Hashimotos Thyroiditis Part 2

Tips to manage Hashimoto’s

  • Health risks of not treating Hashimoto’s adequately
  • Lifestyle/stress reduction tips to manage energy and emotional ups and downs
  • How to naturally increase biologically active T3
  • Diet strategies to help heal
  • Nutritional supplements that can aid in recovery and optimal health
  • How to advocate for yourself in the healthcare field when dealing with Hashimoto’s

Health risks of not treating Hashimoto’s adequately

  • May cause impaired carbohydrate metabolism leading to an increase in type 1 and type 2 diabetes- A study that examined hospitalized patients between the years of 2001 and 2010, the Endocrinology and Diabetology Department in Bydgoszcz concluded : “Conclusions: Carbohydrate metabolism disorders in the form of type 1 diabetes connected with an autoimmune process, as well as type 2 diabetes connected with the increase of the insulin resistance, occurred in average of half of the patients with Hashimoto’s thyroiditis.”
  • Cognitive decline/brain fog, inability to focus, – Hashimoto’s thyroiditis is an inflammatory disease (hence the “itis” at the ending of thyroiditis) This extends to brain tissue, where brain inflammation can cause a multitude of problems.
  • Fertility issuesAn unregulated thyroid condition of any kind can lead to lack of or incomplete implantation or early miscarriage. Thyroid disorders in men can affect sperm quality and motility
  • Higher risk of heart disease and high cholesterol

A large study in Demark over a period of 7 years revealed that   individuals with mild hypothyroidism who were not treated had an 83% increased risk of developing heart problems as compared with individuals with normal thyroid function or hypothyroidism that was treated. 

High cholesterol – Low thyroid function negatively affects lipid metabolism, leading to an increase LDL, the “bad cholesterol.”

Lifestyle/stress reduction tips to manage energy and emotional ups and downs

Hashimoto’s disease can have you feeling great one day and totally exhausted the next. Even when optimally managed, excess stress, either emotional or physical can leave one feeling exhausted for days. It is important to maintain good diet, adequate exercise, avoid stress as much as possible and keep a consistent schedule.

  • Remove/reduce sugar from the diet as much as possible, replace with fiber rich fruits. Sugar can place a tremendous burden on the body, flooding cells with insulin to deal with excess glucose in the bloodstream. This can set off a cascade of reactions that challenge thyroid regulation and can affect fat cell receptors and metabolism.
  • Make time for exercise-Make sure you are getting at least 15 minutes of brisk walking in a day. However, don’t overdo any physical activity. This can cause adrenal fatigue, cortisol overload and other stressors that can create a cascading downward spiral resulting in an overload on thyroid function.
  • Plan your days, but don’t over plan. Make time in your schedule to eat a healthy diet, exercise and get good quality sleep. In addition, make relationships and community a priority. Healthy relationships help carry life’s burdens and reduce stress hormones.
  • Get adequate, good quality sleep- The body repairs, heals and detoxifies during sleep. Good quality sleep is vital for Hashimoto patients. Aim for at least 7 hours of shut eye.
  • Keep stress at a minimum. Overactive adrenals, cause by stress can lead to thyroid dysfunction, diabetes, heart disease and more. Nurture and maintain supportive relationships. Avoid news and media if it negatively affects you. Take up a hobby. Hobbies have proven to reduce stress and calm the mind.

How to naturally increase biologically active T3

T3, the biologically active thyroid form can be increased by:

