatitis C
- Cytomegalovirus (CMV)
- Lyme disease
3. Emotional and Physical Stress
Stressors of all kinds can be a trigger for autoimmune issues. Emotional and physical stressors may include:
- Life events (divorce, trauma)
- Physical, emotional, or sexual abuse 
- Social rejection
- Blood sugar abnormalities
- Excess exercise
- Sleep apnea
- Sleep deprivation
4. Nutrient Deficiencies
Low calorie diets and the Standard American Diet (S.A.D.) can result in nutrient deficiencies, as can various digestive enzyme deficiencies.
Examples of some common nutrient deficiencies that have the potential to trigger Hashimoto’s include: 
5. Food Sensitivities
6. Blood Transfusions
We know when a person gets a blood transfusion, they are going to be exposed to antigens that were in the donor’s blood. Blood transfusions have been found to increase the rate of autoimmune disease, including Hashimoto’s.  I am not sure why this is, but in theory, this could be due to potential infections or toxins that can be transmitted via the blood. Generally, blood products are tested for infections such as HIV, but other infections that are not tested may also be present. Someone may receive a blood transfusion in the case of:
- Major injuries
- Bleeding disorders
7. Hormonal Shifts
Estrogen dominance, prolactin elevation, and progesterone deficiency can all lead to, or exacerbate, autoimmune thyroid issues. The biggest hormonal shifts in women’s lives are:
These are the most common times a woman may be diagnosed with Hashimoto’s.  Researchers used to think that pregnancy was a trigger because of fetal cells that got into the maternal thyroid gland; however, further research has shown that the babies’ cells within their mothers’ thyroids are actually protective!
Strategies for Reducing Thyroid Antibodies
1. Removing Gluten
Early on in my healing journey, I came across a research study that highlighted the benefits of a gluten-free diet in individuals with celiac disease and Hashimoto’s. The individuals in this study had subclinical hypothyroidism and elevated thyroid antibodies before going gluten-free. The study revealed that 71 percent of the individuals returned to normal thyroid function; 19 percent were able to normalize their thyroid antibodies within a year. 
After reading the study, I asked my doctor to test me for celiac disease. I did not have celiac disease, but I decided to go gluten free nonetheless, and this intervention really helped me! The gluten-free diet has also helped the majority of my clients with Hashimoto’s, despite the fact that most of them do not have celiac disease. I noticed that often, clients had more energy and their thyroid antibodies began to decrease, yet there were no research studies looking at whether the gluten-free diet helped people with Hashimoto’s when they did not have celiac disease, so I decided to do my own study. 🙂
In 2015, I did a survey of my readers consisting of 2232 people having Hashimoto’s. In that survey, 88 percent of people felt better off of gluten, and 33 percent had a reduction in their thyroid antibodies on a gluten-free diet.
Gluten is a protein found in wheat, barley, and rye, and is often hidden in processed foods. Along with dairy, gluten was a huge trigger for me. When I finally took the plunge and removed both from my diet, it took just three days for symptoms that I had experienced for almost 10 years, to completely vanish.
Furthermore, the antibodies produced in celiac disease can cross-react with thyroid antibodies. The main protein in gluten, gliadin, has a very similar molecular structure to parts of the thyroid, so molecular mimicry may be one of the reasons for the common co-occurrence of both conditions.
Another note about gluten is that it is often the cause of intestinal permeability. (So, you have two of the three conditions necessary to develop Hashimoto’s: a genetic predisposition, intestinal permeability, and a trigger.)
You can read much more about gluten here.
2. Removing Dairy
For me, getting off dairy meant no more irritable bowel syndrome, bloating, reflux, and carpal tunnel. I’ve seen many success stories relating to clients and readers feeling better, even going into remission (Read Crystal’s Hashimoto’s Success Story about dairy) when they removed dairy from their diet.
In my survey, 79 percent of respondents with Hashimoto’s felt better when they went off of dairy, and there was a 20 percent reduction in antibodies.
Limited studies are available on dairy proteins and Hashimoto’s, but to me, the proof is in seeing this lifestyle intervention making people feel so much better. Plus, it is an easy intervention to try. You can read more about removing dairy here.
3. Removing Soy
My clients and readers have reported an increase in palpitations, nervousness, and thyroid antibodies after consuming soy.
In my 2015 survey, 60 percent of respondents felt better when they removed soy from their diet, and there was a 34 percent reduction in antibodies.
I recommend skipping tofu, miso and soybeans in order to support your thyroid. Better yet, cut out all processed foods, as soy is often a hidden ingredient in these products!
4. The Paleo Diet – Removing Grains and Processed Foods
Two diets that I like for reducing thyroid antibodies and improving how people will feel, are the Paleo and the Autoimmune Paleo diets.
Prior to these diets, I usually have people start by removing gluten. Removing one thing is just easier, and the removal of gluten often makes many people feel much better right off the bat. The Paleo and Autoimmune Paleo diets are increasingly more restrictive.
Keep in mind that the best diet for any given person will depend on what food sensitivities they have, as well as if they’re having issues with blood sugar, intestinal permeability, ongoing chronic stress, infections, or toxin exposures.
A Paleo diet eliminates all grains and all processed foods. After eliminating grains and processed foods, a Paleo diet replaces these with nutrient-dense foods thought to have been eaten during the Paleolithic era: nuts and seeds, vegetables, fruit, and eggs. Meat, a caveman staple, is also allowed, as are fish and other meat products (organ meats).
Depending on the particular Paleo plan you are following, dairy may also be allowed, but I do not recommend it, as you’ve seen earlier that it is a highly reactive food for most people. Other food items of controversy on a Paleo diet include eggs and sweet potatoes. Over the years, I’ve observed that many people have food sensitivities to eggs — 48 percent of my survey participants identified eggs as a sensitivity.
While there aren’t studies that point to a Paleo diet as a means to reduce thyroid antibodies, in my survey, 81 percent of respondents felt better on a grain-free or Paleo diet. Corn, in particular, was noted as a large sensitivity.
And as mentioned above, 88 percent of those surveyed felt better on a gluten-free diet.
A Paleo diet has helped many people with Hashimoto’s feel better by improving symptoms such as fatigue, joint pain, brain fog, bloating and gas.
You can read more about the Paleo diet here. This article discusses the benefits of the Paleo diet, how it differs from the Standard American Diet (S.A.D.), the downsides of grains, and how to get started. You can even get some free Paleo recipes on the page!
5. The Autoimmune Paleo Diet (AIP) – Further Restrictions
Although the Paleo diet has helped many people feel better and even recover completely, the Autoimmune Paleo diet (AIP) can be even more successful for some.
On a personal note, this was one of the key dietary protocols on my own healing journey. But it isn’t easy to just jump into, and I consider it a more advanced intervention.
In my survey, 75 percent of my readers and clients reported significant symptom reductions on an AIP diet, with almost 40 percent seeing a reduction in thyroid antibodies.
You can read an overview of the AIP diet, including the foods it allows and restricts, best practices and other information, here. The diet is more restrictive, so I generally suggest people go on the Paleo Diet first.
6. Addressing H. Pylori Infections
Chronic infections are the triggers that get the least amount of attention, yet identifying and treating them can result in a complete remission of Hashimoto’s. Additionally, some of the infections can be progressive, leading to more and more symptoms, if not identified and treated accordingly.
A variety of bacterial infections have been implicated in triggering autoimmune thyroiditis, including Helicobacter pylori, the same bacteria that causes ulcers; Borrelia burgdorferi (associated with Lyme disease), and Yersinia enterocolitica. 
Helicobacter pylori (H. pylori) is a gram-negative spirochete-shaped bacteria that burrows into our stomach lining and secretes urease, which neutralizes stomach acid. The byproduct of the urease and stomach acid is toxic to epithelial cells, as are the other chemicals produced by this bacterium, leading to damage to cells, a disruption of tight junctions, and inflammation. 
When I initially removed gluten and dairy from my diet, I felt so much better, and most of my symptoms went away. But I still tested positive for thyroid antibodies, so I had to dig deeper into my other root causes. That ended up being gut infections! And yes, initially it grossed me out, but then I realized it was a common trigger.
In 2015, 80 percent of my clients who had hit a plateau with nutritional intervention, and who had taken the gut tests that I recommended, tested positive for at least one gut infection.
I’ve had numerous readers and clients with Hashimoto’s report that their symptoms were greatly improved following treatment of their H. pylori Infection. Most of them showed a reduction in thyroid antibodies following the eradication of H. pylori. A few have even gone into Hashimoto’s remission!
