Dr. Izabella Wentz, PharmD

Thyroid Pharmacist

Can Thiamine Help Reduce Thyroid Fatigue?

The Missing Link to Thyroid Fatigue

Medically reviewed and written by Izabella Wentz, PharmD, FASCP

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Sometimes we can get stuck on our healing journey.

We may be on a seemingly great diet, taking the right supplements, and doing everything in our power to feel better, but still feel like we’re making no progress. But, many times, we’re only one small change away from seeing a huge difference.

In my case, I was well on my way to feeling better with Hashimoto’s after changing my diet and incorporating key supplements. But I hit a wall. I continued to struggle with low energy levels, adrenal fatigue, and low blood pressure.

At a loss, I decided to take a test for nutrient deficiencies and found out that I was depleted of thiamine. A few days after starting a thiamine supplement, my energy levels began to bounce back, and I felt great!

Could thiamine be the missing link to your thyroid fatigue?

Read on to learn about:

  • What thiamine is
  • The thyroid fatigue and thiamine connection
  • How thiamine deficiency occurs
  • Testing for thiamine deficiency
  • How to supplement with thiamine

What is Thiamine?

Thiamine is one of the B vitamins, known as B1. Its main responsibility is to change carbohydrates into energy. [1] Thiamine also helps with the digestion of proteins and fats, as it is necessary for the proper release of hydrochloric acid in our stomachs (which is required for proper protein digestion). [2]

Given that most people with Hashimoto’s have low stomach acid or do not release any stomach acid at all, it’s important to have optimal levels of thiamine. [3] The recommended daily allowance for thiamine is 1.1 mg for women over 19 years of age. However, this amount may not meet the needs of those with autoimmune thyroid disease.

This is because most dietary sources of B1 (fortified grains, beef liver, pork, dried milk, eggs, legumes, peas, nuts, and seeds) are omitted on grain-free healing diets, which are often recommended for those with autoimmune thyroid disease. With the exception of liver and pork, most foods containing thiamine (as listed above) are restricted on the Paleo diet, and all of them are restricted on the Autoimmune Paleo diet!

Furthermore, many people with Hashimoto’s often experience digestive problems that make absorbing nutrients difficult.

On top of all this, the B vitamins become depleted in stressful situations that often precede the development of autoimmunity, as well as in times when we are pushing ourselves, and our adrenals, to work harder. [4]

Thus, having low levels of thiamine is common in those with Hashimoto’s… and can be one of the root causes of thyroid symptoms, including fatigue!

Research on Thiamine and Thyroid Fatigue

I often scour PubMed, the largest database of scientific publications, for the latest research on Hashimoto’s, and was excited to find an article about thiamine and thyroid fatigue. Though I had already seen positive results when I took thiamine, it’s always exciting for me to see nutrient deficiencies in Hashimoto’s getting more attention in the medical literature.

Italian clinicians Dr. Antonio Costantini and nurse Maria Immacolata Pala, have hypothesized that the chronic fatigue that accompanies inflammatory and autoimmune diseases may be a result of a mild thiamine deficiency. [5] They had already found that thiamine helped relieve fatigue in people with ulcerative colitis (an autoimmune condition that affects the gut), and decided to try using thiamine in three women with Hashimoto’s who were on thyroid medications but continued to experience fatigue.

Two of the women were given an oral dose of thiamine (600 mg) per day, while the third was given an injection of 100 mg, every four days.

All of the women were given a survey to rate their fatigue before starting the thiamine, and again, the same questionnaire, 20 days into the treatment. During the second survey, all three reported that they experienced a relief in their fatigue — and two had a complete remission of their fatigue!

The woman who had the injection felt that her fatigue was lifted within six hours of receiving it, while the women who took the oral dose of thiamine felt relief within three-to-five days.

Interestingly, none of the women had thiamine deficiency on standard lab tests that are used to measure thiamine status.

How Common is Thiamine Deficiency?

In pharmacy school, we were taught that thiamine is a rare nutrient deficiency, usually found in alcoholics. Other well-known causes of thiamine deficiency may include Crohn’s disease, malabsorption (likely to be an issue for most people with Hashimoto’s and autoimmunity), anorexia, and kidney dialysis.

Certain medications, including Digoxin (used for heart conditions), diuretics — especially furosemide (also known as Lasix), as well as the seizure medication phenytoin (Dilantin), can also deplete the body of thiamine. I recently came across the link between a frequently used antimicrobial, metronidazole (Flagyl), that can cause a significant depletion of thiamine.

Thiamine deficiency has been deemed as a rare deficiency in the developed world, but this is due to the fortification of cereals and bread. If you’re on a grain-free diet, you are very likely going to be deficient in thiamine. Additionally, the thiamine added to food products is usually a water-soluble form that is less bioavailable than other fat-soluble forms (such as benfotiamine).

Furthermore, certain food products, such as black tea, coffee, raw fish, and shellfish, contain thiaminases, which are enzymes that destroy thiamine. Consuming large quantities of these foods, and eating them alongside other thiamine-containing foods, can inhibit our ability to absorb adequate levels of thiamine.

Types of Thiamine Deficiency

Severe thiamine deficiency is known as beriberi and is associated with swelling, tingling, a burning sensation in the hands and feet, confusion, trouble breathing, and uncontrolled eye movements. [6]

Severe thiamine deficiency can cause Wernicke-Korsakoff syndrome, a brain disease that can present as confusion, memory problems, and nerve damage.

But most people with Hashimoto’s never have thiamine deficiency that is this severe.

Symptoms of milder forms of thiamine deficiency include:

  • Fatigue
  • Irritability
  • Depression
  • Abdominal discomfort
  • Low blood pressure
  • Adrenal issues
  • Trouble digesting carbohydrates

Long-term thiamine deficiency can lead to various symptoms, including mental fog, difficulty breathing, and heart damage. It can also lead to a build-up of pyruvic acid (a byproduct of glucose metabolism), in those who eat high-carbohydrate diets.

Those on low-carbohydrate diets are at a smaller risk of the build-up of pyruvic acid and may not have any symptoms — except for fatigue.

Do any of these symptoms sound familiar? If so, you may want to check your B1 levels!

Testing for Thiamine Deficiency

The standard way to check your B1 levels is by taking a blood test. You can request one from your doctor. If you are in the United States, you can also self-order the Ulta Labs – Vitamin B1 (Thiamine) test.

Unfortunately, standard lab tests for thiamine deficiency will not show if someone is mildly deficient — they only screen for severe deficiencies.

If you’ve been struggling with fatigue, low stomach acid, carbohydrate intolerance, low blood pressure, and symptoms related to your adrenals, you may have a thiamine deficiency and may benefit from extra B1 intake. (Generally, most people can supplement with thiamine without prior testing.)

Supplementing with Thiamine

To boost your B1 levels, you can try increasing your consumption of beef liver, eggs, pork, nuts, and seeds (if tolerated) to increase your thiamine levels.

However, while I love the theory that we should get all of our nutrients from foods, that’s not always possible — especially for people with Hashimoto’s who have multiple food sensitivities and digestive difficulties, or who are following a healing diet that omits many thiamine-rich foods.

Furthermore, as I mentioned earlier, thiamine, and other B vitamins, become depleted when we are experiencing stress — so even if we are eating a diet that is full of nutrients, it’s not always possible to get everything that we need from food, especially if we are also experiencing symptoms of adrenal fatigue.

Don’t get me wrong, I do think that we should get what we need, when we can, from food. However, sometimes we need an extra boost, and thiamine may be one of those boosting nutrients that can really benefit us.

For this reason, I generally recommend incorporating a high-quality supplement. The supplements I recommend are Benfotiamine by Rootcology and BenfoMax by Pure Encapsulations. I recommend 600 mg per day for most people as a starting point.

As I mentioned earlier, research studies have shown that a daily 600 mg dose of thiamine, for as little as three to five days, can produce benefits such as more energy, better brain function, stabilized blood pressure, and improved blood sugar tolerance.

Plus, 36 percent of my readers whom I surveyed in 2015, said that thiamine helped them feel better… so a daily thiamine supplement may just be the key to recovering your old self!

Please note: Some people may need to increase their dosage of thiamine from 600 mg per day.

One particular study published in the Journal of Alternative and Complementary Medicine comes to mind. It looked at the effect of thiamine on patients with Crohn’s disease and ulcerative colitis, and found that effective dosages ranged from 600 mg to 1,500 per day, depending on individual body size. [7]

While 600 mg is a good daily starting dosage, you may need to increase your dosage if your weight is above 60 kg (132 lb). The researchers in this particular study defined the dosage for each patient by first administering 600 mg/day. Every two days, there was a consultation with the patient to assess the therapy. In cases where fatigue had not subsided, an increase of an additional 300 mg/day of thiamine was prescribed in addition to the 600 mg/day.

The researchers monitored each patient’s heart rate after the supplement was increased to help determine the correct dose. Researchers found that if the thiamine doses administered were excessive for the patient’s needs, the patient would experience tachycardia (an increased heart rate, where the heart would beat more than 100 beats per minute), and they would then reduce the dosage.