  • Supplementing diet with selenium and zinc rich foods. A rich source of selenium can be found in Brazil nuts- you only need 1-2 a day, Zinc is found in shellfish, nuts, meats, legumes. If supplementing with either selenium or zinc consult your care provider. Selenium toxicity can cause kidney failure and heart attack or heart failure, zinc toxicity symptoms are nausea, dizziness, vomiting and can lead to copper deficiency and a decrease in HDL (good) cholesterol.
  • Adding healthy fats to your diet– flax, avocado, raw unsalted seeds, and nuts. These foods aid in helping cell receptors take up thyroid hormone.
  • Moderate exercise– Walking, jogging, swimming, tennis, biking, hiking in moderation helps overall thyroid function.
  • Liver detoxification– The liver is involved in the conversion of thyroid hormone and regulation. Some foods that can help detoxify the liver are onions, beetroot, apples, turmeric, leafy greens, tea and in moderation, coffee.
  • Add sea vegetables to your diet. Iodine is a key factor in thyroid function; however, iodine supplementation can be tricky. Too much or too little can negatively affect thyroid dysfunction. Sea salt and iodized salt in moderation along with adding kelp and seaweed powder to your meal can help provide iodine needed supplementation.
  • Drink plenty of good quality, fluoride free water- Filter your water, and if fluoridated use a filter that removes fluoride. Fluoride has an electrical affinity stronger than iodine and will bond to the tyrosine molecule (Thyroid hormone is comprised of tyrosine and iodine) This reduces the amount of thyroid hormone in the body.


Diet strategies to help heal

It is believed that impaired gastrointestinal tract (gut dysbiosis) and intestinal permeability are the main cause of Hashimotos. To learn more check out Dr Isabella Wentz book on Hashimotos Thyroiditis- the root cause. This book is a wealth of information to educate and empower anyone dealing with Hashimoto’s.

  • As stated above, avoid simple carbohydrates. Breakfast should include a quality high protein item and fruit or vegetable if desired. Some quality high protein foods are cold water fish (salmon, sardines, and tuna for example) grass fed and finished meats, eggs, and poultry.
  • Increase leafy greens and vegetables such as carrots, turnips,celery
  • Drink twice body weight in ounces of quality water.
  • Add healthy fats to your diet. Healthy fats include butter (no margarine) flax, raw, unsalted nuts and seeds, avocados, olive oil and cold-water fish such as salmon.
  • Add a digestive enzyme right before meals if you experience stomach issues.
  • Eat soy in moderation- Soy, if paired with iodine deficiency can inhibit thyroid function. Check ingredient labels on every packaged food item, including salad dressings, protein bars, ice cream etc. for added soy. Most nutritionists advise to limit soy, not cut it out completely.
  • Cruciferous vegetables- cabbage, broccoli, cauliflower, brussel sprouts etc. if eaten in excess can suppress thyroid function. These foods are packed with nutrition. Don’t cut them out completely, just don’t eat in excess.
  • Supplement with probiotics and fermented foods- Gut health-restoring the gut microbiome- is a large part of healing and managing Hashimoto’s
  • Do a trial run of going gluten free- It takes about 3 weeks for the body to adjust to a gluten free diet. Many report relief in digestive symptoms and less body aches after stopping gluten. In a select population, gluten consumption can trigger an immune reaction. This is because gluten contains a protein (gliadin) that resembles transglutaminase, an enzyme of the thyroid. In gluten sensitivity or celiac disease, the immune system mistakenly attacks the thyroid.
  • Some people react to casein which is found in cow milk, yogurt, some cheeses and supplements. Casein is very structurally similar to gluten(gliadin) and some people have a negative reaction to it, just like gluten.

Nutritional supplements that can aid in recovery and optimal health

Important-Check with your healthcare provider before taking supplements- many supplements can interact with medications you are currently taking

  • Selenium works in synergy with vitamin E to form active T3
  • Zinc- helps repair intestinal walls and stabilizes immune system.
  • Vitamin D with K2 (K2 aids calcium absorption to bones instead of going to arteries where calcium can build up, leading to heart attack and stroke.)
  • Vitamin C with bioflavonoids
  • Magnesium citrate
  • Iron in the form of ferritin- if iron deficient
  • Iodine
  • B complex (look for the methylated form of B12)
  • Probiotics
  • Betain with Pepsin- a natural gastric acid- many Hashimoto sufferers have low stomach acid
  • Digestive enzymes- hel break down fats, carbohydrates and protein. Many diagnosed with Hashimotos have problems digesting food.