You can read more about H. pylori infections here, including information on testing, antibiotics, and natural treatment options.
7. Eradicating Blastocystis hominis
This protozoal parasite is one of the most common I have encountered in people with Hashimoto’s. It is especially prevalent in clients who develop Epstein-Barr virus. When I did an analysis of BioHealth 401H stool test results in 2015, some 35 percent of people had tested positive for Blasto (please note, these tests are no longer commercially available).
It was also an infection that I had to deal with before I felt completely well.
Symptoms of Blastocystis hominis can include bloating, diarrhea, nausea, flatulence, variable bowel habits, abdominal pain, hives, and fatigue. Blasto can also cause carbohydrate intolerance and intestinal permeability. 
Additionally, I’ve found that this pathogen is notorious for causing multiple food sensitivities. In general, if a person has a food reaction, such as with celiac disease, most symptoms resolve once the triggering food is removed. But, people with Blastocystis hominis infections will have multiple food sensitivities and will keep getting more (this is an indication that the gut and its inhabitants, rather than the individual foods, are to blame). Interestingly, the Blastocystis Research Foundation reports that people with Blastocystis hominis often find that they are sensitive to gluten, dairy, soy, sugars, starches, grains, caffeine, fruit, and carbonated beverages, and removing these foods can keep symptoms at bay. 
I was super excited to learn that a paper had been published in a medical journal, detailing the case of a person who saw a reduction in TSH and thyroid antibodies after the eradication of Blastocystis hominis!  In this case, a 49-year-old man who presented with chronic urticaria, was found to also have Hashimoto’s, even though he never had clear symptoms.
Blastocystis hominis was isolated through a stool examination, and the patient was given a two-week treatment with metronidazole, after which the Blastocystis hominis was eradicated and the urticaria disappeared. During the four years of follow-up, the patient presented without any symptoms. His thyroid hormones were normalized, and his anti-thyroid antibodies had declined.
I’ve found that eradicating a Blastocystis hominis infection in a person with Hashimoto’s often leads to a remission of Hashimoto’s, with an improvement in symptoms, a reduction in food sensitivities, and a reduction in thyroid antibodies. I have an entire article discussing protocols (drug-based and non-drug ones too) for Blasto.
8. Resolving SIBO (Small Intestinal Bacterial Overgrowth)
SIBO is an overgrowth of bacteria in the small intestine. While this is not technically an infection, SIBO does have a bacterial component and can be a trigger, consequence, or exacerbating factor for Hashimoto’s. 
According to a study published in 2007, SIBO can be present in up to 54 percent of people with hypothyroidism.
I have seen people with Hashimoto’s resolve symptoms like IBS, restless leg syndrome, low ferritin, and low B12 by treating SIBO; and in some cases, I’ve also seen thyroid antibodies get reduced — and even go away — with SIBO treatment.
Read more about the symptoms associated with SIBO, how you can do a breath test for it, and how to treat it, here.
9. Addressing Yersinia Infections
You may have never heard of this infection before, but its antibodies are found in people with Hashimoto’s 14 times more often than in people without Hashimoto’s. 
Yersinia membranes bind TSH. Remember I talked about molecular mimicry? Infections like Yersinia can induce antibodies against sites that recognize and stimulate TSH receptors. At least one study found that Yersinia antibodies were more prevalent in people with thyroid disease. 
How is Yersinia contracted? It is an infection found in contaminated meat (commonly found in pork), poultry, dairy products and seafood.
Comprehensive stool analysis tests, such as the GI-MAP or Gut Zoomer, can sometimes identify Yersinia infections, but false negatives are possible.
10. Mercury Removal – Dental Amalgams
Research has shown that mercury found in dental fillings does accumulate in thyroid tissue, and in one study, the removal of dental amalgams decreased thyroid antibodies in patients with autoimmune thyroiditis. 
Amalgam fillings (usually referred to as silver but actually containing 50 percent mercury by weight) are a major source of mercury exposure, accounting for two-thirds of human mercury exposure. 
Many of the symptoms of mercury exposure overlap with those seen in Hashimoto’s, including digestive issues, fatigue, joint pain and hair loss. You can read about one woman’s experience with amalgam fillings as her Hashimoto’s trigger, here.
If you have Hashimoto’s and amalgam fillings, I encourage you to take the MELISA (Memory Lymphocyte Immunostimulation Assay) test. This test can detect hypersensitivity to metals and environmental toxins to help you determine whether removing your fillings should be a priority.
11. Broad Spectrum Gut Healing Approach
The gut plays a big role in Hashimoto’s – in fact, a leaky gut is one of the three factors that must be present in order for autoimmune disease to develop (in addition to genetics and a trigger). 
The gut performs the all-important role of digesting and absorbing the nutrients we take in, but it is also responsible for helping the immune system recognize foreign invaders from self-antigens, thereby facilitating the control of pathogens and preventing autoimmune reactions. When the health of our gut is compromised, it’s likely that other aspects of our health are affected as well.
While not everyone dealing with Hashimoto’s or leaky gut will experience bloating, stomach pains, irritable bowel syndrome and acid reflux like I did, most people with Hashimoto’s do have some degree of intestinal permeability. For anyone living with an autoimmune condition, healing the gut can lead to an incredible reduction in symptoms, and potentially even remission.
While I have an extensive amount of information on gut healing available, I wanted to highlight one particular supplement that supports both gut health and thyroid antibody levels.
I was really excited to learn about a study from Italy, which focused specifically on the benefits of aloe vera in Hashimoto’s.  Interestingly, one of the researchers who initiated the study saw that her own Hashimoto’s markers improved after she began drinking aloe vera on a daily basis, to soothe her digestion and to use as a laxative for constipation.
The researcher had routine lab work done to track her Hashimoto’s markers every few months.
Prior to starting daily aloe vera, her TSH was 5.14 μIU/mL, her free T4 was 8.3 pmol/L, and her TPO antibodies were 1875 IU/mL. Three months after the start of her aloe vera regimen, her TSH dropped to 3.22 μIU/mL, her free T4 improved to 11.44 pmol/L, and her thyroid antibodies dropped to 778 IU/mL.
Another six months later, her labs continued to improve even further: her TSH was within optimal range at 1.83 μIU/mL, and her thyroid antibodies dropped again to 24 IU/mL, which is considered “negative” for Hashimoto’s, according to most labs! I love that Root Cause Rebels are everywhere, and that this particular rebel decided to help the Hashimoto’s community through published research based on her own experience — a woman after my own heart. 🙂
The study was designed using 50 mL of Aloe barbadensis miller juice (or ABMJ, which is the botanical name for the aloe vera plant) twice daily, for a period of nine months, in 30 women with Hashimoto’s thyroiditis and subclinical hypothyroidism. (An additional 15 women served as controls.)
After the nine-month trial, there was a significant decrease in serum TSH and TPO antibodies (a 54 percent reduction!), as well as an increase in serum-free T4, in those who took aloe vera daily. Interestingly, serum-free T3 declined by 16 percent after three months, with no further decline after another six months.
I love aloe for thyroid support, and Rootcology Aloe offers a highly concentrated form of aloe in a convenient capsule. In fact, it takes 200 pounds of aloe vera gel to make one pound of this nourishing aloe extract! It is also prepared using a low-heat dehydration method with no filtering, which ensures that the plant’s beneficial components (long polysaccharide chains) and its natural makeup, remain intact as much as possible.
12. Broad Spectrum Antimicrobial
Gut infections like H. pylori, Blasto, and Yersinia are often triggers for the development of autoimmune disease. Other infections like Epstein-Barr virus and Lyme disease may also potentially set off an autoimmune reaction in the body. You can learn more about infections and how they can trigger Hashimoto’s in my article.
Black seed oil is one of my favorite herbs for fighting infections because of its widely demonstrated antimicrobial properties, making it a useful tool for those with Hashimoto’s.  It’s of special interest because of more recent research that demonstrates it can lower thyroid antibodies as well!
Although there is a lot of data on black seed oil, there has been little study in the Hashimoto’s population until a 2016 Iranian study looked at the therapeutic use of black seed oil in people with Hashimoto’s thyroiditis. 
