Basics of Immune Balancing for Hashimoto’s


This article is part of a special report on Thyroid Disorders. To see the other articles in this series, click here.

In the first post in this series, we established that hypothyroidism is caused by an autoimmune disease (called Hashimoto’s) in the vast majority of cases. Since then, we’ve explored the role of gluten intolerance, vitamin D deficiency, supplemental iodine, blood sugar imbalances, adrenal stress and a leaky gut in perpetuating the autoimmune attack and disrupting thyroid function. We’ve discussed why dietary changes are always the first step in treating Hashimoto’s, and why replacement thyroid hormone is often necessary for a successful outcome.

What we haven’t discussed yet, however, are specific strategies for bringing the immune system back into balance. That will be the focus of this article.

Originally, I planned to go into considerable detail on the specific mechanisms of immune dysfunction that occur with Hashimoto’s, including a review of immunology, immune system classification (i.e. Th1 or “cell-mediated” immunity vs. Th2 or “humoral immunity”) and immune cell organization. It quickly became clear that such an approach would require an entire series of its own.

So, as fascinating as all of that stuff is, I decided to cut to the chase and focus on the practical, clinical applications. But there’s a caveat. Although I’ll be offering some general guidelines here for how to balance the immune system, if you have Hashimoto’s (or any other autoimmune condition) it’s in your best interest to find someone who understands immunology and is current with the latest nutritional and botanical protocols for treating autoimmune disease.

Why? Because autoimmune disease is not only extremely complex, but also highly individualized. Hashimoto’s in one person is not the same as Hashimoto’s in the next person. In one person, Hashimoto’s could present as a Th1-dominant condition. In another, it may present as Th2 dominant. In still another, both the Th1 and Th2 systems might be overactive, or underactive. And each of these cases requires a different approach. For example, botanicals like echinacea and astragalus stimulate the Th1 system. If someone with Th1 dominant Hashimoto’s takes these herbs, they’ll quite possibly get worse. On the other hand, antioxidants like green tea and Gotu Kola stimulate the Th2 system, and would be inappropriate for those with Th2 dominant Hashimoto’s. (For more information on the specifics of Hashimoto’s autoimmune physiology, see this article on Dr. Kharrazian’s blog and pick up a copy of his book.)

The good news, though, is that there are general approaches to balancing the immune system that are suitable for all types of Hashimoto’s regardless of the specific pattern of immune dysregulation. These approaches can be broken into three categories: removing autoimmune triggers, enhancing regulatory T cell function and reducing inflammation.

Removing autoimmune triggers

We’ve already discussed the role of gluten, iodine, stress and a leaky gut in triggering an autoimmune response. Other potential triggers include estrogens, infectious agents, and environmental toxins.

Estrogen fluctuations can trigger the gene expression of Hashimoto’s in the presence of inflammation and genetic susceptibility. In addition to turning on the genes associated with Hashimoto’s, estrogen surges have been shown to exacerbate the autoimmune attack on the thyroid. This may explain why the expression of Hashimoto’s is so common during pregnancy and perimenopause – both times when estrogen may be fluctuating wildly.

Environmental toxins are associated with autoimmune disease, and Hashimoto’s is no exception. Certain antigens like mercury that bypass our barrier system cause a potent immune response that can become chronic and overactive. If you suspect environmental toxicity may be contributing to your condition, it’s probably a good idea to get a test for chemical haptens and heavy metal antibodies.

Autoimmune thyroid disease has also been associated with a variety of infectious agents, including Rubella, Rubeolla, Epstein-Barr Virus, Retrovirus, Influenza B virus, Coxsakie virus and Yersinia. The mechanism in all cases is theorized to be cross-reaction between thyroid stimulating hormone (TSH) receptors and infectious agents. Once again, if you suspect an infectious agent is involved in your condition, a screening for these pathogens is a good idea.

Enhancing regulatory T cell function

These strategies are all designed to enhance the function of regulatory T cells (also referred to as the Th3 system). Regulatory T cells are used to balance the activity between T-helper cells (Th1 & Th2) and T-suppressor cells (which “turn off” the immune attack).

Vitamin D has been shown to influence regulatory T cells, which in turn modulate T helper cell expression and balance the Th1 and Th2 response. For more on this see The Role of Vitamin D Deficiency in Thyroid Disorders.

The gut flora play a significant role in both cell-mediated (Th1) and humoral (Th2) immunity. Studies show that this protective role can be maintained and modulated by taking probiotics. Specific probiotic strains can influence the secretion of cytokines to help direct naïve helper T cells towards either a Th1 dominant, cell-mediated immune response or towards a Th2 dominant, humoral immune response.

Acupuncture has recently been shown to regulate the Th1 and Th2 immune response. In this study of patients with depression, both Prozac and acupuncture were shown to reduce inflammation. But only acupuncture restored the balance between the Th1 and Th2 systems. In another study, acupuncture reduced inflammation and lessened the symptoms of asthma by regulating the balance between Th1 and Th2 cytokines.

Reducing inflammation

Essential fatty acids (EFAs) play an important role in preventing and reducing inflammation. I’ve written an entire series of articles on this topic, which I’d recommend reading if you haven’t already.

The ideal ratio between omega-6 and omega-3 fatty acids is between 1:1 and 3:1. The average American ratio is closer to 25:1, and as high as 30:1, thanks to diets high in processed and refined foods. The result of this imbalance is – among other things – inflammation.

Two steps are required to bring this ratio back into balance. First, dramatically reducing consumption of omega-6 fats, and second, moderately increasing consumption of omega-3 fats. I explain how to do this in considerable detail in this article.

Another benefit of increasing intake of omega-3 fatty acids is that they have also been shown to help balance the Th1 and Th2 systems.

Aside from ensuring a proper balance of omega-3 and omega-6 fatty acids, following an anti-inflammatory diet/lifestyle and avoiding dietary triggers like gluten and iodine is essential.

Putting these general approaches to balancing the immune system into action should give you a good start towards getting the autoimmunity under control. But if you don’t see the results you’d like, I’d recommend working with someone who knows how to address your particular immune imbalance more specifically.

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Comments Join the Conversation

  1. viswa says

    Hi, My daughter age 9 has been recently diag with Hashimoto( antithryoglobulin antibodies 500 but tsh. t3t4 normal- she has a visible neck bulge which endocrnio told is tender/but normal but scan results showded euthyroid with no issues. No medicines prescribed yet as thyroid not yet impacted. Could you pls suggest any natural ways for her to address the autoimmune issue. We are a bit concerned as throat cancer, multiple myeloma etc prevailing in family . We are avoiding gluten but not sure whom to consult for natural ways …Pls advise

    • Diane says

      Viswa, I haven’t seen Chris commenting here in a long time, so I don’t think you’ll get specific answers from him. You might want to join the Hashimoto’s 411 group on Facebook, or if you’re not on Facebook, search for other forums online where you could get advice from patients.

      Have you improved your daughter’s diet yet? At least gone gluten-free? You would also find a lot of help from as she writes a lot about autoimmunity and how to feed kids a healthy diet to avoid many of these health problems.

    • wandamurline says

      My daughter has this and is a teacher, in the afternoon she was actually falling asleep at her desk. I purchased the Hypothyrodism Revolution diet….I cooked all her food for her and on the first day of this diet, she was coherent all day and did not fall asleep. She felt better….this diet is organic, but you have to eat 6 times in a day…small special meals that support your thyroid and this continuous eating helps to keep your blood sugars at a level pace. I am very satisfied with this program from day one. Maybe it will help you also.

  2. Robert says

    I have Hashimoto’s (hormone production/levels fine but antibodies are present).
    Now I’m going to get a blood test to see if I’m TH1 or TH2 dominant (probably TH1 I guess).
    A number of articles (such as state that Ashwagandha stimulates TH1.
    But, I’ve read other articles (which I need to find in my favorites somewhere!) which states Ashwagandha doesn’t boost anything. It acts as a Adaptogen which supposed to balance things out. So if you have too much or to little of something (under and over active thyroid was used in the article example) it helps the body to normalize / re-balance things.

    So does anyone know which situation is correct please? If I find I’m TH1 dominant, should I stay clear of Ashwagandha or not?


    • Diane says

      Robert, I’m no expert, but if you haven’t already read Dr. Kharrazian’s blog, check it out ( He discusses TH1 and TH2 in at least a couple of posts. Here’s one: Also do some reading at She has similar information. I don’t see ashwaganda on the list in Dr. K’s article I just linked. My practitioner has me using an adrenal product with ashwaganda, and I think it’s working well for me. But then…I’m not very sick (compared to some) and not very sensitive to little changes. Hope that info may help, anyway!

      • Robert says

        Thanks Diane, I’ll check out those sites. Yep, like you I’m not bad really. My thyroid hormone levels are fine (but antibodies present), I just want to make sure that it remains that way by lifestyle change.

  3. MJ says

    can anyone explain why Chris recommends getting adequate iodine, while Datis Kharrazian insists it needs to be avoided at all cost. he says its like pouring gasoline on fire. so confused.

    • Diane says

      Disagreement between experts is the most frustrating thing for us Hashi’s folks! Check out and search for “iodine” to see the companion nutrients that need to be in place before you try iodine…very slowly. There are Facebook and Yahoo groups for iodine that should be helpful in answering your questions. Also, I just watched this and it was great! Answered all my questions for now.