One patient in the study who was treated with 1,200 mg/day of thiamine, showed a mild tachycardia (rapid heartbeat) that completely regressed by reducing the dose to 900 mg/day.

Here is a guide for finding your correct dosage, based on the researchers’ finding in the study above:

For female patients:

  • Patients weighing < 60 kg → Take 10 mg of B1 per kg of your weight, per day
  • Patients weighing 60–65 kg → Take 14 mg of B1 per kg of your weight, per day
  • Patients weighing 65–70 kg → Take 17 mg of B1 per kg of your weight, per day
  • Patients weighing 70–75 kg → Take 20 mg of B1 per kg of your weight, per day
  • Patients weighing 75–80 kg → Take 23 mg of B1 per kg of your weight, per day

For male patients, the doses need to be increased by one third compared to females:

  • Patients weighing < 60 kg → Take 14 mg of B1 per kg of your weight, per day
  • Patients weighing 60–65 kg → Take 18 mg of B1 per kg of your weight, per day
  • Patients weighing 65–70 kg → Take 23 mg of B1 per kg of your weight, per day
  • Patients weighing 70–75 kg → Take 30 mg of B1 per kg of your weight, per day
  • Patients weighing 75–80 kg → Take 35 mg of B1 per kg of your weight, per day

***Please note that the table above is in kilograms, as it’s taken from the published article. To determine your weight in kilograms, you can use the following conversion: 1 kilogram = 2.2 pounds.

I encourage you to work with a practitioner to determine the proper dosage for your needs.

Precautions

Thiamine, in the recommended doses, is one particular supplement that is extremely safe for most people, but there are some exceptions.

Thiamine supplementation should be avoided by those with advanced cancers because tumors may steal the body’s reserves of thiamine and use it to proliferate themselves, as thiamine is necessary for cell replication. [8] If a person has thiamine deficiency and cancer, I would advise working with an integrative cancer specialist, because the dose response of thiamine has an interesting pattern in those with advanced tumors.

Giving enough thiamine to just correct the thiamine deficiency can help the tumor grow (the thiamine goes to the tumor instead of us), while mega doses of thiamine may inhibit tumor growth.

The Benefits of Thiamine Supplements

My Experience with Thiamine

As I mentioned earlier, after feeling great with my dietary changes and supplements on my road to Hashimoto’s remission, I hit a wall. I should mention that I was working hard at that time at my day job, as a medication safety pharmacist. I spent every evening, weekend, and day off researching and writing a Hashimoto’s patient guide (that eventually became Hashimoto’s: The Root Cause), starting a blog, and answering people’s questions.

I had already been eating a Paleo diet, and my digestion was 90 percent better, but I continued to struggle with my adrenals, energy levels, and blood pressure. Sometimes my blood pressure would be as low as 90/60 mmHg! My doctor would wonder how I was even walking!

I decided to bite the bullet and ordered a really expensive advanced functional medicine nutrient analysis test for myself, that used a unique technology to pick up nutrient deficiencies that traditional tests miss. (This was the Spectracell test that I discuss in my book, Hashimoto’s: The Root Cause.)

I had already done a lot of research on the nutrient depletions that were causing some of my symptoms, including glutamine, zinc, and the B vitamins, so many of the results were not surprising — except for one: I was deficient in thiamine!

I took three capsules per day (600 mg) for one month, and then reduced my dose to one capsule per day (200 mg) as I continued to work on my digestion, absorption, and eating more liver.

A few days after starting thiamine, my energy began to bounce back, my blood pressure normalized, and I was able to reduce my dose of Betaine with Pepsin, which I had been taking to help me digest proteins.

Over the years, I have continued taking thiamine on and off, with varying doses throughout pregnancy and postpartum, and continue taking it to this day. I have found that I needed more of it, with gaining weight in pregnancy and the postpartum period. I’ve also been astonished by the body of research on the various conditions responsive to thiamine, including POTS, poor appetite, failure to thrive, and numerous other “untreatable” conditions.

A deficiency of B vitamins can contribute to a range of adrenal symptoms as well, and this includes thiamine. It’s one of the nutrients that I recommend for those experiencing adrenal dysfunction, and I cover it in my latest book, Adrenal Transformation Protocol.

Another surprising use of thiamine could be helping with bad dreams! I was intrigued when one of my readers shared this with me:

“I take [thiamine] whenever the heck I feel like it. 🙂 It helps me with nightmares, so I even take it in the middle of the night if I wake up after a gruesome dream.”

It turns out that thiamine has been used successfully to treat people with anxiety disorders, including symptoms manifesting as chronic fatigue, insomnia, and nightmares. [9]

Furthermore, I’ve learned about the subtle differences and benefits of various forms of thiamine, including benfotiamine (which I recommend), the more commonly used thiamine, and synthetic versions that can cross the blood-brain barrier and have nootropic and neurological benefits.

My hope is that thiamine can be just as helpful for my readers.

The Takeaway

Often, people with Hashimoto’s will be started on thyroid hormones but will continue to feel tired. Fatigue is a common symptom of an underactive thyroid, but it’s also a symptom of many other associated conditions, including adrenal fatigue, food sensitivities, and various nutrient deficiencies.

As we peel back the layers of autoimmunity, some of us will be able to reverse our condition just by getting off gluten or eating a clean diet (like the Paleo diet or the Autoimmune Paleo diet).

Others will continue to struggle. This, of course, is where bio-individuality, functional medicine, and nutrition come into play.

If you’ve optimized your thyroid medications, eliminated food sensitivities, and improved your gut health, but are still struggling with fatigue, I encourage you to try a thiamine supplement and see if it can help you like it’s helped so many people with Hashimoto’s.

Who knows… it could be the missing puzzle piece you’ve been looking for!

For more information on overcoming fatigue, download my free eBook below!


As always, I wish you the very best on your health journey!

Have you tried thiamine? I’d love to hear how it worked for you!

P.S. You can also download a free Thyroid Diet Guide, 10 thyroid-friendly recipes, and the Nutrient Depletions and Digestion chapter of my first book for free, by signing up for my weekly newsletter. You will also receive occasional updates about new research, resources, giveaways, and helpful information.

For future updates, make sure to follow me on Facebook, Instagram, Pinterest, and TikTok!

References

[1] Thiamin: MedlinePlus Medical Encyclopedia. NIHNational Library of Medicine. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/002401.htm. Accessed July 25, 2017
[2] Levin LG, Mal’tsev GIu, Gapparov MM. Vliianie nedostatochnosti tiamina na sekretsiiu soliarnoĭ kisloty v zheludke [Effect of thiamine deficiency in hydrochloric acid secretion in the stomach]. Vopr Pitan. 1978;(5):36-40.
[3] Ebert EC. The thyroid and the gut. J Clin Gastroenterol. 2010;44(6):402-406. doi:10.1097/MCG.0b013e3181d6bc3e
[4] Stough C, Simpson T, Lomas J, et al. Reducing occupational stress with a B-vitamin focussed intervention: a randomized clinical trial: study protocol. Nutr J. 2014;13(1):122. Published 2014 Dec 22. doi:10.1186/1475-2891-13-122
[5] Costantini A, Pala M. Thiamine and Hashimoto’s Thyroiditis: A Report of Three Cases. The Journal of Alternative and Complementary Medicine. 2014;20(3):208-211. doi:10.1089/acm.2012.0612.
[6] Wiley KD, Gupta M. Vitamin B1 Thiamine Deficiency. [Updated 2021 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537204/ Accessed December 11, 2019
[7] Costantini A, Pala MI. Thiamine and fatigue in inflammatory bowel diseases: an open-label pilot study. J Altern Complement Med. 2013 Aug;19(8):704-8. doi: 10.1089/acm.2011.0840. Epub 2013 Feb 4.
[8] Comín-Anduix B, Boren J, Martinez S et al. The effect of thiamine supplementation on tumour proliferation. European Journal of Biochemistry. 2001;268(15):4177-4182. doi:10.1046/j.1432-1327.2001.02329.x.
[9] Cornish S, Mehl-Madrona L. The role of vitamins and minerals in psychiatry. Integr Med Insights. 2008;3:33-42.

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

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Disclaimer: The information contained herein is for informational purposes only and should not be construed as medical advice. Please consult your physician for any health problems and before making any medical or lifestyle changes.

Lifestyle changes can result in improved thyroid function and/or an increased absorption of thyroid hormone medications, leading to a lower required dose and possible symptoms of hyperthyroidism at a dose that was previously stable. Please discuss lifestyle changes with your physician and ensure that your thyroid function is monitored every 6-8 weeks while making lifestyle changes. Symptoms of overmedication include, but are not limited to: rapid or irregular heartbeat, nervousness, irritability or mood swings, muscle weakness or tremors, diarrhea, menstrual irregularities, hair loss, weight loss, insomnia, chest pain, and excessive sweating. Do not start, change, increase, decrease or discontinue your medications without consulting with your physician.