During the trial, serum thyroid stimulating hormone (TSH) levels reduced from an average of 6.42 mIU/L, to 4.13 mIU/L in the group receiving the black seed oil. Serum T3 also improved from an average of 0.92 mmol/L, to an average of 1.06 mmol/L. Both of these changes were statistically significant. Anti-TPO antibodies were also reduced during the study.
Another way black seed oil may be useful in lowering thyroid antibodies is through its ability to eradicate H. pylori, which can be a root cause trigger of Hashimoto’s, as I discussed earlier in this article.
Personally, I used black seed oil after the birth of my son when I started to experience hair loss and new food sensitivities. I also found that my voice was becoming more hoarse. I tested my thyroid antibodies and they were elevated above 100 IU/mL — my Hashimoto’s was no longer in remission! (Under 100 IU/mL is considered in remission by many professionals.)
I found out I had H. pylori through a GI-MAP test. Sure enough, after supplementing with black seed oil for a few weeks, testing showed that my antibodies were reduced and that I no longer had H. pylori.
13. Blood Sugar Balance
When blood sugar levels are constantly fluctuating, the body experiences these changes as chronic stress. When the adrenals (the glands that are responsible for releasing stress hormones) become stressed, they release an excess of the hormone cortisol, which can also lead to an increased production of inflammatory proteins that are associated with a heightened immune response. This pattern eventually leads to an altered release of cortisol, which can lead to numerous symptoms, including chronic fatigue, mood swings, and increased thyroid antibodies.
Balancing blood sugar is one of the best things we can do for thyroid health. I recommend starting with food – prioritize protein and healthy fats at meals, and minimize the consumption of carbohydrates, especially in the form of processed foods.
Exercise and getting adequate sleep can also help support healthy blood sugar levels.
Interestingly, metformin, a drug that supports blood sugar metabolism and insulin sensitivity, and is commonly prescribed to those with diabetes, has recently been studied in Hashimoto’s, and has been shown to have the ability to reduce thyroid antibodies!  Berberine is a plant alkaloid that has been shown to have similar beneficial effects on blood sugar. Studies have shown that one gram of berberine per day lowered fasting blood sugar by 20 percent in people with diabetes, which is comparable to metformin.  If you struggle with balancing blood sugar, in addition to lifestyle changes, berberine is a great alternative to try!
14. Weight Loss
There has been a notable increase in both autoimmune disease and obesity in recent years, and many studies have been conducted on the association between the two. One potential mechanism is that because adipose tissue in obesity functions like an endocrine organ, it releases cytokines that cause proinflammatory effects by activating T helper cells and suppressing T regulatory cells.  This can lead to an autoimmune response, especially in those with a genetic predisposition.
A 2021 study examined whether weight loss could impact thyroid antibody levels in obese individuals with Hashimoto’s.  Included in the study were individuals with a BMI over 30 and TPO antibody levels over 5.6 IU/mL. At the end of the six month study, researchers found that those who lost weight also lowered their TPO antibody levels. Losing excess weight could benefit those with Hashimoto’s.
The irony of this is not lost on me – I know how difficult it can be to lose weight with Hashimoto’s! Please see my article all about how to lose weight with Hashimoto’s.
Reducing Oxidative Stress (As a Mechanism to Reduce Thyroid Antibodies)
The next section covers a few ways to reduce oxidative stress. People with Hashimoto’s have increased oxidative stress, so this can be a beneficial strategy to reduce thyroid antibodies and feel better. 
15. Iodine Restriction to Reduce Oxidative Stress
Iodine restriction has been shown to reduce oxidative stress, and according to various studies, some people have been able to lower thyroid antibodies by restricting their iodine intake.  Take note, however, that others have reported that taking increased iodine has lowered their antibodies. This just underscores the point as to why finding root causes is so individualized.
In my survey, 356 people tried high-dose iodine, and out of that group, 25 percent said that it made them feel better; 28 percent said it made them feel worse. Forty-six percent said they saw no difference, although this doesn’t mean their thyroid antibodies weren’t affected in some way.
On the other hand, iodine restriction made 31.7 percent feel better and 7 percent feel worse. You can read more about iodine and Hashimoto’s here.
Iodine is a very controversial subject, but I put it out there just in case it can help you. Having said that, I’d start with removing common triggers before I look at modifying iodine intake. There are also other actions you can take that reduce oxidative stress that have had better results, such as taking selenium.
16. Selenium as an Antioxidant Manufacturer
One particular nutrient that is depleted in Hashimoto’s is selenium.  It is a trace mineral that is involved in the manufacturing of antioxidants like glutathione peroxidase. Glutathione peroxidase helps with the removal of the cells affected by oxidative damage.
A dosage of 200 mcg per day has been found to reduce thyroid antibodies in clinical trials.  In some studies, selenium cut the antibodies significantly within six months.
In my survey, people taking a selenium supplement helped 63 percent of respondents feel better. Thirty-four percent saw no difference, while 3.5 percent felt worse.
I have found that when clients and readers take selenium supplements, not only can it lead to them feeling better, but it can also lead to a reduction in anxiety, antibodies, and other symptoms.
Note that gluten- and grain-free diets are associated with deficiencies in selenium… another reason to focus on a healthier diet and supplementation when needed, to ensure you address these common Hashimoto’s deficiencies!
17. Myo-Inositol to Reduce Oxidative Stress (and Anxiety, too)
Research has shown that anxiety, depression, 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 number is still normal. 
The most common type of anxiety disorder reported in people with thyroid antibodies is obsessive compulsive disorder (OCD). 
OCD is also more common in Type A personalities (like me and many other pharmacists; and likely many of you out there too), so my own OCD tendencies definitely used to flare up with rising thyroid antibodies and then reduce as my antibodies dropped.
Research has found that myo-inositol can help with PCOS (polycystic ovarian syndrome), OCD, and anxiety.  As a bonus, myo-inositol has been found to reduce TPO antibodies, reduce TSH, and also balance blood sugar.  As a pharmacist, one of my favorite things about myo-inositol is that it tends to be really easy to take. It has a pleasant, sweet taste, so you can just add a little bit of the powder to your tea. 🙂
In a study that combined myo-inositol and selenium to treat Hashimoto’s patients, researchers found that the combination resulted in decreased TSH, TPO and TG antibodies, as well as improvements in thyroid hormones and a feeling of personal well-being. 
This is why I formulated Rootcology’s Selenium + Myo-Inositol, which contains the studied amounts of each nutrient for optimal synergistic support. I’ve found it to be incredibly powerful, and so have my readers. Here’s what one had to say: “As a subclinical Hashimoto’s patient, with elevated TSH, TPO, I wanted to add selenium supplementation as I begin to work through Dr. Wentz’ 90-day plan. I chose the Selenium + Myo-inositol as this was the same formulation used in one of the referenced studies. As a happy surprise, I did not realize I was not feeling well until I began feeling so much better (with less brain fog too). I can’t wait to dive into the protocols and begin the journey to better thyroid health. Thank you Rootcology for a superior product.”
Please note, if you have kidney disease or are taking diuretic medications or herbs with diuretic properties, please check with your practitioner before taking myo-inositol. During one of my guinea-pigging adventures, I decided to try myo-inositol while trying an antiviral protocol that included Cleavers, a diuretic herb… and almost fainted.
These days, I take myo-inositol daily with meals, and it has helped me balance my perimenopause hormones so much!
Myo-inositol may not be properly cleared when the kidneys are overworked, such as in kidney disease or while taking diuretics. #thingsIlearnedthehardway
18. NAC to Strengthen Your Body’s Defense System
N-Acetyl-Cysteine (NAC) supports healthy levels of glutathione, a key component of the body’s antioxidant defense system.
Research has shown that people with Hashimoto’s disease have lower levels of glutathione. In a study done in 2010, NAC and 15-Deoxy-Prostaglandin J2 (a fatty acid compound with antioxidant and anti-inflammatory properties) exerted a protective effect against autoimmune thyroid destruction in vivo.  Significant associations were seen in the levels of glutathione, as well as TSH and thyroid antibodies. Researchers concluded that the maintenance of a minimal oxidative load was essential to safeguard thyroid cell function.
I have seen benefits using 1800 mg per day of N-Acetyl Cysteine, and recommend Rootcology’s Pure N-Acetyl Cysteine, which is free of potential reactive ingredients and harmful fillers. As an additional bonus, NAC is also associated with helping with heavy metal detoxification. 
19. Broad Spectrum Antiviral Approach
Various viruses have been suggested to be possible triggers or exacerbating factors for Hashimoto’s – Epstein-Barr virus is the one that gets the most attention!
