Dr. Izabella Wentz, PharmD

Thyroid Pharmacist

How to Use Enzymes to Overcome Hashimoto's

Using Enzymes to Overcome Hashimoto’s

Medically reviewed and written by Izabella Wentz, PharmD, FASCP

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“Bad digestion is at the root of all evil,” said Hippocrates, the ancient Greek physician who is considered to be the father of modern medicine. Although he was born in 460 BC, I think he was onto something!

In the world of functional medicine, we often refer to this concept that all disease (and thereby all healing) begins in the gut. The gut performs the all-important role of digesting and absorbing the nutrients we take in. I like to say, “You are what you absorb.”

In a well-functioning gut, the body produces the appropriate enzymes to break down the food that is ingested. However, compromised intestinal function is almost always a factor in people with Hashimoto’s — and oftentimes, the root cause of their thyroid condition.

An enzyme deficiency can, directly and indirectly, contribute to thyroid symptoms and autoimmunity. Supplementing with specific enzymes can help with overcoming symptoms of Hashimoto’s (including fatigue, hair loss, nutrient deficiencies, infections, and food sensitivities), as well as reducing thyroid antibodies.

In my survey of over 2000 individuals with Hashimoto’s, about 73 percent of those who tried digestive enzymes reported that the enzymes made them feel better. Some of the main improvements include increased energy, better mood, and clearer skin.

Read on to learn more about:

  • The role of enzymes
  • How enzymes deficiency affects Hashimoto’s
  • The six types of enzymes that might be beneficial

The Role of Enzymes

Enzymes are a form of protein present throughout the body. They manage cell metabolism by making the chemical reactions that keep us alive, happen more efficiently.

Because of enzymes, cells can manage millions of chemical reactions per second, making our bodies efficient at creating energy from the raw materials we provide.

Some of the key roles that enzymes play include:

  • Digestion – Digestive enzymes help the body break down larger complex molecules into smaller molecules to be used as fuel. In doing so, they can help the digestive system better absorb and utilize nutrients, making them helpful for nutrient deficiencies (commonly observed in those with Hashimoto’s).
  • DNA replication – Each time a cell divides, that DNA needs to be copied. Enzymes help in this process by unwinding the DNA coils and copying the information, aiding in healthy cell growth and renewal.
  • Detoxification – Liver enzymes help the liver break down toxins in the body for elimination. Providing support to these enzymes can help the liver function more optimally. This can be especially useful in helping an overburdened liver (commonly observed in those with Hashimoto’s) clear out elevated levels of toxins.

There are many things that can change the way that enzymes function in our body and throw enzyme production out of balance, including aging (as we age, we produce less digestive enzymes), and conditions like Hashimoto’s and hypothyroidism.

There’s an intimate connection between thyroid function and the body’s ability to digest our foods. Let’s explore the thyroid and digestive enzyme connection.

Enzymes and Hashimoto’s

As mentioned earlier, poor gut health is linked to altered enzyme production. We know that everyone with Hashimoto’s has some degree of intestinal permeability, or leaky gut, which occurs when poorly digested molecules of food or other toxins permeate the intestinal lining and become absorbed into the bloodstream. When this occurs, the body may recognize them as foreign invaders. This causes inflammation in the body as it begins to attack the intruders, and eventually leads to autoimmunity.

Intestinal permeability can be a result of poor digestion caused by a reduction in enzymes that help break down food. Many people with Hashimoto’s experience acid reflux, bloating, and constipation, along with fatigue, brain fog, joint pain, and many other symptoms that may be caused by poor digestive function.

One of the key “aha” moments on my road to recovery from Hashimoto’s, came when I decided to try a betaine with pepsin supplement to support protein digestion. I woke up the next morning with more energy than I had felt in a decade! I was finally able to digest my food properly.

As I’ve delved more into the world of food pharmacology (food as medicine), I’ve come to realize how important proper digestion is to health, particularly for those of us managing thyroid conditions. People with Hashimoto’s usually experience some level of nutrient deficiencies, food sensitivities, digestive issues, and infections. These symptoms are often caused by a diminished ability to absorb proper nutrients from the food we eat.

This is where adding digestive enzymes that help the body break down food, can be a critical tool for improving digestive health, boosting nutrient uptake, and reducing the symptoms of Hashimoto’s.

6 Types of Enzymes that May Benefit Hashimoto’s

There are six different types of enzymes that are particularly helpful for people with Hashimoto’s. They have been shown to improve digestion, relieve many symptoms commonly associated with the condition, and even improve thyroid labs.

These six enzymes are:

  1. Protein digestive enzymes
  2. Systemic enzymes
  3. Fat digestive enzymes
  4. Broad spectrum enzymes
  5. Veggie enzymes
  6. Gluten/dairy digestive enzymes

1. Betaine with Pepsin (Protein Digestive Enzymes)

Most people with Hashimoto’s and hypothyroidism also have low stomach acid.

Low stomach acid makes it more difficult to digest proteins, making us more tired, as digestion is one of the biggest energy-requiring processes of our bodies. Additionally, when proteins are poorly digested, we are more likely to become sensitive to them. Thus, many people with Hashimoto’s will be sensitive to gluten, dairy, and soy (as well as possibly other foods). This is because these proteins are amongst the most difficult to digest and are also the most commonly eaten proteins in the standard western diet.

People will often develop IgG antibodies to the various proteins, which are also the same types of antibodies that target the thyroid gland in autoimmune disease. When someone continues to eat these proteins, the immune system attack becomes upregulated as the influx of poorly digested proteins triggers the immune system to make more of these types of antibodies. While simply eliminating the ingestion of such reactive proteins can help a person to feel much better and downregulate the autoimmune attack, continuing to have low stomach acid may contribute to developing new food sensitivities to proteins that are found in grains, eggs, nuts, and seeds.

These poorly digested proteins then become “food” for the opportunistic bacteria that live in our gut. The gut is a delicate environment of probiotic (beneficial) and opportunistic (potentially problematic if conditions are right for them to grow out of control) bacteria. An overgrowth of opportunistic bacteria has been linked to autoimmunity.

Additionally, having low stomach acid makes us more susceptible to acquiring gut infections like SIBO (Small Intestinal Bacterial Overgrowth), H. pylori, Yersinia, and parasites, which can be potential root causes of autoimmunity.

Numerous parasites such as Giardia, E. histolytica, and Blastocystis hominis, among others, have been found to cause intestinal permeability.

Low stomach acid can result from a nutrient deficiency, such as thiamine or B12, and can contribute to low iron levels and anemia, as we need stomach acid to extract B12 and iron from our protein-containing foods. This leads to a vicious cycle that results in hair loss, fatigue, food sensitivities, etc. Many people have been able to improve their levels of ferritin and B12 through improving their stomach acid and vice versa.

While having hypothyroidism or Hashimoto’s in itself can cause low stomach acid, as can aging and genetics, there are other root causes of low stomach acid that need to be considered.

Addressing these root causes should always be done in conjunction with betaine HCl and pepsin supplementation:

  • H. pylori infections, which can trigger Hashimoto’s, ulcers, acid reflux and low stomach acid, among other conditions.
  • B12 deficiency, which may be associated with a vegan diet or with anti-parietal cell antibodies (proteins that are produced by our immune system and mistakenly target specific cells within the stomach lining).
  • Adrenal dysfunction, which can deplete nutrients required for stomach acid production.
  • The MTHFR mutation, which is associated with a buildup of homocysteine due to impaired methylation. There are two main pathways of breaking down homocysteine. One of them involves the use of trimethylglycine (betaine), and this gene mutation could theoretically make someone trimethylglycine deficient.
  • Other nutrient deficiencies, especially thiamine.

Using a betaine hydrochloride with pepsin supplement (naturally occurring components of gastric juice that make nutrients and amino acids from our protein-containing foods more bioavailable, by breaking down protein bonds), such as Rootcology’s Betaine with Pepsin, can help with this.

Betaine, also known as trimethylglycine, is a naturally occurring amino acid derivative that is isolated from beets, and the acidic HCl version of it promotes acidity in the gastric opening. Pepsin is a naturally occurring digestive enzyme that breaks apart proteins into smaller pieces so they can be properly absorbed by the small intestine.

For those with the MTHFR gene variation and low stomach acid, taking betaine with pepsin is a great way to get extra trimethylglycine, which helps metabolize homocysteine.

In my 2015 survey of 2232 people with Hashimoto’s, out of 627 people who took betaine and pepsin, 59 percent said that it made them feel better, 33 percent said that it made them feel worse, while seven percent saw no difference in symptoms.

Taking betaine with pepsin with protein-containing meals, can help with getting your energy back. After beginning to take betaine with pepsin with my protein-containing meals, my 10-year long debilitating fatigue was lifted practically overnight! I went from sleeping for 11-12 hours per night, to eight hours — just because I started digesting my foods better! Having enough energy gave me the confidence that I could overcome Hashimoto’s and my long list of health struggles.

For full details on how to use Rootcology’s Betaine with Pepsin, as well as alternative ways to increase your stomach acid if you don’t want to take a supplement, you can download my Low Stomach Acid Quick Start Guide:

Who is most likely to benefit from betaine with pepsin (protein digestive enzymes)?

If you find yourself feeling tired or with a heavy feeling after protein-containing meals, have a history of SIBO, a known B12 or iron deficiency, the MTHFR gene variation, or a history of PPI use, Betaine with Pepsin might be right for you.

Who should avoid Betaine with Pepsin?

Using this supplement in excess can lead to stomach irritation, which is why I always recommend a slow dose titration to determine your optimal dose. That said, some people should NOT take Betaine with Pepsin. This supplement should not be used by those with a history of peptic ulcers or gastritis, those with an active H. pylori infection, or those with an overproduction of acid. Discuss with your primary care practitioner before taking if you are pregnant or breastfeeding.

Avoid this supplement if taking blood thinners, non-steroidal anti-inflammatory drugs (NSAIDs), steroids, or other medications that may increase one’s likelihood of developing an ulcer.

I also recommend avoiding this supplement if you are taking proton pump inhibitors or other acid-suppressing medications, as these will negate the effect of the supplement.

2. Systemic Enzymes

Systemic enzymes are also known as proteolytic enzymes and act as natural immune modulators, bringing our immune system into balance. Systemic enzymes are a blend of plant and animal-derived enzymes, and may contain a mix of some of the following ingredients:

  • Bromelain (from pineapple)
  • Papain (from papaya)
  • Rutin or rutoside trihydrate (bioflavonoid)
  • Chymotrypsin (porcine)
  • Trypsin (porcine)
  • Pancreatin (porcine)

Systemic enzymes break down inflammatory cytokines (immune response proteins) that are seen in autoimmune disease. They also contain proteases that may be involved with breaking down pathogens such as bacteria and parasites. Furthermore, these enzymes speed up tissue repair by reducing inflammation.

Additionally, the enzymes reduce the antibodies to both foods and the thyroid, by breaking down circulating immune complexes (CICs) that are formed in autoimmune disease.

Systemic enzymes have been studied extensively in Europe, and have become a popular alternative to pain medications for arthritic disease and many inflammatory conditions.

A poster presentation from April 21-24, 2002 presented in Cannes, France, found that Wobenzym, a proprietary blend of systemic enzymes, taken at a dose of five capsules, three times per day, showed very promising results in Hashimoto’s.

Here’s the summary of the study:

Forty people with Hashimoto’s who were taking levothyroxine, were given systemic enzymes for three to six months. The patients reported a reduction of thyroid symptoms, a normalization of thyroid ultrasounds, a reduction in the number of inflammatory cells in the thyroid, and significant decreases in TPO and TG antibodies.

