DR. IZABELLA WENTZ, PHARM D

Thyroid Pharmacist

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The Best Probiotics for Hashimoto's

The Best Probiotics for Hashimoto’s

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Note: Originally published in May 2015, this article has been revised and updated for accuracy and thoroughness. 

The Role of the Gut

When I was first searching for a healing plan for Hashimoto’s, I learned about the role of the gut in autoimmune disorders.

According to research from Dr. Fasano and colleagues, every person with an autoimmune disorder has something called intestinal permeability, also known as a “leaky gut.” This made a lot of sense to me because I had many of the symptoms of intestinal permeability including bloating, stomach pains, irritable bowel syndrome (IBS) and acid reflux, as do many people with Hashimoto’s.

However, not everyone with intestinal permeability will have these symptoms. Some may have no apparent gut symptoms at all. As awful as it was to deal with IBS for almost a decade and acid reflux for three years, I’m grateful that I had them as these symptoms were signals from my body as to what part of the system was broken.

Autoimmunity has been determined to be a three-legged stool, needing a combination of the right genes, the right triggers, and intestinal permeability to manifest itself. This was exciting to me because I knew that I couldn’t change my genes and wasn’t sure if I would be able to identify the exact trigger that set off the autoimmune cascade in my body, but I was hopeful that I could fix my intestinal permeability.

I found that there are various reasons why a person may have intestinal permeability. Gluten, the protein found in wheat products, has become a well-known producer of intestinal permeability, and many individuals with autoimmune conditions have been able to find relief in symptoms by following a gluten-free diet, the Paleo diet, or another elimination diet such as the Autoimmune Paleo diet (AIP). Some people have even seen a complete remission in their autoimmune condition after removing gluten from their diet.

Another reason why a gut may be more permeable is due to an imbalance of probiotic (good) vs. opportunistic (bad) gut bacteria, also known as dysbiosis.

People with autoimmunity have been found to have lower amounts of the probiotic bacteria Lactobacillus and Bifidus, and higher amounts of the opportunistic E. coli and Proteus bacteria. E. coli and Proteus bacterial species are often referred to as “opportunistic pathogens” because they only become pathogenic when the opportunity is just right. If they are outnumbered by probiotic bacteria, they behave like good citizens of the gut and may add value, but in times where they outnumber the probiotics, they may start to damage the gut wall, leading to intestinal permeability.

I’ve seen this pattern of low levels of probiotic bacteria with high levels of opportunistic bacteria on my lab tests as well as the tests of many clients with Hashimoto’s that have had the GI Effects Gastrointestinal Function Comprehensive Profile – METAMETRIX KIT test that quantifies the microbial flora. (You can have your functional medicine doctor order this test for you, or you can self-order the METAMETRIX KIT or GI-MAP.)

When I first took this test, I was shocked to see that I had zero growth of Lactobacillus bacteria, even though I was eating yogurt on a daily basis. I didn’t realize at the time that the problem with most commercial probiotics and yogurts is that they don’t have enough beneficial bacteria to make a difference.

I started to eat fermented foods and added high doses of probiotics and started to feel better and better (I had already been gluten and dairy free and had hit a “healing” wall).

I retested myself with the GI Effects Gastrointestinal Function Comprehensive Profile – METAMETRIX KIT (we have also been using GI-MAP with great success as well) when all of my Hashimoto’s symptoms were gone and found that my probiotic bacteria were in the optimal range and the E. coli and Proteus species were no longer predominating my gut flora.

Thus, one of the very first recommendations I make for EVERYONE with Hashimoto’s is to be sure to get enough probiotics on board.

You can do that by eating fermented foods (like my friend and mentor Donna Gates recommends), as well as through taking probiotic supplements.

Probiotic Rich Foods

  • Fermented coconut yogurt: CoYo Coconut Milk Yogurt and So Delicious Dairy Free are two potential options sold in the United States
  • Fermented coconut water: The Body Ecology one from Donna Gates.
  • Fermented cabbage (make sure you get the kind that is refrigerated, the probiotic bacteria only survive for a couple of weeks at room temperature). Check your organic grocery, otherwise Thirty Acre Farm ships in the US.

Probiotic Supplements

Probiotics have been widely researched for a variety of conditions including irritable bowel syndrome, constipation, anxiety, depression, and even skin disorders. Probiotics can help with improving digestion and nutrient extraction from the foods we eat and can also balance the immune system.

Probiotics can help with all types of gut symptoms, some can help with treating small intestinal bacterial overgrowth (SIBO) present in >50% of people with Hashimoto’s and responsible for leaky gut, and have helped me with symptoms of anxiety and helped me with digesting my food. (Please note, some probiotics can exacerbate SIBO.)

Types of Probiotics That I Have Used Successfully

Beneficial Yeast Probiotics

Saccharomyces boulardii (S. boulardii) is a beneficial yeast that helps to clear out pathogenic bacteria, candida, some parasites (including Blastocystis hominis), and H. pylori, an infection that has been implicated in ulcers and has been linked to Hashimoto’s.

S. boulardii does not colonize the gut wall, but instead, it causes an increase of secretory IgA, which supports our own body’s natural defense against infections and opportunistic gut bacteria.

While the label of the product recommends taking 2 capsules twice per day, I used higher doses, building up to 4 capsules three times per day.

This probiotic is generally safe for SIBO and should be used whenever you are taking a course of antibiotics (or after their use) to help rebalance the gut flora.

Lactobacillus-Based High-Dose Multi-Strain Probiotics

Most grocery stores and health food stores sell Lactobacillus-based probiotics that contain 10 billion colony forming units (CFU’s) of one probiotic strain. While this seems like a really big number, in reality, we have one trillion bacteria in our gut, and that small amount is not likely to make a difference. In fact, most probiotic supplements only contain enough probiotics to maintain an already healthy gut, not to restore gut microbe balance. I personally haven’t seen major benefits from using Lactobacillus probiotics until we get them into really high doses.