Cordyceps (Cordyceps sinensis) is a fungus that was originally a combination of caterpillar and fungus/mushroom, but is now often synthetically produced. It is an adaptogen with antiviral properties that has been used by traditional Chinese herbalists for centuries. Traditional healers recommended it for “all illnesses” as a tonic, because they saw that it improved energy, stamina, endurance, appetite, libido, and sleeping patterns.
Cordyceps may also have the ability to lower levels of thyroid antibodies while reducing Hashimoto’s immunoinflammatory process. Studies using a drug derived from cordyceps called Corbrin Capsule, have shown improvements in the autoimmune condition, as well as lowered levels of thyroid antibodies.  These positive results applied to both Graves’ as well as Hashimoto’s patients who used Cobrin Capsule along with conventional thyroid hormone replacement medications.
I often recommend Cordyceps by NOW to my clients.
Cordyceps has another interesting connection to Hashimoto’s as well. Cordyceps is rich in selenium, and, as previously discussed, selenium supplementation has been shown to reduce thyroid antibody levels as well.
20. Thyroid Medications to Prevent Oxidative Stress
As you whittle away the triggers and root causes of why you are displaying elevated thyroid antibody levels, you and your clinician may also opt for thyroid medications as well as some of these other corrective actions below.
Studies have shown that in euthyroid and subclinical hypothyroidism (remember, as discussed earlier, this happens during stages 2 and 3 of hypothyroidism, with stage 2 being the “early warning” stage), thyroid medications such as levothyroxine can reduce thyroid antibodies. 
The downside is that some medications have been shown to cause oxidative stress themselves. In particular, there is one study relating to the increased risk of lung cancer.  You can read more about this study, as well as my interpretation of its results, here. You may also be interested in downloading my free eBook on optimizing thyroid medications.
21. Photobiomodulation (Use of Low Level Laser Therapy)
Low level laser therapy has shown to be capable of reducing about 50 percent of thyroid antibodies over the course of 10 targeted treatments.  It directly reduces oxidative stress in the thyroid gland.
In one study in Brazil, all patients who received low level laser therapy were able to reduce their levothyroxine dose, while 47 percent were able to discontinue it and have normal thyroid function during the 9-month follow-up. 
You may have heard of red light therapy, which is another term used for laser therapy. Red light therapy has gained popularity in the last few years, with people using it for everything from joint pain and inflammation, to injuries, skin health, and hair growth stimulation.
These days, there are more at-home options available for red light therapy than ever. You can learn more about laser and red light therapy in this article.
Oral Tolerance Strategies (to Reduce Thyroid Antibodies)
Now, let’s talk about how focusing on addressing oral tolerance can help reduce thyroid antibodies. Oral tolerance is basically inducing immune non-responsiveness through introducing an antigen by the mouth.
22. Thytrophin PMG as a Decoy
I’ve seen people reduce their thyroid antibodies by taking this supplement. While it doesn’t address a root cause (trigger), it seems to help minimize the effects of the immune system attacking itself.
According to the manufacturer of this supplement, Thytrophin PMG acts like a decoy of sorts. It seems to distract the immune system from your thyroid gland while you work on addressing triggers, intestinal permeability, and all of your other root causes. It may prompt the immune system to attack the Thytrophin PMG versus its own thyroid gland, and allow the thyroid tissue to regenerate.
23. Moducare to Address Adrenal Balance
Moducare is a supplement that helps promote a normal balance of the adrenal hormones (our stress response), such as cortisol. When the adrenals are out of balance, the rest of the body quickly follows suit. This is especially significant for Hashimoto’s patients because stress is often a major contributing factor, and the adrenals and immune system work so closely together.
Moducare contains natural plant sterols and sterolins that balance Th1 and Th2 cytokines or helper cells, which strengthens cellular immunity and overactive immune responses. One study found that participants taking Moducare maintained a healthier immune response, thought to be related to addressing cortisol levels. 
Readers and clients have been able to improve their adrenal function, as well as reduce antibodies, using Moducare.
24. LDN (Low Dose Naltrexone) to Stabilize Immunity
In my 2015 survey, 38 percent of respondents that tried Low Dose Naltrexone (LDN) felt better. But the amazing stat related to these individuals is that they had spectacular results. Of those that felt better, 48 percent were able to reduce thyroid antibodies, 61 percent saw an improvement in mood, 66 percent had more energy, and 40 percent had a reduction in pain.
The theory about how LDN works is that it likely increases endorphin activity, and may also increase the number of endorphin receptors and/or the sensitivity of the receptors. All of these activities can result in stabilizing the immune system.
Many people have been able to eliminate their symptoms and reduce the dosage of their thyroid medications using LDN. I’ve seen women with thyroid antibodies in the 1000s IU/mL range that were able to reduce them down to about 100 IU/mL!
LDN is not a supplement and requires a prescription, and as with many things, it won’t work for everyone. At the beginning of my own thyroid journey, I tried using LDN just briefly, but it didn’t make me feel well, and I became very irritable, so I had to stop using it. To learn much more about LDN, please check out this article.
Immune Modulation Strategies to Reduce Thyroid Antibodies
25. Systemic Enzymes
Systemic enzymes act as natural immune modulators, helping to bring our immune system into balance. 
There has been a lot of research done on systemic enzymes coming out of Europe. There, the enzymes are a popular pain medication alternative for arthritic diseases and inflammatory conditions such as Hashimoto’s.
Systemic enzymes can reduce antibodies to both foods and the thyroid by breaking down circulating immune complexes that are formed in autoimmune diseases. They can also aid in tissue repair by reducing inflammation. I recommend either Rootcology Systemic Enzymes, or Pure Encapsulations Systemic Enzyme Complex.
One particular blend of systemic enzymes, Wobenzym+, was the subject of a study that found that when given with levothyroxine, Wobenzym resulted in a greater reduction of thyroid antibodies than in those patients only given levothyroxine.  Those patients taking Wobenzym also had a reduction of thyroid symptoms, a normalization of their thyroid ultrasound, and a reduction in inflammatory cells found in the thyroid.
For more info on the above research utilizing Wobenzym, please review the article here.
Please note that Rootcology’s Systemic Enzymes contain a stronger formulation than is used in most other brands and studies. Do not exceed the recommended dose of Rootcology Systemic Enzymes unless working under the guidance of an experienced practitioner.
26. DHEA to Increase Stress Tolerance
Our body’s adrenal response is very tied to our immune health, and low levels of the hormone DHEA (dehydroepiandrosterone) may predispose some individuals to developing autoimmune diseases. Plus, chronic stress leads to a reduction in DHEA.
This is why over the years, I’ve developed my Adrenal Transformation Protocol, which is designed to help you balance your stress response, build up your resilience, and set you up with a foundation to stay strong and healthy through life’s turbulence.
Stress management techniques are helpful in supporting our adrenal stress response, as is supplementation. I have found that DHEA supplementation can be very helpful.
DHEA supplementation increases stress tolerance, lowers the cortisol/DHEA ratio, and protects against cortisol-induced cellular damage.  It also has effects on the immune system, increasing Th1 and decreasing Th2 cell production. It may be an effective immune modulation strategy for reducing thyroid antibodies as well.
In one study, DHEA was given to women with premature ovarian failure and Hashimoto’s, and those taking the DHEA, showed a reduction of TPO and TG antibodies. 
Please note, while this hormone is available without a prescription in the United States and some other countries, I always recommend using it under the supervision of a practitioner due to potential side effects (cystic acne galore, over-conversion to estrogen, and feeding estrogen-sensitive cancers are some potential side effects when used in the wrong person and/or at the wrong dose) and contraindications (like a history of certain cancers).
Anatabine is a synthetic substance made from a naturally occurring alkaloid found in the nightshade plant family (which oddly includes tobacco). Back in 2012-2014, it was available as a supplement that was marketed for Hashimoto’s, due to promising clinical trials. 
I tried anatabine for three months 10+ years ago, when I was in the middle of my root cause search, and it actually lowered my TPO antibodies by about 50 percent. (I didn’t have any more TG antibodies at the time.)
Unfortunately, it was subsequently removed from the market, but I include it here in case it makes its way back.
The manufacturer had been marketing it as a supplement but made drug-like claims about the supplement, so they were disciplined by the Food and Drug Administration. The last I heard (as of 2014), the manufacturer was trying to make anatabine into a pharmaceutical.
