A variety of diets have been reported to be helpful in healing autoimmune conditions like Hashimoto’s. These diets include a gluten-free diet, the Specific Carbohydrate Diet, the GAPS diet, the Paleo diet, the Autoimmune Paleo diet, the Weston A. Price diet and the Body Ecology Diet.
Many people will ask me, “Which diet do you think is best?”
My answer, as always, is the diet that works for you. You are unique. Your genes, your ethnicity, your blood type, your gender, your digestive capability, your intestinal environment, your food sensitivities all make you unique.
The diets are meant to be a starting point for you and should be tailored to your response. Your needs may also change as time goes on, or as you get rid of infections or balance your intestinal flora. Just because one diet worked for someone, does not mean it will work as well for you.
I have tried a variety of diets on my Hashimoto’s healing journey. I started by going gluten and dairy free after having food sensitivity tests that showed I reacted to both. My stomach was extremely grateful. I no longer had a chronic cough, diarrhea, acid reflux or bloating. Having learned about the connection between food and autoimmune disease, I excitedly I retested my TPO antibodies… unfortunately, they increased. I also became more tired, and my anxiety worsened.
I was surprised at first but came to learn that I made the same rookie mistake that people who go gluten free usually do. I replaced my previous junk food with “GFJF” (gluten-free junk food), like soy and rice-based gluten-free bread, pretzels, “milk” and cookies.
Soy has been linked with thyroid autoimmune disorders and gluten free junk foods, bread, cereals and “milks” have an incredibly high glycemic index. The blood sugar imbalances from gluten free junk foods promote adrenal dysfunction which can affect thyroid function.
Eventually, I made a point to remove soy and balanced my blood sugar better. I felt better, my antibodies decreased, but then healing plateaued, and unfortunately, I started becoming bloated again.
So I went back to the drawing board. I researched alternate diets.
One of the diets that I had heard wonderful things about was the GAPS diet. I purchased the book and very much enjoyed the theory behind it. I then started the GAPS diet…with nutrient dense foods that consisted of soups, meats, vegetables, fruit, eggs, and nuts. I felt better at first. Increased muscle tone, energy and felt more “clear.” But after a few months, I continued to have digestive issues. (Please note: I could not find a GAPS practitioner in Chicago at the time, and thus, only went by the book and didn’t modify the diet properly.)
Again, my results were not so great. I was tired, bloated, and lost too much weight. I was down to a BMI of <17! I started breaking out more and then retested my TPO antibodies in three months. They doubled from the 300’s to the 600’s….I was devastated. I had been trying so hard. I almost gave up. But I didn’t.
Instead, I decided to follow the approach of the Body Ecology Diet. This diet is gluten free, dairy free and limits fruit. Additionally, it considers each person’s individuality and can be tailored to each person based on their unique needs and makeup. Donna Gates, the creator of the diet has done a tremendous amount of research into optimal nutrition, and she has been ahead of her time. I started to immediately have positive results.
I felt happier. My skin cleared up, my hair became bouncy and shiny again, I was glowing! Three months after following the Body Ecology Diet, I retested my TPO antibodies, and they dropped to the 200 range.
So what wasn’t working for me?
I had an imbalance of fungal and bacterial organisms that fed on fructose and poorly digested proteins, so all of the fruits, meats, nuts and seeds that were allowed on the GAPS, SCD, and Paleo diet were making me feel worse instead of better. Additionally, the fruit was causing blood sugar imbalances.
So I made some changes…
I did additional testing and figured out that I was not digesting protein correctly (especially eggs). I cut out eggs and began to supplement digestive enzymes with all of my protein meals. I recommend Digestive Enzymes Ultra from Pure Encapsulations.
I also added green smoothies to the mix and started eating a whole bunch of raw (but pureed) veggies that I feel really helped my skin.
Note: Although the Body Ecology Diet contains gluten-free grains, I did not include them.
And some more changes…
I further refined my diet by diet by doing an elimination diet and had a different type of food sensitivity test; this one measured a few different pathways of inflammation, not just the pathway that affects the gut.