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  1. I have been diagnosed with hyperthyroidism and pernicious anemia, b12. I was told, if my understanding is correct, that it am missing a binding protein for the absorption of the B 12. I currently take a monthly injection. If there is a “missing” protein, would it follow that any oral supplements in the B family would not be properly absorbed?
    Reply

    • Tammy- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
      Hashimoto’s Protocol
      https://smile.amazon.com/Hashimotos-Protocol-Reversing-Thyroid-Symptoms/dp/006257129X/ref=sr_1_1?ie=UTF8&qid=1482698453&sr=8-1&keywords=Hashimoto%27s+Protocol

      Reply

      • I have severe fibromyalgia, degenerative disc. Broke my back 3 times compression fractures. Extremely fatigued all the time and so bring on depression and anxiety. Could this be part of my problems?

        Reply

        • Joy – thank you for reaching out and sharing your journey. I am so sorry you are struggling with all of this. <3 While I only work with patients with Hashimoto’s, oftentimes patients will have additional autoimmune conditions. 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. A great place to start is with diet/nutrition: The diet I recommend for people with autoimmune conditions is the traditional Paleo diet which eliminates grains, dairy, soy, and processed foods and focuses on nutrient-dense foods like meats, vegetables, nuts, seeds, and eggs. It has helped a lot of people feel much better, and some have even been able to eliminate thyroid antibodies by following this diet.

          Unfortunately, not everyone gets better on the Paleo diet. In some cases, we need to dig deeper. People may have additional sensitivities that contribute to the immune system dysfunction. People with Hashimoto’s are especially sensitive to a multitude of foods, especially gluten, dairy, soy, and eggs.

          That’s where the Autoimmune Paleo (AIP) diet comes into play. This diet goes beyond Paleo and removes an additional couple of foods such as nuts, seeds, and eggs. AIP is the starting point - if you don’t remove the inflammatory foods, you can’t know if your other interventions are working or not. An elimination diet is the gold standard for determining the foods one is sensitive to.

          Here are a few articles related to diet that hopefully help you get started:

          IMPORTANCE OF GUT HEALTH
          https://thyroidpharmacist.com/articles/importance-gut-health/

          FOOD SENSITIVITIES AND HASHIMOTO’S
          https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

          AUTOIMMUNE PALEO DIET
          https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

          FOOD PHARMACOLOGY FOR HASHIMOTO’S
          https://thyroidpharmacist.com/articles/food-pharmacology-hashimotos/

          Reply

  2. There are Vit B12 methylcobalamin shot/spray/under the tongue kind/cream a person can use and MTHF folate may help. Hyperthyroid may go to hypothyroid eventually. No gluten/dairy/soy/sugar/GMO…vitamins/good oils etc help me. Best wishes.
    Reply

    • Wendy- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
      Hashimoto’s Protocol
      https://smile.amazon.com/Hashimotos-Protocol-Reversing-Thyroid-Symptoms/dp/006257129X/ref=sr_1_1?ie=UTF8&qid=1482698453&sr=8-1&keywords=Hashimoto%27s+Protocol

      Reply

    • Hello Dr. Wenz,

      Thank you for your innovative research and findings. Can you please tel me if it’s necessary to use benfotiamine to relieve Hashi related fatigue, or can those on a very tight budget use thiamine instead? If the later option is possible, would you mind suggesting a general dose?

      Thank you very sincerely, Angie

      Reply

      • Angie – thank you for reaching out. I am not able to advise on whether this supplement would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss the use of this supplement with your personal doctor or pharmacist. You might also want to check the references at the bottom of the article for more information as well. <3

        Reply

  3. Intrinsic factor is needed for the absorption of B12. Intrinsic factor isn’t needed for the other B vitamins. Intrinsic factor is produced in the stomach. So, if the cells are damaged there, that might be the reason for your problem. There are some oral B12 supplements that include a little intrinsic factor. B12 is absorbed much further down in the intestines. If you have an overgrowth of bacteria in the small intestine this may interfere with the absorption of B12. The condition is called SIBO, which stands for Small Intestine Bacterial Overgrowth. If you have SIBO, you also have a more difficult time of absorbing your fat soluble vitamins A, D, E, K. These are important for intestinal health. However, if you have SIBO, sometimes vitamin K2 is high. This is because the bacteria can turn K1 into K2. It is vitamin K1 that allows the blood to clot. It is K2 that is anti-inflammatory.
    Reply

  5. I too had a problem worth b12, folate and iron. I take Methylcobalamin, the live form of b12. Your body cannot make b12 into this. It has worked! Fir folate I take methylfolate, now I am normal. Still working on the iron.
    Reply

    • Jessica- I think it is great you are empowering yourself to take your health back!

      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
      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

      Reply

    • Seeing your mention of Iron reminded me – I just started a Chelated Iron (a liquid) so I can put the drops under my tongue because I am celiac (gluten intolerant) followed by leaky gut and candida so malabsorption is a concern for me. Just taking it for several weeks (3 drops twice a day) has brought richness into my pale skin and is rebuilding my Red Blood cells/anemia – my principle intent. Start with just a couple drops the first week….

      Reply

      • Leon – thank you for following this page. To restore your iron levels, you can eat cooked liver twice per week or eat beef a few times per week. Vitamin C increases the absorption of iron, so taking a vitamin C tablet or vitamin C rich food such as broccoli along with an iron-rich food is the best way to increase iron and ferritin levels. Creating an acidic environment by taking a Betaine and Pepsin supplement with meals can be helpful as well.

        Most iron supplements are in the non-heme form and thus may not be absorbed as well. Additionally, many people find that they get terrible stomachaches from the supplements, and they find them extremely constipating! If choosing to take iron supplements, do so with much caution as they are one of the leading causes of overdose for children and adults. An iron overdose can be deadly, so make sure you keep the iron out of reach of children. Be sure you speak to your physician or pharmacist about a dose appropriate for you.

        Reply

  7. So interesting!! So is the combination of all the “active ingredients” in the one recommended above the important factor, or is it the Benfotiamine exclusively? 🙂 Thank you so much!!
    Reply

  8. Is taking a thiamine supplement during pregnancy ok? I read a lot of conflicting info online. I am 16w3d and take nature throid daily. Prepregnancy I had all of the symptoms listed above and during my pregnancy an still experiencing them on a greater level.
    Reply

  9. I would also like to know if thiamine is safe in pregnancy, I am 12 weeks with #3 and have Hashimoto’s and have really been struggling with fatigue. I eat a grain free paleo /primal diet most of the time so little grains here.
    Reply

  10. B vitamins fortunately are water soluble. So what Bs you can’t use, they will eliminate from the body. Some of the best prenatal vitamins have high B vitamin content. See Country Life Maxi Pre-Natal.
    Reply

  12. Excuse my ignorance, but is this only related to women. I’m a male and I’m always tired. I can sleep 10-12 hours a night and then still have a 2 hour sleep during the day. Thanks Kev
    Reply

    • Kevin- Hashimoto’s affects predominantly women at a rate of seven women for every one man with Hashimoto’s. 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

      Reply

  13. I think that men could definitely have a thyroid problem, but wondered if you have had any adrenal testing? Find someone in your area or look online for info on testing options!
    Reply

  18. Great articles as always, Izabella. Have your book too.
    Would be so great if you could make them available to share on Pinterest, please. Thank you : )
    Reply

    • Ana- 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. 🙂

      Reply

  19. Wonderful article. I am so glad I subscribe by email to the current information you provide. I am allergic to pine. I also have Celiac disease. Do you have another recommendation for a thiamine supplement that does not contain pine bark and is gluten free?
    Reply

  20. Thank you for this article. Reading it created a huge ‘aha’ moment for me. Been taking a Vitamin B Complex supplement for 10 days as well as other dietary changes, and I def. have more energy. Now, I understand why!
    Reply

  21. Do you only take 1 B-Complex?… I have Super B-Complex that I purchased & am currently taking just 1, along w/zinc and fish oil..
    Reply

  23. Thank you for this blog post! I am currently reading your book and I love how you did extensive research on the matter and present all the facts and biological processes. I’ve read so many books about various diets, ect in which the author is very good at sounding like an expert, however, their theories aren’t necessarily backed up well with research. I’ve been dealing with various health issues my entire life, and was diagnosed with Hashimoto’s three weeks ago. It feels like I’ve been going in a hundred different directions between diagnosis of adrenal dysfunction, anxiety, insomnia, candida and low digestive enzymes and HCl, but with your book, it brings every single issue together. Now I can see this orchestration of events happening in my body. Even your explanation of how thyroid medication can cause more stress on the adrenals! I had NO idea and most doctors are not going to address that or they focus on one and not the other. I realize that may be why I am even more fatigued after taking the medication. Thank you so much for your work, it’s making a huge impact.
    Reply

    • Jillian- 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. 🙂

      Reply

  24. How much Thiamine would a person need, at least to start? I had to have my thyroid removed (90%) taken and I found that if I push my Armour too high (4 grains) I start to feel just crummy. My adrenals and pituitary are fatigued. 20 years on T4 only meds! I eat Paleo, no grains, still fatigued.
    Reply

  25. I too have a pine allergy…though I would love to try this! Any advice you wonderful thyroid pharmacist you? 🙂
    Reply

  26. Hi Izabella, can you share what the dosage is initially and then what dosage you reduced to after a month? Do you still take Thiamine daily?
    Reply

    • Fionnuala- The recommended daily allowance for thiamine is only 1.1mg for women >19 years of age, and may not meet the needs of those who are on a grain free diet and have malabsorption issues.