This supplement could be a helpful tool in reducing inflammation and antibodies while searching for the root cause as to why your immune system is imbalanced. Read the article here for the story about that, as well as other info regarding anatabine.
In a study conducted with euthyroid patients with Hashimoto’s, the results showed a statistically significant reduction in thyroglobulin antibodies with the use of anatabine.  Fifty percent of patients reduced their antibodies by at least 25 points, while 25 percent reduced their TG antibodies by at least 100 points.
I really wish that this supplement would come back, and it’s one of the drug entities I would like to create if I ever win the lottery and start my own pharmaceutical company.
28. Vitamin D – An Easy Immunity Booster
If you live in a northern climate and don’t spend much time outside on a daily basis, you are at risk for vitamin D deficiency. Vitamin D deficiency (due to lack of sun exposure, using sunscreen, or poor dietary intake) is associated with improper immune function.
Vitamin D deficiency is also more commonly found in people with Hashimoto’s. Sixty-eight percent of my readers with Hashimoto’s reported also being diagnosed with vitamin D deficiency — and this deficiency has been correlated with the presence of anti-thyroid antibodies.
One study 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. 
A more recent study showed that vitamin D supplementation reduced thyroid peroxidase antibody levels in patients with autoimmune thyroid disease. 
Vitamin D supplements can improve our mood and can help us reduce thyroid antibodies. 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.
You can read about vitamin D, and the benefits of sunshine, here.
29. IVIG – An Expensive Option… But Perhaps Alternatives May Help?!
IVIG (intravenous immunoglobulin) therapy has been shown to suppress thyroid antibodies by using immune cells isolated from blood donations. 
Unfortunately, it is prohibitively expensive, has a difficult route of administration, and may cause side effects. So, it is usually reserved for a serious condition called Hashimoto’s encephalopathy, a life-threatening illness where thyroid antibodies attack the brain. Most of the research available on IVIG is related to Hashimoto’s encephalopathy. 
I do want to point out a “poor man’s IVIG”, though, and that is camel milk! It’s much easier to access and consume. 🙂
Camel milk also contains immunoglobulins that can modulate the immune system. You can read more about how camel milk may potentially reduce thyroid antibodies, here.
Another more accessible option is serum-derived bovine immunoglobulin concentrate (SBI). This has been used as a medical food product to support gut health and the immune system. More recently, it’s been made available in supplement form. Ortho Molecular makes one that I like, and Designs for Health recently started offering a powdered form.
30. Plasmapheresis – Plasma Exchange
If you have Hashimoto’s, your plasma contains thyroid antibodies that attack your body’s immune system. A machine can be used to remove the affected plasma and replace it with healthy plasma or a plasma substitute. This is called plasmapheresis or plasma exchange.
Plasmapheresis is known to be effective at removing thyroid antibodies, but it is expensive and carries other risks with it.  The benefits of this treatment are also temporary and are typically used in emergency situations (thyroid medication overdose, amiodarone-induced hyperthyroidism, Hashimoto’s encephalopathy, etc).
31. Plaquenil – Used in Many Autoimmune Diseases
Hydroxychloroquine (Plaquenil) is a medication that was originally used to prevent or treat malaria. However, during World War II, it was found that this medication was also effective in treating the symptoms of lupus, rheumatoid arthritis, and other autoimmune diseases.
Thyroid dysfunction and antibodies have been frequently associated with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). 
Plaquenil reduces lymphocytes, the production of auto-antibodies, immune mediators, cytokines, and NK cell activity; and inhibits antigens presenting to B cells, dendritic cells, and monocytes.
In one study, treatment with Plaquenil significantly decreased the DNA-hydrolyzing activity of thyroid antibodies.  Patients with hypothyroidism have a higher level of DNA-hydrolyzing IgG antibodies. Usage of Plaquenil resulted in a reduction in these antibodies, as well as improvements in thyroid hormone production and elevated functional activity of the thyroid gland. Plaquenil also improved the clinical state of the patients.
Plaquenil is currently in clinical trial relating to reducing thyroid antibodies, so I will update you all later on the findings.
Please note, this drug does have a lot of potential side effects, including: irregular heartbeat, mental/mood changes (anxiety, depression, hallucinations), shortness of breath, blurred vision, arm/leg/back pain, fatigue, and chest discomfort. It may rarely cause serious eye problems, muscle/nerve damage, seizures, or serious allergic reactions. If you have diabetes, your doctor may need to adjust your diabetes medication.
32. Rituximab for Addressing Epstein-Barr Reactivations
Epstein-Barr (EBV) is a virus that initially causes mononucleosis (also known as “mono” or “glandular fever” in the UK), a debilitating viral infection that is common among college students and is known as the “kissing disease”, because individuals are thought to be exposed to the virus through the saliva of those who are infected.
The Epstein-Barr virus creates a latent infection in the body where it lies dormant until the right time, when it reactivates and awakens. The reactivated virus has the potential to induce the production of thyroid antibodies and has been implicated in many debilitating autoimmune symptoms. 
A 2015 Polish study found the Epstein-Barr virus in the thyroid cells of 80 percent of people with Hashimoto’s and 62.5 percent of people with Graves’, while controls did not have EBV present in their thyroid cells. 
Rituximab (brand name Rituxan), is a medication used for rheumatoid arthritis and certain cancers. It may have a positive effect on Hashimoto’s as well. A few research reports have suggested that this medication may also induce a remission of Hashimoto’s and Graves’ disease (including Graves’ associated eye disease), as well as an improvement in chronic fatigue syndrome (CFS), which is often connected to EBV. 
Please note that Rituximab is associated with very serious side effects that have resulted in death and disability, so again, it’s not my first choice! For more information on the Epstein-Barr virus, please review this article.
Immune Suppression as a Strategy to Reduce Thyroid Antibodies
33. Corticosteroids for Immunosuppression
Prednisone and prednisolone are common corticosteroid drugs used for immunosuppression. Limited studies have been done relating to the use of steroids in extreme cases of Hashimoto’s encephalopathy, as well as one study relating to pregnant women going through In Vitro Fertilization (IVF). 
In the IVF study, the presence of thyroid antibodies was associated with decreased rates of pregnancy and live birth, and the use of low dose prednisolone helped those women with thyroid antibodies have greater success when going through IVF.
Generally, immune-suppressing steroids can reduce thyroid antibodies, but in my view, only for short-term. When you withdraw the steroid, the thyroid antibodies can flare back up again.
Nonetheless, it could be useful in certain cases, such as when needing to induce remission in Hashimoto’s encephalopathy.
Target Removal as a Strategy to Reduce Thyroid Antibodies
Having your thyroid surgically removed eliminates thyroid antibodies… as there is nothing left to attack. However, removing the thyroid does not remove the autoimmune disease. I’ve seen countless times when people have had their thyroid glands removed due to thyroid disease (most commonly Graves’, nodules, and thyroid cancer, though occasionally Hashimoto’s as well).
I generally do not recommend this strategy for Hashimoto’s. There are so many other ways to feel better with it. In some cases, people with co-occurring Hashimoto’s and thyroid cancer may wish to follow this approach.  Nonetheless, I still recommend working on all the other interventions mentioned above to prevent the progression of autoimmunity. Read my article about thyroidectomy for Hashimoto’s for more information.
35. Stem Cells – An Emerging Solution?
Stem cells have recently become a potential option for people with autoimmune disease. In stem cell treatments, one will receive an infusion of cells that can go to fix a damaged organ. In the case of Hashimoto’s, some have reported a reduction of thyroid antibodies and thyroid tissue regeneration.  Please note, using donor stem cells may actually increase the risk of autoimmune disease, while using your own stem cells has been reported to help autoimmune disease.
In the future, I will write more about the possibilities relating to stem cell use.
How Long Does it Take to Lower Antibodies?
I often get asked how long it takes for thyroid antibody levels to shift when implementing an intervention. Most people will start seeing a trend in antibody reduction within a month of starting an intervention, but I’ve noticed that the full effects may take anywhere from three months to nine months or more, to fully see the effects.
In my clients with celiac disease and gluten sensitivity as their Hashimoto’s root cause, the shift in antibody levels seems to align with gut healing. In my clients with H. pylori as the root cause, it can take many months to heal the intestinal lining after H. pylori is eradicated.
I recommend testing every 1-3 months when implementing interventions. This can give you an idea of what direction your antibodies are trending, and give you confidence that the changes you’re making are having an effect.
