The Most Important Thing You May Not Know About Hypothyroidism

hypothyroid

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

An estimated 20 million Americans have some form of thyroid disease. Up to 60 percent of these people are unaware of their condition. One in eight women will develop a thyroid disorder during her lifetime. Levothyroxine, a synthetic form of thyroid hormone, is the 4th highest selling drug in the U.S. 13 of the top 50 selling drugs are either directly or indirectly related to hypothyroidism. The number of people suffering from thyroid disorders continues to rise each year.

Hypothyroidism is one of the most common thyroid disorders. One recent analysis suggested up to 10% of women over 60 have clinical or subclinical hypothyroidism. It is characterized by mental slowing, depression, dementia, weight gain, constipation, dry skin, hair loss, cold intolerance, hoarse voice, irregular menstruation, infertility, muscle stiffness and pain, and a wide range of other not-so-fun symptoms.

Every cell in the body has receptors for thyroid hormone. These hormones are responsible for the most basic aspects of body function, impacting all major systems of the body.

Thyroid hormone directly acts on the brain, the G.I. tract, the cardiovascular system, bone metabolism, red blood cell metabolism, gall bladder and liver function, steroid hormone production, glucose metabolism, lipid and cholesterol metabolism, protein metabolism and body temperature regulation. For starters.

You can think of the thyroid as the central gear in a sophisticated engine. If that gear breaks, the entire engine goes down with it.

That’s why people with hypothyroidism experience everything from weight gain and depression to infertility, bone fractures and hair loss.

One of the biggest challenges facing those with hypothyroidism is that the standard of care for thyroid disorders in both conventional and alternative medicine is hopelessly inadequate.

The dream of patients with thyroid disorders and the practitioners who treat them is to find that single substance that will magically reverse the course of the disease. For doctors, this is either synthetic or bio-identical thyroid hormone. For the alternative types, this is iodine.

Unfortunately, in the vast majority of cases neither approach is effective. Patients may get relief for a short period of time, but inevitably symptoms return or the disease progresses.

So what’s the problem? Why have replacement hormones and supplemental iodine been such dismal failures?

Because hypothyroidism is caused by an autoimmune disease.

Studies show that 90% of people with hypothyroidism are producing antibodies to thyroid tissue. This causes the immune system to attack and destroy the thyroid, which over time causes a decline in thyroid hormone levels.

This autoimmune form of hypothyroidism is called Hashimoto’s disease. Hashimoto’s is the most common autoimmune disorder in the U.S., affecting between 7-8% of the population. While not all people with Hashimoto’s have hypothyroid symptoms, thyroid antibodies have been found to be a marker for future thyroid disease.

Most doctors know hypothyroidism is an autoimmune disease. But most patients don’t. The reason doctors don’t tell their patients is simple: it doesn’t affect their treatment plan.

Conventional medicine doesn’t have effective treatments for autoimmune disease. They use steroids and other medications to suppress the immune system in certain conditions with more potentially damaging effects, such as multiple sclerosis, rheumatoid arthritis and Crohn’s disease.

But in the case of Hashimoto’s, the consequences – i.e. side effects and complications – of using immunosuppressive drugs are believed to outweigh the potential benefits. (Thanks to conventional medicine for a relative moment of sanity here.)

So the standard of care for a Hashimoto’s patient is to simply wait until the immune system has destroyed enough thyroid tissue to classify them as hypothyroid, and then give them thyroid hormone replacement. If they start to exhibit other symptoms commonly associated with their condition, like depression or insulin resistance, they’ll get additional drugs for those problems.

The obvious shortcoming of this approach is that it doesn’t address the underlying cause of the problem, which is the immune system attacking the thyroid gland. And if the underlying cause isn’t addressed, the treatment isn’t going to work very well – or for very long.

If you’re in a leaky rowboat, bailing water will only get you so far. If you want to stop the boat from sinking, you’ve got to plug the leaks.

Extending this metaphor to Hashimoto’s disease, thyroid hormones are like bailing water. They may be a necessary part of the treatment. But unless the immune dysregulation is addressed (plugging the leaks), whoever is in that boat will be fighting a losing battle to keep it from sinking.