Many patients were able to reduce their dose of levothyroxine, and some were able to discontinue their medications completely. Additionally, cholesterol profiles improved in the patients that had high cholesterol levels before starting the enzymes.

As systemic enzymes act on the immune system altogether, using them is also thought to be protective of developing future autoimmune conditions.

The key thing to remember about these enzymes is that they are not to be taken with food, rather they should be taken on an empty stomach, at least 45 minutes before a meal, or one and a half hours after a meal. Otherwise, they will get used up in the process of digestion instead of getting into the bloodstream to act on circulating immune complexes.

NOTE: While most labels of systemic enzymes will state to take six capsules daily, the dose of enzymes used in this particular study was 2.5 times higher at five capsules, three times per day (on an empty stomach).

Experienced clinicians will use five capsules, three times per day, with a glass of water (at least 8 ounces or 240 mL). In some cases, even ten capsules, three times per day may be used in the acute phase to modulate the immune system effectively. The six capsules per day dose on the label is thought to be a maintenance dose.

The brand of systemic enzymes I have used successfully, and was used in the above-mentioned study, is the Wobenzym brand.*

*Wobenzym N is the formulation that was studied. However, I’ve also seen similar clinical benefits with Wobenzym PS.

Who is most likely to benefit from systemic enzymes?

You may benefit from this type of enzyme if you have elevated TG and/or TPO levels, or if you have food sensitivities, pain, elevated cholesterol, impaired wound healing, or chronic inflammation.

Who should avoid systemic enzymes?

Systemic enzymes should not be taken by pregnant or lactating women. Individuals with allergies to pineapple or papaya should not take products containing bromelain. Some individuals with Candida may react to these enzymes. In addition, systemic enzymes should be avoided by those currently taking leukotriene inhibitors.

3. Fat Digestive Enzymes

Fat malabsorption is easily overlooked by patients and practitioners alike. If you have issues with digesting fat — like up to 73 percent percent of people with Hashimoto’s do — you may benefit from an enzyme that aids in fat digestion.

We know that whatever we eat eventually makes it down into the small intestine, but some people have trouble digesting the fats that we consume from the foods we eat.

Our liver produces a substance called bile. Bile from the liver is sent to the gallbladder via a passageway called the common bile duct, and then it is concentrated and stored there. When we eat a fatty meal, the concentrated bile is released from the gallbladder through the common bile duct, then heads to the initial part of the small intestine (called the duodenum). There, the bile begins to break down the fats into tiny globules.

At the same time, the neighboring pancreas organ releases its own pancreatic juices (containing digestive enzymes such as lipase and bicarbonate ions), mixing with the bile and tiny globules of fat. The pancreatic juices neutralize the digesting food (which is very acidic) and also help with protein and carbohydrate digestion.

Both bile and pancreatic secretions emulsify the fats (or lipids) so that they can be digested in the watery small intestine.

The lack of thyroxine associated with hypothyroidism can affect the sphincter of Oddi (layers of muscle that regulate the flow of bile into the small intestine/duodenum, which close between meals, preventing bile from continuing to flow into the small intestine when it isn’t needed). The sphincter may experience increased tension, which can prevent normal bile flow. This has been thought to contribute to the formation of common bile duct stones, as well as gallstones.

Thus, it’s not surprising that there is an increased prevalence of hypothyroidism found in patients with common bile duct stones. In fact, patients with common bile duct stones and gallstones have, respectively, seven-fold and three-fold increases in the frequency of hypothyroidism.

Experiments with hypothyroid rats have confirmed the thyroxine effect on bile composition, decreased bile flow, and relaxation of the sphincter of Oddi. Research in rats has shown that the administration of thyroid hormone improves bile flow, suggesting that there is a strong correlation between developing gallbladder issues and hypothyroidism.

There are various reasons why a person may have difficulty with fat malabsorption. Some of the common ones include bile deficiency, pancreatic enzymes deficiency, liver backlog, and small intestinal bacterial overgrowth (SIBO).

There are two recommended supplements that can help you with fat digestion — one targets the liver and gallbladder, and the other supports the pancreas.

Who is most likely to benefit from fat digestive enzymes?

If you experience gas and bloating after meals, frequent diarrhea, stomach pain, foul smelling and greasy stools, unexplained weight loss, or a low fecal elastase count on a gut screen (such as the GI-MAP test), you may have problems digesting fat and may benefit from a fat digestive enzyme.

If you’ve had fat malabsorption for some time, you may also find that you will start to develop symptoms of fatty acid deficiency, as well as potential vitamin A, D, E, and K deficiencies. Signs of fatty acid deficiency include dry hair, weight loss, eczema, depression, dry itchy/flaky skin or scalp, dandruff, oily scalp, and rashes.

Vitamin D deficiency can be identified on a lab test, and generally, if a person has been supplementing with vitamin D but is still showing a deficiency, I suspect fat malabsorption issues.

Improve Fat Digestion with Liver & Gallbladder Support

If you are experiencing symptoms associated with fat malabsorption, your gallbladder is not functioning optimally, or you have had your gallbladder removed, I recommend using a supplement that supports a healthy bile flow and fat digestion, like Liver & Gallbladder Support by Rootcology.

Rootcology Liver & Gallbladder Support helps fat digestion in three different ways: it supports the liver’s ability to process fat with ingredients such as milk thistle, gives us extra bile through ox bile, and supports our bile flow with ingredients such as dandelion, artichoke, and beet. This can be a life-changer if you have issues with fat malabsorption.

Who should avoid Liver & Gallbladder Support?

Do not take Liver & Gallbladder Support if you have Addison’s disease, a history of electrolyte imbalance, or are allergic or sensitive to any of the ingredients. Consult with a doctor before use if pregnant or breastfeeding. Please also review my article on gallbladder health for more information about potential drug interactions, and be sure to discuss any concerns about supplements with your practitioner as well.

Improve Fat Digestion with Pancreatic Enzymes

In some cases, people with fat malabsorption may also have exocrine pancreatic insufficiency, or a deficiency in pancreatic enzymes. Some potential reasons for pancreatic insufficiency include damaged microvilli, celiac disease, SIBO, toxicity, stress, as well as alcohol use.

In such cases, I’ve found Pancreatic Enzymes Plus from Rootcology to be very helpful. These enzymes are taken with every fat-containing meal. In about 50 percent of cases, I’ve seen pancreatic insufficiency resolve simply by using pancreatic enzymes for a few weeks to a few months; in other cases, people may need to take the enzymes long-term and do more detective work to identify why they are deficient in pancreatic enzymes.

I have also used Pancreatic Enzyme Formula by Pure Encapsulations personally and with clients, with great results. I find this option especially helpful for advanced stages of exocrine pancreatic insufficiency, where one may require high doses of the enzymes (and may need to take multiple pills with each meal and snack, based on his/her weight).

Who should avoid Pancreatic Enzymes Plus?

Do not use Rootcology Pancreatic Enzymes Plus if you are allergic to pork, pineapples, pancreatic enzymes, or ox bile, or take certain medications including blood thinners. Consult with a physician before use if pregnant or breastfeeding. Please check out my article on pancreatic enzymes to learn more about potential medication interactions with this kind of supplement.

4. Broad Spectrum Digestive Enzymes

In addition to poor protein digestion, many people with Hashimoto’s may have an impaired ability to digest fiber, starch, and fat.

In the case of poor fiber absorption, many fibers of undigested vegetables may be found in the stools, and a person may feel very bloated after a high-fiber meal. When someone is not properly digesting fats, they will often present with diarrhea, steatorrhea (fat in stools), cramping, bloating, and muscle cramps.

In addition to betaine with pepsin, some may also find that a broad spectrum digestive enzyme may help them reduce symptoms of nutrient deficiencies and feel more energetic. I recommend Digestive Enzymes Ultra from Pure Encapsulations.

Following a nutrient-dense diet (filled with veggies and fruits, which are powerhouses for nutrients), can also be helpful. When foods aren’t properly digested, however, we are not going to be very effective at extracting nutrients from them. Juicing or blending them up in a smoothie may help with getting the nutrients to be better absorbed.

Getting enough fats and vitamins is another helpful strategy that should not be overlooked. Fat is a crucial component of our diet, and fat malabsorption may lead to a deficiency of fat-soluble vitamins like A, D, E, K, as well as a fatty acid deficiency. Deficiencies in these nutrients can lead to numerous symptoms including vision problems, immune system imbalance, fragile bones, poor wound healing, easy bruising, bleeding gums, nosebleeds, dull hair, depression, skin disorders, and many other symptoms.

Some pathogens that have been tied to triggering Hashimoto’s, like Blastocystis hominis, thrive in the guts of those that have a difficult time digesting fats in lipid-coated homes or biofilms that make them impenetrable to digestive acids, immune cells, medications, and herbs.

In addition to eating a nutrient-dense diet, taking vitamin, mineral, and fatty acid supplements may be required until digestion is optimized.

Who is most likely to benefit from broad spectrum digestive enzymes?

If you notice undigested food in your stool, a feeling of bloating after a high fiber meal, diarrhea, or abdominal cramping, you may want to consider this type of enzyme.

Who should avoid broad spectrum digestive enzymes?

At this time, there are no major drug interactions or precautions of note, but please check the ingredient list to ensure that you are not sensitive or allergic to any ingredients listed. Consult with your healthcare physician prior to consuming these types of enzymes if you are pregnant or lactating, or if you are taking blood thinners.

5. Veggie Enzymes

We all know how important it is to eat our vegetables. In fact, many of my recommendations for healing the body through nutrient-dense whole foods, revolve around fueling the body with nourishing green vegetables. But for some people with Hashimoto’s, a damaged gut and a lack of digestive enzymes can make vegetables difficult to digest, as their high fiber and starch content may be difficult to break down, especially in their raw form.

In some cases of hypothyroidism, an indigestible ball of plant fiber material known as a phytobezoar, which is formed out of undigested vegetable fibers, has been found to cause bowel obstruction. These masses of undigested material commonly consist of vegetable fibers from pulpy fruits, orange pits, seeds, roots, and leaves, but can be formed from any indigestible food fibers. Fibrous foods that are often found in phytobezoars include celery, pumpkin, prunes, raisins, leeks, beets, persimmons, and sunflower-seed shells.

Interestingly, insoluble fibers, which are high in vegetables like leafy greens, corn, celery, and bell peppers, have been shown to mechanically trigger symptoms of irritable bowel syndrome (IBS) as they move through the digestive tract. However, certain fibers — particularly soluble fiber such as psyllium — may actually be a helpful treatment for IBS. So perhaps the inability to digest the insoluble fibers is due to an enzyme deficiency, further contributing to the autoimmune cascade and IBS symptoms.

Common symptoms of poor veggie digestion include bloating, gas, constipation, and stomach pain. Symptoms of nutrient depletions that may occur when the body is unable to break down and absorb the nutrients in fibrous vegetables, are much further reaching and may include fatigue, hair loss, muscle pain, and autoimmunity itself.

Deficiencies in antioxidants such as vitamin C (which is found in high amounts in cruciferous vegetables, bell peppers, and leafy greens), vitamin E, beta-carotene (a vitamin A precursor), and the minerals selenium and manganese, often result due to poor vegetable digestion.

Folate is another important nutrient that can become depleted when vegetables aren’t properly absorbed. Common sources of folate include broccoli, asparagus, avocado, spinach, and Brussels sprouts.