Testing for Antibodies
The most common antibodies in Hashimoto’s are thyroid peroxidase antibodies (TPO antibodies) and thyroglobulin antibodies (TG antibodies). Most people with Hashimoto’s will have an elevation of one or both of these antibodies. TPO antibodies are the most common.
While not all clinicians will agree to the following ranges, based on research and my clinical experience, here are the numbers I keep in mind when looking at antibody numbers:
- Thyroid antibodies above 500 IU/mL are considered a very aggressive case of Hashimoto’s
- Antibodies under 100 IU/mL indicate remission, or a less aggressive case
- Antibodies under 35 IU/mL mean you no longer test for Hashimoto’s according to conventional medicine standards
- Antibodies under 2 IU/mL are optimal (scientists believe that there may be some antibodies present as part of a normal repair process)
Ulta Lab has tests for both TPO and TG antibodies. Please note that some TPO tests will only test up to 900 IU/mL, so if you know you have high levels of antibodies and would like a test that gives you more accurate numbers, be sure to check with the lab on their parameters before ordering. The TPO Antibody Endpoint test from Quest will give you TPO values beyond the 900 IU/mL limit, all the way up to 10,000 IU/mL, while the Thyroid Peroxidase Antibodies (TPO) version does not go above 900 IU/mL.
Where to Start to Reduce Thyroid Antibodies
I’ve just given you an abundance of information and strategies that can help you to reduce your thyroid antibodies. I know it might feel overwhelming, so I wanted to give you some simplified guidance on where to start, while you test and continue to dig for root causes, which will help you determine the best strategies for you to try.
I recommend starting with your diet – eliminate gluten, dairy, and soy. In my experience, these are three of the most reactive foods for Hashimoto’s, and eliminating them can bring tremendous relief in symptoms and can lower thyroid antibodies.
Next, focus on blood sugar balance. This will help with mood, inflammation, and energy levels. Prioritize protein and healthy fats at meals, and reduce your intake of carbohydrates. I love starting my day with a Root Cause Smoothie using one of my Rootcology protein powders, as it sets me up for a day of steady blood sugar. Of course, don’t forget lifestyle support with quality sleep and stress-reduction.
Third, you may wish to consider discussing thyroid hormones with your doctor if you have elevated thyroid antibodies and are not already on medication. Optimizing or starting thyroid medications can be helpful with lowering thyroid antibodies, even in the early stages of hypothyroidism.
Lastly, you may wish to consider some of the supplements that can lower thyroid antibodies as you are searching for root causes. I created Rootcology’s TPO & TG Support Kit, a specially curated collection of the most helpful supplements for antibody reduction, all of which I’ve covered in this article.* It includes Selenium + Myo Inositol, Systemic Enzymes, Pure N-Acetyl Cysteine, Aloe, and Black Cumin Seed Extract (black seed oil).
By doing these things, you’ll be providing your body with the support it needs for improved thyroid function and reduced thyroid antibodies.
In the meantime, you can do more testing and digging to discover any other root causes that are keeping your antibodies elevated. Stay tuned for my Root Cause Testing article, coming later this summer, that will give you comprehensive guidance on the best tests for Hashimoto’s.
Final Thoughts – You Can Reduce Your Antibodies!
I often receive messages from readers who say that they’ve tried everything and are hopeless. I want to let you know that there is hope and that there are so many strategies that can help. I’ve highlighted just 35 of the 100+ strategies I’ve identified with my clients over the last few years.
As you can see, there are many interventions and corrective actions that you can currently take to reduce your thyroid antibodies and feel better. And there are other strategies that are still emerging. Some focus on root causes and others do not. I share strategies in my weekly newsletter, so be sure to subscribe here.
My books Hashimoto’s: The Root Cause and Hashimoto’s Protocol go into specific details on how to reduce your antibodies (and symptoms!), and my latest book, Adrenal Transformation Protocol, focuses specifically on healing the adrenals, which can be a root cause in many cases of Hashimoto’s.
If you have a genetic predisposition, close relatives with Hashimoto’s, and/or symptoms, consider starting by getting your thyroid antibodies tested. (Better yet, order a full thyroid panel.)
If you are just starting your Hashimoto’s journey, I suggest you begin at the top of this list, implementing some healthier dietary strategies and choices. Think in particular about food sensitivities. My 2015 survey results consistently showed that dietary changes and the removal of food sensitivities can make people feel better, faster… and reduce their thyroid antibody levels.
Bump up your vitamin D, evaluate the non-thyroid related medications you take that may be affecting your thyroid, and look around to clean up your environment from endocrine disruptors.
Take one step at a time. The good news? Many of these steps will make you feel better very quickly!
I love interacting with my readers on social media, and I encourage you to join my Facebook, Instagram, TikTok, and Pinterest community pages to stay on top of thyroid health updates and meet others who are following similar health journeys. For recipes, a FREE Thyroid Diet start guide, and notifications about upcoming events, be sure to sign up for my email list!
 Hutfless S, Matos P, Talor MV, Caturegli P, Rose NR. Significance of prediagnostic thyroid antibodies in women with autoimmune thyroid disease. J Clin Endocrinol Metab. 2011;96(9):E1466-E1471. doi:10.1210/jc.2011-0228
 Müssig K, Künle A, Säuberlich AL, et al. Thyroid peroxidase antibody positivity is associated with symptomatic distress in patients with Hashimoto’s thyroiditis. Brain Behav Immun. 2012;26(4):559-563. doi:10.1016/j.bbi.2012.01.006
 Bucci I, Giuliani C, Di Dalmazi G, Formoso G, Napolitano G. Thyroid Autoimmunity in Female Infertility and Assisted Reproductive Technology Outcome. Front Endocrinol (Lausanne). 2022;13:768363. Published 2022 May 26. doi:10.3389/fendo.2022.768363
 Geracioti TD Jr, Kling MA, Post RM, Gold PW. Antithyroid antibody-linked symptoms in borderline personality disorder. Endocrine. 2003;21(2):153-158. doi:10.1385/ENDO:21:2:153
 Wang N, Sun Y, Yang H, et al. Hashimoto’s Thyroiditis Induces Hippocampus-Dependent Cognitive Alterations by Impairing Astrocytes in Euthyroid Mice. Thyroid. 2021;31(3):482-493. doi:10.1089/thy.2020.0139
 Geracioti TD Jr, Kling MA, Post RM, Gold PW. Antithyroid antibody-linked symptoms in borderline personality disorder. Endocrine. 2003;21(2):153-158. doi:10.1385/ENDO:21:2:153
Wang N, Sun Y, Yang H, et al. Hashimoto’s Thyroiditis Induces Hippocampus-Dependent Cognitive Alterations by Impairing Astrocytes in Euthyroid Mice. Thyroid. 2021;31(3):482-493. doi:10.1089/thy.2020.0139
Mazaheri T, Sharifi F, Kamali K. Insulin resistance in hypothyroid patients under Levothyroxine therapy: a comparison between those with and without thyroid autoimmunity. J Diabetes Metab Disord. 2014;13(1):103. Published 2014 Oct 30. doi:10.1186/s40200-014-0103-4
 Brent GA. Environmental exposures and autoimmune thyroid disease. Thyroid. 2010;20(7):755-761. doi:10.1089/thy.2010.1636
 Edwards C. Surgical mesh implants may cause autoimmune disorders. Medical Device Network. August 1, 2018. Accessed June 28, 2023. https://www.medicaldevice-network.com/news/surgical -mesh-implants-autoimmune-disorders/.; Fadaee N, Huynh D, Khanmohammed Z, Mazer L, Capati I, Towfigh S. Patients with systemic reaction to their hernia mesh: An introduction to mesh implant illness. Frontiers. January 30, 2023. Accessed June 28, 2023. https://www.frontierspartnerships.org/articles/10.3389/jaws.2023.10983/full.
