Taking supplements can help restore your nutrient levels, overcome fatigue, and even increase hair growth. But as a pharmacist, I am well aware that all supplements are not created equally. Vitamin and supplement companies do not undergo the same scrutiny as pharmaceutical products. This can result in ineffective — and even dangerous — products. Here’s what you should look for when choosing supplements:
- Supplements should be free of artificial additives, gluten, and dairy. Even small amounts can be detrimental and interfere with absorption.
- Methylated forms of B12 (methylcobalamin) are superior to cyanocobalamin.
- Folate should be in the form of methylfolate, metafolin, or naturefolate, especially for those with MTHFR gene variations. Avoid folic acid, which is a synthetic form of folate.
- Formulations should be tested for purity, and the supplements should be tested to make sure the contents match the label description. I have spent a great deal of time researching and testing various supplement brands, but I’ve always been hesitant to recommend specific brands or even products that I created. I didn’t want people to think that I was giving them biased information because of my relationship with a specific company — or worse — that I was only sharing information to sell my own products.
In my first book, Hashimoto’s: The Root Cause, I kept recommendations to a minimum. However, numerous clients and readers have asked for specific recommendations and brands and many have even asked that I formulate my own line of products. I get it. You’re busy and tired, and the last thing you want to do is to evaluate thousands of supplements out there to see which ones will work for you.
This is why I’ve created an eBook that outlines not just my favorite supplements, but also, specific brand recommendations and guidelines for use, including dosing and precautions.
I was also inspired to create my own line of supplements, called Rootcology, as I wanted to be sure that my clients were getting consistent results with my recommendations.
Below is an overview of the most common supplements I recommend. For a deeper dive into these supplements, recommended dosage amounts, testing information, and brands that I recommend, you can download my FREE eBook below!
Naltrexone is actually a medication, rather than a supplement — but due to its low propensity to cause side effects, many say that it actually acts as a supplement. The primary use of Naltrexone is to counter drug addiction, but it also has an off-label use as an immune modulator. When used in low doses, naltrexone has been found to reduce the autoimmune attack on the thyroid.
Low Dose Naltrexone (LDN) helps reduce antibodies and stabilize immunity. It balances the immune system by increasing the amount of T-regulatory cytokines and modulating TGF-B. This leads to a reduction of Th17, which is a major promoter of autoimmunity.
Many people have been able to eliminate their symptoms and reduce the dosage of their medications with LDN. I’ve also seen women with thyroid antibodies in the 1000s range that have been able to reduce them down to about 100. Some people have even been able to get off their medications completely!
In the beginning of my journey, I used LDN for a few days but gave up on it after experiencing symptoms of irritability. I now know that LDN works best in combination with a leaky gut diet and in titrated doses so that it is better tolerated.
LDN is only available through compounding pharmacies and is not commonly prescribed, so it can be difficult to get access to this medication. I recommend reaching out to your local compounding pharmacist to find out which doctors in your area are knowledgeable about prescribing LDN. Read more about LDN here.
Intestinal permeability (leaky gut) is one of the three legs of autoimmunity. We know that eating gluten can cause a leaky gut, and many people have been able to reduce their symptoms and antibodies by following a gluten-free diet. However, there are various other root causes of intestinal permeability, including an imbalance of good and bad bacteria in the gut.
We often use antibiotics to fight off bad bacteria and heal infections but, unfortunately, antibiotics also eliminate the good bacteria we need in our gut to help our digestion processes. If there aren’t enough good bacteria to keep the bad under control, they start damaging the gut walls causing leaky gut. Supplementing with probiotics is a natural way to put the good bacteria back in and help restore balance.
Probiotics are known to help with anxiety, gut symptoms, extracting nutrients from our food, and balancing the immune system. They can also help with treating Small Intestinal Bacterial Overgrowth (SIBO), which is present in over 50 percent of Hashimoto’s patients and can lead to a leaky gut.
When supplementing with probiotics, you want to make sure you’re getting enough. I recommend starting off with a low dose and building your way up. Many probiotics sold in stores have around 10 billion colony-forming units, but your gut has a hundred trillion unit colonies of bacteria. So, most commercial probiotics and yogurts don’t have enough to really make a difference.
My favorite probiotics include Pure Encapsulations Probiotic 50B, Klaire Labs Ther-biotic, and the yeast-based probiotic, Saccharomyces boulardii. In addition to supplementing with probiotics, I also enjoy eating fermented coconut yogurt, fermented coconut water, and fermented cabbage. Read more about probiotics here.
