Note: Originally published in February 2015, this article has been revised and updated for accuracy and thoroughness.
Over the years, I have researched, evaluated, purchased, and tried a variety of medications, supplements, and lifestyle changes to determine which would be most helpful in overcoming Hashimoto’s. Evaluating the safety, efficacy, and cost of various treatments was a large part of my training as a pharmacist, and I have put my training to good use in overcoming Hashimoto’s!
I have found that a combination of the right medications (when indicated), right lifestyle changes, and right supplements can make a tremendous impact on recovering from Hashimoto’s. I like to use technology to my advantage and have found that certain supplements are a great way to speed up the healing process.
I have spent hours upon hours researching supplements. I have purchased and tried truckloads of supplements and often receive samples from various companies.
I have found that some supplements make zero difference—despite their high cost. Snake oil anyone?
Some supplements can be harmful if taken without proper lab testing and medical supervision. For example, spirulina and echinacea can cause new onset autoimmune conditions; high dose iodine can increase the autoimmune attack on the thyroid; and adrenal hormones can cause breakouts, swelling, palpitations, joint pain, and brain fog (personal experience, ouch!).
I have also found supplements that are safe and effective for most people.
I’ve covered many of these helpful supplements in my book, Hashimoto’s The Root Cause, but have also found quite a few additional supplements since the book was published over 3 years ago. If you are struggling with thyroid symptoms and looking for some support, here are six supplements that can help:
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.
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% of Hashimoto’s patients and causes 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 VSL#3, 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.
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% 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.
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% 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.
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 like Wobenzym PS by Douglas Laboratories. Read more about systemic enzymes.
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.
Hope this information helps you on your journey!
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- 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.