How to advocate for yourself in the healthcare field when dealing with Hashimoto’s

Dealing with thyroid disorders can be a complicated and complex health issue. Many diseases mimic others- Some heart diseases may have undiagnosed thyroid function. This also is common with depression, anxiety, and other mental health disorders. Some medications can affect thyroid function. Diabetics have a higher incidence of thyroid disorders.

Educating yourself and seeking a health professional who understands  thyroid disorders is vital to overall wellbeing.

At the very minimum, request a TSH and free T4 lab if hypothyroid is suspected.

Keep a journal of food, activity, mood and physical symptoms that you have recorded for a week or so before your appointment. Include physical signs of hypothyroid you may be having. This will enable your care provider to provide the best care possible.  

- Brooke Lounsbury, RN

Medical Content Writer

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Hashimotos Thyroiditis Part 1

Part 1 will cover

  • Hashimoto’s description
  • Prevalence of Hashimoto’s
  • Symptoms of low thyroid (Is it Hashimotos?)
  • Other not as common hypothyroid conditions
  • Lab tests to diagnose Hashimoto’s
  • Medications to treat low thyroid/Hashimotos

Part 2 will cover:

Tips to manage Hashimoto’s along with medications such as

  • Health risks of not treating Hashimoto’s adequately
  • Lifestyle/stress reduction tips to manage energy and emotional ups and downs
  • How to naturally increase biologically active T3
  • Diet strategies to help heal
  • Nutritional supplements that can aid in recovery and optimal health
  • How to advocate for yourself in the healthcare field when dealing with Hashimoto’s


Hashimoto’s thyroiditis is an autoimmune disease that affects the thyroid. An autoimmune disease is a condition in which the body’s immune system mistakes its own healthy tissues as foreign and attacks them. Most autoimmune diseases cause inflammation of the affected tissue. In the case of Hashimoto’s thyroiditis, the thyroid gland is inflamed and attacked by the body’s immune system.

Note: any word with “itis” at the end indicates inflammation. (Arthritis, bursitis, conjunctivitis for example)

Over 90% of hypothyroid cases are Hashimoto’s.

Other causes of low thyroid are:

 (Excerpt from American Thyroid Association)

  • Pituitary gland disorder/damage-The pituitary, the “master gland,” tells the thyroid how much hormone to make. When the pituitary is damaged by a tumor, radiation, or surgery, it may no longer be able to give the thyroid instructions, and the thyroid may stop making enough hormone.
  • Medicines-Medicines such as amiodarone, lithium, interferon alpha, and interleukin-2 can prevent the thyroid gland from being able to make hormone normally. These drugs are most likely to trigger hypothyroidism in patients who have a genetic tendency to autoimmune thyroid disease.
  • Too much or too little iodine. The thyroid gland must have iodine to make thyroid hormone. Iodine comes into the body in food and travels through the blood to the thyroid. Keeping thyroid hormone production in balance requires the right amount of iodine. Taking in too much iodine can cause or worsen hypothyroidism.
  • Surgical removal of part or all of the thyroid gland due to nodules or cancer
  • Radiation treatment-Patients with Hodgkin’s disease, lymphoma, or cancers of the head or neck are treated with radiation. All these patients can lose part or all of their thyroid function.
  • Congenital hypothyroidism (hypothyroidism that a baby is born with). A few babies are born without a thyroid or with only a partly formed one. A few have part or all their thyroid in the wrong place (ectopic thyroid). In some babies, the thyroid cells or their enzymes don’t work right.
  • Rare disorders that infiltrate the thyroid. In a few people, diseases deposit abnormal substances in the thyroid and impair its ability to function. For example, amyloidosis can deposit amyloid protein, sarcoidosis can deposit granulomas, and hemochromatosis can deposit iron.

Prevalence of Hashimoto’s

  • Most common in women– The American Thyroid Association (ATA) estimates that five to eight women are affected with Hashimoto’s for every one man. The ATA also estimates that one in eight women will be affected with Hashimoto’s or another thyroid disorder at some point in their lives.
  • Runs in families (genetic predisposition)
  • Affects about 5 percent of the US population
  • It is suspected that it is underdiagnosed


The onset of Hashimoto’s disease can be difficult to diagnose. As thyroid hormones are released in the bloodstream from  antibodies attacking the thyroid, transitory (temporary)hyperthyroidism (high thyroid) results.