Furthermore, as research is showing that probiotic diversity is associated with greater health and improved gut function, I prefer probiotic blends containing Lactobacillus strains in addition to other probiotics, instead of single strain probiotics that only contain one type of Lactobacillus. Probiotic blends generally contain various strains of Lactobacillus, Bifidobacteria, and in some cases, beneficial Streptococcus bacteria. Thus, I recommend taking higher doses of multi-strain probiotics. If you’ve never taken probiotics, you will want to start with the 10 billion CFU probiotic but then work your way up to a higher dose over time.

Rather than taking multiple pills, numerous companies have created high dose probiotic blends.

Probiotic 50B by Pure Encapsulations, which contains 50 billion colony forming units, is a great high dose probiotic one can start with as you work your way up.

Another high dose Lactobacillus-based probiotic that I have used with great success and that has the most research behind it is known as VSL #3 and contains 450 billion CFU’s per dose. This particular probiotic has been clinically studied for ulcerative colitis and irritable bowel syndrome. The probiotic has been so successful in inducing remission, it has been labeled as a “medical food.” Please note, this is a very expensive probiotic, but you can get it covered by your insurance if you have the right diagnosis.

I have learned about a less expensive equally effective brand of high dose multi-strain probiotics from my brilliant nutritionist friend, Tom Malterre, called Klaire Ther-Biotic.

High-dose, multi-strain probiotics can be very helpful for people with Hashimoto’s in general, and especially for those who often show low levels of them on gut lab tests. However, they may be problematic for people with SIBO, which can be caused by an overgrowth of various bacteria, including Lactobacillus and Streptococcus bacteria, which are often found in probiotics. It’s important to note that up to 50 percent of people with Hashimoto’s may have SIBO, and the overgrowth, in up to 75 percent, may be comprised of Lactobacillus or Streptococcus bacteria.

Soil-Based Probiotics

Soil-based probiotics came on my radar after some colleagues reported having excellent results using them with their clients. Soil-based probiotics are naturally occurring, spore-based, and have a unique mechanism of action, which allows them to directly modulate the gut microbiome. Spore-based probiotics have shown promise in various autoimmune diseases and in reducing allergies and asthma. Spore-based probiotics also have an ability to boost Lactobacillus colonies, so they can be used concurrently with Lactobacillus probiotics as well as in place of them. Unlike the Lactobacillus probiotics, spore-based probiotics can reduce SIBO and increase gut diversity by boosting the growth of other beneficial flora.

Clients and colleagues with Hashimoto’s have reported the following after using for thirty to ninety days: a reduction in thyroid antibodies, an improved mood, less pain, better bowel movements, more energy, and a reduction or complete elimination of food sensitivities.

I have had clients use MegaSporeBiotic with great success. The starting dose for MegaSporeBiotic probiotics is one capsule every other day, and the therapeutic dose is two capsules per day. Once the desired effect has been seen (generally three to six months in people with Hashimoto’s), I recommend dropping down to a maintenance dose of one capsule per day.

Tips for Using Probiotics…

If you’ve never taken probiotics, you will want to start low and go slow, as you may have increased symptoms if your gut flora changes too rapidly. If you’ve found that you can tolerate that dose, but have not reached your gut health goals, you can work your way up to higher doses.

Tips for Healing the Gut

Gut healing is a journey; you may need various interventions like removing reactive foods and infections, taking enzymes and probiotics, and balancing nutrients. In some cases, such as after a bout of food poisoning, antibiotic treatment, or a stressful life period, you may need to start from scratch once more. Remember, be kind to yourself and learn to listen to your body so that you can support and feed it properly! You are worth it!

Wishing you all the best on your journey!

P.S. To learn more about other helpful interventions, consider picking up a copy of Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back and Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause.

For continued updates and interaction, please become a part of my Facebook community and sign up for my newsletter. I love interacting with my readers!

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Comments

  1. Thanks so much for the info about probiotics. I’ve been making my own ferments but I think I’ll add probiotics now. I tried replying to the email you sent but your mailbox wouldn’t accept…just wanted to say thank-you for all you do in your work to help and support us a Hashi’s patients, it makes a difference and you are appreciated. Hope you had a beautiful weekend with your “love”, the pic was great!
    Reply

  3. What about avoiding strains of Bifidus? I have read that it should be avoided with Leaky gut ( especially with crohns and colitis) and it is in the VSL #3. I have been sticking with Acidophilus and Lactobacillus GG with good results. Interested in your thoughts. Thanks!
    Reply

  4. I have successfully been using Enzymatic acidophilus PEARLS. They are coated to bypass the stomach to best work in the intestines. Right now I only need one 1 billion CFU . Contains Lactobacillus acidophilus and Bifidobacterium longum.
    Reply

  5. I sense that I am reacting to my probiotics (VSL) and bone broth and kambucha, which leads me to believe I am Histamine inttolerant. My reactions are incredible itching. Do you have a recommendation for how to replace healthy bacteria when you have HI?
    Reply

    • Hi Kelly,
      I have the same problem with VSL#3. I take Custom Probiotics d-lactate free, Megaspore Biotic, Sacro B by Thorne, and Just Thrive by Body Ecology.
      Be well,
      Ali

      Reply

        • Dr. Wentz,

          Thank you for teaching us so much. I saw my naturopath and a medical intuitive on Sunday and they both said my biggest problem is a heavy viral load (EBV) so now I’m taking an antiviral. According to self-muscle testing I have 40/60 EBV strains probably most came from a blood transfusion when I had an apendectomy while I was four months pregnant. Yay me! It will get better.

          Ali ?

          Reply

          • Ali – thank you for following this page. Without going into too much detail, the first of the crucial defining moments in my disease development may have started during my undergraduate studies at the University of Illinois. Due to the communal living setting of dormitories (and less than stellar hygiene habits of most college students) I had recurrent strep throat infections and even contracted mononucleosis, a viral infection caused by the Epstein-Barr Virus (EBV), which is implicated in triggering many autoimmune conditions. I received multiple courses of antibiotics as well as flu shots (which may be associated with EBV infections), and started birth control for menstrual cramps.

            It is my belief that this combination had a profound impact on my gut flora, and thus my immune system.