      Food sources of Thiamine include fortified grains, beef liver and pork, dried milk, eggs, legumes and peas, nuts and seeds. Basically, with the exception of liver and pork, most of the foods that contain thiamin are restricted on the Paleo diet, and all of them are restricted on the autoimmune Paleo diet!

      Reply

  27. Thanks Doc! I have been trying to find out why my compounded dose is not helping me lose the extra pounds and why I am still tired. I have the other symptoms (and the Paleo connections) too.
    def gonna do this for a month and see what happens! Thanks
    for doing all the leg work and finding the info that could make all the difference!
    Reply

    • Annie- You are so very welcome! 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/

      Reply

  29. I too was wondering about this being only female issue, I have no thyroid since my cancer treatment, was radiated, and I’m extremely tired everyday.
    Reply

  30. I also have pernicious anemia B12, taking sublingual 2000mg per day…still weak and tired, and gained 20 of the 52lbs. I lost, back! Also I’m on synthroid..0.05 mcgrams..blood testing indicates normal level of tsh…so, what is recommended? On many meds for heart, have carotid stenosis, severe, can not tolerate fibre well…
    Reply

    • Francine- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

    • Kerrie- I decided to bite the bullet, and ordered a really expensive advanced functional medicine nutrient analysis test for myself, that uses a unique technology to pick up nutrient deficiencies that traditional tests miss (the Spectracell test that I discuss in my book, Hashimoto’s The Root Cause) I had already done a lot of research on the nutrients that were causing some of my symptoms, including glutamine, zinc and the B vitamins so many of the results were not surprising, except for one: I was deficient in Thiamine!

      Reply

  33. Thanks for this!! I can sleep for England! I have 8/9 hrs a night but I have a nap after work as well. I recently had my thyroid level checked and all was fine! At the same time my feet and hands are sore all the time which the doctors have said is the start of arthritis. However reading this makes me think if it is thaimine!
    Going tomorrow for vitamin supplements, to see if this can help……will keep you posted!!
    Reply

  35. I followed the link for the supplement you recommend and it says in the description that thiamine is fat soluble. I know it is water soluble so I’m wondering what I’m missing here??
    Reply

  36. I have under active thyroid, on 150mg of nature thyroid, psoriasis, and psoriatic arthritis. In 5 years I have gained about 12kgs. The thiamin won’t make me put on extra weight will it? I get so tired I fall asleep before my 6 year old lol!
    Reply

    • Raquel- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

  38. What was the response to your question? Just curious, as I have the same issues and question!!! Please help!
    THANK YOU!
    Nicki!
    Reply

  39. Hi, I’ve just come across your post, I’m really
    Interested in your knowledge & help. I was
    Diagnosed 4 months ago following check up
    For other problems. I’m on 50g Levothyroxine & I’m no different to what I was. Tiredness is overwhelming, would be great for some knowledge & help!!!! Very frustrated!!! Jackie
    Reply

    • Jackie- 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

      Reply

  40. I have HASHI’S. Been on Paleo diet 2 years, LDN 8 months, high quality selenium, B1, B5 & B12 plus…B multi.
    HCI for over a year. Still no relief.
    Reply

  41. I took Synthroid did not help my symptoms.just improved the numbers. I kept trying to get doctors to put me on natural thyroid but for years couldn’t find one that would I finally found one and within three weeks everyone around me saw an increase in my energy level. Try to find a doctor willing to write you for the natural thyroid. The natural is usually made of pork and contains both the T3 and T4. One is the energy part that fights the fatigue. Synthetic thyroid does not contain the energy one. Their thinking is the T3 will convert over to the T4 energy part. This is true for some but not all. Those with Hashi will not convert and must have the energy part already there beause our body is still fighting our thyroid.
    Reply

  44. I have Graves’ Disease, but had a complete thyroidectomy 10 years ago so now I am technically hypothyroid since I no longer have a thyroid. My question is – does this also relate to those with Graves’ Disease (and not just Hashis) as I have terrible terrible fatigue and tiredness that simply cannot be explained. I’ve looked into CFS with my doctor and he doesn’t seem to think I have that, though puts my tiredness down to my MDD (Major Depressive Disorder) and the meds. I just wonder whether there could be a possibility that this could relate to Graves as well?
    Thanks.
    Reply

    • Christina- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
      Hashimoto’s Protocol
      https://smile.amazon.com/Hashimotos-Protocol-Reversing-Thyroid-Symptoms/dp/006257129X/ref=sr_1_1?ie=UTF8&qid=1482698453&sr=8-1&keywords=Hashimoto%27s+Protocol

      Reply

  45. I believe Grave’s can also be auto immune. I would read Dr. Wentz’ website. She knows a lot about autoimmune disease and if you follow her, you may find relief. Look into Paleo to stay away from Gluten
    Reply

  46. So I was the person who told you that when I took 300mg in the am of B1, I had the burned tongue feeling. It was helping with weight and energy, but the burned feeling persisted, and in Sept the soles of my feet started feeling burned too.. I quit using it then, but I still have the symptoms.
    I thought I’d report back since you asked me to keep you posted! I am not even sure what test to do to confirm this or to resolve the burnt tongue and soles issue. Any thoughts?
    Reply

  47. Hi Dr. Izabelle Wentz, It was a pleasure to be able to talk to you on one of your phone conferences, I really wish I had more time and really appreciate your time and dedication and knowledge for those of us don’t know who to turn to or trust to help us find the root cause! My thyroid was radio active iodine due Graves back in
    time2006, turning it to Hypothyroidism! I am so fatigued
    and struggling with inflammation and hair falling out,
    inflammation in my shoulder blades and spine and into
    my neck and very fatigued to where I can’t focus and
    memory fog is through the roof, it’s depressing that no
    one understands what I’m going through! I very been
    trying the AIP diet and I’m loosing weight more that I
    should be due to and over growth bacterial in my intestinals! Can’t take a antibiotics due to being allergic
    to them! It’s really making me weak and wish I lived
    closer to you so could help me through such a difficult time getting my Hypothyroidism under control! Would you also know why I’m having difficulty with heat sensitivity to hot water why either doing dishes or taking a shower, my nervous system is really sensitive and my hair is still falling out and very brittle, have a real bad body oder that is very embracing and not sure what shampoo or conditioner and body soap or deodorant is non allergenic! My doctor put me on antidepressants and a pill to help me sleep but their causing havoc! I just had my thyroid labs done last week, T3 Free is 3.6 units pg/ml Ref Range [2.3 -r-2] T4 Free 0.8 ng/dL [0.8 – 1.8] TSH # 1.190 mIU/L [o.550-4.780] and my doctor says it’s normal! I’m currently taking good Armour Thyroid 60mg and I’m getting good so weak, my husband doesn’t believe most of what I’m telling him is really what’s going good on, I feel like I’m a lone with this! I am begging for some one who knows what I’m talking about and can help me, that sad thing is we already took out alone to get help and when my thyroid meds changed from taking good Level thyroxine to Armour thyroid my synthetic hormone bottomed out and the natural ones had a rough time adjusting and that’s when the gs started going haywire! I wish I could talk to you again, I am so desperate for my health to get back on track!
    Reply

    • Marilyn- You may be interested in my 12 week online program called Hacking Hashimoto’s that covers all of the strategies that I go through with my one-on-one clients, in a self-paced format, so that participants have access to all of the things I’ve learned about Hashimoto’s without having to schedule costly consults with me or another practitioner. There are a few requirements that you should pay attention to, such as my book is a required read.

      HACKING HASHIMOTOS
      http://hackinghashimotos.com/

      Reply

  48. are you saying that B vitamins are no good? I take a whole food multi vitamin plus whole food b vitamin as well as L glutamine for my gut problems. I just started taking Mega Benfotiamine by LF 250 mg 2x per day.. But I take this for my neuropathy pain.
    Love your book… Learned a lot.
    Reply

    • Evelina- 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. On page 328. Not everyone should be taking every supplement and the book will help uncover your root cause. This will help you figure out your supplementation.