For those who have undigested vegetable fibers in their stool, taking an enzyme that helps to digest plant fibers may be helpful. I created Veggie Enzymes by Rootcology, which is a vegetarian-friendly digestive support formula. As a blend of amylase, protease, lactase, and other important enzymes, it aids in the digestion of proteins, fats, and carbohydrates. The cellulase breaks down plant cellulose, while the amylase breaks down starches to help the body digest starchy and fibrous foods like raw veggies and fruits.

Who is most likely to benefit from Veggie Enzymes?

If you experience gas and bloating after meals, as well as constipation and a feeling of fullness after eating only a small quantity of food, or if you notice undigested fibers in your stool, taking a veggie enzyme such as Veggie Enzymes by Rootcology may help.

Who should avoid Veggie Enzymes?

While there are no major drug interactions or precautions of note, I recommend avoiding Veggie Enzymes if you are allergic or sensitive to any of the ingredients in this supplement, or if you are taking blood thinners. Consult with a doctor before use if pregnant or breastfeeding.

6. Gluten/Dairy Digestive Enzymes

Two of the most common food sensitivities found in people with Hashimoto’s are gluten and dairy. Gluten (the main reactive protein found in wheat), and casein (the main reactive protein found in dairy) are large protein molecules that may not be fully broken down in the human body and thus may be targeted by the immune system. As the antibodies to the foods are made by the same branch of the immune system (IgG branch) that makes antibodies to the thyroid, every time one of these reactive foods is consumed, there is a greater production of IgG antibodies — including antibodies to the thyroid.

Dipeptidyl peptidase IV (DPP-IV) is a special enzyme that splits gluten into smaller fragments, making it easier to digest. It can be found in a combination enzyme product that also contains enzymes that break down casein, beta-lactoglobulin (whey), and lactose (milk sugar molecules found in dairy).

While these enzymes may not be enough to allow a person with celiac disease to eat a whole bowl of pasta, the enzymes can be very helpful for those with gluten and dairy sensitivity. I use this product whenever I go out to eat and am concerned about cross-contamination issues, and have used it after accidental consumption of dairy/gluten.

Here’s a scenario that I’ve experienced numerous times…

Me: “I follow a gluten/dairy/soy-free diet. Are you able to accommodate my dietary needs?”

Cook/waiter/family member: ”Of course.”

Food comes, I try it, it tastes suspicious…

Me: “Are you sure this doesn’t have dairy/gluten?”

Cook/waiter/family member: “No dairy/gluten… just cheese/butter/casein/whey/flour!”

Me: “I knew it! Glad I always keep my gluten/dairy digestive enzymes in my purse!”

Maybe you can relate? 🙂

I used to have severe reactions to dairy and gluten, but I have found that the Gluten/Dairy Digest blend of enzymes from Pure Encapsulations effectively minimizes my reactions when I accidentally consume small amounts of dairy and gluten. I still have a reaction, but instead of suffering for two or three days, I only have problems for a couple of hours after being exposed to gluten/dairy.

I should emphasize that using these enzymes is not an excuse to go crazy with gluten and dairy — I still recommend that most people with Hashimoto’s remove them from their diets long term — however, they are a great supplement to have on hand when eating out or accidentally exposed.

Who is most likely to benefit from Gluten/Dairy Digest?

If you react to gluten and dairy but want to enjoy a meal out on occasion, this type of enzyme may reduce the symptoms of accidental exposure to these food sensitivities.

Who should avoid Gluten/Dairy Digest?

While this may seem like a trick question ;-), it is important to note that this supplement is not helpful for those who have celiac disease. At this time, there are no major drug interactions or precautions of note, but please check the ingredient list to ensure that you are not sensitive or allergic to any ingredients listed. Consult with your healthcare physician prior to consuming these types of enzymes if you are pregnant or lactating, or if you are taking blood thinners.

The Takeaway

Enzyme deficiencies are common in those with Hashimoto’s, and supplementing with the right types of enzymes can relieve many of the symptoms associated with the condition.

Specific enzymes can help lower inflammation in the body, speed up tissue repair, reduce food sensitivities, decrease thyroid antibodies, improve nutrient absorption, reduce pain, improve cholesterol levels, and even reduce harmful pathogens.

Benefits of Supplementing with Enzymes Infographic

Have you tried enzymes? Have they made a difference in your health?

I hope that you find this information helpful on your journey in overcoming Hashimoto’s!

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

For future updates, make sure to follow us on Facebook and Instagram!

References

  1. Newman, T. Enzymes: How they work and what they do. Medical News Today. https://www.medicalnewstoday.com/articles/319704. Published January 11, 2018. Accessed August 14, 2020.
  2. Cooper GM. The Cell: A Molecular Approach. 2nd edition. Sunderland (MA): Sinauer Associates; 2000. The Central Role of Enzymes as Biological Catalysts. Available from: https://www.ncbi.nlm.nih.gov/books/NBK9921/.

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

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Dr. Izabella Wentz

Dr. Izabella Wentz, PharmD, FASCP, is a clinical pharmacist, New York Times Bestselling Author, and a pioneering expert in lifestyle interventions for treating Hashimoto’s Thyroiditis.

She received a Doctor of Pharmacy degree from the Midwestern University Chicago College of Pharmacy at the age of 23, and has worked as a community pharmacist, a clinical consulting pharmacist, as well as a medication safety pharmacist. She is a Fellow of the American Society of Consultant Pharmacists and holds certifications in Medication Therapy Management and Advanced Diabetes Care.

Dr. Wentz has dedicated her career to addressing the root causes of autoimmune thyroid disease, after being diagnosed with Hashimoto’s Thyroiditis in 2009. As a patient advocate, researcher, clinician and educator, she is committed to raising awareness on how to overcome autoimmune thyroid disease.

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. Laurie says

    I’m confused. If I am currently taking the Digestive Enzymes Ultra, should I also be taking the betaine with pepsin? Can your digestive system get dependent on digestive enzymes?
    Reply

  2. Izabella Wentz, PharmD says

    The Digestive Enzymes Ultra are broad spectrum enzymes, while the Betaine with Pepsin is specific to protein containing foods. Some may benefit from both. Some may be able to lower the requirement for digestive enzymes as they fix their digestion and nutrient depletions.
    Reply

      • Deb says

        May I ask what the proper dose of Pure Encapsulations Bentaine and Pepsin were for you. It is recommended 1 at each meal, but I may need more and don’t want to overdo. Thank You!

        Reply

        • Dr. Izabella Wentz says

          Deb – 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

          • Linda says

            I had my thyroid removed because of thyroid cancer. I have been cancer free 6 years, but my levels got high all of the sudden. I am on synthroid. I am having the symptoms you are describing. Can I still take the supplements you are listing?

          • Dr. Izabella Wentz says

            Linda – thank you for reaching out and sharing your journey. <3 I am so happy to hear you are cancer free! Please understand, I am not able to advise on whether these supplements would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your personal doctor.

  4. Marsha Scheitlin says

    Great post! I do have a question…about the use of digestive enzymes and HCI. I have heard that HCI can disrupt the potential of digestive enzymes and that it is best to take them about 15 minutes to 1/2 hour apart. So if you can speak on that issue….also what is your opinion of Bragg’s apple cider vinegar or apple cider vinegar in general. Does this take the place of HCI with Pepsin? Thanks!
    Reply

  5. izabella Wentz, PharmD says

    Hi Marsha- So the systemic enzymes should be on an empty stomach. I would take the digestive enzymes ultra when starting to eat, and Betaine with Pepsin at the end of your meal. Some people swear by diluting ACV in water and using it to aid digestion. Personally, it didn’t work for me very well, so you have to see what works for you best.
    Reply

  6. Gerti says

    Thanx a lot for this article!!!I just came out from the Emergency Room ,after 28hours of I.V. and heart monitoring.I have the Hashimoto’s and gluten,soy free..because until now I tolerated quite well the cheese.So I ate a small pice of cheese and a pair of “gluten free”winners and in 4hours, I ended up with such a gut pain and strong diarea and throwing up…so finally I passed out and ended up with 911 and emergency room.Nobody in the hospital could tell me what was the problem..just the huge nutritional deficiency.
    Sooo scary!!!!Please advice me what brend of enzyme should I buy to be sure I do not end up in the same condition
    Reply

  7. Izabella Wentz, PharmD says

    HI Gerti, I’m so sorry about your experience, that must have been very scary. While I can’t provide medical advice online, I think the Systemic Enzymes are really helpful for reducing food reactions.
    Reply

  8. Paula says

    Thank you Izabella, I appreciate these articles! I got the results of my GI Effects stool test (collected on 2/20/14) and it indicated, among other things, that I don’t handle fats very well: High Triglycerides means “fat maldigestion”, High LCFAs means “fat malabsorption due to pancreatic, biliary insufficiency, or acute bacterial infection that produces intestinal cell destruction.” and High Total Fat “usually signals malabsorption (fat)”. Given that my pancreatic elastase 1 was great: “>500″ and that the test showed no parasites, no yeast/fungi, no opportunistic bacteria”, I assumed that my fat digestion/absorption problems were related to “biliary insufficiency”, some kind of gallbladder problem. So, I spoke to my doc about it, and as I didn’t currently have symptoms of Gallbladder problems (no pain, no steatorrhea) he didn’t recommend getting a GB ultrasound. Still, I thought it would be useful to take some digestive enzymes since I really don’t want to cut back on my added oils (about 4-6 Tbs/day and 2-3tsp/olive oil) too drastically, unless necessary. So, I did cut back on the coconut oil anyway (2-3T/day) and I started taking Digestion GB (Pure Prescriptions) . I’ve had GB problems in my 20s/early 30s like RUQ pain, etc, but nothing in the last 10 years, I’m 47. I’ve been taking the Digest GB (mostly for the ox bile component, if I remember correctly), and taking it with meals as the bottle instructions suggest. In the setting of a patient who is already eating an AI Paleo approach (coconut/olive oils, no butter, starchy vegetables that are low in fructose, no fruit, greens/veggies at every meal, protein (just started pea protein powder today, bison, fish, sardines, occasional turkey-all grass-fed and/or no hormones, or wild-caught), what would you recommend when a patient has fat digestion/fat malabsorption problems only, in other words pancreas appears to be functioning well, and no bacterial/parasite/yeast infections found in the gut? Also, how soon do you recommend repeating the GI Stool test?
    Reply

  9. Izabella Wentz, PharmD says

    Paula- great question. The Ox bile should help, but I wouldn’t take it for longer than a month. I would also recommend doing another gut test, like the 401H from Biohealth lab as well as looking into Spectracell testing to determine what deficiencies you may have that are keeping you from digesting correctly. Often, people with Hashimoto’s may be deficient in oleic acid, which in turn prevents us from emulsifying our fat. Taking Choline 500mg- 750mg may belp, as well as flaxseed oil capsules that contain oleic acid. Hope that helps
    Reply

  10. Paula says

    RE: Betaine HCL with pepsin
    I had stopped taking the Betaine HCL after about 6 weeks, because I seemed to be better, very few symptoms of GERD (I stopped taking it due to requirement for stool test). Since then, I have noticed some GERD symptoms, especially when eating protein meals, so I’ve since added it back into my supplement regimen. I appreciated this reminder though about the purpose for taking it and I already have your book, well-worn, so I’ll reference it for the proper way to take it, thank you. Repetition is good when finding one’s root cause, I think, because my brain still isn’t as sharp as before the Hashi (probably was 7-8 years in the making) and it’s good that you present and re-present this info in different ways, articles, books, webinars, etc.
    Reply