Selenium is a natural antioxidant that provides support for the immune system and promotes healthy blood flow. It works in synergy with vitamin E to assist in healthy growth and fertility, protect normal cell function, and enhance the function of certain energy producing cells. (1) Selenium deficiency has been recognized as a trigger for developing Hashimoto’s.
It is thought that when there is a depletion of selenium in the body, we are not able to neutralize hydrogen peroxide which is produced as a byproduct of thyroid hormone conversion. So, it begins damaging the surrounding tissue and may cause an influx of immune cells that tend to get confused and start attacking the immune system. The selenium forms selenoproteins to protect against hydrogen peroxide damage and acts as a catalyst for converting inactive T4 into biologically active T3.
Selenium has been found to reduce thyroid antibodies and makes people with Hashimoto’s-induced anxiety feel calmer. People have also been able to improve their thyroid conversion by taking selenium. When the body is functioning at the optimal level, you feel good, and you’re able to process foods and detoxify naturally. This helps process stress, and life in general, and can lift your overall feelings of anxiety considerably.
Thyroid antibodies have been shown to be reduced by 50 percent in three to six months, with dosages of about 200 micrograms of selenium. However, I recommend consulting with your practitioner to determine what dosage is best for you. Read more about selenium here.
4. Betaine with Pepsin
Betaine with pepsin is a natural, gastric acid that helps with the absorption of calcium, B12, protein, and iron. It helps break down food for the body to absorb. This is especially significant in Hashimoto’s patients because many of us have a deficiency in stomach acid.
The breakdown and digestion of protein requires stomach acid. If you’re not digesting your food properly, you’ll have more food sensitivities and symptoms of acid reflux. It makes you tired because your body is using more resources to try to digest food, and it can also lead to liver backlog because you won’t be excreting toxins correctly.
Based on my survey of 2232 people with Hashimoto’s, 50-70 percent of people with Hashimoto’s are likely deficient in stomach acid. Symptoms that improved for participants included higher energy levels, reduced pain, and improved moods. One-fourth of respondents even reported weight loss. Betaine with Pepsin helped me to digest proteins and finally get my energy back after almost 10 years of fatigue!
Betaine with pepsin dosage needs to be individualized. The best way to find your target dose for Betaine is to start off with one capsule with a protein-containing meal. If you don’t feel anything, increase the dosage by one capsule with the next protein-containing meal. This rate of increase is continued until a slight burning sensation in your esophagus is felt. Then you know that you have too much stomach acid and need to decrease the dosage by one capsule. Read more about betaine with pepsin here.
5. Systemic Enzymes
Systemic enzymes help to normalize TSH and reduce or eliminate antibodies. They work by helping to break down circulating immune complexes, which can trigger autoimmune disease. Basically, an immune complex is where an antibody and antigen combine forces to damage our immunity. Breaking these immune complexes apart is very important in getting into remission because when they can’t attack the immune system, our bodies are given a chance to heal.
One study found that when people took five capsules of systemic enzymes three times a day, they were able to improve the appearance of their thyroid on an ultrasound, normalize their TSH, and lower their thyroid antibodies. Participants in this study also reported improved symptoms.
In another study, 40 people with Hashimoto’s who were on levothyroxine were given systemic enzymes for 3-6 months. Participants saw a reduction of thyroid symptoms and antibodies, as well as a normalization of their thyroid ultrasound. Many patients were able to reduce their dose of levothyroxine or even discontinue their medications!
Systemic enzymes are best taken on an empty stomach, at least 45 minutes before a meal or 1 ½ hours after a meal. If you take them with food, they will be used for the digestion process instead of getting into the bloodstream to work against the immune complexes. I’ve seen great results with Wobenzym PS by Douglas Laboratories and the Systemic Enzyme Complex by Pure Encapsulations. Read more about systemic enzymes here.
Our adrenals are critical to maintaining overall health. When the adrenals are out of balance, the rest of the body quickly follows suit. This is especially significant for Hashimoto’s patients because stress is often a major contributing factor, and the adrenals and immune system work so closely together.