      Reply

  49. Grateful for all of the valuable info provided by u here and in thethyroidsummit.com ! I have been diagnosed with hashimotos almost 8 yrs ago and while I have a great doctor who is very open minded, I still have no direction In managing my health other than what standard conventional medicine offers and I refuse to b on any meds. I have searched unsuccessfully for Drs. With a background in functional medicine. Do u have any referrals in the New York area?
    Reply

  50. I mailed was diagnosed with hypothyroid after our second daughter’s birth. Then irritable bowel, colitis etc. years later Fibromyalgie/Chronic fatigue. Now it a genetic mutation MTHF. Do I just take a methylated B with
    Reply

  51. I had thyroid cancer and now I’m having problems sleeping. Will the B vitamins help. My medicine has been reduced from 200mcg daily to 175 mcg 6 days. Thank you!
    Reply

  52. I had thyroid cancer almost 4 years ago. I had my thyroid removed but I keep complaining that I’m tired but feel nobody listens. I also have tingling in my thighs like they go to sleep and awfull cramps in my feet. All I’m ever told is take my medicine. I feel helpless. I’m mean I sleep about 15 hours a day. That is not normal. I want to enjoy my life again not sleep it away. I take about 16 pills a day
    Reply

  53. Dosage to begin with? Could this help with stubborn weight gain around the mid-section due to thyroid meds?
    THANK YOU FOR YOUR TIME!!
    Reply

    • Nicki- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

  54. How much thiamine to start with? I have been diagnosed with hypothyroidism but every time I take meds I start gaining weight. So I refuse to take any. So what dose should I start with
    Reply

    • Donna- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

  55. A study of 3 people is not enough scientific evidence for people to increase any vitamin or mineral above the normal RDA. Are there other case studies that have been completed with larger numbers? If so who did the studies and where would I locate those studies.
    Reply

  56. Eradicated thyroid at age 23. Been on synthroid and/or armor for 40 years. Tired, overweight, struggling. Is there any hope for me? I’ve tried everything. I do mostly organic and work out 5 days a week. But I don’t feel better, I don’t feel anything but tired.
    Reply

  57. I am 57yr. female diagnosed with hypothyroid and have need on Armour 15mg. a day for several years. I’m still exhausted, I had gastric bypass 11yrs.ago. How do I knw if my Thiamine is low? TIRED.OF BEING TIRED!!!!
    Reply

  58. I am almost 68 yo, retired RN Case Manager with fibromyalgia. I actually quit work at 60, with 38 years of nursing, because of the brain fog, fatigue, severe pain to the slightest touch, depression, chronic insomnia. After six months off work, I attempted to return PRN to fill in for vacations and sick days. It was just too stressful and my mind would not stay on task and focused. Finally, I decided to apply for disability. I was denied the first time, but appoved the second time I applied. I was referred to a neuroligist to rule out multiple sclerosis because of chronic incontinence and long time migraine headaches. He has helped my quality of life tremendously with Duragesic patch 50 mcg. However, I still cannot overcome the fatigue, mental issues, lack of sleep. Mt house is becoming more cluttered, and unkept. I lost all creative interest un sewing, designing, needlework, and flower gardening.
    I have had some improvement with incontenence with magnesium, calcium, supplements. I also take co q 10, and omega 3. I have tried a supplement called neueopathy tx, which is Vit B 1,6,12, and lipuric acid. I cannot tell any real improvement.
    One daughter, 43 yo RN, has hashimoto’s, and hx of intractable migraines. She has the severe pain issues, extreme fatigue, never sleeps well. Treatment is unsuccessful. My 37 yo daughter has a physics and chemistry background. She was in synthoid for ten years and lost her excess weight, got her energy, and did very well. Then, her lab work improved so her synrtroid was stopped. She has severe pain, excess weight gain, chronic staph infections, cellulitis, severe pain in her hands and feet then deffinite swelling. She is being referred to a rheumatologist, but cannot get appointment for four months. I think this goes back to her thyroid. But the doctor has not tested for the specifuc hashi test that is senr off and others come back normal. She has cellulitis in her inner thigh 8″ by 12″ right now. I am concerned for her overall health. No one will research her underlying problem. They only look superficially and treat with a bandaid tx. Can you please advise on common illness or nutrient defficiency. I look forward to your reply.
    Reply

    • Sandra- These are the recommended labs from my book, page 32.

      RECOMMENDED THYROID FUNCTION TESTS
      TSH
      TPO Antibodies
      Thyroglobulin Antibodies
      Free T4
      Free T3
      Reverse T3 (Optional)

      Have you read my book, Hashimoto’s The Root Cause? Here’s the link in case you’re interested.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
      
      HOW TO GET ACCURATE LAB TESTING WHEN TAKING MEDICATIONS
      https://thyroidpharmacist.com/articles/how-to-get-accurate-lab-tests-when-taking-thyroid-medications

      Reply

      • Sandra- When it comes to weight gain these are a couple of things to think about.

        1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

        2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

        3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

        BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
        https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

        HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
        https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

        Reply

  59. Actually, it sounds like you may have a histamine intolerance/mast cell issue. But that’s just a guess. I would certainly avoid wheat and any gluten grains.
    Reply

  60. I have Hashis and have many of your daughters problems. Get her tested for TPOab and TgAb types of antibodies to see if she has Hashimoto’s. If she does she would benefit from LDN. Also when a doc takes someone of a med and their health deteriorates there is a case for going back and complaining so that you can get it back. If not joy there try another doc, maybe an ND. People with low thyroid get multiple deficiencies which compounds the problems we already have. Good luck x
    Reply

  64. I have goiters on my thyroid, I go every year for biopsy’s and blood work. Blood work is always normal, Free T-3 and Free T-4 as well. Everyone in my family has some type of Thyroid disease. I have every symptom to under active there is, Cold, skin flaky, hair falls out, extremely tired all the time, over weight now.. Etc. you name it I have it! Will the Thiamine help with my energy level or would you suggest something else? I take Iodide 2 now even though my doctor says I don’t need anything because my levels are normal., But we know our bodies and I know this is not the way I should feel at my age…Any advice would be appreciated. Thank you
    Reply

  65. Please find an LLMD or Lyme Literate Medical Doctor. I’ve had Fibromyalgia and CFS for over 8 years now. My sister has Fibro as well and just about everyone in my family has thyroid issues as well. Thyroid levels on everyone (including T3 and T4) have always been normal for us all. Recently was diagnosed with late stage or chronic Lymes. Long story short, it can be genetic! However, most regular Doctors refuse to believe Lymes exists and they give us more toxic drugs when our bodies are severely toxic and undernourished because of it. My LLMD is wonderful and cured a friend of mine which is how I found out. He’s been practicing almost 30 years and has stated it is his opinion that Fibro IS Lymes until proven otherwise…which it never is. How many of us have been to every specialist there is and still no answers. Makes you go hmmmm…..!!
    Reply

  66. Interesting. Doctors should run these types of bloodtests for everyone. It’s how I found about my Magnesium deficiency. A doc has me taking it and B2 for migraine prevention. Another doc told me to add calcium to avoid stomach issues. I wonder about Thiamine, as I too have had shockingly low bp reads for about 12 years now.
    Reply

  67. I had a gastric bypass 11 years ago. This past November, I had a hysterectomy and then January 30th, I had to have an emergency appendectomy surgery because my appendix ruptured. The 2 surgeries were totally unrelated. I had a hard time after the 2nd surgery eating. Every time I tried to eat I would vomit. My surgeon happened to be the same surgeon that performed the bypass surgery so of course he was very concerned. Upon doing some lab work, he found that all of my vitamin counts were low. The thiamine count did not show low, but he suspected it was low as well because of my symptoms (fatigue, blurred vision, memory problems, other things you mentioned in the article.). He immediately began a once a week 4 week series of thiamine injections. My energy level did go up. The last shot was about 3 weeks ago and I feel awful again. The vomiting has not stopped the entire time. The doctor has ran every test to try and figure out why I can’t hold much food down. Protein is the hardest thing to keep down. The doctor said he really didn’t want to give me another round of the thiamine injections this soon. What do you think? I am a middle school prealgebra teacher with a very demanding schedule. I also have 2 teenage boys of my own. I an so sick of being sick. I am only 43 and feel like I am 80. I am not a drinker at all. I have 25 pounds in 6 weeks. My doctor is good, but you sound very knowledgeable of thiamine and he seems to think there is a problem there too. Any advice or help is appreciated. Thank you.
    Reply

  68. I have hypothyroidism and take .200mcg of synthroid daily. Still tired all of the time and have gained almost 50 lbs what do you recommend?
    Reply

    • Sherri- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply

  71. I have hypothyroidism and take .200mcg of synthroid daily. Still tired all of the time and have gained almost 50 lbs what do you recommend? At my worst, my TSH was 395 and I literally felt like I was dying!
    Reply

  72. I am searching for help with Hash.. Been on med for over 30 years.. Over 1 yr ago, Ins Co, switched me over to Generic brand.. Terrible things happened, have been back on synthroid for aprox 6 months.. Still very, very depressed, and foggy.. I know what I feel like good and this isn’t it.. I am searching for help.. I have recently purchased Zinc, Fish Oil.. What do I need for Thiamine and how much… I have heard you say, drops are the best.. Help!!!
    Reply

  73. Does it help if you are adrenal insufficient? My gun tested my tester one because I was so tired which was fine but my DHEA was not even traceable. I still get bouts of fatigue where I can’t even keep my eyes open . I am so tired of being tired.
    Reply

  74. I did Cyrex Labs multiple tissue autoimmune panel. I make antibodies to intrinsic factor. My functional med doc told me to never take B12 w/ intrinsic factor. I do take the active form without intrinsic factor. I also had H-Pylori at the time. I definitely believe that hashimotos and this condition is related, as are other common forms of autoimmunity.
    Reply