  12. Patricia Lewis says

    I’d like to pass on to you my current experience regarding low stomach acid. For the last two days I’ve been drinking a juice with beets, celery, cucumber and apple along with may regular food. Juicing is new to me. I became alarmed when I had a bowel movement and my stool became blood red and my urine turned a deep pink. I totally freaked! I thought I was bleeding internally but, I felt fine. Upon process of elimination on what I ate for the day I went on line and started researching beets. I found several sites that confirmed beets caused this reaction. Additionally, I learned that When you are low in stomach acid, your body in not able to metabolize and assimilate beetroot pigments properly” and causes the discoloration of urine to red or pink.
    http://www.bodyenlightenment.me/articles/2012/05/do-the-beet-test-how-to-tell-if-you-have-low-stomach-acid-weak-digestion/
    The reason I’m highlighting this is because in your book and your current post you write about probiotics, digestive enzymes and Betaine w/Pepsin. I’ve been following this protocol; however, now I believe I’m not taking the correct supplements and need to change to a better brand. I was wondering why I still had some of the symptoms described for low stomach acid and contributed it to something else. I will be ordering my supplements from the site you suggested.
    Reply

  14. N. Borse says

    Hello, I am wondering if you might have any info or direction regarding the use of systemic enzymes CAUSING pain (under xiphoid process toward stomach). I have tried these 3-4 different times over the years with same results…consistent pain that even wakes me from sleep. Any ideas? Thank you.
    Reply

    • Dr. Izabella Wentz says

      Holly- 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

      • Deborah says

        Hello Dr. Wentz…thank you for all this good information. I’ve been taking the Wobenzyme for about a month now and since the last two mornings I’m waking up with nausea and it continues into the afternoon. I’m just thinking it might be too much for my stomach and maybe I should hold off for a while and start on probiotics. I do also want to let you know that my anxiety completely vanished while taking the enzymes and I’m sleeping better. I’m afraid the anxiety and insomnia will come back when I stop taking them, but I can’t stand the burning and nausea in my stomach.

        Reply

        • Dr. Izabella says

          Deborah – thank you for reaching out and sharing your journey. I am sorry to hear you are experiencing these side effects. Please understand it would not be legal or appropriate for me to give any type of medical advice here. I recommend that your contact your trusted clinician who’s care you are under. <3

          Reply

  16. ivana says

    hello, i am taking 1 pill Betaine pepsine with my meals for 4 days, and i am sensing very strange feeling of slight headache , and blood sugar imbalances, and cramps in my muscles, i am taking magnesium, but i do feel like once used to be person, having no brain fog, wich is absolutely amazing thing, but if i dont take a pill i burp, and have feeling of heavy digestion if i dont take it, i know i had stomach acid low before because was feeling very sick in the summer when bacteria in my stomach would flourish…..i had that 4 years in a row at almost exact time! in August! ……now my question is can taking betaine affect my natural production of HCL, so it will make me life dependant? Why do i have a feeling of sickness with slight headache pressure 1-2 hours after the pill? Later it feels so good …..and why it looks like i need more water and magnesium when taking it? Also tried to supplement selenium but after 3 pills i fel crash in my energy and i read it may be because i am iodine low?….Please help, i know my bad digestion is culprit for having thyroid issue for the last 7 years , and who knows how longer ago it started….many thanks for an answer, i am reading your book!
    Reply

  17. Laura says

    I have just begun treatment for Hashimoto’s after two years of debilitating fatigue and other associated symptoms. After reading this article, I decided to try supplementing with betaine hcl with pepsin to see if it would help. I found that one pill caused burning in my stomach, so I assume I do not need it. However, within a few minutes of taking it, my fatigue remits, my brain fog dissipates, and the world seems much brighter. What could be causing this? I wish I could continue taking it!
    Reply

  18. izabella Wentz, PharmD says

    Laura- Though I can’t provide medical advice online without knowing your case, some of the common reasons why someone may have that reaction. 1) Taking the Betaine without protein containing food 2) The dose is too high. It was helpful for me to take the Betaine at the end of the meal, and perhaps you may want to look at a different Betaine/Pepsin supplement where the capsules have smaller amounts of ingredients or using apple cider vinegar or lemon water may help.
    Reply

  19. Ary says

    I started taking the betaine with pepsin and the digestive enzymes ultra. Now I have horrible gas and bloating! I separated them to see which one was causing it and it seems to be the digestive enzymes. Does this mean it is doing me some good or that I don’t need them? Thanks for all your great advice!
    Reply

  20. Jo says

    Hi, Izabella, I don’t have any questions at this time, but just wanted to thank you for the information you are so generously providing to us! I plan to buy your book and begin to deal with my thyroid issues. Thanks for being out there!! I heard you on the thyroid summit and you were awesome. 🙂
    Reply

    • Dr. Izabella Wentz says

      Jo- 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

  21. Neli R says

    Hi Izabella, first of all thank you very much for sharing your studies, it looks very helpful.
    I am treating for hashimoto’s with synthroid 75mcg a day, have been on treatment since last November, started with 50mcg went to 62.5 after 3 months and after other 3 went to present dose. The doctor will see me in september again, the cholesterol went down a little
    and the t3 also. I read about supplementing with woobenzym but it says on their label to take it on empty stomach (away from food) for muscle pain, my question is; should i take it with food to help with the thyroid problem? Would it help also with fat digestion?
    I normally take Transformation Enzymes LipoZyme to help digest fat, also take selenium and zinc. Your comments will be greatly appreciated.
    Reply

  22. Phyllis says

    I am taking 120mg of armour once a day. I have Hashimoto, and have bad constipation. Should I continue on armour if I am taking the betaine HCI with pepsin?
    Reply

  23. Wendy says

    Zinc/Se/iron (enough) may help change T4 to T3. Some people take Amour split into twice a day instead of once a day since T3 wears off.. No gluten/dairy/soy/sugar/GMO…vitamins/good oils, LDN, detoxing helps me. Osteoprocare, Chia on top of brown rice, raw walnuts and later lemon juice in water, Mg citrate, fiber and right dose of thyroid medicine helps my constipation.
    Reply

  25. Wendy says

    An Alternative doctor may help. HCl and enzymes are natural in a body so to me if I needed them I would take them. Pregnant women have less room in their stomach..smaller meals may help. I wish I could do my pregnancies all over again in a healthy way. I need no gluten/dairy/soy/sugar/.GMO. Gluten may cause acid reflux issues and HCl and enyzmes may help. Best wishes.
    Reply

  26. Bonnie says

    Do you have advice for people who has gastric bypass and Hashimotos?
    I am so disappointed that my Dr. Didn’t suggest any help w that before the surgery.
    Reply

  27. Teresa Martinez says

    I take Wobenzym N daily so I am familiar with it. My daughter was diagnosed with Hashimoto’s last Dec. and we have read your book and done many of the things you talk about in your book, including going gluten, soy, dairy free. We did the food sensitivities testing and found out she has a lot of food sensitivities including one to pineapple. She struggles with her stomach a lot and I wanted to use systemic enzymes to see if they might help her, but if Bromelian is from pineapple does this mean it probably wouldn’t be good for her and are there others that might be able to work for her instead?
    Reply

  28. Izabella Wentz. PharmD says

    Hi Teresa-
    Thank you for writing. I hope the book has helped your daughter. If this helps, I also had a reaction to pineapple, so I put off taking Systemic enzyme, but when I took Systemic Enzymes I did not react to them, and I can eat lots of pineapple without a reaction now. She may be different, but it may be worth a try. Keep me posted….
    Reply

  29. Paula A. says

    I was dx in Feb. of this year, with Hashimoto. About two to three months a ago I became optimal. My blood tests looked good, my antibodies were falling and I felt great. About three weeks ago, I began taking wobenzym. I could feel it helping with my inflammation and pain. My last blood test showed my antibodies were climbing, my free t4 and Free t3 numbers are falling. And now I’m feeling symptomatic again. Heart palpatations, less energy and air hunger. Could the enzymes be the cause of this? I did a little further digging about them and read that they might increase TH1 or TH2. I’m not sure which I’m dominate in. Have you read about this being a possibility?
    Reply

  30. Thom says

    I will be starting Wobenzyme thiss week. I heard about it on the summit last week. I read your book but there is so much info to absorb. My TPOs were 890 in feb 720 in May and 670 in August. I am so hopeful, I have tried a pelthora of things but I also have the MTFR 677T to compund my issues. At least my numbers are going in the right direction!
    Thom
    Reply

  31. Janine says

    Thanks for this post. I’m especially interested in the use of systemic enzymes to improve Hashimotos. I was wondering if taking the enzymes (on an empty stomach) too close to when I take my thyroid medication would interfere with the absorption of the medication.
    thanks,
    Janine
    Reply

  32. Thomas says

    I am about 1 week into taking wobenzyme N. It is hard to take it at the appropriate time. I take it about 15 mins after my natur throid. Not sure if this is good or bad but I am hopeful!
    Reply

  33. Deborah Wilson says

    I take omeprazole for a hiatus hernia and had a total thyroidectomy 7 years ago. I often read your posts and articles but with my specific issues I can not work out what I should take to help me stop taking the omeprazole. I also have chronic fatigue and IBS. I eat a low Fodmap diet which helps and recently started taking armour which has also helped but would like to improve my health further. Specifically to stay sleeping through the night and have the energy to get through the day and evening. Can you suggest anything to help me stop taking omeprazole?
    Reply

  34. miriam says

    Hi Izabella, thank you for your most informative articles! I have hypothyroidism & hashimoto’s. I am gluten/ dairy/soy/ sugar free. I do not have any digestive problems. My question is: Can I take digestive enzymes for general digestive health? Which brand would you recommend? Thank you.
    Reply

  35. Susan says

    I would like to try the systematic enzymes but for how long do u suggest taking the 15 capsules per day? I was looking at the price and a $50 bottle of 180 capsules is only a 12 day supply.
    Reply

  37. Alyssa says

    Hi! Can you post which brands of the enzymes you take? Or find to be reputable brands? Right now I take vitamin D bc I am deficient, I also take align as well as another probiotic and a multivitamin. I am on armour thyroid and my antibodies have come down to 127 from over 1000 at diagnosis. But, I still can’t seem to shake any of the weigh I put on bc of it! I am gluten free bc I was celiac long before hashi and recently dairy free and mostly soy free. I feel a million times better and don’t get sick nearly as often but even with all of that the scale won’t budge :/ wondering if it’s still my gut, Malandrino of things etc.
    Reply

  39. Marilyn says

    Can I Take Betaine with Pepsin and a probiotic with the H_pylori bacterial infection? I am allergic to the antibiotics they want me to take, do you know what I can do to rid this bacterial infection? My gastrolonologist told me to let it run its course. Thought really im the way im feeling, please i wish i could find something that will help me get rid of this! I also had the radio active iodine treatment so now my thyroid glands dmmon’t function anymore and I’m having a lot of digestive issues to where the enzymes the help make folic acid isn’t functioning to break down my vitamins B’s and proteins and carbs! I’m really fatigued and loosing weight and loosing my hair, memory fog, depression and anxiety! I have recently put on Clonazepam for anxeity and Quetiapine generic for Seroquel, and been taking Armour Thyroid since June! After want being switched from taking Level thyroidroxine after 6 years, I bottomed out in July to where now I have no energy and major digestive issues and no appetite! My doctors think I’m trying to diagnose myself and think it’s all in my head! I even showed them your book and pointed out what’s going on and still feeling very weak and wish someone would believe me! I want to feel better and need answers very soon, what do I do or who do I turn to? Very desperate!
    Reply

  40. Connie Stoicescu says

    Hi Izabella!
    I have Hashimoto, avoid gluten, vegetarian, no fish, organic eggs and cheese sometimes, taking a lot of whole food suplements.
    Read about the systemic enzymes and their good effect on antibodies. Would it be ok for me to take these enzymes even though I don’t eat meet? Trying to get pregnant and need to lower my antibodies. Do not take Thyroid medicine, but I do take tyrosin and jod.
    Many thanks,
    Connie
    Reply

    • Dr. Izabella Wentz says

      Connie- Recovering from adrenal fatigue and hypothyroidism when following a vegetarian diet is very challenging, as vegetarian diets are often carbohydrate heavy.
      Vegetarian sources of protein such as legumes (beans), dairy, grains, soy and some seeds may be incompatible with trying to heal a leaky gut, which is almost always present with Hashimoto’s. Pea protein is an alternative that may be easier to digest and is less likely to cause food sensitivities (I use NOW Foods brand).