The test showed that I was reactive to some “healthy” foods I occasionally ate: chard, apples, garlic, and strawberries. I decided to “test” the validity of the test and ate a whole bunch of these foods all at once. I noticed more joint pain. This joint pain would wax and wane without any seeming food causing it.
I hope that this article helps you understand that diets are meant to be a starting point to your healing journey and that each diet should be tailored to your body.
The moral of the story? Listen to your body, and not a dietary theory. Don’t force foods that don’t agree with you on yourself because someone else thinks they are healthy. Dietary theories are meant to be a starting point; your body will give you further directions.
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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.
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I apologize if you posted this somewhere . . . Could you tell us what enzyme you use? Thank you for sharing your results, and best of health to you. p
I use Betaine with Pepsin 🙂 Has really helped me! http://www.purecapspro.com/thyroidrootcause/pe/products/product_details.asp?ProductsID=929
I did the ALCAT test. It measures different types of immune responses.
Susan- The gold standard, or the most accurate test for uncovering reactive foods and individual food sensitivities is actually the Elimination Diet.
It works better than trying a recommended dietary approach (i.e. gluten-free, Paleo, etc.) and even better than food sensitivity testing (which may be helpful in many cases, but may not be affordable for many people). The elimination diet can work as a stand-alone or in symphony with food sensitivity testing.
In contrast to other diets that simply exclude common problematic foods, an elimination diet is done to determine what particular food intolerances the individual may have. This allows us to tailor the diet to the person, not to the dietary philosophy! Going though an elimination diet will help you figure out your own individual food triggers and your specific response to each trigger food.
ELIMINATION DIET FOR HASHIMOTO’S
https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos
I recently had an allergy panel done, and had a low allergy to gluten, soy, egg whites, and wheat. I went gluten free but did not cut out soy or egg whites. Could these “low” levels o allergies keep antibodies active?
Lunch- salmon Greek Salad
Dinner- stir fry veggies with chicken
You can get all of the recipes by signing up for my list http://www.thyroidpharmacist.com/gift 🙂
Found this from Chris Kresser’s radio broadcast, scroll down to “When to call it quits on the GAPS Diet”
http://chriskresser.com/answers-to-your-burning-questions-about-digestion
“Now, more specifically about GAPS, there are a few issues with it and that can make it not helpful or appropriate for certain people. Number one is that, as we talked about earlier and talked about in more length with Paul when he came on the show, is that yeast can thrive on ketones, and GAPS, especially the Intro GAPS diet, is by definition a very low-carbohydrate diet and will probably be ketogenic. So, for some people who have a systemic yeast infection, doing a ketogenic diet can actually make things worse, and I’ve seen this in my practice. What’s a little confusing to me is that it doesn’t seem to always be the case. Some people tend to improve, so I don’t know how to explain that. Maybe some species of yeast are more able to utilize ketones than others, I’m not sure. But I sometimes even use that as a diagnostic protocol. If you put somebody on a ketogenic diet for a short period of time and they get a lot worse, then that could be an indicator of a yeast infection. So, that’s one issue. Another issue is that because it’s a low-carb diet and someone’s on GAPS for a long time, that could affect thyroid function, which we’ve talked about before. Glucose is required for the conversion of T4 to T3. There are studies showing that fasting and very low carb diets over a prolonged period can cause a decline in thyroid hormone and conversion of T4 to T3, and T3 is five times more metabolically active than T4, so that’s significant.”
Individualizing one’s diet is challenging, I’m glad there’s this post!”
Paula- Here is an article you may find interesting as well! 🙂
CANDIDA AND HASHIMOTOS CONNECTION
https://thyroidpharmacist.com/articles/candida-and-hashimotos-connection
I had a Standard Food Panel IgG completed a while back. I had several items that came back with a moderate to severe classification. There were also many with a mild classification. My question is, do you think it best to eliminate all items from mild to severe for a period of time and then try reintroducing at least the mild ones back in? Your thoughts on this would be greatly appreciated.
Thank you!
Laura- 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
RE: Body Ecology Diet Principles
How important is the food combining principle, in your opinion, for Hashi patients? For example, is it worthwhile to avoid combining starchy vegetables and protein at the same meal? Or, is it better to always have protein at every meal for the sake of blood sugar balance?