    • Heather- 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 🙂

      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

      Reply

  77. Dr. Wentz: Has anyone ever got violently sick taking this? The first time I took one with breakfast I felt fine all day and then all of a sudden about 5 hours later I was throwing up with diarrhea for about 4 hours. I thought I had a bad stomach bug. A week later I tried it again with the exact same results. I have been grain free since November and I take a Super Enzyme before each meal to help digestion as I have no gall bladder. I am still surprise I reacted this way and wondered if you had any suggestions? I ordered your book and should receive it tomorrow. I cannot wait to dig a little deeper to find my root cause but I do not think I will pursue the above right now! Bless you for all your work in sharing information about Hashimoto’s.
    Reply

  78. My NutrEval results show that I have a high need for Thiamine and recommends 50 mg day. I have Hashimoto’s, adrenal fatigue, high mercury and styrene, dysbiosis, leaky gut, malabsorption, hormonal imbalances. My T3 is very low and I am very fatigued. Looking for something else to give my energy a much needed boost as I continue to heal. It doesn’t look like any of my supplements have Thiamine so I am willing to give it a try. What dosage do you suggest?
    Reply

  79. Hi Dr. Wentz,
    LOVING the Thyroid Secret series, I’ve learned so much and you and your team are angels for writing and producing such an amazing source of information never heard before. You mentioned Tiamine for addressing fatigue but clarification question please: I have no thyroid due to RAI Graves — so would Tiamine still help me with fatigue or no? Also can it be taken at night and not influence sleep quality? Thanks so much and best, Terri

    Reply

  80. Hi Isabella,

    Can we take thiamine at supper time or does it affect sleep? I started taking the dosage you recommend (600 mg). I take 2 tablets of 100 mg in the morning, 2 at lunch and 2 at supper time. I am so full of energy that it takes me a while to fall asleep. Could it be related to the thiamine? I feel as if I drank too much coffee in the afternoon. However, once I finally fall asleep, I sleep very well. Should I take my last tablets earlier in the afternoon or is it not related at all to the thiamine?

    Thank you very much for all your research!! I’m putting my health back on track because of you…

    Cindy

    Reply

    • Cindy – thank you for following this page and for the kind words. 🙂 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. Perhaps try taking it earlier in the day.

      Reply

  81. This a issue that i’m trying to understand for a long time.I think I’ve thiamine deficiency because of all simptoms already mentioned and also calves muscle aches., poor memory, ecc.)
    I’ve done blood test and my thiamine was higher than normal and then I done a hair test and the result was that I have thiamine deficit.
    I start to take thiamine (not benfothiamine) and I start to feel better (higher energy, less depressed, ecc.) but I read that candida toxin acetylhaldeide (as alcool) inibithts thiamine and I try also probiotics, caprilic acid and detox .
    Then I got shingles (i.ve been under stress and poor sleep) but I read also that to much thiamine in blood can reactivate zoster herpes.
    I stop to take thiamine and i.m feeling again so tired.
    I wonder :
    1) if is true that high levels of thiamine can cause shingles and if so if Dr, Constantini pacients are at risk? Strange!
    2) if acetylhaldeide from candida inibiths thiamine as it is a kind of alcool is this the cause for thiamine deficience in so many people and can be the reason why my lab test level is high (thiamine isn’t metabolize?) and instead on the hair analises it comes out that It’s low?
    Thank you so much if you can enlighth me about this issues.

    Reply

  82. Dear Dr. Wentz: In your article you mention that high levels of Thiamine (B1) are not harmful because they are water soluble, but then you go on to recommend taking Benfotiamine, which is a fat-soluble form of B1. Should we not be concerned about taking too much of this form of vitamin B1? I learned about Benfotiamine from this article in Life Extension ( http://www.lifeextension.com/Magazine/2008/4/Protecting-Against-Glycation-High-Blood-Sugar-With-Benfotiamine/Page-01 ) which claims that therapeutic doses have been used up to 1000 mg/day without adverse effects, but it’s not clear for how long such high doses were administered. Given that it’s fat-soluble, how long do you believe it would be safe to use a dose as high as 600 mg/day? And, if one finds some relief from the fatigue, would you recommend backing off to a lower maintenance dose? In the study you cited, the patients who took the 600 mg oral dose experienced benefits in 3-5 days, though it sounds like the study continued for 20 days. What happened after that? Did they continue to take such high levels to maintain the benefit? Was their “remission” contingent on continuing some maintenance dosage? I’d appreciate any further light you could shed on this. Thank you!

    Reply

    • Tania – 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

  83. Dr. Wentz,

    Thank you for this article. I was diagnosed with Hashimotos just over a year ago. At the same time, I was told my thiamine level was low. The endocrinologist I was seeing said there was no connection. I had my doubts. I’ve been taking a high quality multivitamin and additional lipothiamine, but my thiamine is still low. I know now that this could be due in part to the antibiotics I received in the last 3 months, as well as an appendectomy I had in January. My TPO increased during the year, too. I’m increasing my lipothiamine & magnesium to see if it helps. Also, I’m seeing a IFMCP RDN to help me with supplements & she’s been far more helpful than my PCP. I look forward to reading more on your website!
    L. Perry, RDN

    Reply

  84. Hi!
    I would like to order youre supplements, do you send to Norway?, I cant find the country on your supplementsordersite. In case you dont ship to Norway, where else can I buy it? Other brands?
    Maria

    Reply

  86. Hello Dr. Wentz,
    Thank you so much for this information! I’ve just started taking Benfomax, per your article here and the suggestions and information in your Thyroid Secret docuseries. My hopes are that the Benfomax will combat my continual Hashimoto’s Thyroiditis symptom’s that I experience daily, despite taking a dual T3 & T4 hormone replacement therapy. I also take Vitamin D3 daily, and Selenium. My hopes is that the Benfomax will bring me more vitality.

    I took Thiamine daily for a month after watching the Thyroid Secret, and could start to feel an improvement in my overall well-being. Once I ran out I could feel the fatigue start to crawl back in. I decided to go for the Benfomax this time around instead of the Thiamine, as it seems that you are recommending it as an alternative due to it’s absorption and it’s amazing results. My question though is: Do I need to be taking Benfomax and Thiamine together or just one or the other?

    Many Thanks,
    Mer

    Reply

  88. Hey Doctor Wentz,

    Thank you sooo much for all the wonderful information. I LOVE Your website 🙂
    It is fantastic to find someone who is soo passionate about helping so many people. Thank YOU!!!
    I just have a question. The BenfoMax you talked about on your article is Thiamine. Is B1 thiamine? I’m just a bit confused. I found a product on Amazon labeled B1from Douglas Laboratories that contains NO yeast, wheat, gluten, soy protein, milk/dairy, corn, sodium, sugar, starch, artificial coloring, preservatives or flavoring. Is B1 thiamine? I noticed this product is not expensive. Does the Benfomax has more of quality ingredients?

    Thank You very much for your assistance!
    Have a blessed day!

    Ana

    Reply

    • Lucia- 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. The supplement I have taken for thyroid fatigue and recommended is the highly absorbable BenfoMax (which can be purchased here), and I took 3 capsules per day for one month and then reduced my dose to one per day as I continued to work on my digestion, absorption and eating more liver. Thiamine( Thiamine is one of the B vitamins, known as B1) is a water-soluble vitamin, so it does not build up in the body. Here is the link below! 🙂 https://www.purerxo.com/thyroidpharmacist/rxo/products/product_details.asp?ProductsID=1886

      Reply

      • Thank You doc Izabella for the detailed explanation. I so appreciate you always take the time to answer any of our questions. You’re a Great doctor!

        Have a wonderful day! 🙂

        Reply

  89. Hello,

    I am currently taking benfomax. Can I take 3 pills at once OR those it has to be 1 three times? I have been taking 3 in the morning at once or 1 and then 2 at lunch. I get scared if I take it too late it will keep me up. I am having trouble staying asleep since I started taking benfonax but I also started taking 2 optiferin-c. Which one you think it’s keeping me up at night? I can fall asleep easily but I will make up multiple times during the night. Thank you!

    Reply

    • Glory – thank you for sharing your journey! You should start with the directions on the bottle and adjust your dosage from there. I took 3 capsules per day for one month and then reduced my dose to one per day as I continued to work on my digestion, absorption, and eating more liver. Thiamine is a water-soluble vitamin, so it does not build up in the body. You can find more information here:

      THIAMINE AND THYROID FATIGUE
      https://thyroidpharmacist.com/articles/thiamine-and-thyroid-fatigue

      Reply

  90. Hi Izabella!

    I read as much of your stuff as possible! I’m in the bulletproof health coaching program. Got into it from nutritional reasearch, functional medicine side due to getting diagnosed with acid reflux (jr. High) insomnia (high school) college super hypersensitive to most foods, hashimotos (after couldn’t get pregnant with second baby) , hypothyroidism, candida, Sibo, chronic fatigue……now I’m 31 & we have a 6 & 2 yr old and I NEED ENERGY!!!! We moved to Boulder this last month & my passion is to help others in their health journey! But my own self is so complicated! I’ve pushed away my symptoms so long until I completely broke. Ive worked with a functional medicine doctor for the last 6 months and taking 18 different supplements….I’m really not sure if what I’m taking is working or if I’m taking to much? My Sibo & candida are definitely not gone. I eat completely clean besides a little turmeric infused honey from the farmers market. I’m super tired all the time and not as joyful…..I’m always a happy person so it’s really bugging me! Do you see any patients? Bc I’d love to come in and see you! Or pay for a consulting fee? Via phone, zoom video chat, or meet at your office or at a park? Lol I’m sure you understand, I just want to figure this out! ? Thanks for reading! Hope you have a great day!