      Eggs, some seeds, and nuts would be the preferred sources of protein for vegetarians, however, some people with Hashimoto’s may be intolerant to those as well, especially in the early stages of starting a healing diet.

      Being a vegan is even more challenging, and nuts and seeds would be the go-to source of protein, which are usually too difficult to digest for many in the beginning of their thyroid healing journeys.

      While vegan and vegetarian diets have been reported to be extremely helpful with autoimmune and chronic conditions, I have not been able to find reports of people recovering from Hashimoto’s by following a vegan diet. Even devout vegans who are nutritionally conscious still struggle with low body temperatures, hypothyroidism and Hashimoto’s.

      Additionally, many former vegans have reported improved symptoms of Hashimoto’s following transitioning to a Paleo diet. Based on this, I believe that animal proteins must play an important role in building back the health of people with Hashimoto’s.

      That said, while meats and fats are important for healing, eating them exclusively will produce an acidic environment in the body; hindering healing, and thus the diet should be balanced with plenty of nutrient rich vegetables (suggested ratio may be 20% meat/80% veggie).

      Additionally, vegan and raw vegan diets can be extremely helpful for cleansing and detoxifying, especially for those with persistent protein digestion issues. A vegan diet can be followed for a few days to a few weeks and may help the body detoxify. B12 and iron or ferritin supplements should be utilized at this time to prevent deficiency.

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

      Reply

  41. Wendy says

    People may need thyroid medicine to support a pregnancy as the baby grows. When thyroid/nutrients absorbed from healed gut lining due to 100% no gluten…then some people may get pregnant. Best wishes.
    Reply

  42. Andrea says

    Love all the information that you are sharing!!!! I have tried taking the systemic enzymes and end up with various aches and pains within a day or two. Wondering if that is a normal response? Like maybe the enzymes are cleaning up some old inflammed areas cleaned up??? Thanks in advance for your response!!
    Reply

  43. Judy says

    Just wanted to thank you for providing the information in WRITTEN form. I can re-read the info that applies to my particular condition and even print it for future reference. Very helpful!!
    Reply

  44. Lorrie says

    I am also wondering if I can take the Wobenzym at the same time as my thyroid meds since they both have to be taken on an empty stomach. I take Nature-Throid. Will the enzymes be OK to take at the same time, right after waking up?
    Reply

  45. Natalie says

    Thanks for all your info. Have you heard of Ortho Molecular DygestzymeV? Seems like it covers all of them. Taking it every day seems too much for me. I might try your suggested brand.
    Reply

  46. Janet says

    Excellent article. I’m so tired of trying different doctors for help in this exact problem that can’t/don’t help me. Is there a directory that has the kind of doctors in my area that can help me. I live in Austin, Tx
    Reply

  48. K. Anderson says

    *48yo/Female: I have developed GERD over the past 3 years – slowly, until now – where it is daily. Sometimes the upper ab pain is unbearable. Gallbladder is fine (ruled that out), but the reflux is just plain awful, and food feels stuck in my esophagus – resulting in extreme pain for a few minutes, then a ‘break’ (thankfully). T3 T4 normal range, but TPO is 540. Dx with Hashimotos after biopsy of largest nodule (I have many on all lobes). Fatigue, hairloss, acne (but am also perimenopausal), etc — not entirely unbearable, but the GERD (or whatever it is) IS, at times. I have G.C.Hemangiomas (liver) – but don’t think that is a contributor. So when you discuss having low stomach acid – that puzzles me because mine seems high and out of control. I am ordering your book, but am wondering if high stomach acid is also a symptom of Hashimotos? I’m confused. Thanks. *Dr just prescribes omeprazole, and endocrinologist says there is nothing I can do for Hashimotos unless and until I have severe symptoms. 🙁 **The only foods I know for sure that are triggers: lemon, peppermint, pork, anything with cream. Bread doesn’t seem to have an effect -and is sometimes the only thing I can eat that doesn’t cause stomach pain.
    Reply

    • Dr. Izabella Wentz says

      K. Anderson- 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

  49. jenni says

    I take my Naturthroid and a bovine adrenal supplement as soon as I wake up and then wait an hour or more to eat. Can you take the systemic enzymes at the same time, or do I have to wait even longer to eat? Then I also wait to take the vitamin B supplements that I take so I’m not taking them with vitamin c. What is the proper timing/delays for all these, and how do I do it without starving or waking up to early. The bovine adrenal stuff is finally helping me sleep a little longer. I want to sleep and eat and stop feeling tired.
    Reply

    • Dr. Izabella Wentz says

      Brenda- 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

  51. jess says

    I have Hashimoto’s and I am wondering if it can cause a sudden inability to digest red meat (also lamb and sausage). I take betaine HCL and don’t have a problem with other meats.
    Reply

  52. Genie Goykhberg, N.D. says

    HCl does not harm digestive enzymes, pancreatic enzymes remind dormant till they reach second half of duodenum where pH reach mark of 7.2. Taking plant based enzymes with a first bite get you the best return on investment, as they participate in pre-digestion, which make life of SI much easier. Betaine (beet roots) provoke our body to produce more HCl. Russian healers believed that our longevity and quality of our life is in direct proportion of the quality and quantity of HCl our body can produce. There are probably millions enzymes in our body with different functions – participating in billions body’s processes. In an essence enzymes do just two things – break down food and enhance our immune system = all systems. Proteolytic enzymes taken between meal do just that – clean the body, picked up protein debris, address inflammation, triglycerides and such. ANY STRESS, be it mechanical, emotional, nutritional/chemical, requires a serious doze of proteolytic enzymes taken on an empty stomach and, please, support your kidneys to help them to get rid of whatever was captured and destroyed by proteolytic enzymes, as that waste was, more likely, pretty toxic.
    Reply

  54. Therese says

    Thank you for your book! I started taking Betaine HCL with pepsin after high protein meals and notice I’m bloated. Does this mean I probably don’t need this supplement? My capsules are 650mg betaine with 25mg pepsin. Bloating isn’t a normal issue for me now that I eat gluten free, etc. Thanks for your help!
    Reply

  55. Lydia says

    I ended up with a full Hemeroid ectamy after taking Armour thyroid and my anti bodies went out the roof and the constipation was really bad, please take stool softeners, Mira lax, prune juice don’t go through what i did.
    Reply

  57. Valentine says

    Hi! I have been diagnosed with hypothyroidism in August last year and with Hashimoto April this year. I do not take and do not want to take thyroid hormone due to bad experiences with cortisone treatment in my previous autoimmune disease. I try to keep Hg and ferritine in check with supplements. It is a struggle, but a positive one. Regardless, my body temperature has stayed around 35.7-36.3 C (96.3 F-97.3 F) for a long time now. I started taking mixture of digestive enzymes on Saturday last week and next day body temperature rose to 36.6-37.2 C (97.9-99.0 F) and stays that way until now. Has someone else experienced such body temperature raise with digestive enzymes? Will it stabilize at some point to some lower value? Reason why I’m asking is that I feel cold/feverish with this new temperature so much so, that it leaves me pretty low on energy by the evening. My CRP is good, below 5. One thing that lowers body temperature to 36.5 C is a good long sleep. Do not dare to take medicines, because they easily bring temperature too low to about 35 C.
    Reply

  58. Valentine says

    One week taking enzymes update. Feverishness/cold feeling went away, but temperature remains at the new position. Mornings 36.6, evenings 37.2. Last two days felt incredibly low on energy with brain fog. Took vitamin D in spray and zinc (reason for zinc found on another forum, apparently it helps to convert T4 to T3, my current T3:T4 ratio is 1:3). Energy-wise a bit better after vitamin D and zinc. Will keep monitoring and updating news here. My endocrinologist says I am healthy, other endocrinologists that I tried to see say they cannot help me, because my fat intestine has been removed (due to colitis ulcerosa). In my country we do not have as it seems holistic endocrinologists. I have found a functional medicine doctor, will try to schedule an appointment, but my expectations are very low, even for the 450 USD that they charge for 1 visit. Thankfully, this forum exists for support information! And to blow off some steam at the current state of the medicine 😉
    Reply

  59. elsie seviour says

    Whatbif your not sensitive to dairy but gluten. And can i still eat meatball still take probiotics and other supplements.
    Reply

  60. Rose says

    Thank you for all this free education. I was diagnosed with Hashi in 2004. In 2008 I had total thyroidextomy and RAI. It is my understanding that I still have hashi because I will always have the antibodies even though I no longer have a thyroid. Is that correct? I take Synthroid 112 and Cytomel 5 and still suffer from fatigue and brain fog.
    Reply

  61. Leslie says

    I’m curious about this, however I’ve been told that I have GERD. wouldn’t taking supplements to increase stomach acid worsen the problem?
    Reply

  62. Ann says

    Thank you so much for this. I have been sick for years and putting these pieces together alone. Doctors have been of little help. I discovered, after talking to someone in a meeting, I had an allergy to sulfites. Finally found an immunologist who figured out the autoimmune issue and put me on cyclosporine. Thru trial and error and lots of research, I found pancreatin and ox bile extract to make a huge difference in my quality of life. Still looking for the right doctor to get back on natural thyroid meds. Been trying for years. I’ve asked about Hashimotos for a while. I keep being told all my blood tests are normal. Keep taking the synthroid. But all my symptoms fit what you describe. Ordered more of the enzymes. Please, please, let them work.
    Reply

  64. Debbie says

    Can you tell me if all the supplements above should be used for getting rid of h pylori. I have it and antibiotics helped me feel better but, did not get rid of it 100% now back and I have hashimoto’s too. I know I’d feel better if the h pylori was gone for good! Can you advise on all of them, one of them? Thank you
    Reply

  65. Barbara says

    Is it better to eat organic raw food that contain higher amounts of enzymes? than supplements and are the supplements suitable for vegans please? Thanks 🙂
    Reply

  66. Pat says

    I have Hash. as well. I am 58 and had my gallbladder removed 12 years ago. Do you have any suggestions on how to handle this with the enzymes. I currently am taking Alli for weight loss and wonder if the other supplements I take could be hindered by this . Thanks for you insight!
    Reply

  67. lee says

    Do you know of a Betaine without cellulose? Or the enzymes in vegetarian form? I’m auto immune to cellulose –which is in everything, including food, vitamins, medicine. Its been a real problem for me as i have celiac, Hashi, and severe SIBO.
    Reply

  68. Lynda says

    After I take my thyroid hormone, how much time should I wait before using papaya chewable tablets? I’m trying the papaya for reflux symptoms
    Reply

    • Dr. Izabella Wentz says

      Lynda- The digestive enzymes should stimulate your body’s own production
      of acid, and help you extract nutrients from your food. After some
      time, you should be able to get off the enzymes as your own body
      begins to produce enough digestive acid.