Paula- We are all different, and although we may have the same condition, different interventions may be required for each of us to heal. 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
I have no GI problems. Then again I have no gluten or dairy symptoms but I went off them too. No change. I don’t eat any grains now at all, but I have mozzarella on almond and garbanzo crust pizza now when i make it.
Just wondering if you’ve heard of this extreme tolerance of HCl esp with NO GI distress? My bowels are very good too. I eat tons of veggies and take flaxseed ground. I take iron for possible ferritin depletion and still go just fine lol. I do take magnesium in my calming amino acids so maybe thats why lol
I am just perplexed at my body as nothing is making a difference :0
Hélène- While changing your diet is a really important first step that will greatly help many of you, if you do not see a complete remission of your condition within 3-6 months, I encourage you to dig deeper. Changing my diet was a really important step in my healing journey, but it was just the beginning.
6 DIFFERENT ROOT CAUSES
https://thyroidpharmacist.com/articles/6-different-hashimotos-root-causes
Jedda- Here are the links below! 🙂
AMAZON
Hashimoto’s Root Cause Book
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Hashimoto’s Protocol Book
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
Lorraine- you may be interested in checking out the Root Cause Recipe Portal. It is full of autoimmune paleo and paleo recipes. You’re able to organize weekly shopping lists, meal planning, etc. Hope you check it out.
http://rootcauserecipes.com/
Paul- 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
Crystal- You may find this article interesting! 🙂
CANDIDA AND HASHIMOTOS CONNECTION
https://thyroidpharmacist.com/articles/candida-and-hashimotos-connection
CDuncan- 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
Tammy- The gold standard, or the most accurate test for uncovering reactive foods and individual food sensitivities is actually the Elimination Diet.
It works better than trying a recommended dietary approach (i.e. gluten-free, Paleo, etc.) and even better than food sensitivity testing (which may be helpful in many cases, but may not be affordable for many people). The elimination diet can work as a stand-alone or in symphony with food sensitivity testing.
In contrast to other diets that simply exclude common problematic foods, an elimination diet is done to determine what particular food intolerances the individual may have. This allows us to tailor the diet to the person, not to the dietary philosophy! Going though an elimination diet will help you figure out your own individual food triggers and your specific response to each trigger food.
ELIMINATION DIET FOR HASHIMOTO’S
https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos
Shauna- Thank you so much for your support! You may be interested in checking out the Root Cause Recipe Portal. It is full of autoimmune paleo and paleo recipes. You’re able to organize weekly shopping lists, meal planning, etc. Hope you check it out.
http://rootcauserecipes.com/
Anne- 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. I can tell you that while reference ranges of what’s “normal” may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between 0.5-2, and with Free T3 and Free T4 in the top half of the reference range.
Terri- That’s great!! you may be interested in checking out the Root Cause Recipe Portal. It is full of autoimmune paleo and paleo recipes. You’re able to organize weekly shopping lists, meal planning, etc. Hope you check it out.
http://rootcauserecipes.com/
Jean- Here are a couple of articles you may find interesting.
6 DIFFERENT ROOT CAUSES
https://thyroidpharmacist.com/articles/6-different-hashimotos-root-causes
INFECTIONS AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/infections-and-hashimotos/
Kacye- I’m very hesitant in recommending iodine in Hashimoto’s. Although iodine serves as fuel for our thyroid and is very important in iodine deficiency hypothyroidism, Hashimoto’s is a different mechanism. It’s like pouring gas into an engine that’s on fire… that’s essentially what’s happening in Hashi’s, thyroid inflammation, and adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, animal and human studies. I have spent 4 years researching this and have seen too many people suffering the consequences of adding iodine too soon. My approach is, let’s fix the engine first (usually a gut issue), and then add the fuel once we know that the engine is no longer on fire. Hope that you will check out my book. I have a whole chapter on the iodine controversy that references numerous studies as well as the work of Abraham and Brownstein.
AMAZON
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
I was just diagnosed with Hashimotos after taking thyroid medication for years. My functional medicine doctor recommended I read your book. She placed me on the supplements you have recommended. I have read as much as I can find from you and am listening to the autoimmune summit this week.