            Epstein-Barr is a virus that causes mononucleosis (commonly called “Mono”) , a debilitating viral infection that is common among college students, and is also known as the “kissing disease,” because individuals are exposed to the virus through saliva of those who are infected.

            Specific immune cells known as CD8+ T cells are needed to fight off the Epstein-Barr virus, however, some individuals may have a low baseline level of these types of immune cells. (CD8+ T cells decrease with age, are lower in women, and in the presence of low vitamin D intake). When these fighter cells are low, the Epstein-Barr virus may take up residence in our organs (such as the thyroid) and essentially hijack the organ to help the virus hide and multiply.

            The timing of infection may also matter as well, for example, children in developing countries usually contract the Epstein-Barr Virus when they are under the age of 10. This usually results in an asymptomatic infection—one that does not cause them symptoms. In contrast, in developed countries, where individuals are not usually exposed to the virus until they are in high school or college, the infection is symptomatic in 50% of the older kids affected. This is because by the time we reach college age, CD8+ T cells, the ones that fight EBV, have declined by threefold compared with the number of cells we had in childhood.

            Additionally, animal fat and broths, soups and stews support the body’s ability to suppress the viruses. Monolaurin/lauric acid, one of the components of coconut oil, has been found to be active against the Epstein-Barr virus. Replication of many viruses including Epstein-Barr is inhibited by glycyrrhizic acid, an active component of licorice root. Quercetin, Co-Enzyme Q10, N-Acetylcysteine, and glutathione were also reported to be helpful in chronic fatigue syndrome because of their anti-viral properties.

            EPSTEIN-BARR VIRUS AND HASHIMOTO’S
            https://thyroidpharmacist.com/articles/epstein-barr-virus-and-hashimotos

          • Hi again,

            Thanks again. I have read that before and I have your book. For some reason, I muscle test poorly for quercetin. I take liposomal glutathione 3 times a day and unbiquinol once a day plus a whole bunch of other things. I’ll check out glycyrrhizic acid though.

            I just started Viru-tox for the EBV by Physica Energenics – it’s so powerful, I can only handle three drops a day.

            I have mild psoriasis, celiac, hashimoto’s, and microscopic colitis. I plan to get rid of the EBV and reverse all of the autoimmune diseases. ?

            Ali

          • Ali – I am happy you are taking charge of your health! We know that intestinal permeability (aka leaky gut) is present in every case of autoimmunity and often precedes the development of Hashimoto’s. Symptoms of leaky gut may include bloating, diarrhea, constipation, stomach aches, acid reflux and irritable bowel syndrome. According to the Institute of Functional Medicine, many people develop IBS 5-10 years before an autoimmune diagnosis. I was one of them and didn’t take my gut health as seriously as I should have. Gut problems are often caused by infections like H. pylori, parasites like Blasto, SIBO, an imbalance of bacteria, and enzyme deficiencies or food sensitivities (especially to gluten, dairy, and/or soy). Even stress can be a factor in gut permeability. The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.

            Hashimoto’s Protocol
            thyroidpharmacist.com/protocol

            Hashimoto’s Root Cause
            http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

  7. I use the brand Ultimate Flora. It has 30 billion of 10 diff strains and it works great! Normally I only take one, but sometimes I will take two if I forget to take one the day before. It has helped tremendously!
    Reply

  8. I have been on probiotics for a few years w good success with suspected leaky gut, but could probably do better. Can I take one of these more expensive ones for a month or two to give my gut an extra boost and then go back to my probiotics that are half the price? (All 5 of us in the family are on probiotics that are in the billions and with a varied array of probiotics so it gets very expensive when you add in the cost of other supplements we take as well.) Hope my question makes sense. Also, our docs and pharmacists cant seem to tell me if we are supposed to stay on probiotics indefinitely or give ourselves a break. Thanks So much for the great info you put out into the world!
    Reply

  9. My dr had recommended Garden of Life Raw Probiotics for women. Can you tell me if you have heard of them or if they are any good?
    Reply

  12. Please stand me the name of the probiotic you are talking about I missed the brand an where to buy it!
    Blessings!
    Reply

  16. Did you take all the suggested probiotics at once or did you take them at separate times and the VSL was the one that worked the most?
    Reply

  17. i have Ankylosing Spondylitis, an original “leaky gut” disease that causes fusion in the spine and SI joints. Do you know the roll of KLEIBSELLA bacteria in the lower gut ? I take Align probiotic, avoid wheat/gluten and eat anti inflammatory foods.
    Reply

  18. I take Ultimate Friendly Flora by Andrew Lessman Pro Caps Laboratory. 25 billion Cfu per capsule. I have taken them for 2 years with great results! Please check them out and let me know what you think. I Have a very sensitive stomach and vitamins would make me really sick until I tried his products! The probiotics have done wonders for me!
    Reply

  19. Klaire Ther-Biotic is ONLY sold to or through healthcare professionals. Do not buy it on Amazon… read the reviews; they do not ship cold, etc. If you go to the Klaire site, you’ll see that an individual patient can NOT buy the product directly.
    Reply

  20. I was able to purchase Ther Biotic Complete online through The Natural. It was shipped with cold packs.
    Reply

  25. First of all, I would like to thank you for all information. I recently started reading about fermented foods and its benefits. I was wondering if Kombucha is safe in hypothyroid or not. And, if yes, then how much kombucha per day or week. Please reply or you can email me at health.auto15@gmail.com.
    Thanks,
    JC
    Reply

  26. I was wondering if there are any less expensive probiotics that will work. I am on a limited income and these are $83.00 a bottle. Yes my health is important but I was hoping there might be a cheaper alternative.
    Reply

  27. How about making youd own kimchi ? Or sauerkraut? Any thoughts on that? Are these not good enough? I also have Hashimoto and trying to figure out best diet for me and my budget!
    Reply

  30. I has to stop dairy all together it made me so nausea and severe stomach pain and now I can’t tolerate it at . I literally will vomit and have either area diarrhea or get constipated at the same time. And I can only tolerate fruit sugar. Gluten makes me constipated. But on a good note,I found this aloe drink ,I love to drink and it dose wonders for my stomach and intestines . And I have cut back on any fungus (yeast -related ) foods . so far those are my major triggers . grains bine my stomach up .
    Reply