      Reply

  70. Leanne Murphy says

    Hi Izabella, how long do you keep taking the digestive enzymes? I would like to do something to improve my own digestive acids without having to continue using these…. You have said vitamin B12 or thiamine deficiency… So if I supplement with these will my acids increase? Or is there something else I need to do? Thanks, Leanne
    Reply

  71. bran says

    Can you use this enzyme protocol before doing a full elimination diet or are the diet and this protocol to be used together?

    Reply

  72. Pepa says

    Speaking about enzymes you don’t mention Serrapeptase. Do you think this enzyme is good to be taken by people with Hashimoto’s? Thank you.

    Reply

  73. Pablo Schenquerman says

    Dr Izzabella:

    I would like to start using Wobenzym. How many tablets should I take to reduce antibodies ?
    Thanks
    Pablo

    Reply

    • Dr. Izabella Wentz says

      Pablo – 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

  74. Brentley says

    If one was having a problem spacing out systemic enzymes due to timing of other supplements and meals. Would there be any contraindications to taking systemic enzymes on an empty stomach but at the same time as thyroid replacement medication? Or with other supplements that are to be taken without food? I haven’t been able to find any information about this online. Any thoughts would be helpful.

    Reply

    • Dr. Izabella Wentz says

      Brentley – thank you for following this page. I’m hesitant to say what you should do … based on liability. If something were to happen to you I could lose my license

      The problem when combining all these is that you may be over supplementing.

      I do outline this in the book and have a full chapter on supplementation explaining.

      Have you picked up a copy?

      Reply

  75. Carol says

    Thanks for the information. My digestion is really off due to no gallbladder and no thyroid. I switched from Armour to WP thyroid and have gained 15 lbs. I take Pure Encapulations Digest GB – but that doesn’t seem to be making a difference any longer. Tired of being constantly hungry. I appreciate any suggestions you might have. I had papillary thyroid cancer. Currently no antibodies. 🙂

    Reply

    • Dr. Izabella says

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

      Hashimoto’s Protocol
      thyroidpharmacist.com/protocol

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

      Reply

  76. Sara says

    Hi dr. Wentz,

    So I searched and searched for the Systemic Enzyme Complex from Pure Encap. but I could not find it in Europe. I live in The Netherlands. Can you recommend another product? And, is it enough to use the Systemic Enzyme Complex or is it a must to also use the Digestive Enzymes Ultra also by Pure Encap.

    Please let me know :).

    Thanks!

    Sara

    Reply

  78. Marlene says

    I love Wobenzym! Thanks to this article I bought them and after two years of constant pain in my neck and shoulders (Currently diagnosed with Fibromyalgia) I am pain free! And last appointment with endocrinologist showed a tiny reduction of bigger nodule! Thanks

    Reply

  79. MaryEllenNorwegianPrincess Seehafer says

    I have Celiac, hypothyroid (no antibodies), EPI, RA and fibromyalgia. I take Pure Encapsulations Digestive Enzymes Ultra. Should I still add the systemic enzymes? It seems there are overlaps in the ingredients. Im on a limited budget and don’t want to take more than is needed.
    I used to use Creon but quit using those because of the fillers used.

    Reply

  80. Keisha Forbes says

    I am wondering about the difference between digestive bitters and digestive enzymes. Would it be beneficial to take both, or is one better to take when experiencing hypo thyroid, gall bladder/pancreatic issues and SIBO.

    Reply

  81. Biljana says

    Greetings Izabella,

    I am so grateful to have discovered your book few years ago, soon after I got diagnosed with Hashimoto. Also for your openness, and courage to speak not only about physical symptoms many of us are going through, but also emotional challenges.

    On this blog page you discuss enzymes. I do use HCL with Pepsin from NowFood, and just noticed that latest bottle has different ingredients: pepsin has fungal origin, from Aspergillus niger (earlier it was wild boar pepsin). Please advise if fungal origin will have negative impact on someone who is also suffering from Candida and/or mold allergy?

    Many thanks, may God Bless you
    Biljana

    Reply

    • Dr. Izabella says

      Biljana – thank you for following this page. I regret that I do not have the time to evaluate every supplement on the market. As a pharmacist, I can tell you that many supplements are ineffective, and some are even downright unsafe. The truth is that most supplement companies do not undergo the same scrutiny and testing that pharmaceutical products do. This is because many of the tests required of pharmaceutical companies are voluntary for supplement companies and most companies do not take the extra steps to test their products to ensure safety and purity. 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 their website for the supplements I have found helpful for Hashimoto’s. Here are some links you might find helpful.
      https://www.purerxo.com/thyroidpharmacist/rxo/products/product_details.asp?ProductsID=929
      Link to the store
      http://www.purerxo.com/thyroidpharmacist/rxo/company/my_recommendations.asp

      Reply

  82. Berta Marquez says

    Hi,

    Thank you for all of the work you are doing to educate and assist patients in achieving wellness.

    I had one small question. I know betaine production naturally decreases with age. However, for a relatively young person have you ever seen low betaine production increase after betaine supplementation? In other words, do supplementation or other approaches ever encourage the body to again generate its own stomach acid at adequate or normal levels?

    Thank you for your time and any insights you might lend on the matter.

    Reply

  83. Kristina says

    Izabella, thank you so much for sharing all of your research. It has helped me immensely in my healing journey.
    I have a question regarding the systemic enzymes. I have recently started taking Wobenzym (however not in the dose that was used in the study) and I have noticed some improvement in my symptoms. Would I have to continue with this enzyme indefinitely or would there be some end point?
    Thank you.

    Reply

  84. Michael says

    Hi, great info, can these different type of enzymes be combined (ie betaine pepsin AND a broad spectrum enzyme) or some other combo above?

    Thanks

    Michael

    Reply

    • Dr. Izabella says

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

      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…

      Hashimoto’s Protocol
      thyroidpharmacist.com/protocol

      Reply

  85. Seyhan says

    First of all thank you soooo much for your contributions! I’m 29. I had to get a health report for my job and a problem was discovered with my ekg, which lead the cardiologist ask if i had a heart attack. And as no problem was seen in the blood tests and eco he was confused (i was almost failing the health report!) Then some other doctor told me it might be my thyroid, but then the values were almost(!) okey. Then i bought your hashimoto’s protocol and i swallowed it like in a few nights. I did the anti TPO and anti T tests in a private lab. Both were around 8.

    I wasn’t satisfied of course. I made my mother and father do the test. Mother’s anti-TPO is avove 300 and father’s is above 40.

    I feel so hopeful and hopeless at the same time. Because now i know my future and that i’m not imagining that my physical and mental performance is lowering day by day for years, and also i van do something about it both for myself and my parents (first things firat, i begged them to go gluten free).

    And the question is on the hopeless side. I’m living in a country where it’s impossible to find most of the supplements you advise, especially betaine hcl with pepsin. I can only find two brands with pepsin with glutamic acid. May it work ?

    I would really like to buy pure encapsulation stuff but it’s impossible with all the customs regulations. So will pepsin&glutamic acid work ?

    Thank you again for being a real healer with the right mind.

    Reply

  86. M M B says

    Hello Dr Wentz,
    Can digestive enzyme supplements cause digestive upset? If so, is this a temporary reaction until one adapts to the enzymes? How long does this usually take? Also, I live in a small town in Nevada, without specialists nearby. I have a good primary care doc, and a good acupuncturist. I am only taking 50mg of Levothyroxine, and the Chinese herb supplements provided by my acupuncturist. My thyroid, T-3, is now testing normal, so my primary care doc thinks all is well. I am gluten free, mostly grain free, nearly 100%organic, etc. However, I still am not well, and I would like to see a specialist who is open to the compounded T-3/T-4 combo with natural thyroid. I can go to San Francisco or Davis fairly easily. I am having trouble figuring out who to see. Many thyroid docs, but few specify Hashimoto’s specialty/expertise. I see your list of docs who have ordered your book. Is the best course to call each one in my area? Any suggestions of a more efficient way to find an endocrinologist who specializes in Hashimoto’s and who is willing to prescribe compound meds?

    Reply

  87. Mia says

    I have been on the search for the strangest thing – what has made me feel energetic, well and not achy- all of a sudden. I have tried to jot down each thought of what it could be that made this big difference I just noticed. After my own research I deduced that it had to be the Betaine Hcl. So to reinforce my belief I started doing some online reading. Thanks for this article that helps confirm my belief! To anyone wondering if they should get it, please note, I have only once or twice noticed a direct difference from taking any type of supplement, BUT with Betaine Hcl, which I took for a recent bout of heartburn not thinking it was related to my hashi’s, it was immediate relief of heartburn, overnight that I felt good, and after taking it maybe 5-6 times in the following week that I kept think, “wow, I am feeling great”! It is not expensive and is worth a try. I can not believe how much better I am feeling.

    Background: I am female, over 50, had hashi’s for about 15 years and for the last 16 years felt like I was pulling my body through mud to accomplish anything. And, never had heartburn (other than during pregnancy) except for the 2 weeks prior to trying Betaine HCL.

    Reply

  88. Krista Haire-Patten says

    Hello Dr. Wentz. I’ve been reaching alot through your books Hashimoto’s Thyroiditis Root Cause and Hashimoto’s Protocol. I’ve never taken digestive enzymes before where do I start? I don’t have stomach pains, I make 1-2 bowel movements daily, and I’m having trouble gaining weight. I was thinking that I should start with the Liver and Gallbladder support or would Betaine with Pepsin be a good place to start. Any suggestions?

    Reply

  89. Katherine says

    What type of enzyme would you suggest for someone who has had a gallbladder removal and a history of stomach ulcers?
    I have many issues with my stomach.
    Thank you
    Katherine

    Reply

    • Dr. Izabella says

      Katherine – thank you for following this page. Betaine HCL with Pepsin is very helpful for people who no longer have their gallbladder. You may want to look into taking an ox bile supplement to help you break down fats so you don’t become deficient in nutrients. Supplementing with bile salts can also take a lot of strain off the digestive system when a gallbladder is no longer there to concentrate and release bile as needed for digestion of fats.

      HASHIMOTO’S AND LOW STOMACH ACID
      https://thyroidpharmacist.com/articles/hashimotos-and-low-stomach-acid/

      Acid Reflux Video
      https://www.facebook.com/ThyroidLifestyle/videos/917587155058494/

      Reply

      • Katherine says

        Thank you for your reply, I would love to take Betaine HCL with Pepsin but I have a history of stomach ulcers, so I will try the Ox Bile Substitute. Is that ok to take with a history of ulcers?

        Reply

        • Dr. Izabella says

          Katherine – thank you for reaching out. I wish I could give you more direct advice but, each person will react differently. I would advise you to ask your trusted clinician who’s care you are under. I am not able to respond directly to these types of questions here.

          Reply

  90. Gina says

    I have Hashimoto’s… I currently use the gluten/dairy digest as well as a broad spectrum enzyme.
    Are you recommending taking all of these different types daily? Or does it depend on what we eat? That seems like a lot of pills… in addition to the other supplements. I wish the pharmaceutical companies would make a “multi” enzyme kind of like a multi vitamin that had everything in one capsule!
    Thanks!

    Reply

    • Dr. Izabella says

      Gina – thank you for reaching out. I am not able to advise on whether these supplements would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your personal doctor or pharmacist. 🙂

      Reply

  91. Jamie says

    Hi I have Hashimoto’s and no gallbladder should I be using enzymes. I sometimes get the burning heartburn feeling. If you could remend some enzymes for someone without a gallbladder. Thank you!?

    Reply

  92. Jamie says

    I have Hashimoto’s and my labs come back fine. But I am experiencing hot one minute and cold the next. Joint and muscle pain, neck will hurt and digestive problems. Also falling asleep by 7:30 at night. Does it sound like maybe my medicine needs to be adjusted, even know my labs are fine. Thank you ?