What the vast majority of hypothyroidism patients need to understand is that they don’t have a problem with their thyroid, they have a problem with their immune system attacking the thyroid. This is crucial to understand, because when the immune system is out of control, it’s not only the thyroid that will be affected.

Hashimoto’s often manifests as a “polyendocrine autoimmune pattern”. This means that in addition to having antibodies to thyroid tissue, it’s not uncommon for Hashimoto’s patients to have antibodies to other tissues or enzymes as well. The most common are transglutaminase (Celiac disease), the cerebellum (neurological disorders), intrinsic factor (pernicious anemia), glutamic acid decarboxylase (anxiety/panic attacks and late onset type 1 diabetes).

In the next post we’ll look more closely at why Hashimoto’s can’t be treated successfully without addressing the autoimmune component, and why both the conventional and alternative approaches to treating hypothyroidism are destined to fail from the start.

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Comments Join the Conversation

  1. Rosemary says

    I have been looking forward to your info on hypothyroid and autoimmunity. Great post.
    I am particularly interested in what you have to say on follow-up pertaining to the dessicated porcine replacement therapies (Armour and NatureThroid in the US and THYROID in Canada.)
    I am also interested in having you speak about diet and hypothyroidism. SO much confusing info out there on this. I have read in various places that soy and certain vegetables in their raw form are “goitrogenic” suppressing thyroid function, such as bok choy, broc­coli, brus­sel sprouts, cab­bage, cau­li­flo­wer, gar­den kress, kale, kohl­rabi, mus­tard, mus­tard greens, radishes, ruta­ba­gas, soy, soy milk, soy­bean oil, soy lecithin, soy anything, tem­peh, tofu and turnips. And mildly so, bam­boo shoots, millet, peaches, pea­nuts, pears, pine nuts, radishes, spi­nach, straw­be­rries and sweet potatoes.
     
    Thanks Chris!

    • Chris Kresser says

      Rosemary,

      I will indeed cover those topics. It may take a while to get to them, with my licensing exam coming up, but I will at some point.

      I can tell you this briefly: the effects of dietary goitrogens are negligible. I don’t advise hypothyroid patients to stop eating the foods you listed for that reason.

      • Celeste Baxa says

        How do I find a doctor that will do the correct testing? My daughter has hashimoto and I have all the symptoms…loss of hair, dry skin, tiredness, weight gain and depression. My family dr did the normal blood test that came back negative and an endocrinologist won’t see me without a diagnosis. I know I have a thyroid problem. I am in Tampa,Fl

        • Sunshine says

          I had been bitten by an infected tick when I was 24 and within weeks my thyroid went on the blink to the point that they said I had to have it removed. Bummer…..I would tell anyone with this prognosis to have a test done for Lyme Disease . I would bypass the Elisa test and have all the panels done from a test kit , from Igenex , in Paulo California. Then find a Lyme Literate Doctor that has helped many to recover…. It does affect the thyroid. Check it out before any surgery , because surgery means hypo thyroid for the rest of your life. and mine was Lyme afterall. I am now 59 years old and I know there are symptoms of thyroid problems with Lyme…Just saying!!!!

        • Ana says

          Hi Celeste, I’m in Tampa too and I see Dr Judah, Michelle in Valrico. She’s a great family doctor. I have hypo and she’s the one that diagnosed me with hashimotos. Hope this helps.

          • Karen says

            Hi,
            My lab result say that I have hypothyroiditis in a subclinical setting and that I should be investigated for Hashimoto’s Disease. Some reports say brocolli, bok choy, soy are good while others say they are goitrogenic. I am very confused. A doctor prescribed Synthroid 0.5 mcg – 1 pill daily which I took for 4 days until another doctor told me to stop it. I now hear singing, chanting and wailing and it is causing me so much distress. I understand that hypothyroidits, if untreated, can cause a psychotic reaction. Does anyone out there with hypothyroiditis know the answer? Thanks.