      Sherry Tenpenny, DO outlines the many disorders that come from iodine deficiency IAOMT 2007 L.V.

    • Jean says

      From my understanding, regular hypothyroidism is recommended to take iodine, however since hashimotos is an autoimmune disease, iodine reacts differently and makes the disease worse.

  4. Khali says

    Hi, i just read in one of the comments that Glutathione it’s bad for you, why? I take Luposomal Glutathione daily and Dr Kharrazian says it is the best. Can you explsin please.

  5. dani says

    I have just beendiagnosed with Hoshi’s but also have heavy metal poisoning (i’ve been in treatment for 5 years). I understand that using selenium is helpful to treat hoshimotos, however I recently learned that selenium binds to mercury. My naturopath advised me not to chelate right now as ai treat hoshi’s but with the binding, my concern is that my thyroid is not getting the benefits of the selenium. Also, if the seleium is binding to th mercury, don’t i need to chelate to remove it?

  6. Khali says

    Hi, I am supposed to do a heavy metals test where I have to take like six sulfur pills then collect the urine for six. Hours, the pills. Are according to your weight , mine is 103. I was wondering if this sulfur it’s bad for me. Or give me any bad reaction, I am worried about that and don’t know if I should do it.

    Thanks, Khali

    • Tim Lundeen says

      You are right to be concerned, if you have mercury poisoning this could make you worse. The best test is a hair mineral analysis, interpreted per Andy Cutler’s rules. See his book Hair Test Interpretation: Finding Hidden Toxicities.

  7. Lisa Lombardi says

    Ive just been diagnosed with hashimoto do I have to be concerned that my children my be affected as well? My daughter had cowsackie recently is this cause for alarm?

    • Esther Luna says

      I purchased Tom Brimeyer’s program. Going gluten-free has eliminated the bloating, painful, trapped gas and just gas that I had all my life (until I went gluten free at the age of 49). My body temperature and pulse did not regulate as expected. But, I have not done everything he suggested. I am confident that it has helped me.

  8. Jeff says

    Hi i’m looking for some advice I have Hemochromatosis (Iron Overload) and just got my Results for my Thyroid back today and to me they seemed fine from everything i’ve read on the subject. However I wanted an expert opinion….

    here are my Lab Test Results:

    3.6 TSH
    1.24 FREE T4
    3.2 FREE T3
    6.0 TPO

    31.3 VITAMIN-D

    242 SERUM IRON
    265 TIBC
    23 UIBC

    (Male, 33yrs old, White, 165lbs, 97.1F is my normal body temp)

    I know my Iron is high so i’m currently doing Phlebotomy every 8 weeks and also taking: EGCg (Green tea extract), Quercetin & IP-6 for Iron Chelation.
    As well as a Multi-Vitamin with the best Forms I could find
    and 5000IU of Liquid Vit-D a day too because I live in Alaska and it’s pretty dark in the winter time.

    Any advice would be much appreciated thanks for your time!

    • Alicia A Mitchell says

      I would request a complete abdominal ultrasound from your treating physician in order to rule out any precarious conditions of the liver and/or pancreas. Iron accumulation in the liver is sometimes a symptom of chronic disease – such as any brand of autoimmune disease. However it is sometimes a symptom of some other serious disease state. It is always best to know so that you select the correct solution set. Don’t worry…just be informed.

    • Laura says

      Can you get your doctor to run a Free T3 to RT3 ratio? That’s the test that finally showed I do have a thyroid problem, even though my other numbers were within lab specs. (My ratio is 0.157/1 … it should be 20+/1) After that was discovered, my doc finally checked my antibodies and diagnosed with Hashi’s, but you can have an imbalance in the ratio for many reasons. (Primary suspects are adrenals and iron (low, but I see yours is high), which is the next step we’re working on.) Read:

  9. Tamara says

    Would love to find a doctor in the buffalo, ny area that specializes in hashimotos disease as I would like to get my condition under control because primary care doctor doesn’t really know how to handle. I have dealt with doctors that say it’s all in your head or that is what happens with hypothyroidism..they should not be allowed to practice, seriously! I would love if anyone knows of a doctor or even one who would handle long distance via Skype! Thanks!

  10. Natalie says

    I had metal fillings in few of my teeth for 10-15 years. I asked my dentist to replace them with white fillings. Only when he completed the procedure I have discovered that he only removed the top part of the old fillings and covered them with white fillings (he removed about 60-70% of old fillings, so about 30% of old metal fillings are still in my teeth). I was not impressed at all as I was hoping he will remove all metal from my teeth. His response was – ” Once the amalgam is covered with white resin, mercury can not “leak” into your system”….It sounds a bit not right to me as inside part of my teeth is also “my system”…. So I wanted to ask your opinion – Am I safe now from mercury upsetting my health or should I insist he removes amalgam completely? Please advise.My thyroid antibodies are very high, >1000. Thank you

    • Tim Lundeen says

      No, you are not safe. Mercury will continue to leach, and until you get all the mercury removed you will not be able to treat and resolve the problems that mercury might be causing for you.

      The best resources to understand this, and to treat any mercury toxicity that you probably have with frequent-low-dose-chelation, are Andy Cutler’s books (Hair Test Analysis for diagnosis, and Amalgam Illness for treatment). There is also an excellent review by David Hammond, Mercury Poisoning, the Undiagnosed Epidemic, that is more accessible than Cutler’s books.

      Do NOT get a mercury challenge test, or IV Glutathione/DMPS/DMSA, or use lipposomal glutathione to diagnose or treat. These are very dangerous, they can permanently hurt you.

      • Trish says

        Tim Lundeen, I’ve seen a lot of that info lately regarding glutathione. Have you found any info regarding taking NAC for low glutathione?

        • Tim Lundeen says

          I wouldn’t take NAC until I had removed the amalgam mercury and chelated properly; NAC can mobilize mercury and make you ill. That said, I wouldn’t use NAC at all because it isn’t clear it really helps — there is some evidence both pro/con. ALA does upregulate glutathione, if you chelate for mercury and use a frequent-low-dose protocol with ALA, that will make a big difference over time; many people see a big improvement in 12 rounds or so.

      • Raquel says

        Yeah but in Dr. K’s “thyroid book” he states not to remove mercury, and says sometimes it’s best to live ‘peacefully’ with mercury.

  11. Jess says

    Hi! I am trying to access the other articles in this series but when I click the link “To see the other articles in this series, click here.” in the first paragraph, it takes me to an e-book download. What I am interested in finding is why you say in this article that iodine is a dietary trigger. I have never heard that and want to see if you say more in earlier articles. THANKS!

    • Alicia A Mitchell says

      Thyroid hormone is made of iodine. If your body has targeted the hormone itself for destruction it will increase the signal to the immune system to attack as the body has determined iodine to be a foreign invader.

  12. Faith Harper says

    Chris, can you recommend a practitioner in the metro Atlanta, GA area to me? I seem to have autoimmune issues going on and have many food sensitivities and intolerances as well as thyroid issues. I haven’t eaten gluten, soy, refined sugar or dairy in several years and also have to avoid cruciferous vegetables. I take yeast support supplements and probiotics daily and am getting by but far from thriving. Thanks.

  13. Brooke says

    Hi Dr. Kresser,

    I have started a gluten-free diet. Much of what you say resonates with me. I have read both perspectives on Iodine (Dr. Brownstein and Dr. Kharrazian). I have always had a problem with breast cysts despite not drinking caffeine. I was having to go back for mammograms every 3-6 months so they could keep a close eye on 2 of my cysts. Despite having Hashimoto’s disease, I started supplementing with iodine and the cysts became smaller (can barely feel them). After 3 months of supplementing, at my next appointment, I was told I didn’t have to come back and they no longer needed to follow them closely. My concern is what it’s doing to my autoimmune condition. What should a person do who finds it beneficial for breast health but wants to avoid it for autoimmune disease? Any thoughts? Thanks.

    • Diane says

      Brooke, before you get any more mammograms, take time to research “dangers of mammograms.” Thermography is the safe method for monitoring breast health, and far more sensitive and useful.

    • Raquel says

      This is a good question and have always wondered this myself. My doc says he has no problem with iodine in foods … It’s the supplemental he has N issue with and says the iodine itself ca actually cause hashimotos

  14. Carrie says

    I realize this is an old article.
    My 8-year-old’s TgAb antibodies are elevated at 1.6 with the top of the range being .9. I have Hashimoto’s myself and became severely hypothyroid. My latest TgAb was over 200)
    Her Free T4 and Free T3 look pretty good with the Free T4 being mid range and Free T3 being higher in the lab range.

    Our Course of Action:
    Began her on an Omega-3, Vitamin D3, Selenium and L-Methylfolate. (One MTHFR gene mutation)
    Reducing and/or eliminating the foods that cause inflammation via food sensitivity blood test.
    Will this course alone stop the damage to her thyroid?
    Will this course stop the antibodies from elevating and causing damage?
    Would a TH1 and TH2 blood test and balancing be on my list for her?

    As all parents would I want to do everything in my power to keep her thyroid from being damaged by an auto-immune attack. Can an auto-immune disease be prevented?

  15. Melissa says

    I am interested if there is any connection between hashimotos and vaginal prolapse (due to hormone imbalance in particular after pregnancy)?

  16. says

    Environmental factors indeed,

    Radioactive Iodine
    Halogen compounds
    and Heavy metals

    All target the glandular system and more. Go to for a complete list of toxins in the air.