Early symptoms can mimic hyperthyroid. This condition presents as an elevated T3 (the biologically active form of thyroid) and elevated T4, along with suppressed TSH. This condition is called thyrotoxicosis (Hashitoxicosis). This phase can last for 1-2 months, however in rare cases this phase can last for 2 or more years.

 Early-temporary symptoms can include

  • Anxiety
  • Nervousness
  • Diarrhea
  • Sleeplessness
  • Mood swings and muscle weakness.

 As the disease progresses (the autoimmune attack continues) thyroid production decreases, resulting in hypothyroidism (Hashimoto’s thyroiditis).

Symptoms of low thyroid are:

  • Dry skin,
  • Hair loss,
  • Constipation,
  • Depression,
  • Intolerance to cold,
  • Low energy
  • Brain fog,
  • Heavy menstruation,
  • Unexplained weight gain.
  • Muscle aches and cramps

Your care provider will take a thorough physical history (which includes checking for enlarged thyroid gland) and medical history along with a family history and your symptoms.

Lab tests for Hashimoto’s

TSH – The pituitary gland produces this hormone which stimulates the thyroid gland to produce thyroid hormone

Free T4– Free T4 is thyroid hormone not bound to protein, it is freely flowing in bloodstream.

Thyroid peroxidase antibodies (TPOAb) – Thyroid peroxidase (TPO) antibodies are a type of thyroid antibody. Thyroid peroxidase is an enzyme which helps to make thyroid hormones (T3, T4 and TSH). The body’s immune system makes antibodies in response to non-self proteins. These non-self proteins are called antigens.

Thyroglobulin antibodies (TGAb) Thyroglobulin antibodies (Tg Ab) are another type of thyroid antibody. Thyroglobulin is a protein made by thyroid cells. It helps to make thyroid hormones. Thyroglobulin antibodies (Tg Ab) are made when the body attacks it’s own thyroglobulin. Thyroglobulin antibodies can be raised in Hashimoto’s thyroiditis  They are also raised in 10-15% of the general population.

You may be diagnosed with Hashimoto’s disease if your TSH is high, your free T4 is low, and your TPO Ab is elevated. High TPO Ab is the key marker because it is present in over 90% of those with Hashimoto’s. TG Ab is present in about 60-80% of cases.

Total T3- as symptoms dictate

  • Low T3 levels may mean you have hypothyroidism,
  • T3 test results are often compared with T4 and TSH test results to help diagnose thyroid disease.

Reverse T3-as symptoms dictate

Reverse T3 is created by the body from T4. Your body can convert T4 into the ACTIVE thyroid hormone T3 or the inactive thyroid called reverse T3.  Reverse T3 slows metabolism to conserve energy during times of extreme stress and inflammation.


Hashimoto’s requires a multi prong approach. Along with medication, and lifestyle/stress management, diet and supplements can go a long way to achieve optimum health.  Diet, lifestyle and supplements will be covered in part 2.


Note: A word about generic and label medications- Though the names are different, generic and brand-name drugs work the same. According to the FDA, generic drugs are just as effective as their branded counterparts. Drug makers must prove that generic medications can be substituted for brand-name drugs and offer the same benefits as their brand-name counterparts

Levothyroxine – also known as Synthroid Euthyrox, Unithroid,  Tirosint. and Levoxyl– These medications use only T4 hormone as primary ingredient.

One advantage to generic levothyroxine, unlike Synthroid is it does not contain corn. This is invaluable for anyone with an allergy or sensitivity to corn.

Armour thyroid- Desiccated thyroid- made from bovine thyroid hormone- contains both T4 and T3

  Cytomel – (generic name is liothyronine) – A manmade T3 hormone

There are many other brands of thyroid medications, however the above represents the majority of medications.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

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