 Tomer Y, Davies TF. Infection, thyroid disease, and autoimmunity. Endocr Rev. 1993;14(1):107-120. doi:10.1210/edrv-14-1-107
 Mizokami T, Wu Li A, El-Kaissi S, Wall JR. Stress and thyroid autoimmunity. Thyroid. 2004;14(12):1047-1055. doi:10.1089/thy.2004.14.1047
 Hu S, Rayman MP. Multiple Nutritional Factors and the Risk of Hashimoto’s Thyroiditis. Thyroid. 2017;27(5):597-610. doi:10.1089/thy.2016.0635
 Coucke F. Food intolerance in patients with manifest autoimmunity. Observational study. Autoimmun Rev. 2018;17(11):1078-1080. doi:10.1016/j.autrev.2018.05.011
 Rogers MA, Levine DA, Blumberg N, Fisher GG, Kabeto M, Langa KM. Antigenic challenge in the etiology of autoimmune disease in women. J Autoimmun. 2012;38(2-3):J97-J102. doi:10.1016/j.jaut.2011.08.001
 Desai MK, Brinton RD. Autoimmune Disease in Women: Endocrine Transition and Risk Across the Lifespan. Front Endocrinol (Lausanne). 2019;10:265. Published 2019 Apr 29. doi:10.3389/fendo.2019.00265
 Sategna-Guidetti C, Volta U, Ciacci C, et al. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. Am J Gastroenterol. 2001;96(3):751-757. doi:10.1111/j.1572-0241.2001.03617.x
 Hollon J, Puppa EL, Greenwald B, Goldberg E, Guerrerio A, Fasano A. Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity. Nutrients. 2015;7(3):1565-1576. Published 2015 Feb 27. doi:10.3390/nu7031565
 Bell DS, Ovalle F. Use of soy protein supplement and resultant need for increased dose of levothyroxine. Endocr Pract. 2001;7(3):193-4.
 Fruzza AG, Demeterco-Berggren C, Jones KL. Unawareness of the effects of soy intake on the management of congenital hypothyroidism. Pediatrics. 2012;130(3):e699-702. doi: 10.1542/peds.2011-3350
 Eschler DC, Hasham A, Tomer Y. Cutting edge: the etiology of autoimmune thyroid diseases. Clin Rev Allergy Immunol. 2011;41(2):190-197. doi:10.1007/s12016-010-8245-8
 Aghili R, Jafarzadeh F, Bhorbani R, Khamseh ME, Salami MA, Malek M. The association of Helicobacter pylori infection with Hashimoto’s thyroiditis. Acta Med Iran. 2013;51(5):293-296.
 Yason JA, Liang YR, Png CW, Zhang Y, Tan KSW. Interactions between a pathogenic Blastocystis subtype and gut microbiota: in vitro and in vivo studies. Microbiome. 2019;7(1):30. Published 2019 Mar 11. doi:10.1186/s40168-019-0644-3; Lepczyńska M, Białkowska J, Dzika E, Piskorz-Ogórek K, Korycińska J. Blastocystis: how do specific diets and human gut microbiota affect its development and pathogenicity?. Eur J Clin Microbiol Infect Dis. 2017;36(9):1531-1540. doi:10.1007/s10096-017-2965-0
 Diagnosis | Blastocystis Research Foundation. Blastocystis Research Foundation. http://www.bhomcenter.org/info/diagnosis.htm. Accessed June 30, 2017.
 Rajič B, Arapović J, Raguž K, Bošković M, Babić SM, Maslać S. Eradication of Blastocystis hominis prevents the development of symptomatic Hashimoto’s thyroiditis: a case report. J Infect Dev Ctries. 2015;9(7):788-791. Published 2015 Jul 30. doi:10.3855/jidc.4851.
 Patil AD. Link between hypothyroidism and small intestinal bacterial overgrowth. Indian J Endocrinol Metab. 2014;18(3):307-309. doi:10.4103/2230-8210.131155
 Shenkman L, Bottone EJ. Antibodies to Yersinia enterocoliticain Thyroid Disease. Ann Intern Med. 1976;85:735–739. doi: 10.7326/0003-4819-85-6-735
 Chatzipanagiotou S et al. Prevalence of Yersinia plasmid-encoded outer protein (Yop) class-specific antibodies in patients with Hashimoto’s thyroiditis. Clinical Microbiology and Infection. 2001;7(3):138–143.
 Pamphlett R, Doble PA, Bishop DP. Mercury in the human thyroid gland: Potential implications for thyroid cancer, autoimmune thyroiditis, and hypothyroidism. PLoS One. 2021;16(2):e0246748. Published 2021 Feb 9. doi:10.1371/journal.pone.0246748; Sterzl, Ivan I. Removal of dental amalgam decreases anti-TPO and anti-Tg autoantibodies in patients with autoimmune thyroiditis. Neuro-endocrinology letters. 27(25):0172-780X.
 Mutter J. Is dental amalgam safe for humans? The opinion of the scientific committee of the European Commission. J Occup Med Toxicol. 2011;6(1):2. Published 2011 Jan 13. doi:10.1186/1745-6673-6-2
 Fasano A. Leaky gut and autoimmune diseases. Clin Rev Allergy Immunol. 2012;42(1):71-78. doi:10.1007/s12016-011-8291-x
 Metro D, Cernaro V, Papa M, Benvenga S. Marked improvement of thyroid function and autoimmunity by Aloe barbadensis miller juice in patients with subclinical hypothyroidism. J Clin Transl Endocrinol. 2018;11:18-25. doi:10.1016/j.jcte.2018.01.003
 Forouzanfar F, Bazzaz BS, Hosseinzadeh H. Black cumin (Nigella sativa) and its constituent (thymoquinone): a review on antimicrobial effects. Iran J Basic Med Sci. 2014;17(12):929-938.
 Farhangi M, Dehghan P, Tajmiri S, Abbasi M. The effects of Nigella sativa on thyroid function, serum Vascular Endothelial Growth Factor (VEGF)-1, Nesfatin-1 and anthropometric features in patients with Hashimoto’s thyroiditis: a randomized controlled trial. BMC Complementary and Alternative Medicine. 2016; 16: 471. doi: 10.1186/s12906-016-1432-2
 Jia X, Zhai T, Qu C, et al. Metformin Reverses Hashimoto’s Thyroiditis by Regulating Key Immune Events. Front Cell Dev Biol. 2021;9:685522. Published 2021 May 28. doi:10.3389/fcell.2021.685522
 Zhang Y, Li X, Zou D, Liu W, Yang J, Zhu N, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab. 2008 Jul;93(7):2559-65. doi: 10.1210/jc.2007-2404.
 Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab. 2004;89(6):2548-2556. doi:10.1210/jc.2004-0395
 Mutlu HH, Mutlu HH. The impact of weight loss on thyroid autoimmunity – Weight loss decreases thyroid peroxidase antibody levels: a retrospective cohort study. ProQuest. 2021. Accessed June 22, 2023. https://www.proquest.com/docview/2615437773
 Chakrabarti SK, Ghosh S, Banerjee S, Mukherjee S, Chowdhury S. Oxidative stress in hypothyroid patients and the role of antioxidant supplementation. Indian J Endocrinol Metab. 2016;20(5):674-678. doi:10.4103/2230-8210.190555
 Joung, Ji Young JY. Effect of iodine restriction on thyroid function in subclinical hypothyroid patients in an iodine-replete area: a long period observation in a large-scale cohort. Thyroid. 2014;24(9):1050-7256.
 Hu S, Rayman MP. Multiple Nutritional Factors and the Risk of Hashimoto’s Thyroiditis. Thyroid. 2017;27(5):597-610. doi:10.1089/thy.2016.0635
 Zagrodzki P, Kryczyk J. Znaczenie selenu w leczeniu choroby Hashimoto [The importance of selenium in Hashimoto’s disease]. Postepy Hig Med Dosw (Online). 2014;68:1129-1137. Published 2014 Sep 12. doi:10.5604/17322693.1120989
 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. doi:10.1210/jcem.87.4.8421
 Siegmann EM, Müller HHO, Luecke C, Philipsen A, Kornhuber J, Grömer TW. Association of Depression and Anxiety Disorders With Autoimmune Thyroiditis: A Systematic Review and Meta-analysis [published correction appears in JAMA Psychiatry. 2019 Jun 19]. JAMA Psychiatry. 2018;75(6):577-584. doi:10.1001/jamapsychiatry.2018.0190
 Caykoylu A, Kabadayi Sahin E, Ugurlu M. Could the Thyroid Gland Dominate the Brain in Obsessive-Compulsive Disorder?. Neuroendocrinology. 2022;112(12):1143-1154. doi:10.1159/000524627
 Unfer V, Facchinetti F, Orrù B, Giordani B, Nestler J. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocr Connect. 2017;6(8):647-658. doi:10.1530/EC-17-0243; Fux M, Levine J, Aviv A, Belmaker RH. Inositol treatment of obsessive-compulsive disorder. Am J Psychiatry. 1996;153(9):1219-1221. doi:10.1176/ajp.153.9.1219; Palatnik A, Frolov K, Fux M, Benjamin J. Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder. J Clin Psychopharmacol. 2001;21(3):335-339. doi:10.1097/00004714-200106000-00014
 Nordio M, Basciani S. Myo-inositol plus selenium supplementation restores euthyroid state in Hashimoto’s patients with subclinical hypothyroidism. Eur Rev Med Pharmacol Sci. 2017;21(2 Suppl):51-59.