    You can:

    Organic juice (beets, green apples, carrots, pineapple)
    Take Atlantic Kelp pills
    Walk at least one mile a day
    Find a pure water source (like Noah’s water ph 8.4)
    Take pure maca root pills or powder
    Eat sardines (high in D and B12)
    Use Reflexology and Reiki if possible

    and of course Astragalus root as directed from your herbalist.

  17. Jen says


    I forgot 1 more dimmer switch item…….organic coconut oil in a jar. 1 tablespoon in morning, just swallow it:) it blocks/ binds to the antibodies from attacking thyroid tissue and tissue behind your eyes, my vision became blurry… And has resolved.
    Cooking, and body moisturizing…

    Additional notes::: Your body Is hyper sensative during Hashimotos .. Try to avoid at all cost !!!!!
    Sented items of any sort, laundry soap, personal hygiene items , I have not worn make up for 2 yrs or used lotion or cream only coconut oil.
    Antiperspirants have metals in them …. Avoid or minimize
    Amalgam fillings, have them replaced!
    House cleaners, bye bye…. Only vinegar and water
    Dishwasher , cuts some lemons and throw in baking soda
    Per – rinsed dishes only. Dish washing detergent very toxic!
    No dry cleaning, no candles no air fresheners in home or vehicle. All of these thing have a cumalitive affect .
    As for fruit…… No soft cover tree fruit pears, plums
    Grapes…… Tomatoes :( I eat tomatoe products only when
    I am not hasihi’s. Strawberries, melon, apples r great.
    Stay away from nitrates…. Hot dogs, bacon, deli meats
    Turkey is the only meat that farmers cannot hormonely
    modify. Bake one slice it up.
    Night shade fruits and vegetables can trigger food allergies
    Tomatoes, potatoes etc….
    No peanuts or peanut butter very toxic nut absorbs
    pesticed and ground impurities…
    Try fresh almonds or almond butter.
    Potato Chips… :( Sorry very bad chemical on them.
    No microwave popcorn :(
    Stay away from broccoli and cauliflower they can trigger.
    I’m so sorry the list goes on and on.
    The above items have been modified or deleted from my day to day.
    As I feel I may have a work environment component, pesticides, fungisides a lot of sunscreen,
    a perfect storm of an aging decline in progesterone, sports
    drinks instead of alkalined lemon water was probably enough
    to overtax my system.
    I’ve never done recreational drugs, or used alcohol daily,
    I have always been active and maintained a low BMI.
    There r a lot of chemicals out there!!!!

    Didn’t mean to be so long winded……
    God Bless You and Yours

    • mel says

      Autoimmune paleo diet and elimination diet experiments have helped me a ton with my hashi’s symptoms. But avoiding goitrogens, chemicals of all kinds, fluoride, chlorine, iodine except from the cleanest possible sources, and most immune stimulants is also very helpful!

      • says

        A great resource you might look into is Dr. Alejandro Junger’s books Clean Gut and Clean ….. if you’re looking for great CLEAN food and recipes, he also has one out called Clean Eats. It’s close to Paleo but more focused on immune function, leaky gut and has helped a lot of autoimmune people.

      • Jen says

        Hi Hashi Sufferrr,
        As for wheat , I’ve never been
        A big bread, pasta, flour eating individual.
        Croutons on a salad daily that’s was about it……
        June 2014 gluten free, and
        I have experienced another degree of relief. Wheat / flour are on a lot of things you would not even think of. Research gluten free!!!Small relief for me but relevant enough to incorporate the restriction.
        Gut flora has been a game changer as well.
        I’m in the process of finding
        out why my body has a heavy
        Metal toxic over load.
        Dr and I feel we are at the pinnacle of the problem.
        Basically when heavy metals are absorbed, the body recognizes them as minerals.
        Your thyroid needs minerals to function properly unfortunately your thyroid
        Receptors accept the heavy metals and are unable to
        Detoxify !!!!!!! There are only a few things that can chelate them out of your system.
        And if you try to chelate detox
        to quickly you can damage hour kidneys.i will be starting this process and hopeful my
        Research is solid.

        ????? Look up heavy metal toxicity syptoms…..

        God Bless

    • V. Christina says

      Anyone with thyroid issues should only consume organic strawberries, as well as products made only with organic strawberries, such as jam. Commercially grown strawberries are sprayed with a pesticide called Methyl Iodide which attacks the thyroid. Actually, no one should consume strawberries treated with Methyl Iodide, as it can cause thyroid issues in people who previously had none.

    • Alicia A Mitchell says

      Well done! Add to that … that too much almonds reduce Immunoglobulin A, primary defense in the gut, so if consumed daily may be problematic and that peanuts absorb high amounts of Barium.

  18. Jen says

    Hi fellow Hashimoto patients…….
    I am a 50yr woman w/ 2 .5 years of Hashimotos research….
    Levoxyl had undesirable side effects!!!…I only took it for 3.5 months….. This is what works for me.
    1st read up on alkalining your body, with distilled water…
    Cook only in ceramic coated pans or glass. Eating & drinking
    from glass or proper plates and bowls….. No lead values
    I use SmartWater and baking soda if I’m not home.
    Alkalining your body will give your body the natural ability
    To absorb needed nutrients and expell toxins… It’s called
    Homeostasis – cells having the ability to repair themselves and
    Balance systems. 1st 30 days, just touching the surface of things after 90 days of religiously testing urine w/ PH strips
    All of your organs will be saturated.
    2nd Dimmer Switches for inflammation and maintenance
    1stSelinium 1-200mcg 2x’s Brkfst , dinner 2 HRT. 2 2nd Progesterone on my neck 1 gram daily none during your period. I still have my menses.
    3rd Glutothiane ….. Can not be absorbed w/ supplement form… Needs to be organic Top 5 foods containing highest amount . #1 raw egg whites #2 Avocado#3 Brazil Nuts
    #4 Garlic#5 Asparaus & Sesame Seeds these are in potency
    order. I eat at least 1 item + 4 Brazil nuts w/ every meal.
    My Endo is shocked at my remission!!!!!
    As for iodine sea kelp is my option and 1/225mcg 2x’s with
    Brkfst and dinner……Cannot take this with thyroid meds!
    My Vitamine D runs low …… I use D3 liquid drops
    As a bonus I integrated Vibrant Health — Green Vibrance

    I hope this helps one person…… It’s been a sucky road
    Trying to educate myself when I was feeling sooo bad…

    God Bless

    • sara says

      Thank you – you’ve helped this one person! Its been a minefield working out what the doctors don’t tell you and what you need to know. Been diagnosed three months with auto immune disease and had to beg for tests for iron, vitamin d, cortisol , serums and B12 etc the first three were very low… 24,25, 300… and antibodies of TgAB were 966! TSH 6 and Free T4 was 11.2 so all out of normal range. Have about 30 of the classic symptoms. But hypo adrenal too is a double horror.

      They stuck me on waiting list for endo appointment in 3 months time. Offered me levothyroxin 50mg and totally ignored that the adrenal glands were knackered with low cortisol and that meds like this could put seriously compromise them further without prior improvement. !!!! So am doing all the nutritional supplement and household things I can….. and visited a homeopath that maybe co incidentally rendered me with dry hacking cough for 6 days and counting had paramedics over this morn felt so low.

      So going through painful process of learning. Found a Dr who has traditional background but went private as his holistic approach was threatening to the GMC! So with his support and a second homeopath hope I’ll get there. WAs advised to take flax seed oil by a naturopath only to discover after drinking it every day in smoothies its not good for slow thyroid! So looking at as many sites and their contradictory statements to gather general info on T cells, inflammation, and correct foods.

      Am taking selenium, magnesium, anti oxidant, pro biotic, L Glutathione, Iron, B complex, A, C tablets, D3 spray, barley grass, collagen!, omega oils, adrenal support with liquorice and borage, ginseng tinctures…. and oh yes, trying to cook whole food meals but without cruciferous, grains and nightshades, gluten, dairy and soy….. whilst exploring how to do hair mineral analysis test for mercury lead and aluminium, even nickel, much early dental work exposure and some mercury amalgams badly removed…..

      talk about stress overload!!! Hoping it will all start to pay off when this bug shifts..

      Wish the GP would hand out a leaflet with all this info on so you could get the full picture in a day…. oh yes, waiting for my T3 results I had to beg them for and a second (actually 8th blood in all) sample as they forgot to test before!

      • Jen says

        In regards to my glutathione diet options…….
        Glutathione is made in the liver, after
        certain foods……. Supplinents of glutathione are not processed!!!!
        Don’t waist your time energy or more
        Money!!!!! Egg whites/ with the least amount of shock coming out of shell.
        Raw if u can swallow it like “Rocky”
        movie……#2 Avocado #3 Brazil Nuts,
        #4 asparagus# #5 sesame seeds
        Progesterone and cortisol cream spread on neck in the morning are dimmer switches….
        My doctors had not researched my info until after my blood work came back in remission 1.5 yrs….no thyroid medication , It’s working with the right food and life balance..
        God Bless

  19. Kimball Chatfield says

    You state that astragalus and echinacea stimulate Th1 and that taking them could increase autoimmune response. I have just finished writing book on astragalus that will be out in a month or so. In doing so, I read over 1800 studies on astragalus. I am unable to find any data that supports this idea that astragalus pushes the immune system to inappropriately cause Th1 domination when that could harm the patient. Every study I have read shows that astragalus alters the very complex immune system to benefit the patient. Sometimes astragalus increases Th1 dominance and sometimes it increases Th2. This over simplistic idea about astragalus revving up the immune system and causing an attack on normal tissue is a canard. There is no data that supports this idea. Astragalus has been shown to down regulate autoimmune responses in: Lupus, rheumatoid arthritis, allergic asthma, myasthenia gravis, etc. You are in good company with this myth as almost every website that sells/discusses astragalus also parrots this idea. You are too good a doctor to not use original data in your assessment of this important herbal medicine.