    Reply

  93. François says

    Hello,
    It’s been 3 years i discovered having Hashimoto.
    Fortunately, i found your website and book and i followed your protocols.
    I used betaine HCL to overcome my low digestion problem and gastric reflux. It was successful, so i dit not take betaine anymore. Recently, i try to eat food with gluten and milk which i had avoided. First, i thought nothing happenned but i have my digestion problem came back. I stopped gluten and milk and i began to take betaine HCL. What can i do ? Thanks

    Reply

  94. Stephanie says

    Hi there,
    I am VD deficient, dry brittle hair/nails/skin (and other symptoms) so I think I will start with the Pancreatic Enzymes Plus. The bottle says to take 1 pill 3x per day with meals. Should I take before or after the meal? Is one pill enough or is there a formula like you have for the Betaine & Pepsin? I appreciate all suggestions. Thanks!

    Reply

  95. Lisa Gibson says

    Hi Dr. Wentz. I had gastric bypass surgery approximately 8 years ago. I’m sure I have low stomach acid from that alone.
    I don’t have a functional medicine doctor close by that I work with. Do you have a directory to find one? I’m in Colorado.

    Reply

    • Dr. Izabella says

      Lisa – thank you so much for reaching out and sharing. I understand how hard this is. <3 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://thyroidpharmacist.com/database-recommended-clinicians/

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

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

      Reply

  96. Tammy Neal says

    I have Hashimoto’s and was having asthma with sinusitis. Took systemic Enzymes by Pure encapsulation from this article hoping this would help with that along with helping my Hashimoto’s. I took 1 for 3 days felt so sick to my stomach with cramping like menstrual cramps. 5 days after stopping I still feel nauseous with cramping. I am 54 post menopausal with fibroid tumors. Is it possible to still be feeling sick? With only taking 1 a day for three days? I was thinking maybe it started eating away at my fibroids maybe waking them as to why I am cramping still with nausea? I don’t know but the symptoms all started after I took the Enzymes. Any in input on this would be greatly appreciated. Thank you.

    Reply

    • Dr. Izabella says

      Tammy – thank you for reaching out. I am so sorry you had this experience. I am not able to advise on what is causing these symptoms without a comprehensive health assessment. I recommend that you discuss this with your personal doctor whose care you are under.

      Reply

  97. Walt says

    In a phased manner, I took all the supplements that were recommended from your book Hashimotos Protocol and did not improve. From my Diagnostic Solutions testing in the category of Digestion, I was very LOW on Elastase-1 (Suppressed pancreatic function). In the category of Bacterial Flora I received a LOW result for Enterococcus spp. (Insufficiency of beneficial bacteria) and a HIGH result for Clostridium spp. (Reduced digestive capacity). In the category of Immune Response I was very HIGH in Secretory IgA. This is leading me down the path of supplementing again, but maybe for a longer period of time with Betaine with Pepsin……In addition I have recently had multiple occurrences of gout in one foot and an episode of Raynauds syndrome in my other foot’s toes. I am thinking about trying Wobenzym again after trying Betaine with Pepsin thinking that it may help with these issues……Without being specific to my situation, would you typically recommend I try one supplement at a time?

    Reply

    • Dr. Izabella says

      Walt – thank you for reaching out and sharing your journey. <3 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. If you have any other questions about the protocols or supplements please feel free to email my team at info@thyroidpharmacist.com and they will be happy to help you.

      Reply

  98. Elaine says

    I have been successfully following your recommended protocols for healing my gut with food restrictions and supplements. I’m feeling immensely better, but my antibodies have gone from 761 to 300, and I can’t get them to reduce any further for the last 6 months. I cut coffee out again to see if that will make a difference. I also tried using Wobenzym when I first started a year ago. It made me feel better in terms of reduced inflammation, however, I have since discovered that I am allergic to pineapple and possibly papain. Wobenzym made me break out around my nose and mouth. I also seem to have issues with nightshades. Is there anything you can recommend if I am interested in taking systemic or fat digestive enzymes? Even the products you endorse on your website seem to have “bromeliad” properties.

    Reply

    • Dr. Izabella says

      Elaine – thank you so much for sharing your journey with me. I understand how frustrating this can be. <3 IgG subclass antibodies have a half-life of 21 days and stick around on immune cells for about two to three months. They need constant “reminders” in the form of an antigen so that their production continues. If the antigen is removed, the antibodies will go away as well. The time period required for them to completely forget about the antigen and disappear is nine to twelve months.
      The following things need to be in place for the antibodies to forget about the thyroid:
      1) The thyroid stops expressing TPO.
      2) The thyroid cells are not damaged and able to regenerate.
      3) There are no substances that look like TPO (glandulars, gluten, infections, other triggers).
      4) The immune system is balanced.
      5) The autoimmune cells are confused by a decoy.
      Some of these requirements are quick and easy, and others will take some time ...
      The thyroid will stop expressing TPO for two reasons. One of them is thyroid destruction, which we do not want; the other is thyroid suppression. Thyroid suppression is induced by limiting iodine and taking a thyroid supplement to bring TSH to 1 mIU/L or so. This can take up to three months
      In the case of autoimmune conditions, traditional and alternative medicine practitioners may focus on rebalancing the immune system (i.e. steroids and immune-modulating drugs used in traditional medicine, or else herbs, supplements, or acupuncture used in alternative medicine).
      While this approach may be helpful for taming the immune system in the short term or overcoming autoimmune flares, it is often a temporary solution and the immune system may become imbalanced again once the medications,acupuncture, and herbs and supplements are stopped if the underlying issue that lead to the immune system imbalance is not addressed. Thus we can say that immune modulation treats only the symptoms, and not the root cause. As we can’t change genes, our approach to addressing the root cause of Hashimoto’s is threefold:
      1) Reducing triggers
      2) Eliminating intestinal permeability
      3) Providing the body with nutrients to regenerate
      Identifying and eliminating triggers and toxins will likely take a few weeks to a few months. Providing the thyroid with the nutrition needed to help rebuild and detoxify will likely take three to six months.

      Rebalancing the immune system by addressing the root cause of autoimmunity (intestinal permeability, gut dysbiosis, infections) may take one to three years, but in the meantime, we can modulate the immune system and throw our thyroid antibodies a decoy. Here are some articles I hope you find helpful:

      HASHIMOTO'S AND TPO ANTIBODIES
      https://thyroidpharmacist.com/articles/hashimotos-and-tpo-antibodies/

      HASHIMOTO’S AND THYROID ANTIBODIES: PART 1
      https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-antibodies/

      HASHIMOTO’S AND THYROID ANTIBODIES: PART 2
      https://thyroidpharmacist.com/articles/part-2-mechanisms-reduce-thyroid-antibodies/

      Reply

  99. Chris says

    Hi Dr Wentz,

    I must say I am reluctant to take enzymes that I am not sure that I need. At the same time, however, in the midst of brain fog it is difficult to know and then remember what tests I should ask for or what symptoms I should know about at an indicator.

    I have lots of problems and I am on an elimination diet but the worst thing is that I get nasal inflammation (no phlegm), chronic burping and difficult breathing no matter what I eat!

    I was reading through your article to see what I can do about it. My TSH is over at the moment and my medicine has recently been increased. I take D supplements, iron, selenium, and fish oil too.

    The digestive issues are hard to discern from cardiovascular ones but empirical data shows no irregularities with the heart or lungs bar the occasional palpitation. However even when my TSH is within range (and even about 1-2) the burping and breathing difficulty does not abate.

    I have had every test you can think of and the doctors all say there are no irregularities. But given that my thyroid antibodies are way over one thousand, I assume there is a more systemic issue at play here.

    What signs and symptoms should I be looking out for? I take responsibility for my own actions so in your experience are there any enzymes I should pay particular attention to in order to find a way out of this mess I’m in? Any recommendations would be great so that I can read around the issue before making a decision on what to do.

    By the way, your Root Cause book was extremely informative. Thank you very much.

    Reply

    • Dr. Izabella says

      Chris – thank you for reaching out and sharing your journey. I am so sorry you are struggling with this. <3 Acid Reflux is a very common symptom that occurs in people with Hashimoto's. Studies have shown that most people with Hashimoto's either have very low stomach acid or produce no stomach acid at all. The person who does not have enough stomach acid will have the same symptoms as a person with an overabundance of stomach acid. There aren’t too many tell-tale signs of low stomach acid, other than perhaps feeling full and tired after meals as well as experiencing acid reflux-like symptoms. Other symptoms may include: low B12, low ferritin or iron levels, fatigue despite thyroid medications, and constipation/diarrhea. Here are some articles that might be helpful as well.

      GOT ACID REFLUX?
      https://thyroidpharmacist.com/articles/got-acid-reflux

      HASHIMOTOS AND LOW STOMACH ACID
      https://thyroidpharmacist.com/articles/hashimotos-and-low-stomach-acid

      GOING DAIRY FREE TO REVERSE HASHIMOTOS
      https://thyroidpharmacist.com/articles/going-dairy-free-to-reverse-hashimotos

      Reply

      • Chris says

        Dear Dr Wentz,

        thank you so much for your reply. I guess it is important to stay strong. For whatever reason, Hashimoto’s seems to exert a sizeable influence all over my body and with no evidence of other conditions, the task is simply to find ways to manage this disease. The articles you sent me might mak all the difference so thank you 🙂

        Reply

        • Dr. Izabella says

          Chris – you are very welcome! Hang in there! <3 Hashimoto’s is often a combination of food sensitivities, nutrient deficiencies, adrenal issues, gut issues as well as an impaired ability to get rid of toxins. Any of those things would prevent a person from getting better. <3 Hashimoto's is very much an individual condition. While there are root cause commonalities, each person will have their own or in some cases, more than one root cause. You will have to start with the simplest modifications, by removing triggers, followed by repairing the other broken systems to restore equilibrium, allowing the body to rebuild itself. You will need to dig down to why the immune system is imbalanced in the first place and this will tell you how you begin to finally feel better, reduce your thyroid antibodies and even take your condition into remission.
          You will have to create your own health timeline. Look back at your overall history as far back as you can remember. Look for infections, periods of severe stress, the use of medications (especially antibiotics, antacids, and oral contraceptives), accidents, and exposure to toxins. These are events that may have contributed to Hashimoto's. Once you do, you will know what types of changes you need to implement to make yourself feel better.
          If you need further support, please check out the list of lab tests inside the “Testing” chapter of my book, Hashimoto’s Root Cause. I also offers a 12-week program, Hashimoto's Self Management Program. Here are some resources I hope you find helpful as well.

          BUILDING YOUR OWN HEALTH TIMELINE
          https://thyroidpharmacist.com/sample-health-timeline/

          Hashimoto’s Self-Management Program
          https://thyroidpharmacist.com/enroll-in-hashimotos-self-management/

          Reply

  100. Monica frank says

    Do you have any recommendation for enzymes ( if any) for someone with history of hyper cholesterol since childhood and later diagnosed with Hashimoto’s. No digestive symptoms associated but cholesterol no changing with any intervention.