Moducare helps to promote a normal balance of the adrenal hormones, cortisol, and DHEA, and works as a safeguard against negative stress reactions. (2) It contains natural plant sterols and sterolins that balance Th1 and Th2 helper cells, which strengthens cellular immunity and overactive immune responses. People have been able to improve their adrenal function, as well as reduce antibodies to the thyroid and in other autoimmune conditions, with Moducare.
One study found that participants taking Moducare maintained a more healthy immune response in comparison to individuals taking a placebo. The healthier immune response was thought to be related to cortisol levels, which did not increase in response to the exercise stress in those taking Moducare. (2)
While these sterols can be found naturally in fruits and veggies, I’ve found that using supplements like Thorne Moducare works best because we don’t always know how much is in our foods. It may be helpful to try different amounts and work with your doctor to see what works best for you.
7. Thiamine (B1)
Thiamine (B1) is the fatigue terminator! Thiamine is required for proper release of hydrochloric acid in our stomachs, which is needed for proper protein digestion. (Most people with Hashimoto’s have low stomach acid or do not release any stomach acid.) Thiamine also supports blood sugar function, adrenals, and can boost our energy levels.
One reader said: “After feeling really great with my dietary changes and supplements, I hit a wall. I had already been eating a Paleo diet and my digestion was 90% better, but I continued to struggle with my adrenals, energy levels, and blood pressure. Sometimes my blood pressure would be as low as 90/60 mmHg; my doctor would wonder how I was even walking! A few days after starting thiamine, my energy began to bounce back, and my blood pressure normalized.”
8. Vitamin B12
Vitamin B12 is the energy creator. Taking a vitamin B12 supplement is essential for vegans and may be helpful for those with low stomach acid and pernicious anemia, until the conditions are corrected.
Low levels of hydrochloric acid, commonly found in those with Hashimoto’s, put people at risk for B12 deficiency. (Note: An intake of breads and cereals fortified with folic acid may mask this deficiency on standard lab tests.)
Please note, I recommend testing for this nutrient, as it’s possible that oral supplements may not be enough. While lab tests will say that levels of 200 pg/mL are adequate, I like to see them above 800 pg/mL.
9. Vitamin D
Vitamin D is a potent immune-supporting substance. It has been shown to prevent and modulate autoimmunity, and I believe that vitamin D is especially important for people who have had a prior Epstein-Barr infection (this infection can often trigger Hashimoto’s and create a chronic low-grade infection), as the cells that fight the virus (CD8+ T cells) are vitamin D dependent. Please note, I recommend testing for this nutrient, as it’s possible to have too much Vitamin D.
People using this nutrient report miraculous improvements in many symptoms! Magnesium is a nutrient that is very commonly deficient in thyroid patients and may be responsible for a number of symptoms that can potentially lead to thyroid abnormalities.
Magnesium is one of the tools in my toolbox to address my client’s symptoms. Known to help resolve constipation, insomnia, period cramps, body cramps, anxiety, headaches and more, magnesium could play a vital role in helping you eliminate symptoms.
Ferritin is the iron storage protein that gives us beautiful hair! Ferritin is a big deficiency to pay attention to, because it’s the storage place for iron in our bodies. If we can’t absorb iron, then we become anemic. When we lack iron, our hair falls out. In fact, this is one of the main reasons why most women start losing hair perimenopause. (Please note, you should ONLY use this supplement if you have been found to be deficient in ferritin, as you can also have toxic levels of ferritin).
Taking the right supplements to address any underlying deficiencies, can help restore your nutrient levels… and even lead to a remission of Hashimoto’s symptoms!
This is why I’ve created an eBook that outlines the top supplements that I recommend for those with Hashimoto’s. In it, you’ll also find specific brand recommendations and guidelines for use, including my recommendations for dosing, as well as precautions. You can download this eBook for FREE, below!
Hope this information helps you on your journey!
P.S. Be sure to sign up to my weekly newsletter to get a free book chapter, recipes, my Thyroid Diet Quick Start Guide, notifications about upcoming events, and my latest research.
- Seo Y, Sweeney C, Smith M. Selenomethionine induction of DNA repair response in human fibroblasts. Oncogene. 2002;21(23):3663-3669. doi:10.1038/sj.onc.1205468.
- Pegel K. MODUCARE® – A Brief History And Mode Of Action.; 2002. Available at: http://www.moducare.com/wp-content/uploads/2016/05/moducare-summary-of-research.pdf. Accessed September 5, 2017.
Note: Originally published in February 2015, this article has been revised and updated for accuracy and thoroughness.