      • Kimball Chatfield says

        Yes, the book will be available on as well as an e-book. It’s called, Astragalus-Ancient Herb For Modern Times. Look for it in May. Thanks.

    • John Seville says

      I agree 100%! I have Sjogren’s Syndrome and have used many of the recommended natural treatment, the results being so-so. From my reading I was drawn to Astragalus. Though I was warned by everyone that since my condition was TH1, this would cause further problems. I just had a gut feeling I was making the right choice so I started off slowly. Right from the first day I began to feel better, I have continued to full dose and am doing great now, to the disbelief of many others on the forums I post that have autoimmune issues. It barely know I have it anymore, it has made a big difference and I am NOT on any medications either. I would advise others to try it, just one capsule and see for yourself.


    • says

      Agreed. All data I’ve seen shows Astragulas has a modulatory on the imbalance state of Th1/Th2. I use it with Herpes patients with great success.

      • mel says

        I didn’t do well with astragalus. Is it common in your practice for people with hashi’s to have an uncomfortable autoimmune reaction to it?

  20. karen says

    Hi Chris,
    do you know what the difference of TPO and TG’s are?
    my Anti-TPO is 14 and my Anti-TG is 320.
    I have noticed most people have higher anti-TPO’s.
    Is one more involved in the Th1 or Th2?
    thanks so much, karen

  21. Daciana says

    Hi Chris, I’m pregnant (12 weeks) and I’ve lost 3 pregnancies so far – 2 of them in the 17th week. Doctors tested me for:lupus, autoimmune antibodies, antiphospholipid antibodies, coagulation disorders, trombophilia, antithyroid antibodies, CD19 lymphocites, CD16/CD56 NK cells, IgG, IgA, IgM, C-reactive protein, toxoplasmosis, cardiolipids, and other hematology tests – all NEGATIVE, except CD3+ CD4+ , CD4+/CD8+ which are elevated, and the rest outside the range:CD3+ at the upper normal in range (range is 55-83 and I have 83), abs CD3+ is 2,24 (range is 0,70-2,10), CD3+ CD4+ is 61(range is 28-57), abs CD4+ is 1,64 (range is 0,30,-1,40), ratio CD4+/CD8+ is 3,05 (range is 0,70-3) . As for abs CD8+, it is within range 0,54 (range is 0,20-0,90).
    The problem I have is that the 2 immunologists I saw said this means nothing; my 2 gynecologists said they don’t know what it means and they want to put me on wide range antibiotics and send me to the hospital to be closely monitored, fearing it was infection that led to acute chorioamniotitis, even if the cultures they tested came up negative and I had absolutely no symptom of infection, in the second pregnancy being on antibiotics a week before the miscarriage happened.
    I know this is off topic, I am just trying to find help anywhere it is offered. Do you think I could be Th1 dominant and reject the pregnancy thus?
    On the other hand I seem to have a serious allergy to dust mites – IgE 305 (range is 0-100) and I read that this is one of the signs of Th2 dominance.
    I would take all steps necessary to shift the Th1-Th2 balance, I’m just afraid not to make the wrong choice. I live in the Czech Republic and access to more tests than the ones I mentioned is rather difficult.
    Thank you so much in advance and I hope you will reply soon :)

    • Diane says

      Damiana, I don’t think the author has time to answer questions any more–judging from how many above are not answered, or have been answered by other people. I sympathize with your concerns! But I’m not an expert, so I can’t imagine what all those numbers mean. I have Hashimoto’s myself, but it’s not bad like some. I finally found a functional medicine doctor who is helping me, but I don’t know if you have those in your country.

      I wanted to suggest that you join a Facebook group that I’ve been a member of for a while now. There are over 9,000 members, and when someone asks a question, most of the time there are many who can answer, or direct the asker to a good resource like books or websites. It’s been extremely helpful to me. If you’re on Facebook, look for the “Hashimoto’s 411″ group.

      I also remembered this blogger’s story because she also lost a baby due to autoimmune problems. You might find her site very helpful–and she might be able to answer some questions if you write to her. I hope you can find some help soon!

      • Daciana says

        Hi Diane, thank you for the reply and the link, I checked it and there are many things I learned.
        I will join the facebook group, too. I’ve finally managed to make an appointment with a reproductive immunologist in Prague next week and now I have some hope. Thank you again!

        • Diane says

          Damiana, I’m glad to hear that! Sure hope you can make some progress soon. I know this disease can be very complex, and it takes time to understand what’s going on and what to do about it. Best wishes!

    • J says

      go see this doctor. he was one of the few recommendations by dr mark starr, author of type 2 hypothyroidism. if you cant go there then pay for a consult via skype with them.

      Thierry Hertoghe
      Brussels, Belgium
      + 32 2 736 68 68

      • Daciana says

        Hi J, thank you for the info. I checked the link and I’ll most surely pay a consultation via skype if the doctor from Prague cannot help me. I really hope he will, I’ve seen great reviews though so I have some hope.

  22. Angie says

    Hi, I was diagnosed with Hashimoto’s after my pregnancy which had a tragic ending. Everything seemed to be perfect until I was about 22.5 weeks when all of a sudden my amniotic fluid dropped to nothing. I was on bed rest in the hospital until 32 weeks when I delivered my son, and he passed a day after I delivered due to his lungs not being developed. I tried everything in the hospital to regain fluid, and his kidneys looked healthy from the autopsy (we only had the kidneys looked at) although doctors say there could of been some abnormality in the function of the kidney. No one can unfortunately tell me what happened to my son, he was a beautiful and healthy looking baby, and a good size for a premie. I have been on a search since to find out any connection with thyroid as I suspect I have had this condition undiagnosed for a while. I was so good through out my pregnancy (no coffee once I found out, sugar, etc) but I did eat a lot of gluten. I am just looking for any findings of this type of situation.

    • Diane says

      Angie, I don’t have information about that (I’d be googling it, just like you), but I wanted to take a moment to express my sympathy for the loss of your beautiful baby boy.

      I’m part of a group at Facebook called Hashimoto’s 411, with over 9,000 members. There’s a lot of good information shared there…you might consider joining us!

      Also, I remembered a blogger who lost her baby as a result of Hashimoto’s, so I eventually found the entry I remembered:

  23. Corine says

    What should I look at when deciding what probiotic to buy? I am not really a vegetarian, although I very seldom eat meat. I hate the pieces getting stuck between my teeth. I get a lot of wind, and very smelly, if I do dare to eat meat. How can I overcome that problem? I’ve been diagnosed with both Hashimoto’s and Grave’s disease.

    • Diane says

      Corine, almost any refrigerated probiotic will be good. Maybe some on the shelf will be okay, too–I’ve just heard in the past that refrigerated is best. Get the highest count you can afford–or just ask for advice at the health food store.

      About the “wind,” you might be interested in a book I just read. It’s called “Kick Your Fat in the Nuts,” and the Kindle e-book is free at Amazon. He goes into the problems of digestion, with symptoms such as gas and burping, and how to correct digestion with hydrochloric acid and a beet supplement. It’s fascinating. I haven’t tried it yet, but he explains how many people lose weight just by correcting their digestive problems. I didn’t think I had digestive problems until I read that book, but now it’s clear to me that I do, and I’m going to follow his advice.

      • says

        Probiotics are certainly NOT created equal … there are so many options when it comes to different strains, potency, and processing and quality.
        Chris talks a little above about Th1 and Th2 dominant states … and if you are autoimmune or trending that way, finding out your T-helper systems is extremely important. Now back to probiotics … there are certain strains that are helpful for Th1 dominant individuals that reduces the pro-inflammatory cytokines and/or promotes anti-inflammatory cytokines (for instance L. salivarius and L. bulgaricus reduce TNF-alpha). There are also strains of good bacteria that stimulate IL-12 and therefore stimulate Th1 such as L. casei and and B. Longum.
        This is certainly not a complete list of strains and support but if you’re really serious about supporting your bio-identity and current metabolic state, a general approach of consuming any ole probiotic isn’t enough or complete.
        In general, Klaire Labs is a very good reputable probiotic company and there’s a lot of positive info and research on VSL#3 for certain conditions as well. In general, I’ve found most of my patients needing much higher doses than they expected for results. Whether doing a GUT REBOOT or working on immune regulation, many patients are on at least 100 billion of a multi-strain probiotic daily.

        P.S. How it is made/encapsulated matters too …. it’s got to be able to survive the stomach acid to reach the gut where it is needed. This is sometimes the defining factor of two labels that both “look the same” but one if much more expensive. That’s why I trust Klaire Labs is they understand and practice good manufacturing for probiotics especially.