    Reply

    • Courtney – Thank you for following this page. I do provide a limited number of consultations, however, my consultative schedule is all full at the moment. I have a 12 week online program called Hashimoto’s Self-Management Program that covers all of the strategies that I go through with my one-on-one clients, in a self-paced format, so that participants have access to all of the things I’ve learned about Hashimoto’s without having to schedule costly consults with me or another practitioner. In addition, any person that goes through the program will get access to a Quick search Q&A Database of 1000+ questions asked by past program participants, Root Cause Assessment based on 100’s of my clients’ root causes and triggers, 2-week Meal Plans, recipes, and shopping lists to get you started on the following diets: Paleo, Autoimmune Paleo, SIBO, Candida. Also, Discounts on lab tests, high-quality supplements, and consultations and much more to support you in your journey! There are a few requirements that you should pay attention to, such as my book is a required read. Hashimoto’s Self-Management Program http://hackinghashimotos.com/ I also have a team of consultants who I’ve personally trained on the protocols outlined in my books and program. Generally, the team will give priority for consultations to those who have read the book and completed the program. You can find out more about my team and consulting services here. https://www.thyroidpharmacistconsulting.com/pages/meet-the-thyroid-pharmacist-team

      Reply

  91. Dr. Wentz. My main issue is I sleep but I never feel well rested. I see that you took 3 BenfoMax for a month. And then you went down to taking 1. My question is do you still take the BenfoMax or was it just for a time?

    I read this article but I didn’t get to the end of it, for the kind/brand you bought, so I already ordered Thiamine, I think it’s 500. I hope that will do! Something has to work right!?! I’ve made so many changes, and I hope this works for me as well. Sleep is kind of important!

    Reply

    • Breann – thank you for following this page. Depending on what is happening in my life at the moment and depending on testing, I change my supplements as needed. As a Pharmacist I am very picky about what brands I recommend to my family, clients 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. These supplements are normally only available through healthcare professionals, however the company has agreed to allow me to set up a store on my website for the supplements I have found helpful for Hashimoto’s.

      Link to the store
      http://www.purerxo.com/thyroidpharmacist/rxo/company/my_recommendations.asp

      Reply

  92. Injection worked better since gluten/GMO may have hurt the intestines of the other women. Benfotiamine (fat soluble Vit B1) goes into the brain and stops obsessing. Blood tests for most things doesn’t work…Celiac/Lyme/Vit B12/Mg/Vit A/Fe/hormones/thyroid TSH etc… Hair tests/ Genova tests/Zyto scans/electrodermal testing helps me. Genova has vitamin testing. Trial and error…best way to see if it helps. Each supplement was like a miracle to me since I was very low in nutrients due to undiagnosed Celiac. Gluten may hurt most people, but most don’t realize it. Gluten may hurt intestines and a person may not feel the hurt, but less nutrients are absorbing which shows up in health issues since cells are not made right to work right without nutrients absorbing well.

    Reply

  93. I am thinking of trying BenfoMax, but just found out that I have 1 variant of the MTHFR gene and was told to stay with the mentholated B vitamins. Is BenfoMax ok with this gene or is there a mentholated version available?

    Reply

  94. Hi,
    Having typed War & Peace twice and losing it ?? I will condense and ask…
    1) Do thyroid antibodies always equate to Hashimoto’s? ( Latest TPO 259 ANTI-gt 4000 with lovely nodules).
    2) how does one know if one has too much iodine or not enough iodine? I was using salt with iodine as I normally have low pb. I don’t use much but still..
    3) In view of the above would taking selenium be okay if one doesn’t know?
    4) This is a far reach, but have you heard of women encountering Hashi when the hit meno??
    Many thanks! ?

    Reply

  95. Dr. Wentz

    Thank you for your article.
    I am allergic to ascorbic acid so unfortunately I cannot take Benfomax. Any other thiamine supplement that you would recommend?

    Thank you
    Al

    Reply

  96. Hi Izabella

    I am a Hashimoto’s patient and started on Benfothiamine two days ago. I only started with 300mg/day. I felt very jittery yesterday for hours after taking the pill – same thing happened today. It feels as if I had gone hyperthyroid all of a sudden.

    Does Thiamine in some way alter intracellular thyroid hormone uptake? Or does it need sufficient adrenal function in order to be processed by the body?

    Thanks in advance!
    Stefan

    Reply

    • Stefan – thank you for reaching out and sharing your journey here. I wish I could give you more direct advice but, each person will react differently. I would advise you to ask your 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.

      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://amzn.to/2DoeC80

      Hashimoto’s Protocol
      http://amzn.to/2B5J1mq

      Reply

  97. I have SIBO issues as well as Sulfate sensitivity. I realized taking benfotiamine gives me anxiety as it contains Sulfate. Any idea what to for people who have Thiamine deficiency but cannot take the B1 supplements due to high sulfur in benfotiamine?

    Reply

    • Racerbiker – thank you for reaching out. I am sorry to hear you are having this reaction. Unfortunately, I am not able to advise on what supplement would be appropriate for you and your specific health needs without a comprehensive health assessment. Please discuss the use of supplements with your personal doctor or pharmacist. <3

      Reply

  98. I just found out I am pregnant. I started supplementing selenium, but was experiencing fatigue and low blood pressure before I conceived. Is supplementing with Thiamine safe during pregnancy? Is BenfoMax the only brand you recommend or is there another brand that is more affordable you have used?

    Reply

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

      Reply

  99. Hi, thank you for all your research and being willing to share your vast knowledge with us. I have benefitted immensely!!! A question about the Thiamin supplement – the label says that the B1 is fat soluble, so will that build up in a person’s system like Vitamin D? Thank you so much!

    Reply

  100. Hi,
    I’ve been recovering from taking 2 weeks of clindamycin for a tooth infection and have been experiencing several side affects such as fatigue and weakness around the heart. I also took a dose of Flagil as well. I’ve been taking Magnesium with Thiamine and slowly increasing the dose every week. I’m up to 300 mg of thiamine a day now and seem to be feeling better, but still have fatigue days. I was tested by my GP for thiamine and came in at the very bottom of the average scale. He said it was normal, but I have my doubts. Can you tell me what kind of doctor can I go to that will test accurately for what is causing my fatigue? You’ve mentioned many possibilities in this article, but I’m at a loss at how to test for them. My GP just looks at me like I’m crazy for even asking.

    Reply

    • Matthew – thank you for reaching out and sharing your journey. I understand how frustrating this can be! I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and prevent serious chronic disease rather than treating individual disease symptoms. I believe that everyone needs to find a practitioner that will let him/her be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It’s a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.

      CLINICIAN DATABASE
      https://www.thyroidpharmacistconsulting.com/pages/clinician-database

      FIND A FUNCTIONAL MEDICINE CLINICIAN
      https://ifm.org/find-a-practitioner/

      http://www.thyroidpharmacistconsulting.com/recommended-compounding-pharmacies.html

      Reply

  101. Thank you Dr Wentz for all your tireless work!
    What is the recommended dose of B1? Did you take 600mg for the first month and then 200mg for maintenance?
    My 80 year old mom does not have her thyroid functioning any more. I believe that it is all shrivelled up. I do not remember if she was given radioactive iodine or not. Would it matter? She does have (had) Hashimoto’s. Can any of your books be still of use to my mom? Which one?
    I should mention that mom speaks only Polish (so she cannot read your articles) and being 80 she might not want to go all crazy on a complicated thyroid protocol LOL. How can I help her? I believe that both of your books are translated into Polish
    Thank you.

    Reply

    • Alina – thank you for reaching out and sharing your mom’s story with me. Yes, I took 3 capsules per day of Pure Encapsulations Benfomax for one month and then reduced my dose to one per day as I continued to work on my digestion, absorption, and eating more liver. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition. As for which book it really depends on you. The Root Cause is a bit more science intensive while the Protocol is a bit more “here are the steps”. Did you know? I am a Polish-American and after I started researching ways to help my own condition, my mom encouraged me to share my research in a book, so that she could translate it for family members in Poland with Hashimoto’s. I would not have been able to write the book without my mom’s support and encouragement! You can check out my books in Polish, here:

      Hashimoto’s Root Cause:
      https://amzn.to/2O1q8fY

      Hashimoto’s Protocol:
      https://amzn.to/2IzpS1C

      Zapraszam też na Polską stronę Facebook: https://www.facebook.com/zapalenietarczycyhashimoto

      Reply

  103. I have come to this article way too late and intend beginning B1 asap. But my question: can it be taken within an hour of the synthetic hormones or should it be taken at the same time as the selenium and calcium at the opposite end of the day? Thank you, Isabella!