        • April says

          Keep fighting, find a new doctor. It took me seven years to find a doctor that sent me to an Endocrinologist. I went in with my own diagnosis. I told them since I am being told I don’t have a thyroid problem (even though it was running through my whole family) then I must have Adrenal Fatigue. Some how that seemed to get the ball rolling….even though first they made me extra ill by giving me all kinds of psychotropic medications. If I were you I would take in lots of articles from the internet. Be sure that you tell them these are your symptoms and that you are not applying the symptoms to yourself after you are finding them but that you were looking up the symptoms you have and everyone’s finger but the doctors is pointing to Thyroid. Then tell him many people are symptomatic before it ever shows up in your blood tests and that you are paying him and want him to refer you to an Endocrinologist and that if he doesn’t you will no longer be his patient.

        • Emmett Grogan says

          Celeste: I suffered from hypothyroidism for 15 yrs with no diagnosis. I finally discovered that thyroid tests which usually consist of TSH only, don’t give accurate measurements. It’s graded on the curve – IOW, TONS of people have low thyroid that are undiagnosed but they still grade it on the “average” thyroid test of “normal” people – which is why the people who are slightly low don’t get diagnosed. It takes an average of 7 yrs to diagnose simple low thyroid (note: low thyroid is different from Hashimoto’s). Here’s a website that I used to cure myself:
          stopthethyroidmadness.com
          They help with thyroid-related disorders as well such as adrenal fatigue. I couldn’t heal my thyroid until I dealt with the adrenal fatigue first. I went on natural dessicated thyroid, NDT (Armour, Naturethroid etc.) You have to convince your doctor that you are hypothyroid and then convince him to prescribe NDT. The Synthroid and other synthetics don’t work very well, no matter what your doc says, he doesn’t know because he learns everything from Big Pharma, which doesn’t make NDT. NDT will address T3 and T4 issues, Synthroid onl addresses one of those. I believe there is a list of docs who understand thyroid on the website. Also, there is a terrific book by Dr. Broda Barnes that will tell you most everything you need to know about thyroid issues; it’s called “Hypothyroidism: The Unsuspected Illness also Janie Bowthorpe wrote a book and it’s on the website. You can get both in used books at Amazon. Also Dr. Brownstein has a book “Overcoming Thyroid Issues” and his book on iodine is excellent. I highly recommend all these books. Hope this helps; I’ve been there, I know what it’s like and it’s miserable. Good luck!

          • susan says

            Emmett: you are right and you need to get gluten and dairy out of your diet as soon as possible as they cause autoimmune disease.

              • Tula says

                It doesn’t. Gluten and wheat can aggravate the immune systems of those with a sensitivity or allergy to it. The same goes for soy and dairy. They have been linked to inflammation, which is an autoimmune response, but they don’t have that effect on everyone. I personally have a mild soy allergy, so when I eat more than a trace of it, I get a lot of immune response (among other unpleasant things). I found out about the allergy the hard way after noshing on edamame (sp?) at a sushi restaurant one night. I also have RA, so my immune system is touchier than most. For the average person, dairy and gluten aren’t a problem. Soy, though, really isn’t a good food for human consumption. It has a lot of not-so-good characteristics.

                • Honora says

                  Direct-MS website had some informationon Molecular Mimicry. There was a lot of research done on this in the late 1990′s. The theory goes: the body gets exposed to antigens such as viruses, the body then develops antibodies to these antigens, These antibodies attack the body’s tissues that have similar sequences of amino acids, then when an individual eats a food containing yet again identical sequences of these amino acids, the antibodies formed against the targeted tissues are mobilised to attack the tissue some more. For auto-immune thyroiditis, it’s wheat, for Multiple Sclerosis, it’s wheat (gluten), dairy (casein) and legumes!

        • says

          Definitely find you an ENT or GP that believes you. I got my ENT to believe that I was having almost all the symptoms(which I was) and it ran in my family distantly which I didn’t even know st the time. I told him my lab work over 10 years had always looked normal, and asked if there is a chance that it could be wrong?! He said an ultrasound of my thyroid would show him definitive answers and if that came up positive then a antibodies test for Hashimoto’s disease would be the next step. I had the symptoms for 10 years and endured horrible symptoms and it made me miserable. I felt bi-polar (extremely moody), lost tons of hair, had dry skin, my thought would swell up & hurt occasionally, etc… I had nodgules on my thyroid, am extremely big thyroid, etc… from the disease. I now see an Endocrynologist and have been finally been properly diagnosed after 10 years of hell. The doctors started thinking I was crazy, but I stuck to my guns and went with my gut. Eventually it paid off lol. I went so long in diagnosed though after a year of treatment I still have many problems and permanent/irreversible damage… Is what I believe. It affected my back and lead to many other problems like Fibromyalgia that I have severe pain all over my body all the time. And have had rods and screws put in my back also bc of these doctors not believing me.