  33. Your posts are great and very informational. I always read them. But, you might want to mention that some folks with SIBO can’t take most probiotics. I fell into that category. Sometimes the bacteria in the small intestine is good bacteria, and mostly in the Lactate-D family. Taking most probiotics in this case makes the SIBO worse! In which case they need to find a probiotic that has no lactase D in it. This was my problem. I stay off probiotics and instead opted to buy the yogurt culture recommended by the SCD folks. I make my own almond milk yogurt. I’m too afraid to try probiotics again until i know my SIBO is gone!
    Reply

  36. I have tried Prescript Assist and Trenev Trio at my alternative Doctor’s suggestion. THEY DID NOT SEEM TO HELP MUCH. I switched to John Barron’s Probiotic and it made a big difference – they measure in the BILLIONS and are room temp stable!!!
    Reply

  37. So I am seeing a new DR. BUT feel like I have all the symptoms of hasimotos and have for years with nobody validating me. I take a pro biotic from Advocare but feel it doesn’t work. My Dr has me on multiple supplements and is adding another. Along with a hormone. I simply just want to feel better. Where do I go from here?
    Reply

  38. I just went yesterday to a chiropractor who does applied kinesiology. I have IBS, interstitial cystitis and fibromyalgia. Its all rooted in a non/low functioning thyroid from what I’ve read. Anyway he is on the way to help me heal. Igained over 20 in two tears also. I would try to find someone in your area to assess you. I’m pretty much done with the general medical doctors. Give it a try you have nothing to lose. He told me that I have most likely Hoshimoto’s. But he is not an MD so he can’t make a that medical diagnosis.
    Reply

  39. I have Hashimotos and Graves eye disease and have had great sucess with Perscript Assist probiotic….
    Reply

  40. Sherri, try going off all wheat and gluten products. If that doesn’t help try also dumping all corn products. People are shocked at the difference they feel after d o ing this.
    Reply

      • Michele – thank you for following this page. Not everyone will need every single supplement! In fact, I believe that most nutrients should come from the diet. This is why I always list food sources in the book and on the blog, for most of the nutrients, vitamins, minerals and probiotics that are depleted in Hashimoto’s. However, some may require/prefer supplements and the supplements on the website are a resource for those that do. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time, and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm.

        I do have a full supplements chapter in my book. Have you checked it out? Not everyone should be taking every supplement and the book will help uncover your root cause. This will help you figure out your supplementation.

        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
        thyroidpharmacist.com/protocol

        Reply

  44. Have you tried Plexus Probio5? It has Bacillus coagulans, Lactobacillus Acidophilus, Bifidobacterium Longum, Lactobacillus Plantarum, and Saccharomyces Boulardii. It also has chitosanase which helps break down the hard outer shell of Candida yeast. It’s a great product. I love it!
    Reply

  46. Hmm. I have histamine issues and the best strains for us are bifida starting strains. There are 5. I also have hashi and surely leaky gut. I’d love to know more if you have research on strains for healing
    Reply

  47. I found i developed itching and skin conditions after using kombucha. Many other people have reported the ssme. Maybe kombucha is best avoided.
    Reply

  49. Actually I got mine Klaire from amazon and they had it cold and with a cold pack. So far it’s going well for me.
    Reply

  53. I use plexus probio5. All my kids use it too. We all suffer from IBS and leaky gut. It helps tremendously. It is formulated to reach the intestines before breaking down and it also contains an anti fungal. It’s $30 for a month supply
    Reply

  54. I so agree! I was introduced to plexus from a friend and it has helped with so much. Anxiety and depression to ibs-d. I only wish I would have found it sooner!
    Reply

  55. I was taking Slipper Elm and it was doing wonders, but stopped.. It helps with IBS, GUT, and maybe more. So I should go back and take them as Thyriod, and very bad gut problems..
    Reply

  56. I was taking Plexus pink drink and their pro biotics, made me sick as a dog, that was prior to my diagnosis of hashimoto thyroiditis, my representative keep telling me to up my dose. My endocrinologist does NOT recommend plexus. Plexus products have no verifiable science behind them that is available for review. All you ever see are “miracle” stories.
    Reply

  57. For me personally, Plexus has worked. I can’t say it will work for everyone. But I had acid reflux for 18 years. 18 years of doctors, scopes, prescriptions, probiotics, OTC meds, diet changes and the only thing that helped was propping up on 4 pillows because I couldn’t lay flat or I would throw up. 18 years of never laying flat. Until I tried Plexus ProBio5. After just 8 weeks I was sleeping flat!!! And have continued to for over a year. I also have Hypothyroidism and my doctor says my numbers are great. So while it may not work for some, it was MY miracle and I think it’s worth a try.
    Reply

  58. I’m sorry to hear you were so sick. I too am taking plexus. I had my thyroid radiated 11 years ago. My endo approved my plexus. I take their slim, cleanse and probio5. I know when you start it could be part of a Candida yeast die off. You should google that. Candida causes an array of issues. I also know that it’s like everything else, not every thing works for everyone. ☺
    Reply

  59. You cannot buy Plexus products from a shelf. Through Rep only. Please message me if it interests you.
    Reply

  61. I would buy them online or check your health food store. Do a Google search of the probiotics listed by Dr Wentz in her article above . Wal-Mart and your local drug stores will most likely NOT have “good” probiotics. I don’t take those listed above but I am going to check them out for sure. Quality is important.
    Reply

  63. Refrigeration of fermented organic food is just NOT necessary. Yes, it slows the process but the science does not support your statement that probiotic bacteria die after a few weeks. Well fermented food will last years at room temp and the full strength of the good bacteria is not reached for 12 weeks, where it holds for a very long time. Love what you bring to the table-I sure would love some clear confirmation on this.
    Reply

  64. to the person that thinks they have thyroid issues….Gynecologist with do Bio identical Hormones will look into your thyroid and help you….and some DO drs but I find BIO identicals drs look at your overall health with hormones and thyroid which can be interconnected…..you can google in your area…..women can have adrenal issues, gut issues, and hormones issues from stress etc..
    Reply