  24. Jill D says

    I am trying to find in depth Hashimotos info. I was diagnosed with it aprox 25 years ago…before age 10 and was on various T4 meds for 20+ years…and higher then normal doses the last 5 years on T4 I kept complaining of symptoms thinking I needed mnore and labs would prompt drs to reduce my labs..the downhill spiral prompted mnonths of research and evetually a change to Armour. I also have had T1 diabetes since age 7. The armour thryoid changed my life aand relieved over 20 ailments and allowed me to stop a handf of other meds that weren’t working anways. My diet is very clean, GF, DF and almost vegan. I supplement everything I lack. My current issue is I can’t feel releived of all my symptoms and have labs in nornal ranges. My FT3 is elevated and my TSH has been completely suppressed for almost 3 years. My heart and bone density have been tested and are ideal. My throid gland is a bit swollen..and last time checked antibodies were still elevated even on LDN. Do you think my thyroid is basically dead at this point? Does hashimotos ever end and just turn into hypothyroidism? By keeping my T3 levels high I have little to no flareups.. All the drs in medical group have fired me and now refuse to run labs for me. I see a private dr who specializes in hormone disorders. I’ve tried T3 only, I supplement with sea salt to keep my sodium levels up in range and adrenals show signs of struggle but can’t tolerate any form of adrenal support. Also I’m interested in the thought that my pituitary gland may be comprimised since my tsh has been so low even before switching to armour and while severely hypo and barely suriving…

    • Tim Lundeen says

      Per my previous comment, I’d suggest Sarah Ballantyne’s auto-immune protocol, and the Jaminet’s Perfect Health Diet as the foundation for nutrition and macro-nutrient balance. You can order labs directly through Life Extension. You probably have some underlying chronic infection/gut issues that need to be addressed as well.

  25. Tim Lundeen says

    Have you seen Sarah Ballantyne’s blog? She healed her autoimmune disease by eliminating *all* food triggers that causes her immune system to flare up. (See

    I think that autoimmune disease is originally caused by leaky gut, which allows large foreign proteins to come into the blood. These proteins cause low-grade inflammation through the innate immune system, but do not initially cause autoimmune issues. However, when an infectious agent is encountered, the infection ramps up the adaptive immune system and, because the leaky-gut foreign proteins are present, can cause the immune system to create antibodies to them as well, and to “learn” that these proteins are dangerous. So in the future, any exposure to these foreign proteins causes B cells to ramp up their antibody production and can cause T cells to ramp up as well.

    So the body is not trying to kill its own cells or create problems with its metabolism — it thinks it is fighting a serious infection, signalled by the foreign proteins leaking through the gut, or recognized by the gut-centric immune system.

    This theory seems to fit all/most autoimmune diseases, and when you eliminate *all* foods that trigger an immune response, the auto-immune disease goes into complete remission. Of particular note is that B-cell-created antibodies have a half-life of about 2 weeks, and eating a trigger for an autoimmune issue will usually cause a “flare” for 1-3 weeks. Sarah says that every time she ate a trigger food, she had two weeks of flared lichen planus, we’ve had similar experiences with food sensitivities.

    Of course, the infectious agent that upregulates the adaptive immune system could be gut bacteria as part of the leaky gut…

    This also explains why taking digestive enzymes helps many people with auto-immune issues. The enzymes break down the larger proteins that would trigger an immune response.

    If this is all correct, then balancing Th1/Th2 is probably irrelevant, and is just addressing symptoms. The cure is to stop eating foods that trigger an immune response.

    Sarah would be a good person to invite for a podcast :-)

    • Tim Lundeen says

      Actually, after more reading and some personal experience, balancing Th1/Th2 is pretty critical :-) A strong, balanced immune system looks like the key to long-term good health. Avoiding trigger foods/environment is treating the symptoms (required until you are healed, because they totally unbalance/stress your immune system).

    • Alicia Mitchell says

      Great comment. Nice to hear well thought out advise being given to those who suffer from this complex disease state.

  26. Brenda says

    I was diagnosed four months ago with Hashimotos after almost two years of fighting fatigue and depression. My doctor had me go gluten free and add a vitamin regiment and it has changed my life. My energy is up, depression gone and focus is back. At first my stomach wasn’t tolerating the vitamins so she recommended liquid vitamins put into a protein shake. I found gluten free liquid multi vitamins and a gluten free chocolate protein powder at a local health food store and the combination works great. I notice when I cheat and eat pizza ot something because my energy drops for a couple days and I get some joint pain. Finding it’s not worth it and there are plenty of other creative ways to improve your diet and still enjoy it. If you approach it as a healthy life style change versus a disease it makes the transition much easier. Good luck everyone!

  27. corine says

    I’ve been diagnosed with Hashimoto’s disease by a Specialist Physician. But not with Hypotheroid. However, he did give me Eltroxin. He also gave ILLOVEX SR 150mg which I refused to take. He was quite upset so I eventually bought it and took it exactly once. I think it is too strong, and I don’t trust any anti-depressants anymore, as the Psychiatrist diagnosed me with Bi-polar and could not understand why none of his medication worked. Another Phychiatrist had me complete a questionaire and said she could find no trace of mania or hypo-mania. Could this confusion be as a result of (then) undiagnosed Hashimoto’s? The ILLOVEX did bring sensation back to my legs. But is it safe?

    • No says

      None of that shit is safe whatsoever. Stop believing doctors who are trying to diagnose you with “mental health conditions.” Don’t take anti-depressents for ANYTHING. The first step to healing Hashimoto’s is to eat a raw foods diet. It’s that easy.

    • Diane says

      Corine, I have read that a diagnosis of bipolar may very often be undiagnosed or untreated Hashimoto’s. I did a Google search on this for a friend who supposedly has both, and found tons of information. Try it! Good luck!

  28. Rayleen says

    Chris, in your opinion are Fibromyalgia and Hypothyroidism related? I’ve noticed in my research a lot of the symptoms are the same.

  29. says

    I was diagnosed with hashimotos 10 years ago live in Australia. Have been on a merry go round ever since. Tried Thyroxine. For 5 years until Everything started to go wrong, became allergic to it Believe it has done so much Damage. Diagnosed with Fybromyalga. Depression. Perniscious Anemia, Barrets. Asophagitis. The list goes on I was fine before going on Thyroxine. I. Get the. Shakes. Tremors. Headaches. Panic attacks. Anxiousness ect ect am now on (pigs Thyriod ). Still having problems dosage can’t seem to get it right it does scare me somewhat to be on this. Would rather be on. Something plant based. There does not seem to be any answers for thyroid problems. As you say everyone is different. It is quite scary at times and very Frustrating.

    • j says

      you need to work with a dr that knows what they’re doing. your case is getting more complex the longer things go uncorrected. read over and and some reasons, for instance, for the probs are that dessicated thyroid has some iodine in it which could be a problem for those with hashimotos, according to dr datis kharizzan… read those pages and search for audio interviews with dr mark starr and dr datis kharrizian and janie bowthorpe at and janie bowthorpe has a good interview at

      • Raquel says

        So is there a safe thyroid hormone that doesn’t have any of these triggers?? What makes it difficult is I’ve read that intolerance’s can also come without symptoms. So what does one do in that situation? Get a specific food allergy test? (but I’ve heard even those test can be inaccurate)

        For instance, I’ve done an elimination diet. Which is supposed to be the “gold standard” to detect problematic foods. However, I never really noticed a difference in my symptoms when I added back foods.

        But yet when I take a food allergy tests, I have intolerance’s to all sorts of foods, and even stranger is gluten never comes up either.

        Sometimes I’ll show intolerant to a food, and then other times wont either.

  30. Melissa says

    This is going to be rambling because I’m in a hurry but I just feel I have to respond. Chris, I diagnosed myself with Hashi’s a few years ago and then got it confirmed by a holistic MD, and have had to do most of my own research for various reasons. I wish I had seen your article three years ago when I was unable to get out of bed for days at a time and lost many friendships and jobs…or 25 years ago when I had had increasing symptoms all my life and asked my doctor if it could be thyroid, and she said I was too young and my insurance wouldn’t cover a test (which would probably have been inconclusive anyway because doc’s don’t know what to look for.) To address some of the critical comments above, yes it’s very frustrating being a patient because autoimmune disease and Hashimoto’s are extremely complex and everyone can be affected extremely differently, treatments that are successful for many are emerging, top endocrinologists are not keeping up, and practitioners from MD’s to chiro’s can be totally on the ball or out of left field trying to cash in on desperate patients. It can’t be easy for the most well-intentioned practitioners because there are so many different things that can go wrong and so many potential causes and treatments, and more accurate diagnosis is expensive and complex. In my case, at least some forms of hormone supplementation made me fluctuate wildly between hypo and hyper. A whole food paleo diet (my own version of autoimmune protocol paleo based on doing elimination diet over and over to test my reactions to every single thing I put in my body), limiting goitrogenic foods to loading up one or two days a week, probiotics, selenium, tyrosine, vitamin d, lots of clean water, a little fish and flax oil and a good multivitamin/mineral a few times a week, organic unsu;phured molasses once in awhile for iron, avoiding chemicals (body products, foods, pesticides, cleaning products, paint…etc) and many both th1 and th2 immune-stimulating supplements and foods, not getting amalgam fillings and avoiding tuna and flourescent bulbs, and a few other measures is helping me slowly get somewhere I couldn’t imagine two years ago. With this disease it’s great to get a good professional if you can afford it so you can find out what’s really going on, but regardless it’s important to read everything so that you know what your doc is supposed to know. For people trying to get a big picture, I recommend Kharrazian to get a [confusing but useful] background, because most of his approaches are based on existing research and studies. Try to take the time to learn and keep an open mind, because if you don’t have a medical background it’s going to feel like the more you learn, the less you know. Remember depression, rage, and panic attacks are symptoms of a hormonal disorder, which is what you get when your endocrine system is affected by autoimmune disease. Accept that it can be very complicated and keep experimenting and reading and you will probably make rapid or gradual progress.