          • Dorothea Crowther says

            Lace, I also suffered from fibromyalgia until I saw an item on the internet from a man who said he had cured his by cutting out cows milk entirely. Within one week I was almost completely pain free after thirty years of intense pain. Try this,it may help you.

          • stefanie says

            I have suffered severly from this disease.The worstpart ismy family doesn’t believe me.My husband actually said to me,”just get up and go do something ,you will feel better”. At this point ending my life is at the top of my list.

            • stefanie says

              it used to be justthe weightngain and No energy, but now its the brain fog, thid deep depression, angry moods swings , no periods, and now these terrible body aches in my legs , feet , neck, the over all no happyness and helplessness.I cant do simple thisngs like I used to, even spell. my husband hates me now and doesn’t think there is anything wrong with me, only that Im a crazy bitch and now so do my kids, honestly I have nothing to live for anymore.My husband said everybody would be happier if I leave, so its probally best!God help me

              • Danielle says

                Stefanie,

                Do not give up hope. Contact as many endocrinologists as you can then. Look on Dr. Kharrizian’s website for doctors in your area who specialize in thyroid treatment. Google thyroid doctors and specialists in your area and if there are none, reach out to others in surrounding areas and let them know your symptoms (maybe leave out the family stuff for now so they don’t think it could be other factors). I found even e-mailing doctors out of state helped me. They have networks and can steer you in the right direction. ALSO, if you haven’t already, CHANGE YOUR DIET. No gluten, soy, dairy. I went even further and follow the Paleo Autoimmune Protocol. Google it and follow it immediately. If you are 100% serious about getting better, follow a strict diet and you can get better (I have hashimoto’s and it ruined my life). Maybe sit down with your family and tell them, you are not well and need help but you appreciate their support and one day you will be healthy and happy again.

              • Dawn says

                Stephanie – You might consider going to a Naturopathic Doctor (google one near you). Mine ran a full thyroid and autoimmune panel, which is how I found out that I have Hashimoto’s in addition to low thyroid function and low free T3. My pharma doc only ran the basic tsh test yearly and prescribed levothyroxine for 10 years. Once the ND and I found out that my thyroid was also producing antibodies to “something” we ordered the next logical test – a food allergy panel. Here I found out I was allergic to eggs, which may be a cause of my antibody production and attack on my thyroid. I was eating eggs several days a week (or products with egg in it) and since omitting feel so much better. One must be diligent and read labels to avoid those products! I was also deficient in vit D3 which (another cause of tiredness, aches, and pains). The ND has me on D3/Vit K2 drops. Vit D3 and K2 work in tandem, so are good to cover together. I will be testing again after a several months of being egg-free and nourishing my deficiency to check on levels of improvement.

                All is not lost for you! Find a good Naturopathic Doctor (ND). They understand the need to find and treat “root cause”. Pharma docs and specialists only treat our symptoms. Chris Kresser provides a wealth of information on running your own tests too. We don’t need a a doc lab slip to do so: http://www.requestatest.com.

                Take action for your well-being. Good luck!

              • Autumn Griffin says

                Stefanie,
                Please don’t give up! I know it is frustrating when your doctor doesn’t listen to you and you feel like you can’t get help. And your family not understanding has to be awful. I have hypothyroidism and before I realized I had it I was so miserable, physically and emotionally. It makes you depressed. I have been having other medical problems lately and can’t seem to get a specialist to take me seriously. I don’t know where you live but if you have access to a larger hospital system, I live an hour from the Cleveland Clinic, maybe you should try a doctor affiliated with them. I know several people who have more success with getting answers by going to the Cleveland Clinic as opposed to the doctors closer to my home. I have an appointment there in early July. So I am praying they can help me. Hang in there. Please don’t take your life it isn’t worth it. Some doctor will help you

              • penny says

                I felt the same way about 2 weeks ago. I was asked to sign my name and actually had to think for a min. Research adrenal fatigue. I did and got some adrenal support supplements and I feel 100% better and it only took like a week to tell I was feeling better. I even had the allergies. Sneezing all day coughing all day now I don’t even have that anymore. It may be temporary but I’m just thankful to feel good for the moment. I have been diagnosed for a year with hypothyroidism.