  65. I am histamine intolerant, and my practitioner switched me to a different Klaire Labs product, Lactoprime Plus. Said that there are certain strains I should stay away from right now… It has 7 different Lactobacillus and 5 Bifidos strains.
    Reply

  67. I have developed Vitiligo over the past 3 years which has gotten so bad along with stomach issues recently. I am waiting for authorization to see a gastro doc but am leery of what’s next. I also believe I may have thyroid issues. I am in excellent shape and eat well so, can you possibly recommend a good probiotic as I am at my witts end? Thank You.
    Reply

  68. I have taken 2 different probiotics in the last year – Plexus probio5 and Solaray multidophilus 12 – and both have caused teeny tiny red dots (almost like blood blisters but they are not raised) all over my body and weird, almost like broken veins and discolored marks on my lower legs and large, red veins around my nose. Do you know why this happened or what causes it? It never happened when I took probiotics from Nature’s Sunshine. Can anyone answer this? I’ve also just recently been diagnosed with Hashimoto’s thyroiditis but don’t know if this has anything to do with it. Thank you for any help in this matter.
    Reply

  69. It is your body detoxing or dying off…it means these probiotics actually work and perhaps the natures sunshine wasn’t. Lower your dose and incease it slowly
    Reply

  70. So weird that you say about the red dots, because JUST THIS MORNING, I noticed the exact same thing. I also take ProBio5…I love it…but I want to know what’s up w/ these dots.
    Reply

  71. Everyone here has their own preferences for whatever probiotics works for them since each of us have different medical issues & were each unique…what works for some doesn’t work for others. For instance, my doctor’s dietitian prescribed VSL3 with the recommended dosage for my stomach problems. I had severe stomach pain with this very expensive med., so I reduced the dosage & still had pain! So there it is sitting in my refrigerator unused! I am now taking Culturell twice daily with no issues…one simple strain in this probiotic which may or may not be doing 100 % of it’s job, but I can tolerate it. So what’s the best probiotic is still an unanswered question for me!!
    Reply

  72. What do you think about ProBio5 with Plexus. I’ve had better results with my IBS with this than anything I’ve taken!
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  73. It’s been the only thing to help my ibs. I suffered panic attacks whenever i had to go somewhere. Was having panic attacks. I’ve gotten off anxiety and depression medications…even lowered thyroid medications.
    Reply

  75. I have been taking Prescript Assist and I just compared the strains with VSL #3. They are completely different so I’m wondering if I would benefit from taking each one on an every other day schedule. I don’t have IBS symptoms anymore (since 2013) so I’m just trying to get to zero antibodies, lots of energy, and optimal health. I’m almost done reading Hashimoto’s Thyrdoiditis Root Cause and I’m trying to see what else I can try. I am doing very well compared to 3 years ago, but I don’t every want to go back to that point.
    Reply

  76. Great article been fighting with Candida and blastocystis omini but am allergic to both Brewers and Baker’s east , IGG and IGM allergies class 1 and 2 . The product sheet of the S.boullardii says dont take if you are allergic to these. What would you recommend as an alternative for one who has been fighting yeast and parasites? Your reply would be very highly appreciated.Am on a standstill .
    Reply

  77. Your book was first inspiration that there was hope of getting rid of or at least controlling Hashimotos. Thank you again for the leads on probiotics. 🙂
    Reply

  79. I have Hashimoto’s and with that I have an Underactive thyroid and take synthroid for that. My blood work says I’m in “normal” ranges but still have really bad Symptoms and continues to get new symptoms. The only symptoms I have with my gut so far is bloating, should I be taking a Probiotic?
    Reply

  80. Help hypo thyroid tsh in June 29.7 an feeling very tired headaches daily tsh in Sept. .016 weight in June 143 now 118 lbs , hair falling out light headed etc
    Reply

  81. Have you looked into Plexus Probio5? It is designed to kill Candida and promote good bacteria growth! Way less cheaper than the other probiotic!
    Reply

  82. I had hashimotos. I have chronic urticaria and vitiligo. My thyroid was removed in Jan 2012 due to large nodules. Does all of this still apply to me since I no longer have a thyroid? I now take Synthroid .75mcg. I don’t feel like Ihave leaky gut symptoms. The biggest thing is that I used to be able to drop 5 lbs whenever I needed to, now I can’t. I’m 61, post-menapausal and now need to drop 20 lbs. Ughhhhh…….
    Reply

  83. I have looked in to Pure encapsulations and found one of their ingredient is Soy which is not good for us Hypothyroid people so what do you suggest in that matter ,please let me know ,thanks.
    Reply

  84. Help hypo thyroid tsh in June 29.7 an feeling very tired headaches daily tsh in Sept. .016 weight in June 143 now 118 lbs , hair falling out light headed etc
    Reply

  85. Help hypo thyroid tsh in June 29.7 an feeling very tired headaches daily tsh in Sept. .016 weight in June 143 now 118 lbs , hair falling out light headed etc
    Reply

  86. My son has Down Syndrome and diagnosed with multiple autoimmune disorders including, alopecia universalis, Hoshimoto/Compensated Hypothyroidism. and chronic constipation. He also has very dry skin. I am certain that all of these are related. His TSH was very low and Free T4 within normal range. He is only 8yrs old and is on synthroid. His diet is extremely limited as he is super picky and only eats 8 or so things…same every single day. He will only drink milk and water and will not eat any meat. His protein solely comes from milk and cheese sticks. Both I am sure are contributor to his issues. He is also nonverbal and globally delayed. I am not sure what dietary changes I can do that he will adapt to but I can hide some things in the foods he will eat. I have not found a doctor yet who is willing to help functionally for him without the standard synthroid. Not sure dosage of bro biotic you suggested are best for his age. Can you make suggestions?

    Reply

  87. OMGosh, how do you do it all! Thanks in advance for all the knowledge you continuously share. Always have recommended that pt’s change up or rotate probiotics.
    You mention & provide a link to MegasporeBiotic in your Hacking Hashimoto’s program, but didn’t mention it here. Is it still one you’d recommend?