  31. Kim says

    Hi, I have hashimotos I’ve stopped taking iodine, glutin, MSG, floride, I read labels now on everything, I have a burning curiosity, Why ??? Why are autoimmune diseases so rampant, so unknowable, Why are we told nobody knows what causes these diseases. Just take this pill for the rest of your life, and here is a list of horrible diseases your twice as likely to get now. Your information is priceless and your sharing with everyone who is curious, for free. Thank you Kris. By far this is the best information, I’ve heard anywhere, I’m healthier and happier my doctors have never seen anyone with my health problems get better, keep sharing your knowledge, and keep on making the world a better place. Kim.

  32. Rachel says

    I was diagnosed with Hashi’s through ultrasound. I’ve heard that you can still have Hashi’s and havenormal/no antibodies (which is my case on both a TPO test and a TGB test).

    I have been avoiding gluten, but I can’t really tell if it helps my thyroid or not because antibody numbers don’t change for me. Could there be a different issue and/or how can I tell if fixing my gut flora is actually helping?

    • says

      5% of hashi patients show no antibodies. Many show up normal to the fluctuation between hypo and hyper thyroid…just depends on when your test (just a snapshot in time) was run. Looking at anti body numbers is not a good way to monitor progress…improvement In your hair falling out, energy, cognitive functions, etc are a good way with free t3…the active hormone that really makes the difference

  33. Miruna says

    hello, i have a question: i have hashimoto and i did my food allergies test and they came out negative. does this mean that it doesn’t matter what i eat? i really wish i could lower my increasingly high antibodies. thank you

      • Raquel says

        Yep, and I was also told this too. But, I rarely if ever catch a cold, a flu. I do however, spend alot of time outdoors (Vit D)

        But how do you explain that? : D Is there a way of knowing if your immune system is ‘THAT’ weak?

        I certainly would hope so. I think it’s very important for one to know exactly what these triggers are. Especially reading up so much about how all accumulated “stressors” in general (mental, emotional, chemical, etc) can affect your immune system….

        But guess what? It can also be an equally BIG stress for someone to unnecessarily restrict, or worry, about a diet.

        Can these triggers “fluctuate” from time to time as well? I realize gluten is off limits. But what about the others such as corn, dairy, etc. There is just some foods that make life worth living too!!

  34. marty says

    Hi Chris:
    My question is about raw milk kefir and hashimoto’s. Dr. K says no dairy, however, kefir is an excellent probiotic. What do you think?
    Thank you very much.

  35. Alexandra K. says

    Dear Chris, your site is a blessing. I developed Hashimoto’s at 25 while pregnant. After a year of trying for the right dose, im on 125mgr of levothyroxine sodium. Three years down the line with good results from standard blood tests, i cant get rid of the symptoms. Pretty much everything you ve mentioned. Im working on removing gluten from my diet, but keep failing since im in a very bad financial way, i live in greece and eat what im given sometimes. I was badly asthmatic as a child and wrongfully had my tonsils and adenoids removed before i was 2, because they couldnt figure out what was wrong. My question is about how to take the meds while i work on my diet. My gynecologist finally told me to take it without eating or drinking anything for 45mins before and after, except maybe chamomile tea? Lately i ve noticed nothing can get me out of my fuzzy head stupor other than some sugar, which works instantly. Im not a real sugar fan though. I would appreciate any comment. Thank you, hope you are well.

  36. Mark Ellis says

    My wife has been very sick for almost 16+ years and no one seems to be able to help. She was diagnosed about 17 years ago as hyperthyroid and received medication which seemed to work and they were stopped as was now normal. Then came pneumonia which she recovered from. Next came years of constant bouts of flu like symptoms, sick for two weeks, good for one, laringistis and so on. Diagnosed as depressed, also rhinitis, polyps. We then decided to move from UK to Australia thinking the cold weather was a trigger. No major improvement, symptoms continued bouts of flu like, horse voice, joint pains, fatigue, dry skin, tongue ulcers, confusion, tinnitis, carpal tunnel sydrome symptoms but now stomach issues with bloating and pain had started and she had also been diagnosed with extremely high bad chloresterol and put on lipitor. She decided to try a gluten free diet and almost overnight felt heaps better so has continued on that for two years however over the last six months symptoms have returned to such a point she hardly has energy to make it through the day. After heaps of blood tests and loads of different doctors and getting a second thyroid test performed it was found that she has high perioxiase thyroid antibodies 360 instead of 60 and was started on 50 mcg of Thyroxine even though TSH, T3 & T4 were within limits.
    Now the doctor has decided to stop her Lipitor and Thyroxine as she says if she continues on Thyroxine she will then go hyperthyroid and different problems and has now ordered a batch of hormone blood tests as well as pelvic & thyroid scans and says she may be suffering from depression which is causing all this.
    We are at an ends loss to where or who we should be seeing anymore as everyone seems to have different ideas as to what is wrong. We do have an appointment to see a Celiac specialist here in Brisbane in two weeks but we are not holding out any luck.

    • Tara says

      Hi Mark, I’m so sorry to hear about your wife. Being chronically ill just stinks. I don’t know if you’ve already tried, but you might look into Lyme Disease as a possibility. That’s what my disease finally turned out to be. It comes with a whole host of random symptoms, including some of the ones mentioned in your post. The standard Lyme test’s (at least in the US) aren’t very accurate, so the one I had was done by Igenex, and of course, insurance didn’t pay for it so it was expensive, but it was definitely worth finally getting some answers. I’m not sure if Brisbane has an Igenex Lab, but maybe something comparable. The other thing you might look into is the possibility of Toxic Mold Poisoning, that comes with a bunch of random symptoms too. Hope you get some answers soon!

    • says

      I think what is not talked about in this series is there are way more than gluten causing gut lining breakdown (cross reactors…other foods that look like gluten) as well as even apples carrots etc can cause the gut lining to inflame and leak out proteins that stimulate more attack on the thyroid, many times cerebellum, pancreas, joints and others your wife is suffering from.

  37. Jeanine Conner says

    So it would be wise to be off estrogen therapy if you’re struggling with Hashimoto’s, Sjogren’s Syndrome and Endometriosis? I developed severe asthma symptoms since I started it but my PCP scared me silly saying I would regret getting off it because of prolapse, vaginal atrophy and severe hot flashes! I should have listened to my instincts. I knew that stuff was making me feel worse.

  38. Maria says

    Hi Chris,

    Thank you so much for all of this info on Hashimoto’s. My antibodies keep going up but they tell me that my symptoms aren’t related to Hash’s. I’m on my 3rd endocrinologist, 3rd internist and on my 2nd cardiologist. Finding this forum reassures me I’m not crazy. No one seems to know what to do do with me. Thyroid within normal range and antibodies increasing. I have palpitations accompanied by tremors, joint pain, fatigue, low body temp, dry brittle hair, dry skin, and hair loss, yet no one can help me.

    My next step is to see an immunologist and of course going gluten free. Do you think seeing an immunologist vs am endo is a good idea. I just don’t know what to do anymore. Your thoughts would be greatly appreciated. Thanks!

    • Chris Kresser says

      Hi Maria: I’d suggest finding someone that will acknowledge autoimmunity is at the root of your problem, and knows how to treat it. You might try the directory at Have you read “Why Do I Still Have Symptoms When My Thyroid Tests Are Normal?” by Datis Kharrazian?

  39. Karina says

    Hi Chris,

    Can you point me to a resource on your website that specifically speaks to HYPERthyroidism? I have found some great resources for hypo, but not hyper. Thank you so much!

  40. Saundra says

    My doctor tells me I have hypothyroidism. She tells me the thyroid is a little low but gives no specifics. This has been going on for about 8 months now. From all of my searching on the internet, I don’t seem to have any of the symptoms…no fatigue, depression, sleepy, etc. To the contrary, I am energetic and feel great. The doctor wants to give me prescribed medicine, which I do not want to take if at all possible.
    Do you have any suggestions?

  41. megan says

    wonderful information. i appreciate how you document studies in order to learn more as well as outside resources/books/blogs etc. please continue doing this.

    you challenge even the fringe re supplementation and differential therapy. which is great! there is much to learn and the info collected here is a great place to begin.

    thank u!

  42. Chris Kresser says


    I’ve mentioned thyroid antibodies elsewhere in this series.

    Insulin resistance may produce symptoms that mimic low thyroid function, such as fatigue and weight gain.  I’m not sure where your reference to fasting comes from.  I didn’t mention that in the article, and I’m not a fan of extended fasts for most people.

  43. Becky says


    Here’s a good short video on thyroid:
    Not mentioned but I heard on a podcast (kharrazian), that you should get your thyroid antibodies (TH2) tested:   TPO (tyhroid peroxidase), and TGB (Thyroglobulin) . And as Chris writes Autoimmune disorders (TH1) can cause hypothyroidism, and can lead to issues of hair loss, fat metabolism and cholesterol.
    However, is it true that insulin surges in men (hypoglycemia?), can look like hypothryoidism symptoms (due to elevated estrogen)?
    Also, instead of fasting what about getting rid of gluten, and supplementing with chromium, vanadium, copper, alpha-lipoic acid, mixed tocopherols, biotin, zinc, inositol, licorice, b-vitamins, coq10 (ubiquinol), vitamin d3, magnesium, selenium, Gymnema sylvestre, and conditionally, iodine?