    Reply

    • Kerrie – thank you for reaching out. Thyroid medication absorption can be impacted by many things, including food, other medications, and supplements. Thyroid medication should be taken on an empty stomach, one to two hours before eating, taking other medications, supplements or coffee to ensure appropriate absorption. Antacids such as Tums, iron, magnesium, and calcium supplements can impair the absorption of thyroid medications. Thus, you need to have at least 4 hours of time in between your thyroid medications and these agents. Please be sure to read the directions provided with the medication. I hope you find this free ebook helpful. https://thyroidpharmacist.com/meds-ebook/ If you have more specific questions on how and when to take particular supplements under normal circumstances, please do reach out to my team by email, at info@thyroidpharmacist.com and they will be more than happy to help ?

      Reply

  104. Hi Izabella,

    I recently saw you on the Broken Brain series and am very interested in reading your material. I do have a question first though. I had my entire thyroid removed due to cancer cells. Could I still benefit from reading your material or can you provide me with a resource for those who no longer have Hashimoto’s due to not having a thyroid? Thank you very much!

    Reply

    • Ivy – thank you for following! I am so happy to have you here! <3 My protocols are designed to help those with thyroid autoimmune disease heal by focusing on gut health, nutrient deficiencies, and root cause discovery and treatment. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Hashimoto’s is a complicated condition with many layers that need to be unraveled. While conventional medicine only looks at each body system as a separate category and is only concerned with the thyroid’s ability to produce thyroid hormone, Hashimoto’s is more than just hypothyroidism, it's an autoimmune disease that needs to be managed. Whether you have all, part or no thyroid, the autoimmunity still persists in most cases. We need to re-balance the immune system which begins in the gut. With the exception of discussing proper thyroid medication dosing, the majority of my website and book's focuses on balancing the immune system. The info I present is based on my own research and journey overcoming my autoimmune thyroid condition.

      Here are some articles I think you might find helpful:
      IMPORTANCE OF GUT HEALTH
      https://thyroidpharmacist.com/articles/importance-gut-health/

      WHERE DO I START WITH HASHIMOTO’S
      https://thyroidpharmacist.com/articles/where-do-i-start-with-hashimotos/

      Reply

  105. I have a question about taking Thiamine supplements. Let me start by giving you some background info. I have long suspected my wife of having a thyroid disorder but she is very stubborn about requesting to have the right test done. I have been tested for thyroid antibodies and the test came back positive so I do have Hashimoto’s and I take NP Thyroid everyday for it. Even with the medication I still suffer from chronic fatigue as does my wife. I don’t suffer from high blood pressure but she does. Your article mentions that supplementing with Thiamine can help normalize low blood pressure which neither of us have. My question is if there is any concerns with trying Thiamine if you have a history of high blood pressure (My wife does)?

    Reply

    • Luis – thank you so much for reaching out and sharing your journey as well as your wife’s. 　I hope you understand, I am not able to advise on whether this supplement would be appropriate for you or your wife and your specific health needs without a comprehensive health assessment. I recommend that you both discuss this with your personal doctor. <3

      Reply

  106. Hello Dr. Wentz,

    Do you know if BenfoMax contains sulfur? The labeling does not indicate that it does however, I saw an article that mentioned it should be avoided if you have a sulfur sensitivity.

    Thanks,
    Michael

    Reply

  108. Hello,
    I’m intrigued by these findings about thiamine, but I am nervous about taking B vitamin supplements, because they are frequently made using saccharomyces cerevisiae (baker’s/brewer’s yeast), which I am allergic to. This is also possibly a problem for people with Crohn’s disease, as there is a strong link between this disease and igA or igG ASCA positivity. Are there any thiamine supplements that do no contain yeast? Thanks for your help!

    Reply

    • Krista – thank you for reaching out. <3 Here is an article where I discuss IgA and IgG that you might find helpful:
      https://thyroidpharmacist.com/articles/gluten-root-cause-thyroid-condition/ As for a yeast free Thiamine, I believe that most nutrients should come from the diet. This is why I always list food sources in the book and on the blog, for most of the nutrients, vitamins, minerals. and probiotics that are depleted in Hashimoto’s. However, some may require or prefer supplements. I recommend getting tested for deficiencies to determine your need for a supplement.

      Reply

  109. Can you share what the healthy range of B1 is? I know you cannot give certain kinds of health advice, but I am wanting support at understanding B1 test results.

    Reply

  110. Dr Wentz, thank you for the thyroid articles…very helpful and I will now be purchasing your book! I have a question regarding the thiamine. I noticed that the supplement you suggested is actually benfotiamine and not thiamine hcl. Benfotiamine is a synthetic precursor to thiamine, is it not? What is your thought on benfotiamine vs thiamine hcl? If you were to take thiamine hcl would you still use the same 600 mg/day dose?

    Reply

    • Sandy, – you are very welcome! 💕  I’m so glad you are finding my research helpful. I use and recommend the Benfotiamine as it is more bioavailable then the water soluble forms. I would recommend discussing the additon of the thiamine HCL and the correct dosage for you with your practitioner.

      Reply

  111. Thank you for this article! In reference to the information given, was the daily doses taken all at one time or can it be spread throughout the day?

    Reply

  112. Hello. I have all the antibodies for both Graves and Hashimoto’s, however there is NO information anywhere on how to treat it when you have both conditions at the exact same time. The graves is usually more prevalent with rapid and extreme weight loss and lots of other hyper symptoms, occasionally I will gain a few pounds while eating nothing more. I am usually at a normal or slightly below weight for my height when I am not hyper. It seems the natural treatments for both are opposite, so what can I do or am I really the only one with Both conditions?

    Reply

    • Lynda – thank you for reaching out. ❤️ This is something that is rare but is possible. My protocols are designed to help those with thyroid autoimmune disease heal by focusing on gut health, nutrient deficiencies, and root cause discovery and treatment. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Hashimoto’s is a complicated condition with many layers that need to be unraveled. While conventional medicine only looks at each body system as a separate category and is only concerned with the thyroid’s ability to produce thyroid hormone, Hashimoto’s is more than just hypothyroidism, it’s an autoimmune disease that needs to be managed. Whether you have all, part or no thyroid, the autoimmunity still persists in most cases. We need to re-balance the immune system which begins in the gut. With the exception of discussing proper thyroid medication dosing, the majority of my website and book’s focuses on balancing the immune system. The info I present is based on my own research and journey overcoming my autoimmune thyroid condition. Here are some articles I think you might find helpful:

      IMPORTANCE OF GUT HEALTH
      https://thyroidpharmacist.com/articles/importance-gut-health/

      GRAVES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/graves-vs-hashimotos/

      THE MANY FACES OF HASHIMOTO’S
      https://thyroidpharmacist.com/articles/the-many-faces-of-hashimotos/

      Reply

  113. Thank you for this article of vitamin B1 I have low blood pressure low blood sugar and the adrenals are messed up from so much stress and other problems for a lot of years and so I’m definitely going to try that thank you for doing these articles on that

    Reply

  114. Kind of confusing on figuring out a Thamine dosage. I’d love to give it a shot for Hashimoto’s related fatigue. What’s a good starting point for a 208lb male?

    Reply

  115. Hi, I have recently started Thiamine supplements and many of my symptoms have improved since, starting from fatigue, through to digestion and peripheral neuropathy. I cannot believe that this vitamin is what I was missing. I started with small doses and after a few days, starting to feel better, now I’m on Ultra Benfotiamine 600mg daily and feel “normal” for the first time in many years! Thank you so much for your advice

    Reply

  116. Hello, the last couple of years I’ve had difficulty regulating thyroid function and my endocrinologist MD and CNP have adjusted the T4 and T3 compounded medications to help get the numbers back in balance. It occurred to me that perhaps there would be nutritional supplements to support that process. I read your article about advised supplements and started taking Benfotiamine, 200 mg capsules (Pure Encapsulations). I notice a little improvement with energy levels at 400 mg, but when I took 600 mg in a day, I had a significant reaction (vomiting and gut spasms for 4 hours). I’ve thought through possible reasons such as the presence of mycotoxins in my system, poor fat digestion, Sulphur issues (don’t tolerate certain cruciferous veggies), and/or maybe I don’t need that much thiamine, or a combination of things. I’d appreciate any insights. Thank you.

    Reply

    • Deborah, Thank you so much for reaching out and for sharing your experience with benfotiamine. I’m glad to hear you noticed some improvements in energy levels at 400 mg. Benfotiamine is often used to support healthy mitochondrial function, but as with any supplement, individual responses can vary.
      The reaction you experienced at 600 mg may indicate that your body is sensitive to higher doses, which could be influenced by factors such as detoxification challenges, sulfur metabolism issues, or digestion-related concerns. These are areas you may wish to explore further with your healthcare provider.
      In clinical experience, many individuals with Hashimoto’s find it helpful to start with lower supplement doses and increase gradually, as tolerated. Nutrients like magnesium or molybdenum are sometimes discussed for supporting metabolic pathways, and digestive enzymes may be considered when fat digestion is a concern. Functional testing, such as a full thyroid panel, organic acids test, or assessments for environmental exposures—may help provide additional insights under the guidance of a qualified practitioner.

      Reply

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