    Reply

    • Nancy- Thank you so much for your support!! Not everyone will need every single supplement! In fact, I believe that most nutrients should come from the diet, this is why I always list food sources for most of the nutrients, vitamins, minerals and probiotics that are depleted in Hashimoto’s in the book and on the blog. However, some may require/prefer supplements and the supplements on the website are a resource for those that do. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm.

      I do have a full supplements chapter in my book. Have you checked it out? Not everyone should be taking every supplement and the book will help uncover your root cause. This will help you figure out your supplementation.

      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
      thyroidpharmacist.com/protocol

      Reply

  88. Dear Isabella
    I’ve tried many different probiotics and fermented foods and I have had a bad histamine reaction to them all. It’s the same with bone broth. Do you have any suggestions for how to heal the gut when you have a histamine intolerance? I’m currently taking L-glutamine and the prebiotic Prescript Assist but I really want to add some other foods or products if possible.
    Thank you so much for all your work. I absolutely loved your documentary. It really hit it home for me and I have started to inplement all of your advice xx

    Reply

  89. Dr. Izabella,

    What are your thoughts on the Custom Probiotics brand? Have you heard of it? It was recommended by my natural path. They have really high CFU’s. I was taking their 11 strain, but after no lactobacillus growth after several months, they recommended their D-lactate. I send in another stool sample in 6 weeks to see what my bacteria growth is at and will be anxious to see if this did the trick with facilitating the lactobacillus. Thanks so much! Tara

    Reply

  90. Should probiotics be taken with or without food? You mention you may need to reset your immune function–how do you do that? Thank you so much for sharing all the information that you do. I loved the webinar.

    Reply

  91. Have you heard of Bravo Yogurt? I just received your Hashimoto’s Protocol book. I’m thinking of doing the Root Cause Autoimmune Diet & Bravo Yogurt. What are your thoughts?

    Reply

  92. Thank you so much blazing this trail! I watched the Thyroid Secrect and learned so much! I am pretty sure I have Candida even though my GI effects test said it was negitive. I have just started your Candida Protocol and hope to get some relief soon. I recently purchased VSL#3 but did not realize it did not have S. Boulardii in it. Can I take both or should I just do S. Boulardii? Thanks so much!

    Reply

  93. What is the amount of time you should wait between taking your thyroid medication and your probiotics? Thank you for everything, you have really helped me personally!

    Reply

    • Constinteen – thank you for following this page. You should start with the directions on the bottle and adjust your dosage from there. I cannot tell you specifically what you can and cannot do over the internet as I could be held liable for what would happen to you.

      Reply

  94. Have you ever heard of PB Assist Doterra Essential oil brand of probiotics .? Have you ever heard of people having success using essential oils in treating Hashimotos? Thanks.? for all the good info.

    Reply

  95. In general do you think people with Hashmito thyroiditis need to take S. Boulardii indefinitely or are you saying in this article just until pathogenic bacteria, Candida, parasites like Blastocystis hominis, H Pylori, or some kind of an infection are cleared up and then generally S. Boulardii isn’t needed? I am not understanding if this is a short term or long term recommendation or assuming you don’t have any of the above, what do you do personally?

    Reply

  96. I wish I had known about the slow & low start recommendation for probiotics. I have certainly had more problems after taking them. Started with 50B. Is it too late or will it just take a long time to adjust? Been over 6 months.

    Reply

  97. Hi, I’m in a hashimotos group on FB and asked about experiences with VSL #3. A number of commenters said that it now contains corn starch which makes it non AIP compliant. Everyone reveres you in the group 🙂 but it was also stated that this article was written before the corn starch became an ingredient. However, after looking at the website, they say VSL has returned to Italy for production and cornstarch was always an ingredient. A bit confusing but my question is would you still recommend this for Hashi’s if corn starch, is indeed, a new ingredient in the formula. Pure encapsulations is not sold in Italy.

    Reply

  98. I have just started taking Prescript Assist. Can someone let me know if these have been successful for them. Any feedback would be greatly appreciated. They were also fairly expensive and are soil based as well.

    Reply

    • Melissa – thank you for following this page. I regret that I do not have the time to evaluate every supplement on the market. Not everyone will need every single supplement! In fact, I believe that most nutrients should come from the diet. This is why I always list food sources in the book and on the blog, for most of the nutrients, vitamins, minerals and probiotics that are depleted in Hashimoto’s. However, some may require/prefer supplements and the supplements on the website are a resource for those that do. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time, and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm.

      I do have a full supplements chapter in my book. Have you checked it out? Not everyone should be taking every supplement and the book will help uncover your root cause. This will help you figure out your supplementation.

      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
      thyroidpharmacist.com/protocol

      Reply

  99. Dr. Wentz,

    Quick question about the GI Effects Gastrointestinal Function Comprehensive Profile (METAMETRIX KIT). When I click on the link and go to the Direct Labs Services page in the link the GI Effects Gastrointestinal Function Comprehensive Profile (Genova kit) is the one that shows up for this test. Do you know if the lab changed their name to Genova or is that test now done by a different lab (Genova vs Metametrix)? Hope you can clear up my confusion about this.

    Thanks for all your help and the great resources!
    Sam

    Reply

  100. Hi Dr. Wentz,

    I’m currently on the AIP and taking the Betaine HCL Pepsin, and currently am up to 9 pills without a real burning sensation. Could this be right, that I need up to 10 pills per meal? I was at about 6 or 7 with a slight warmth, but don’t feel a strong burn. Am I reading too much into the burn I should be feeling in my throat?

    Also, thank you for all you do. Your guidance on diet and your book have been the best thing to happen to me in years!

    Reply

    • Sherry – thank you for following this page. You should start with the directions on the bottle and adjust your dosage from there. If you’ve never taken probiotics, you will want to start low and go slow, as you may have increased symptoms if your gut flora changes too rapidly. If you’ve found that you can tolerate that dose, but have not reached your gut health goals, you can work your way up to higher doses. I do have a full supplements chapter in my book. Have you checked it out? Not everyone should be taking every supplement and the book will help uncover your root cause. This will help you figure out your supplementation.