My daughter and I have been gluten free for almost a month. She feels great and I was feeling very good. For the first time in years I had consistent bowel movements and was digesting almost all my food. But just this Monday I started the elimination diet (mainly veggies and meats and bone broths). I am not eating nightshades. Before this week, I was only gluten and soy free but was eating quite a bit of fruits, some nuts and nut butters, aged cheeses, corn, and beans.
Now with mainly veggies and meat (only 2-3 servings of fruit) I have horrible indigestion, I’m exhausted and semi-constipated. I feel like I have food stuck in my esophagus all the way up to my throat. My tummy/guts hurt like they are rebelling against all of this. I have been on a diet like this before and have always struggled with these same symptoms. I don’t think my body likes meat and veggies as a staple of my diet. Even chicken is causing this and I usually don’t have problems with chicken.
I don’t want to stop the elimination diet because I want to see what I’m intolerant to but it seems like this is counter productive as my guts aren’t healing, they are rebelling.
Also since I started taking L-glutamine at the end of December, when I drink it I feel like I have food stuck in my esophagus.
Any suggestions would be appreciated!
Renae – please, understand that due to liability issues, I am unable to answer specific medical questions.
Here are a couple of articles about diet that you may find interesting or helpful.
FOOD SENSITIVITIES AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos
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
AUTOIMMUNE PALEO DIET
https://thyroidpharmacist.com/articles/autoimmune-paleo-diet
Thank you for your inspiring and meaningful work, Dr. Wentz! I was wondering if you would be willing to share what your current diet is like. I appreciate seeing how your diet evolved throughout your healing journey, and I know since your Hashimoto’s has been in remission, you have been able to add back more foods. I guess the main reason for my curiosity here is because knowing that I might one day be able to occasionally enjoy some of my old favorites without symptoms is extremely motivating.
Maureen – Thank you for asking about me. My diet is very customized. I follow a Paleo diet and avoid any personal food triggers that I have discovered by going on an elimination diet. Here is some information you may find helpful.
AUTOIMMUNE PALEO DIET
https://thyroidpharmacist.com/articles/autoimmune-paleo-diet
TAILORING YOUR THYROID DIET
https://thyroidpharmacist.com/articles/tailoring-your-thyroid-diet-to-your-needs
Could you please give the name of a good book for dealing with candida?
Leya – thank you for following this page. Yeast is an opportunistic organism that acts up when your overall health is impaired or when your immune system is compromised. Most people with Hashimoto’s will have a high degree of yeast overgrowth, especially of the Candida genus. Treating this overgrowth can be very helpful in restoring health. A note about Candida: Candida can be a primary or a secondary root cause. While conventional medicine underdiagnoses issues related to yeast overgrowth, natural medicine practitioners seem to overdiagnose yeast and may say Candida is a root cause for all ailments. I recommend a Candida protocol for most people with Hashimoto’s. I talk more about this in my book Hashimoto’s Protocol I hope you check it out. Hashimoto’s Protocol
thyroidpharmacist.com/protocol
Here is an article you might find helpful as well:
CANDIDA AND HASHIMOTOS CONNECTION
https://thyroidpharmacist.com/articles/candida-and-hashimotos-connection/
You appear to have quite a lot of knowledge in this area so I have some questions I’m hoping you can address.
I have a slew of health issues I’d like to sort out but I am getting so overwhelmed with the amount of people advocating ‘their’ healing diets that I just can’t decide who to follow or which issue to tackle first. I like your 20/80 meat to veggie suggestion because I do enjoy chicken but find I suffer from intense gas after meat and well…not too pleasant either! I’m also not too keen on eating meat everyday for breakfast?!?
I have Hashimotos w/ hypothyroidism, Fibromyalgia, Gilbert’s Syndrome, low ferritin, chronic depression and most likely leaky gut, SIBO, and/or Candida issues. They all have overlapping symptoms which can sometimes make it difficult to tell what’s causing what at the current moment. They all seem to require adding or removing this food or that but trying to accommodate for each issue just ends up affecting the other. And way too many supplements to take for all on a daily basis.
Currently I am only taking Tramadol ER 100mg daily, 0.075mg Synthroid, and no supplements until I figure out what I’m going to address first. I have tried raw, not for me and apparently not a good idea either. I had some success on a 3w plant based food plan but had difficultly sticking with it. Too tired working FT and like many others, I’m addicted to sugar and easy foods as well.