              • Teya says

                Stephanie- Please don’t give up! Many of us experience/experienced most of the same feelings you’re experiencing, and we know that it is very difficult to find understanding and compassion at times. Taking one day at a time is extremely important, as well as taking charge of your health- physical, mental, spiritual, and emotional. We sometimes have to be our own cheerleaders and encouragers. I appreciate and applaud your bravery for openly sharing your true thoughts and pain. I have a sneaky suspicion that you articulated what many sufferers feel but feel ashamed or maybe embarrassed say. With heartfelt empathy, this too shall pass!

          • Linda says

            My story sounded like the first half of yours. Did you find out if you had Hashi’s? I don’t, yet still have all the symptoms, even though my tests come back wnl, just not optimal. What finally got you on the right track?

        • says

          Hi Celeste,
          I do not know of a specific doctor I could refer you to in Tampa, but I think you might have better success looking for a chiropractic physician who practices functional medicine rather than limiting yourself to only consulting with medical physician. Most chiropractic physicians trained in functional medicine will know what to do and there are many of them in Florida. Keep in mind too that most conventional doctors not only do not run all the thyroid tests needed, they use the regular laboratory reference ranges to help determine “normal”. These ranges are too broad. Your lab test results could easily run within the regular lab ranges but be significantly outside the optimal function ranges, so your hypothyroidism could still be missed with even running all the right tests. If that happens in your case, most Endocrinologists will conclude you do not have a problem. Also be aware that even if your thyroid antibody tests come out “normal” you could still have an autoimmune problem. I expect Kriss will be getting in to all of this in future posts.
          Hope this helps.
          Vernon Redd, DC, APC

        • Judy says

          There is a great thyroid doctor in Panama City, Florida and you can self refer. He has the diabetes, thyroid and Endocrine Clinic. His name is Dr. Sheriff kamel. I heard about him on a thyroid blog. I live in the upper west most part of Florida and this doc is worth the trip.

      • Susan Williams says

        For someone suffering from hypothyroidism, do you recommend cooking the goitroenic foods a little prior to eating or do you think they’re okay to eat raw?

        • April says

          They say to cook Cruciferous vegetables before eating as it reduces the goiter factor in them. I have to say I have been eating most of them raw for my whole life and have not developed any nodules or goiters. I am sure it is like everything else. For some it’s okay and for others they end up with growths and goiters. I say mix it up. That way you are not doing to much raw, but you can still enjoy the flavor of the raw on occasion.

      • MikeL says

        Does anyone have a firsthand account of using Anatabloc for treating thyroid symptoms? There’s been at least one apparently successful human trail so far. http://www.ncbi.nlm.nih.gov/pubmed/24178792?dopt=Abstract

        Anatabine supplementation decreases thyroglobulin antibodies in patients with chronic lymphocytic autoimmune (Hashimoto’s) thyroiditis: a randomized controlled clinical trial.

        Results: Anatabine-treated patients had a significant reduction in absolute serum TgAb levels from baseline by study end relative to those receiving placebo (P=.027); however, there were no significant changes or differences in treatment group means for TPOAb or TgAb levels. Mean±SD TgAb values decreased by 46.2±101.1 and 3.9±83.9 World Health Organization units for the anatabine and placebo groups, respectively. Significantly more patients had a >20% drop in TgAb levels in the anatabine than placebo group (P=.023). Overall, the anatabine supplement was safe and well tolerated, although significantly (P<.05) more patients in the anatabine group reported adverse events.

      • karina says

        Thank you for sharing your knowledge about hypothyrodism. I hope and expect that you will also address hypothyrodism NOT related to auto-immunity, such as stress & adrenal fatigue and how to behave/treat under those circumstances.