  44. says

    Chris – I just found your blog last night and have found it to be extremely informative, and I can’t thank you enough for taking the time to answer people’s questions about these subjects.  I just finished reading Dr. Kharrazian’s book, after looking for years for suggestions to address the underlying cause of my Hashimoto’s.  I thought the book was a good start, but I really wish he had addressed more of the “how to” along with the “why to”.  The recurring theme seemed to be “find a professional who follows these courses of treatment”.  Well, thus far I haven’t been able to find anyone in the area with a clue, plus my insurance doesn’t cover preexisting conditions for the first year of coverage, so I am on my own for a bit.
    So, my questions to add to the mix:  Are you aware if preparations such as soaking or fermenting change the gluten in grains to any extent as to make them less inflammatory?  (Nourishing Traditions type prep.)  I’ve read that sourdough bread is better for diabetics than non-fermented breads, so I was wondering if there might be any similar advantage.
    Second, what about do-it-yourself probiotics as an aid to build proper gut bacteria to improve the T4 to T3 conversion process?  I culture and consume water kefir, milk kefir, kombucha and yogurt regularly.
    Do you feel that a GAPS type diet is required, or is Paleo style enough?  I think my guts are pretty healthy, and don’t seem to react to a lot of the foods on the GAPS list (as far as I know).  My thyroid hormone levels test within high normal range, but I did test positive for Hashi’s.  Overall symptoms are minor (some fatigue, dry skin, cool extremities, aches).  I lost around ten pounds by increasing my fat consumption, and have lost another five or so by reducing carbs, so am very curious about all of this.

    • Chris Kresser says

      Laurie: soaking or fermenting grains does improve their digestibility, but it doesn’t eliminate the gluten. I recommend that all people diagnosed with Hashi’s avoid gluten completely, regardless of whether they notice a reaction. We now know that gluten intolerance can manifest in many ways, and gut inflammation is only one of them.

      Fermented foods are an excellent way to get probiotics, but make sure you’re getting prebiotic foods as well. These would include resistant starches contained in sweet potatoes, taro, etc. as well as inulin in onions, chicory, jerusalem artichoke, etc. You can also take a prebiotic supplement to see if that helps.

      The reason Dr. K says “find a practitioner” is that autoimmune thyroid conditions are incredibly complex and therefore not easy to self-treat. I will be working with patients at a distance beginning in the next few weeks, so that’s an option if you find you need further help.

  45. says

    Hi Chris, This is really becoming a helpful series. I forwarded your posts to some acquaintances of mine, who suffer from hypothyroidism. Won’t be long and Kharrazian can serve his apprenticeship with you :-). This week I wrote an easy to read post on how to reverse a leaky gut and stop autoimmune diseases. I hope your readers may benefit from it too: . VBR Hans

  46. claire says

    I’ve been following this series with interest since my N. Doc has me on iodine supplements and is using iodine loading test(s) to check on my progress. Your anti-iodine ideas gave me food for thought, but no real idea if I should stop taking it. What is the test I should ask for from the Naturapath to determine Hasimoto’s. (I know I haven’t had it)
    Also in this article you mention estrogen fluctuations  as a potential auto-immune trigger, but no ideas what to do. This is what my naturapath is helping me with- perimenopausal estrogen dominance and better clearing of estrogen through the liver by working on diet, stress, and helpful supplementation. (she uses estrogen metabolism tests to see how well my liver is doing) I do love your writing, but I can’t help but feel like few doctors, natural or otherwise, do more than just attribute problems like this to perimenopausal hormone imbalances without the corresponding suggestions of tests or treatments.
    I’m trying to prevent myself form developing autoimmune disease and it’s frustrating because when hormone fluctuations are a problem, it’s like I’m supposed to accept this as part of perimenopause and that nothing can be done.
    Please talk a bit about things women might do about hormone triggered autoimmune disease?

    • Chris Kresser says

      Claire: I wish I could give you an easy answer. But these are complex problems, and they’re not amenable to canned, one-size fits all approaches. I couldn’t hope to advise you or anyone else without doing a full work-up and exam to determine the exact mechanisms involved. Hopefully that’s what your naturopath is doing. In general, hormone problems are secondary to (caused by) blood sugar imbalances, adrenal stress (cortisol dysregulation), essential fatty acid deficiencies, hormone clearance issues and gut infections or inflammation. If all of those issues are addressed, the hormones generally balance themselves. In particular, the state of the adrenals is important in perimenopause and menopause because during that time ovarian production of hormones is declining, and the slack is picked up by the adrenals. A salivary test can give your practitioner important information about your adrenal health, and cues for where to go from there.

      • Dr Amy Denicke says

        Maybe all of you should read up on adrenal fatigue and its association to the thyroid and sex hormones. The cause could likely be attributed to stress in our rediculously demanding lifestyles that we choose to lead. The stress weakens the adrenals, steals sex hormones to continue the catabolic spiral derived from stressful stimuli. Thyroid, being your master metabolic manager, will shut down overtime due to chronic breakdown and stress to avoid further breakdown and “age ing” of the tissues. This cascade effect can cause wild fluctuations of the blood sugar (cortisol connection)and can also cause gluten intolerance or allergies (celiac) and/or diabetes. This is how stress can cause hashimotos. You must heal the adrenals in order to restore/regenerate the thyroid. Adding to your list is a quality multivitamin without iodine, iron or boron, Himalayan sea salt in large amounts of purified water and most of all…….behavior modification and low heart rate exercise. Be nice to your mind and body; it takes training, but is imperative to energizing your parasympathetic nervous system. Network chiropractic is a great tool in maximizing your parasympathetic nervous system and quietening the sympathetic system that is chronically triggered in periods of stress (ie, unfulfilling job or relationship)

      • Susan D says

        My endo said the salivary test is a joke. However, I have a Naturopath that had me complete one.
        My natruopath indicated that my cortisol levels were high all day and said that I must get them to come down. My norephinephrine was high and my epinephrine was low. Histamines were high too. Dopamine/DOPAC both low. I don’t entirely trust this naturopath, but starting to wondering if maybe I should be trusting her, more than my endo. My endo just keeps upping my levoxyl (now unithroid-with the non-availability of levoxyl) and I am barely seeing any changes in my free T4. Can’t lose ANY weight. Cut out gluten and sugar about 2 months ago with no results. So, do I have to cut out dairy too? Been researching Paleo. I was snacking on skinny pop-popcorn, but is that not allowed on Paleo?

        Anyone with any comments/suggestions, would be appreciated. Should I be taking any thryoid replacement? I really don’t know which way to go with this? Thanks!

        • Lisa says

          Hi Susan, how are you now- a year later? Did you go full paleo yet? Yes dairy should be stopped as well as nightshades. If you find improvements then reintroduction should be slowly (one thing added back in and monitored), but maybe not a good outcome.

  47. Renee Blancq says

    “In the first post in this series, we established that hypothyroidism is an autoimmune disease (called Hashimoto’s) in the vast majority of cases. ”

    Just to be clear, the above quote from this article is wrong, hypothyrodism is not an autoimmune disorder, Hashimoto’s is an autoimmune disorder with hypothyroidism being the most common symptom of the disorder. Hypothyroidism can be caused by many things but Hashimoto’s is the leading cause of hypothyroidism.

    • Chris Kresser says

      There was a word missing. It should read: hypothyroidism is *caused* by an autoimmune disease in the vast majority of cases.

  48. says

    In this article they are taking everything so piecemeal, yet in reality it’s all connected.  I think it’s kind of nearsighted, as opposed to holistic.  If you add it all up, a diet following the principles of Weston A. Price is really what it all points to.  But they never really add it all up.  It’s sort of like if you describe all the letters in detail but you never say the word.  I don’t see anything simple here!  Also, for most of the practitioners I know who have worked with thyroid disease, they believe that iodine will help even autoimmune thyroid disease.  However, this article says to avoid iodine.  I found than in my case, even though I had an autoimmune thyroid condition and was allergic to iodine, a simple anti-allergy procedure (and a healthy diet) enabled me to take the iodine I needed and recover from thyroid problems without any drugs.

    • Rick says

      Could you please go into more detail of the anti-allergy procedure that allowed your body to process iodine better?

      Please provide details.

      Thanks RJ

  49. Chris Kresser says

    What I’ve said in the articles was 90% of hypothyroidism is caused by Hashimoto’s.  That’s not the same thing as saying Hashimoto’s is equivalent to hypothyroidism.

    Hashimoto’s is an autoimmune disease that progressively destroys the thyroid gland.  During an autoimmune attack, as the gland is destroyed thyroid hormones are dumped into the bloodstream.  This causes a temporary hyperthyroid condition (Hashimoto’s toxicosis), and explains the fluctuations between hypo- and hyperthyroid a Hashimoto’s patient experiences early in their disease.

    As time goes on, more and more of the thyroid gland is destroyed and the condition evolves into frank hypothyroidism without any hyperthyroid surges.  Note that some Hashimoto’s patients never experience significant episodes of hyperthyroidism secondary to glandular destruction, while for others, such episodes can be quite severe (to the point of these folks sometimes being misdiagnosed with Graves’).