      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
      thyroidpharmacist.com/protocol

      Reply

      • Hi Dr Izabella. I am trying very hard to get my hashimotos and hypothyroid under control and lose weight. There are so many probiotics out there, it is difficult to know which one to take to be most effective(hopefully reasonably priced). Could you recommend one to me? Thank you in advance for your help.

        Reply

        • Theresa – thank you for following this page. As a pharmacist, I have access to numerous high-quality brands. After much research and deliberation, I have personally decided on Pure Encapsulations brand for my own health needs. This is also the brand I recommend for family members and friends.

          Pure Encapsulations is a pharmaceutical grade brand that has extremely tight quality control and manufacturing guidelines. Each product undergoes rigorous testing by a third-party laboratory to verify label claims, potency and purity. All the products sold by Pure Encapsulations are free of gluten, dairy, and additives that may impair absorption.

          PROBIOTIC 50B
          http://www.purecapspro.com/thyroidrootcause/pe/products/product_details.asp?ProductsID=1328

          Reply

  102. Hello Dr Wentz!

    I started reading your Hashimoto’s Protocol this week and am really enjoying the information you provide, plus your website is a wealth of information too! Thank you for your calling! 🙂 I have a great functional medicine doctor, but my Hashimoto’s has been getting worse and worse the past few years. I was diagnosed with Hashimoto’s in 2003 and only recently have I been dealing with the litany of effects.. They are compounded by chronic Candida (from 2 years going undiagnosed 10 years ago), heavy metal exposure, HLA-DR mold gene, stress, etc.

    My doctor is starting therapeutic probiotic treatment for me and put me on MegaSpore 6 weeks ago. Since day 1 my energy has plummeted and I’ve been plagued by periodic debilitating die offs of some kind, even though I started out slowly at 1 pill/every other day. My doctor says to keep on it. I’m now up to 2/every day.

    I haven’t found a lot of information on MegaSpore and was keen on your experience. I’ve read that Hashimoto’s patients do really well with it, but in your experience have you seen this kind of continuous dramatic fatigue or die off when taking it? I’ve read of die offs if you start too quickly, but then people seem to have miraculous experiences. I know you can’t give personal medical advice, just trying to figure out if this is a common reaction or if it’s yet another issue to figure out.

    Thank you!
    Jill

    Reply

  103. I contacted the So Delicious company about what kind of B-12 is in there products, and was told it’s the cyanide based. So I would not recommend there brand to anyone.

    Reply

  104. Dear Wentz, My name is Jennifer and I am so grateful I found your web site and information on Hashimoto’s. My gut issues have always been an issue and this past May 2017 they got worse (feeling sick after eating, food allergies to things I have always eat (I am gluten and dairy free and have been for years), I have bad acne roseaca/itchy skin after eating, psoriasis and I have hypothyroidism (Hashimoto’s), which has gotten worse recently — my thyroid which was fine for 20 years on synthroid and is now suppressed plus my menstrual cycle is off. I am seeing this a regular/alternative doctor who diagnosed me with SIBO (currently taking Candibactrin AR and BR), but doesn’t understand the thyroid and hormone component which is frustrating. I have lost weight loss despite being low thyroid, have stomach pain, malabsorption and my hormones are out of whack. I also took a special Parasites test that was sent to a lab in Colorado, as well as a Comprehensive Stool Analysis test (Genova Diagnostics, and Intestinal Permeability test as well to rule out other digestion issues including Leaky Gut. I would love to speak with you, or perhaps you can direct me to the right doctor in my area who can help me(I am in New York City) to help me. Thank you so much!

    Reply

  105. Hello! I have had Hashimoto’s for two decades now and I have had a horrible time kicking a bad soda habit. I notice several people have inquired about the safety of Kombucha teas but their posts were either removed or not answered. I actually like the taste, and it helped me to sleep better than I have in years, but I’ve read articles contraindicating it’s use with a compromised immune system. I’d love to learn more about the safety of Kombucha and Hashimoto’s. I am not home-brewing but am drinking a natural grocery store brand.

    Reply

  106. Hello Dr. Izabella and thank you for all you do. I am a 56 year old female with adrenal fatigue and hashiamotos. I have worked with several functional medicine practitioners and it appears that we are zeroing in on a claustridial bacterial infection as the possible root cause. I have been on several rounds of biociden but it seems to keep coming back. I recently started on megaspore probiotic with hopes of successfully erradicating this infection. My question is what if any other probiotics can be used in conjunction with the megaspore. Thank you in advance for your help.

    Reply

  107. My Rx carrier recently suggested I consider a switch from my usual Armour Thyroid to NP Thyroid Tablet. I can’t find enough information about that prescription and wonder if you may enlighten me. I was also told my a PA that anyone over 65 should no longer take Armour Thyroid…..I’m 72. What is your opinion about that also?

    Reply

  108. I am writing this because im going through one of the biggest crisis of my life. And I cant find a practioner that can help me, these I tried they caused me more pain. Do you have someone good to suggest please?
    Iam suffering all my life and out of desperation I ve tried some things that a person that wasnt exacltly expert suggested me and now im ten times worse. I have chronic fatigue syndrome and hashimoto,fibromyalgia and depression and anxiety. What I ve done is that I took the product restore gut, that solved my mental issues,but then I started taking bravo probiotic,that made me feel very sick and I was taking it for one month,in the middlewhile I was taking everyday chlorella, and few times I took charchoal and I was doing everyday coffee enemas and water enemas, I was also taking many different vitamins sometimes,one liposomal multivitamin made me also very sick. I know I have malnutrition and I was doing all this detox while I had hyperthyroidism,the dose of thyroxin was too much in that period and didnt know it. I ve stopped two months ago all these things and I still suffer a lot. I ve stopped working and going out, I feel extremely weak and exhausted,I feel sick everyday, I have gastroissues,that I think enema caused me, and feel lightheaded and dizzy and a pressure on my head and neuropains on my head, I have a series of symptoms also liver pain nd yellow dark skin,but these are the main. Can somebody help me please? I dont know how to recover and the practitioners I met only made me worse with their suggestions. Its really scary feels like it will never end. 🙁
    Now im only take the restore gut in low dose,magnesium, vitamin d, dandelion and st.johns wort tea. The practitioners suggested me some supplements but was too strong for me and I quitted them. It will past? Or I made a permanent damage?
    Please help
    Thank you in advance

    Reply

  109. Dr.WENTZ ,thank you for the marveless work you do.
    I should like to ask you about prebiotics, are they good to take them with probiotics? Thank you .