    We have your book and following each and every advice but cholesterol slowly creeping up over the years (47,female).many thanks

    Reply

  101. Heidi says

    Hi Dr. Izabella,
    I’ve been struggling with hypothyroidism since August 2015, have gone through 2 different endocrinologists, took Levothyroxine and Armour on separate occasions. My antibodies are still a bit high though not as high as when I was first diagnosed. I’m currently taking 100 mcg of El Thyroxine by Aspen but my overall concern is weight loss, eliminating my antibodies and getting off thyroid medication. I feel the medication is derailing my effort in the gym as well as my fitness goals. My questions are 1) how do I get healthy again? 2) how do I determine whether or not I need enzymes? 3) functional medicine practitioners aren’t covered by my insurance and I’m unable to pay out of pocket. What other recommendations do you have as an alternative? 4) I feel bloated after eating eggs, whether scrambled or hard-boiled and it’s difficult to exercise in the gym after feeling the bloat. Should I take a food sensitivity test?

    Reply

    • Dr. Izabella says

      Heidi – thank you for reaching out and sharing your journey. I would recommend anyone embarking on a program of exercise starts slowly and progresses at their own pace. Exercise can be very healthy, but for people with Hashimoto’s it can create stress. Stress causes our adrenals to pump out extra hormones, and shifts our body from a relaxing, digesting, healing state to a fight or flight state. The body’s energy is shifted from doing “useless” things like growing beautiful hair, metabolizing, making hormones, digesting and repairing itself, and instead, all of the body’s resources are reserved to make cortisol and adrenaline that is pumped through our veins so that we can keep going.
      Eventually, we run out of nutrients that are required for proper adrenal function and we get to a state of adrenal fatigue. This is when our body is no longer able to heal itself and we feel drained. Replenishing nutrients and using adaptogens, that balance out the adrenals can be helpful for everyone. I have also created my own supplements brand, which is named Rootcology. Rootcology’s mission is to provide safe and effective supplement solutions for people struggling with autoimmune thyroid conditions. Rootcology’s Adrenal Support contains nutrients and adaptogens that can help your body repair itself. Here are some articles you might find helpful.

      You may also find this article useful:
      ARE YOUR ADRENALS SABOTAGING YOUR HEALTH?
      https://thyroidpharmacist.com/articles/are-your-adrenals-sabotaging-your-health

      WHICH THYROID MEDICATION IS BEST?
      https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/

      TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
      https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/

      The gold standard or the most accurate test for uncovering reactive foods and individual food sensitivities is actually the elimination diet. In contrast to other diets that simply exclude common problematic foods, an elimination diet is done to determine what particular food intolerances the individual may have. An elimination period of at least 2-3 months is a good starting place, but you may want to continue if you feel that you still have more healing to do. Then you can try a new food every 4 days and monitor yourself for reactions. Going through an elimination diet will help you figure out your own individual food triggers and your specific response to each trigger food. Here is an article I hope you find interesting!

      https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos

      Reply

  102. Nicole says

    Hi Dr Wentz, I am getting ready to order supplements for your 3rd protocol and am blown away by the cost of the Systemic Enzyme Complex!! Am I correct in thinking that I will go through 180 capsules in 6 days? Reading through your book, it seems most beneficial to continue for up to 3 months. I cannot afford this! So I guess my question is, if I cannot afford to take such a high does for so long, should I not bother investing the money at all? Or could I take a lower dose? I don’t want to invest even $60 if the only way to see results is by spending over $300 on just one supplement! I think it is shameful that in order to see true changes in health, one has to have so much money. I can’t afford the naturopath as they require payment up front and it’s out of pocket. And I can’t afford the supplements as they are outrageously expensive! It is a horrible place to be. I have gone through your first two protocols with little change in my symptoms and my hope was that getting through the third would be most beneficial. But my husband has already had to get a 2nd job and there is still no way I could afford the systemic enzymes. I do appreciate your help and all the work you are doing for the Hashimoto’s cause, but for most people, knowing what has to be done isn’t helpful if it is all out of reach.

    Reply

  103. Kay says

    Hi Izabella,
    Thank-you so much for all the information you share with us. I’ve looked in your book but cannot find an answer to this question, can you help? I’m wondering if it’s ok to take Wobenzyme, HCl and your formula for liver/gallbladder? I know the Wobenzyme is for between meals and I hope it’s not destroying my thyroid hormone replacement 🙂 HCl with meals. When would I take your formula if this isn’t too much?

    Reply

  104. Kim says

    Hi Dr. Wentz,

    I was wondering how long should we be taking systemic enzyme for? Is it safe to use this long term?

    Thanks!
    Regards,
    Kim

    Reply

  105. Lisa Gomzales says

    Is there one digestive enzyme pill that covers everything mentioned in this article? I have hashimoto’s and have gained weight that I cant get off. I dont want to have to take a handful of pills to meet all my digestive needs. Thanks

    Reply

  106. Shannon says

    Hello
    Great article! My question is
    Is there a Supplement that has All
    The enzymes and HCL you spoke about or do I buy separate? Thank you
    Shannon

    Reply

    • Dr. Izabella Wentz says

      Shannon – thank you for reaching out. As a pharmacist I am not a big fan of combination products, and prefer to start supplements one at a time, as there is a potential of reacting to some of the ingredients. You might be interested in my new supplement line Rootcology! Rootcology’s mission is to provide safe and effective supplement solutions for people struggling with autoimmune thyroid conditions. Rootcology supplements are composed of high-quality premium, gluten, dairy, soy, pesticide, and toxin-free ingredients and undergo third-party testing to ensure that the ingredients on the label match the ingredients inside each bottle.
      Here is a link to the site. https://www.rootcology.com/collections/supplements.

      Reply

  107. Kimberly says

    Hi,
    I was reading your download book on Betaine w/Pepsin, low stomach acid… and it said that if you have gastritis not to take it?
    I have been diagnosed with gastritis…I have horrible heartburn, Hashimotos, am often nauseous… was thinking I have low stomach acid instead of too much, but why should one NOT take Betaine w/Pepsin, if they have gastritis?

    Thanks
    Ksg

    Reply

    • Dr. Izabella says

      Kimberly – thank you for reaching out. I am so sorry you are struggling with all of this. <3 Unfortunately, Betaine w/Pepsin is not recommended for those with gastritis. Alternatively, lemon juice and apple cider vinegar can also help to produce more digestive acid. Here is a resource you might find helpful:) Hashimoto’s Protocol Book
      thyroidpharmacist.com/protocol

      Reply

  108. Tanya says

    Hi Dr. Izabella. I have allergies to micro crystalline cellulose and in face, any “ose” type ingredient. Ive not found any brand that doesnt contain it and unfortunately the liquid igestive enzymes all use agave [another major sensitivity] .

    Unfortunately, I think I am that person that has the cross-reactivity and all foods are now upsetting my system. I’ve never felt desperate before, but right now I do and I’m hoping you might have a suggestion?

    ps Im in Canada

    Reply

    • Dr. Izabella Wentz says

      Tanya – thank you for reaching out and sharnig your journey. I’m so sorry you are struggling with food sensitivities and allergies. I understand how hard this is. <3 We know that intestinal permeability (aka leaky gut) is present in every case of autoimmunity and often precedes the development of Hashimoto’s. Symptoms of leaky gut may include bloating, diarrhea, constipation, stomach aches, acid reflux and irritable bowel syndrome. According to the Institute of Functional Medicine, many people develop IBS 5-10 years before an autoimmune diagnosis. I was one of them and didn’t take my gut health as seriously as I should have. Gut problems are often caused by infections like H. pylori, parasites like Blasto, SIBO, an imbalance of bacteria, and enzyme deficiencies or food sensitivities (especially to gluten, dairy, and/or soy). Even stress can be a factor in gut permeability. Here is an article you might find interesting.

      6 DIFFERENT ROOT CAUSES
      https://thyroidpharmacist.com/articles/6-different-hashimotos-root-causes/

      I highly recommend that you work with a functional medicine clinician. It’s a whole medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.

      FUNCTIONAL MEDICINE APPROACH TO THE THYROID
      https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid

      CLINICIAN DATABASE
      https://thyroidpharmacist.com/database-recommended-clinicians/

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

      Reply

  109. Alex says

    Awesome article! I just started taking Bromelain enzyme, and it’s amazing!
    Do you recommend taking Betaine with HCL alsongside Bromelain with my meals?

    Cheers

    Reply

    • Dr. Izabella Wentz says

      Alex – thank you for reaching out! <3 Please understand, I am not able to advise on whether these supplements would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your personal doctor whose familiar with your health history
      .

      Reply

  110. Tina says

    Thank you very much for all your helpful articles. I’ve had alopecia since i was 2 yo and hashimoto for 5 years now. I am taking my medication but my alopecia is worse than it’s ever been and i am not able to losr any extra weight. I have been taking broad spectrum enzymes and i noticed my hair starting to grow back, managed to start losing weight and my lab results being very good. I thought it was thanks to vitamin supplements and i didnt want to take digestive enzymes for too long so i decided to stop. I can see now that the enzymes were actully the one helping me. I am wondering for how long can someone safely take broad spectrum enzymes ? Also the one i take says once per day but i was wondering if it is safe to take it with every meal?

    Reply

    • Dr. Izabella Wentz says

      Tina – thank you for reaching out. I’m so happy to hear you are finding the enzymes helpful. <3 The digestive enzymes should stimulate your body’s own production
      of acid, and help you extract nutrients from your food. After some time, you should be able to get off the enzymes as your own body begins to produce enough digestive acid. I do recommend discussing with your practitioner who's familiar with your health history. <3

      Reply

  111. raluca rizea says

    Dear dr. Wentz, i was trying to find the medical report which was presented at the conference in 2002 in Cannes, France to which you are making reference in the article “A poster presentation from April 21-24, 2002 presented in Cannes, France, found that Wobenzym, a proprietary blend of systemic enzymes, taken at a dose of five capsules, three times per day, showed very promising results in Hashimoto’s.”.
    can you please indicate me the ISBN number of the poster/presentation ? or the authors ?
    thank you!

    Reply

  112. IH says

    *We know that everyone with Hashimoto’s has some degree of intestinal permeability.*
    Where exactly do we know this from? Do you have any research paper to back up this affirmation? Is it about all Hashimoto patients or strictly about those who also have hypothyroidism?
    Thank you in advance!

    Reply

  113. Iolanda Teodor says

    Hello Izabella,
    I recently had a non-metals toxins test done and one of the recommendations to remedy my health problems is glucuronosyltransferase enzymes. I looked for products that would contain these enzymes but I couldn’t find any.
    Can you please, help?

    Reply

    • Dr. Izabella Wentz says

      Iolanda – thank you for reaching out. ❤️ I don’t currently have a product that I can recommend. You may want to discuss this with your practitioner who is familiar with your health history.

      Reply

  114. Laurie says

    Hello, Dr. Wentz.
    I am wondering why Betaine and Pepsin should not be taken with an H. Pylori infection. You mention it in your book, also, and I’m curious as to why.
    Thank you for your help and for all of your rich and wise resources.

    Reply

  115. Iris says

    Hello Dr. Wentz,
    I went through RMA FST IgG Food Sensitivity test and found that I had an elevated IgG antibody level for various foods. Obviously, I can’t eliminate all of them from my diet. Would taking broad spectrum digestive enzymes help me in this situation?
    Thank you.

    Reply

    • Dr. Izabella Wentz says

      Iris – thank you for reaching out! ❤️ Unfortunately I am not familiar with this test, so I cannot speak on the accuracy of the results. That being said, I always recommend to abstain from the foods that you test sensitive to while you work on the gut, and then reintroduce them once your gut is healed – generally I see that most people can reintroduce these food 3-6 months after healing the gut. Exceptions would be gluten, dairy and soy as some people may need to remove these foods indefinitely. Supplementing with specific enzymes can help with overcoming symptoms of Hashimoto’s (including fatigue, hair loss, nutrient deficiencies, infections, and food sensitivities), as well as reducing thyroid antibodies.

      Reply

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