That, and finances, will be my biggest challenge I think!
I don’t necessarily need an online guided program per say, as I don’t have the time or energy to put into it right now, but a book or meal plan would suffice.
Just don’t know what area to start with.
Anything you can suggest would be very much appreciated!! ???
Also, I live in Canada so unfortunately cannot order your products. Pure Encapsulations don’t appear to ship to customers but there are a lot of sites selling the brand. Do you know a reputable website who ships to Canada or can you recommend another brand to buy when the time comes? Thanks!
Alicia – thank you for following this page. I am sorry that you are having difficulty obtaining the supplements. Below are some international resources, where you may be able to find other supplement brands recommended in my Hashimoto’s Protocol book or similar products:
* http://www.naturaldispensary.co.uk – based in the UK, but ships to most of Europe. Use “Izabella Wentz” as referring practitioner
* http://www.iherb.com/ – has many supplements that ships all over the world
* nutritiongeeks.co.uk – has most Designs For Health products
* Vitamins – biowitalni.pl
* https://www.suplementosdouglas.com
* https://www.nutrimi.es
* https://www.herbolariohierbabuena.com
* http://www.purenature.es
* superfood.nl
* Vitamins/supplements – farmaline.nl
* http://www.bio-health.co.uk/
* http://www.purebio.co.uk
* https://www.amritanutrition.co.uk/dr-wentz-recommended-products
I hope that the above helps!
Alicia – thank you for reaching out and sharing your journey. <3 Most autoimmune conditions have common root causes, and a lot of times the things that are recommended for one autoimmune condition will help with others. Conditions that I have found to respond really well to the Hashimoto’s protocols have been rheumatoid arthritis, lupus, Celiac disease, irritable bowel syndrome, eczema, asthma, Graves’, premature ovarian failure, psoriasis, Alopecia Areata, and Sjogrens. I have also seen the protocols help with Fibromyalgia, chronic fatigue syndrome, PCOS, as well as Type 2 diabetes, Crohn’s, and Ulcerative colitis. Having worked with over 1000 people with Hashimoto’s, and surveyed my community of over 250,000 Root Cause Rebels, I’ve developed a streamlined approach to help you strengthen your body and start eliminating symptoms in as little as two weeks. I lead you through self directed protocols that are beneficial to you, regardless of your root cause. I also walk you through the maze of identifying your individual triggers to autoimmune thyroid disease.
It took working with 1000+ clients, dozens of functional medical trainings, reviewing thousands of scientific articles and consulting with over one hundred health experts over the course of 7 years to put the protocols contained in the book together for you. I hope you check it out.
Hashimoto’s Protocol : http://amzn.to/2B5J1mq
Even though I never had any noticeable digestive issues, except for some nutrient deficiencies, after reading so much about how many people with Hashimoto’s have low stomach acid, I started doing Betaine and Pepsin, and sometimes ACV with water, but stopped because I started to have burning sensations and stomach pain. When I stopped, it went away again. Does this mean I have optimal stomach acid already? Is there a way to test stomach acid levels?
Elle – thank you for sharing your journey. <3 Acid Reflux is a very common symptom that occurs in people with Hashimoto's. Studies have shown that most people with Hashimoto's either have very low stomach acid or produce no stomach acid at all. The person who does not have enough stomach acid will have the same symptoms as a person with an overabundance of stomach acid. There aren’t too many tell-tale signs of low stomach acid, other than perhaps feeling full and tired after meals as well as experiencing acid reflux-like symptoms. Other symptoms may include: low B12, low ferritin or iron levels, fatigue despite thyroid medications, and constipation/diarrhea. Here are some artices you may find helpful.
GOT ACID REFLUX?
https://thyroidpharmacist.com/articles/got-acid-reflux
HASHIMOTOS AND LOW STOMACH ACID
https://thyroidpharmacist.com/articles/hashimotos-and-low-stomach-acid
GOING DAIRY FREE TO REVERSE HASHIMOTOS
https://thyroidpharmacist.com/articles/going-dairy-free-to-reverse-hashimotos