    Reply

  111. I am currently following your 90 day protocol and just started the gut series a week ago. I’ve never taken probiotics but I ordered your gut bundle from Pure Encapsulations. I’m taking 1 Probiotic 50B/day and 3 Saccharomyces Boulardii/twice a day. I was going to start taking 2 Probiotic 50B today. However, I noticed yesterday afternoon that my face was feeling a little hot and my complexion was very red and breaking out a little. I’m concerned that I may be reacting to pineapple listed in the ingredients of Probiotic 50B, or is this just a side effect of taking probiotics in larger doses. I don’t want to do anything to increase antibodies in my system because I have been feeling much better, generally. I have been having no other side effects this last week.
    EDIT: I am also taking Wobenzym as recommended which has pineapple enzymes, not the probiotics. So, my question is: Am I having a reaction to something like the pineapple in Wobenzym or is this just a normal side effect of Probiotics?

    Reply

    • Elaine – thank you for reaching out. I wish I could give you more direct advice but, each person will react differently. I would advise you to ask your personal pharmacist or a trusted clinician who’s care you are under. I am not able to respond directly to these types of questions here. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time, and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm. You may also contact my team at info@thyroidpharmacist.com and they will be happy to help you. <3

      Reply

  113. Hi there,
    I’ve bought your books and also hoped to find a detailed guideline for intestinal cleansing. In this article and in your book you introduce some probiotics. Should I get all of them? I have read somewhere that when taking probiotica both useful and harmful bacteria are being destroyed therefore the prebiotic Inulin is recommended in addition. Would I need to take that extra? I honestly don’t know how to proceed here. I already eat gluten-,dairy-, sugar free incl. eggs, stopped drinking coffee and substitute them with what you and Dr. Kharrazian recommend incl. the results of my IgG test (which products I should avoid). You give a recommendation for use for Saccharomyces boulardii as well as for soil based probiotica for Lactobacillus you mention Pure E. Probiotic50B. How many do you recommend to take here? If you say you do not recommend to use all at once, would it be okay to start with one, a week later with the second and when everything is fine with the third probiotica in the third week, meaning I’d take three probiotics for the rest of the 90 day? Thanks a lot in advance, Tina.

    Best, Tina

    Reply

  114. I’ve been to several doctors (endocrinologists, rheumatologists, nutrologists, gastroenterologists) and I’m still lost… I’m diabetic, celiac and have hashimoto… I’m studying all by myself to buy my supplements… I still do not know which probiotic I should use…
    I live in Brazil, everything here is so more expensive…
    What do you think of the probiotic

    Healthy Origins, Probiotic, 30 Billion CFU’s, 150 Vcaps (https://www.iherb.com/pr/Healthy-Origins-Probiotic-30-Billion-CFU-s-150-Vcaps/19519)

    and

    Garden of Life, Primal Defense, HSO Probiotic Formula, 90 Vegetarian Caplets (https://www.iherb.com/pr/Garden-of-Life-Primal-Defense-HSO-Probiotic-Formula-90-Veggie-Caplets/3161)
    ?

    Thank you!

    Reply

  115. I’ve been taking Schiff Digestive Advantage for a few weeks now. Decided to try because someone I know was able to get off her Rx for acid reflux. Asked my endo, he was ok with it, just wait 4 hrs after the Synthroid. Started with the gummies, but couldn’t stand the thought of chewing on live thingis. 🙂 Switched to the capsules. Still have the heartburn. Figured it couldn’t hurt since I’ve been on Rx Prevacid and others for 10+ yrs. For a years been taking Prevacid OTC, and now trying to go between that and Zantac. This week started doing baby steps reducing my intake of glutten foods. Reading your Protocol book now.

    Reply

  116. Ok..2 quick things..Is a soil based veggie probiotic the same as a spore based? And though Iam kinda on Paleo Autoimmune but with Hashi’s we have our quirks, so seeds my stomach does not handle as the other normal stuff..Celiac Test was normal, but I think I have a gluten intolerance because even a bulk of non gluten has gluten..so now my bowels go then stop, yet with brain injuries, I have a delay..so eating healthy but having a stop and go, yet I am not uncomfortable..I think I need more water..I do a drink of aloe Vera gel, apple cider vinegar and organic apple juice daily and started spiralina as a supplement..found my body was odd with psyllium husk..so my weight stays at this Mark..goes up 2, then down 2 and inches just stopped yet clothes still fall off and I am finally cutting so the weight can be muscle conversion..My primary food is veggies, fruit and meat, with salads..and I occasionally started adding eggs and just picked up A2 milk to experiment..yes bone broth and I found heating Dr Axe’s powder..wow great for skin compared to liquid boxed..I have not ventured in home made..when I react I get a rash in my opening of my but..it gets red and bumpy, I take Zyrtec and it goes down, so I analyze what is different..so I feel my body progressing, but the bowels could be the message..before I found out about the Hashimoto’s..My Health was declining..the endometriosis effected my ovaries..pain that led to a hysterectomy..my kids were born in vitro because of infertility and I was an anovulator and I had a colon resection before the hysterectomy and the doc found endometriosis as the block..so many answers..thank you for your time..I know, I talk too much and yes, I have been proactive with my twins…

    Reply

  117. Dear Dr. Izabella,

    I was wondering if it was safe to take S. Boulardi during pregnancy? Also is it safe to take systemic enzymes while pregnant? Bought your books and have been following protocols and just found out that I am pregnant and just want to make sure these are safe to continue taking. Thanks so much for your reply. I know your very busy, especially with your family, and truly appreciate your help.

    Reply

    • Megan – thank you so much for reaching out and congratulations on your pregnancy! I am not able to advise on whether these supplements would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend you discuss the use of these supplements during your pregnancy with your personal doctor.

      Reply

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