 Nordio M, Basciani S. Myo-inositol plus selenium supplementation restores euthyroid state in Hashimoto’s patients with subclinical hypothyroidism. Eur Rev Med Pharmacol Sci. 2017;21(2 Suppl):51-59.
 Poncin S, Colin IM, Decallonne B, et al. N-Acetylcysteine and 15 Deoxy-Δ12,14-Prostaglandin J2 Exert a Protective Effect Against Autoimmune Thyroid Destruction in Vivo but Not Against Interleukin-1α/Interferon γ-Induced Inhibitory Effects in Thyrocytes in Vitro. The American Journal of Pathology. 2010;177(1):219-228. doi:10.2353/ajpath.2010.091253.
 Henderson P, Hale TW, Shum S, Habersang RW. N-Acetylcysteine therapy of acute heavy metal poisoning in mice. Vet Hum Toxicol. 1985;27(6):522-525.
 He T, Zhao R, Lu Y, et al. Dual-Directional Immunomodulatory Effects of Corbrin Capsule on Autoimmune Thyroid Diseases. Evid Based Complement Alternat Med. 2016;2016:1360386. doi:10.1155/2016/1360386
 Schmidt M, Voell M, Rahlff I, et al. Long-term follow-up of antithyroid peroxidase antibodies in patients with chronic autoimmune thyroiditis (Hashimoto’s thyroiditis) treated with levothyroxine. Thyroid. 2008;18(7):755-760. doi:10.1089/thy.2008.0008
 Cornelli U, Belcaro G, Recchia M, Finco A. Levothyroxine and lung cancer in females: the importance of oxidative stress. Reprod Biol Endocrinol. 2013;11(1):75. doi:10.1186/1477-7827-11-75.
 Höfling DB. Low-level laser in the treatment of patients with hypothyroidism induced by chronic autoimmune thyroiditis: a randomized, placebo-controlled clinical trial. Lasers
Med Sci. 2013;28(3):743-53.doi: 10.1007/s10103-012-1129-9.
 Höfling DB, Chavantes MC, Juliano AG, et al. Low-level laser therapy in chronic autoimmune thyroiditis: a pilot study. Lasers Surg Med. 2010;42(6):589-596. doi:10.1002/lsm.20941
 Pegel K. MODUCARE® – A Brief History And Mode Of Action. Published in 2002. http://www.moducare.com/wp-content/uploads/2016/05/moducare-summary-of-research.pdf. Accessed February 1, 2018.
 Farhadi SA, Bracho-Sanchez E, Freeman SL, Keselowsky BG, Hudalla GA. Enzymes as Immunotherapeutics. Bioconjug Chem. 2018;29(3):649-656. doi:10.1021/acs.bioconjchem.7b00719
 Kvantchakhadze RG. Wobenzym® in the complex treatment of autoimmune thyroiditis. International Journal on Immunorehabilitation. 2002;4(1):114.
 Rutkowski K, Sowa P, Rutkowska-Talipska J, Kuryliszyn-Moskal A, Rutkowski R. Dehydroepiandrosterone (DHEA): hypes and hopes. Drugs. 2014;74(11):1195-1207. doi:10.1007/s40265-014-0259-8
 Ott J et al. Dehydroepiandrosterone in women with premature ovarian failure and Hashimoto’s thyroiditis. Journal of the International Menopause Society. 2014.
 Schmeltz, Lowell R. Anatabine supplementation decreases thyroglobulin antibodies in patients with chronic lymphocytic autoimmune (Hashimoto’s) thyroiditis: A randomized controlled clinical trial. The Journal of Clinical Endocrinology and Metabolism 2013:0021-972X.
 Schmeltz, Lowell R. Anatabine supplementation decreases thyroglobulin antibodies in patients with chronic lymphocytic autoimmune (Hashimoto’s) thyroiditis: A randomized controlled clinical trial. The Journal of Clinical Endocrinology and Metabolism 2013:0021-972X.
 Chaudhary S, Dutta D, Kumar M, et al. Vitamin D supplementation reduces thyroid peroxidase antibody levels in patients with autoimmune thyroid disease: An open-labeled randomized controlled trial. Indian J Endocrinol Metab. 2016;20(3):391-398. doi:10.4103/2230-8210.179997; Mackawy AM, Al-Ayed BM, Al-Rashidi BM. Vitamin d deficiency and its association with thyroid disease. Int J Health Sci (Qassim). 2013;7(3):267-275. doi:10.12816/0006054
 Wang J, Lv S, Chen G, et al. Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients. 2015;7(4):2485-2498. Published 2015 Apr 3. doi:10.3390/nu7042485
 Antonelli A, Alberti B, Melosi A. Changes in markers of autoimmunity in patients with Hashimoto thyroiditis treated with intravenous immunoglobulins. Preliminary results. Clinical Therapeutics. 1992;141(9 Pt 2):37-42.
 Cornejo R, Venegas P, Goñi D, Salas A, Romero C. Successful response to intravenous immunoglobulin as rescue therapy in a patient with Hashimoto’s encephalopathy. BMJ Case Reports. 2010;2010:bcr0920103332. doi:10.1136/bcr.09.2010.3332.; Drulović J et al. Hashimoto’s encephalopathy: a long-lasting remission induced by intravenous immunoglobulins. Vojnosanit Pregl. 2011;68(5):452-4.
 Nupur G, Arpeta G, Maria S, Robert TY. CALMING THE STORM – ROLE OF PLASMAPHERESIS IN THYROTOXIC CRISES. Presented as part of The Endocrine Society’s 95th Annual Meeting and Expo; June 15–18, 2013; San Francisco, CA.; Boers P, Colebatch J. Hashimoto’s encephalopathy responding to plasmapheresis. Journal of Neurology, Neurosurgery, and Psychiatry.2001;70(1):132. doi:10.1136/ jnnp.70.1.132.
 El-saadany H, Elkhalik MA, Moustafa T, et al. Thyroid dysfunction in systemic lupus erythematosus and rheumatoid arthritis: Its impact as a cardiovascular risk factor. The Egyptian Rheumatologist. 2014;36(2):71-78.https://doi.org/10.1016/j.ejr.2013.12.003
 Nevinsky, G. Effect of different drugs on the level of DNA-hydrolyzing polyclonal IgG antibodies in sera of patients with Hashimoto’s thyroiditis and nontoxic nodal goiter. Medical science monitor.2001;7(2):201.
 Houen G, Trier NH. Epstein-Barr Virus and Systemic Autoimmune Diseases. Front Immunol. 2021;11:587380. Published 2021 Jan 7. doi:10.3389/fimmu.2020.587380
 Janegova A, Janega P, Rychly B, Kuracinova K, Babal P. Rola infekcji wirusem Epstein-Barr’a w rozwoju autoimmunologicznych chorób tarczycy. Endokrynologia Polska. 2015;66(2):132-136. doi:10.5603/ep.2015.0020.
 Kurozumi A, Okada Y, Arao T et al. Induction of thyroid remission using rituximab in a patient with type 3 autoimmune polyglandular syndrome including Graves’ disease and type 1 diabetes mellitus: A case report. Endocrine Journal. 2015;62(1):69-75. doi:10.1507/endocrj.ej14-0152.
 Litwicka K et al. In women with thyroid autoimmunity, does low-dose prednisolone administration, compared with no adjuvant therapy, improve in vitro fertilization clinical results? J Obstet Gynaecol Res. 2014.
 Xu J, Bergren R, Schneider D, Chen H, Sippel RS. Thyroglobulin antibody resolution after total thyroidectomy for cancer. J Surg Res. 2015;198(2):366-370. doi:10.1016/j.jss.2015.03.094
 Anita A. Kurmann et al. Regeneration of Thyroid Function by Transplantation of Differentiated Pluripotent Stem Cells. Cell Stem Cell. 2015. DOI: 10.1016/j.stem.2015.09.004.
Note: Originally published in April 2018, this article has been revised and updated for accuracy and thoroughness.