    Ultimately, without (and often even with) treatment all Hashimoto’s patients will end up being hypothyroid.  How much time this takes depends on the person and the treatment.

  50. Elizabeth says

    Perhaps you weren’t clear, then, Chris. I had the same belief, but maybe that was because that was what you were discussing.

    • Lila says

      The article opens with the following statement:

      “In the first post in this series, we established that hypothyroidism is caused by an autoimmune disease (called Hashimoto’s) in the vast majority of cases.” So, yes, you did say that Hypothyroidism is Hashi’s. Whole different animal. If you’ve ever had it, you would know.

      • Willow Silverhawk says

        Saying that hypothyroidism is caused by Hashimoto’s is very different than saying that Hashimoto’s IS hypothyroidism. Hypothyroidism is one of the dominant symptoms of Hashimoto’s, and it is how most people find out they have Hashimoto’s, but Hashi’s is much more than just hypothyroidism.

    • tisa says

      I have hoshi’s and I thought I had things “figured out,” after the last two years of pain and torture. I’ve been on a low dose of cytomel and eating, supplementing well. suddenly my balanced numbers went way up, T3/T4 through the roof and my antibiodies to 137 when normal is less than 40. I suspect its just the “way it goes.” I honestly haven’t been monitoring my blood b/c of insurance. I finally was able to check it when obama care came through. I’m really disappointed. I was gaining weight and so proud of myself b/c i thought it was due to eating well. turns out i’m just going hypo again. my thyroid is throbbing and I don’t know how to take the pain away. I was trying to look for a trigger and I discovered that 2 months ago I added a mineral supplement to my diet and it has iodine in it. Could that be the culprit? I ‘ve read idoine is good and I’ve read it’s bad. you read one thing and then read the complete opposite somewhere else. I also read recently that kale is bad for hoshi patients! I’ve been drinking kale smoothies for a whole year and I feel they have aided in my getting back to health. Any thoughts out there on the iodine thing? And besides adjusting my meds and taking advil any magic cures for stopping the pain in my neck? I’m getting my ultrasound this mouth.

      Thanks guys.

  51. Tiffany S. says

    It’s my understanding, as explained to me by a variety of doctors, that Hashimoto’s is NOT hypothyroidism but a fluctuation of hypo and hyper that may or may not eventually result in full-blown hypo. I think explaining it as only hypothyroidism is an over-simplification. I have been able to treat my symptoms with T3 therapy and have very little hypo symptoms anymore and rarely feel the hyper but they had been there. Just my two cents, as a Hashi’s patient.

    • Colleen says

      In Hashimoto’s “hypothyroidism”, thyroid tissue is being destroyed by the immune system. Over time, if the autoimmune response is not checked…more and more tissue will be destroyed leaving less of the thyroid gland to produce thyroid hormone = Hypothyroidism. The “hyperthyroid” sx that accompany this condition are caused by the release of an uncontrolled ( ie random ) amount of thyroid hormone into the bloodstream = excess hormone = “hyperthyroid” symptoms. Just another reason NOT to simplify a health condition based on symptoms. Just my 2 cents as a practitioner

    • Lila says

      As another Hashimoto’s patient here who has been to at least 5 Endos and told I have Hashi’s and am very very sick am told that Hashi’s doesn’t cause symptoms. Doctors do not take this disease seriously at all. I has ruined my life. I used to hike Mountainsin Arizona, had a great life, full of energy. Now I can barely function…Oh, but the TSH is in range while the T3 & 4 fluctuate and I have to beg to get those tested, not to mention the antibodies that Endos aren’t even aware of or care to test for. One doc, when I told him about my eyes killing me and the horrid headaches said it had nothing to with my thyroid. Well, 2 weeks later I went to the eye doc and found out I had Thyroid Eye Disease. Why oh why don’t doctors listen. After being put on antidepressants and antianxiety meds and told it was depression, I suffered for years without a dx while this disease wrecked my body. I too go Hyper/Hypo. Before they dx’d me with Hashi’s they told me I must have rapid cycling BiPolar. I think it’s criminal and they should have their licenses revoked….! Endos know nothing about thyroid disease. It should fall under the realm of AutoImmune and Rheumatology if they’re not willing to learn about what this disease really does.

      • Monica says

        I too have had to diagnose myself with everything from gluten intolerance to hashimoto’s disease. I spent incredible amounts of money, time and energy going from doctor to doctor looking for someone to help me with all of the symptoms I have had for many years. The worst part was that I was labeled “crazy” and hospitalized and put on many different psychiatric medications that almost killed me as I underwent phases of hyperthyroidism. I still have not found all of the pieces I need to get well and am very grateful for this information that Chris shares. I believe that doctors are supposed to take an oath of “do no harm” of which I can honestly say has not been taken seriously by those who have taken it. My life is forever “altered” because of this illness and the inability of doctors to diagnose and treat it.

        • Lyn says

          Find a Functional Medicine Practitioner – often they are also Chiropractors. Find one that has credentials such as chiropractic neurology. You want to work with one who specializes in Thyroid, HASHIMOTOS, Immune disorders. Some may help you via Skype or phone. Go to youtube listen to what some of the doctors have to say. Learn what you can to help you sort thru doctors to find some that can help you.

      • Marsha with Hashi's says

        Could not agree with you more on the endos and their complete arrogance about what they know little about. We need a specialized Dr. Whom has been educated properly in our AI disease!

      • Kikay66 says

        I can relate to all of you, and although I have only been on this for a few days, digestacure is looking promising……I’ve been almost home bound for a year…..10’s of thousands of $$ later, I’m worse……someone else who suffered worse than I do has had HUGE success after 35 days……if I get better, I am going to spend every dollar I can to share my solution!

      • StudentDoc says

        Hello Lila
        Sorry to hear you have not found the answers for your condition. If you still have a within normal TSH & fluctuation of T3/4 then you must also consider the possibility of estrogen influence on Thyroid gland, which usually will present with a normal TSH however higher T4. The new guidelines states that Thyroid diseases should not only be diagnosed on the basis of TSH but also primarily based on Clinical Symptoms.
        I am certain you understand the mechanism of the condition as in my experience most patients are well read & have great insight to their body & symptoms. TRH from hypothalamus (brain) activates TSH in the anterior pituitary, which then activates thyroglobulin (TG) in the thyroid gland to join the Iodine with the help of enzyme TPO to form T4/thyroxine. T4 is found in our blood as total T4 which is a combination of free (active) & combine w/ TBG carrier (inactive) state. The free T4 will deionize to become free T3 which is actually the most active & the smallest amount found in the blood.
        Therefore, it is important to rule out pathologies related to various mechanisms throughout the pathway i.e. TRH—>TSH—->T4—->T3

        The best part of the pathway is its negative feedback system, i.e. inactivation of TSH receptors on the pituitary by the free T3 hormones. Coming back to your presentation of high T4/3 with normal TSH, perhaps eludes to the fact that there may be stimulation of T4 to convert to T3 without any +\- feedback mechanism; which can be due to fluctuations in estrogen, as estrogen synthesizes/makes TBG for it self & any access will combine with T4 to then give a higher T4 blood level.
        You may also request an Iodine (I-131) uptake test, which can further help diagnose any “warm,hot,cold” areas in the thyroid glad to then help rule out/in other pathologies on the above pathway.
        Please do NOT STOP advocating for your body & self until you find that one physician that will validate your symptoms & provide the care that works best for you. You know your body better than any health care personal, if you innately are not satisfied with your diagnosis then keep advocating. Good luck & hope you find your “life” back to enjoy the activities you so did :)

      • Wanda says

        Hi Lila-

        I read your story and I not only understood what you were saying, but I can completely understand how you are feeling. Hashimoto’s at times has ruined my life. I’ve always been very happy go lucky, full of life and love to be on the go golfing, traveling, spending time with my son and friends. Now, I don’t know from day to day how I’m going to feel when I wake up in the morning. I have spent the past several years taking my health into my own hands because no Dr.’s have been able to help me. One thing I have come to realize is that I have several food intolerances that will cause Hashimoto’s symptoms and one by one I am figuring them out and it has really made a difference how I feel. I can no longer have gluten, yeast (anything with yeast makes me feel very sick almost like the flu when I eat it), soy, any kind of artificial sweetener just to name a few. I wanted to share what I learned with you because I was amazed at how sick certain food made me feel and I’m still developing intolerances and I just eliminate them as I go. I don’t feel 100% and I’m not sure I ever will but with lots of research and dedication to my health I have found things that have helped me a great deal that no Dr. would have helped me with.

        • Yeramian says

          I’m reading through this forum for the first time and came across this reference to “digestacure,” which has caught my interest! I’m going to look into this. I’ll start out reading about it! Good luck with your journey!

      • Raquel says

        I agree. It’s criminal. Plain and simple.

        I have oftened wondered why more people have tolerated this for so long. They have made a joke of people. Especially easy to manipulate women with this, sending them on years of misdiagnosis, and drugs, making them feel as if they are somehow crazy?

        People with this problem SHOULD be revolted at the care we receive, especially when you consider how many ways this can effect you. An autoimmune disease isnt exactly like catching a cold!

        My endo dismissed the immune system part. He said “cmon you dont want gluten?” He also wouldn’t check anything outside of TSH. I tried to to tell him about research, leaky gut, etc and he dismissed it.

        It was as if he was more concerned with protecting his ego, and his “title” along with being the “authority” in the room vs listening little ole me patient.

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