      • Nickolas says

        I like the info but feel it tells people that if you have hypothyroidism you have an autoimmune disease, which isn’t always the case. I have had hypothyroidism for 6yrs now and take a fairly large dose of levo (.225 micrograms) but do not have an autoimmune disease. We definitely need more knowledge on hypothyroidism and better communication. Plus much better medical treatment. I’ve always felt Doctors , pharmacist s and people in general don’t realize the seriousness of our condition, so thanks for writing this.

    • Monet says

      I have Hashimoto’s and have had a full Thyroidectomy at 28 I am now 43 I have a high titer and calcium bone issues. I had to leave OC Cali to live in Canada in which left me with no health care and landed me in a world of trouble even within the US with trying to do this on my own. Remember words like Coma Adrenal Crisis and Death… Yes many of the meds are awful and quality control is not regulated but like me without insurance and without and endocronoligist I am a mess and sick! This is no laughing matter this little thing can turn into your life or there lack of one. Maybe could well land you in a mental institution as it will mimic many other disorders. Today Amor is your best bet but do not deviate from an endo, I am lucky to be alive to today instead of proper care I rec’d parkinsons meds.

        • Lynn says

          I am wondering what I can eat since I have IBS? Is there a definative test to say, yes, you definitely have hypothyroidism? Im reading you can have this test or that, but not sure if there is one particular test or if its just a process of elimination?

          • Gloria Frazer says

            I spent several years with a GP telling me my thyroid was normal. But the range for a standard blood test is huge and therefore not very accurate unless your thyroid disease is raging out of control.
            I was finally seen by an endocrinologist who performed a TRH Sensitivity Test.
            Kind of like the gestational diabetes test they do when your you’re pregnant.
            The TRH test involves drawing blood samples to measure TSH and then giving an intravenous injection of TRH to stimulate the pituitary gland to release TSH. The TSH is measured after the injection at various intervals.
            The standard test says 15, 30, 45 and 60 minutes. By measuring the response of TSH to TRH, one can usually tell whether someone has an overactive or underactive thyroid. When I had that test, the endocrinologist told me I have chronic hypothyroidism. And was able to start medication. Suprisingly, I’ve met several Gp’s who don’t know of this test. But any good endocrinologist will know of and utilize this test.

          • Gloria Frazer says

            My son wne through a debilitating year with IBS. ER visits, doctors, changing diet, etc.
            We found out that it is widely believed that IBS stems from psychological trauma or stress. A lot of people who suffer from IBS have depression. My son went to a psychologist and they put him on anti anxiety meds. Only helped a little. Then the psychologist suggsted hypnotherapy to address depression, anxiety, etc.
            IT WORKED!!!!!!All of his symptoms have disapeared. He has been symptom free for 2 years now.

    • Alan says

      Hey Chris, and thanks as always for one of the best health blogs out there.
      My peroxidase result was 30, with recommended values of 0-34.

      Should I be worried? I am going for another test to see how it progress in 6 months.

  2. Nancy M. says

    Most goitrogens are reduced quite a lot by cooking. Eating a ton of raw goitrogenic veggies isn’t a good idea, but having some cooked is not so bad, IMHO.

  3. barbara lochner says

     
    This is all well and good for people who have Hashi & antibodies…But you glossed right over those of us who are plain-old, straight-out hypothyroid.  No Hashi, no antibodies.

    • Chris Kresser says

      The focus of the article is Hashimoto’s and the 9 out of 10 hypothyroid patients that have it. Have you had multiple antibody tests? A single negative result isn’t sufficient. The immune system can be so depressed that antibodies aren’t being produced. Patients with hypothyroid need to be tested at least twice for antibodies to rule out Hashimoto’s.

      That said, I will be covering some hypothyroid patterns such as under-conversion of T4 to T3 and decreases/increases in thyroid binding proteins that are relevant to people without Hashimoto’s.

      • Vanessa Diaz says

        Hello,
        I have been reading your posts and I haven’t found any dealing with someone who has had their thyroid removed because of Graves and now has a problem with their levithyroxine leveled and staying leveled. The first two years my medicine seemed to stay level then it crashed as if I wasn’t taking my medicine. Then we upped the dose and I was good for about 6months. Then another crash we repeated and again it lasted for about six months then when my thyriod levels crashed so did my B12. My B12 was so low I had to get shots twice a month. This time my thyroid crashed again in 4 months (again like I wasn’t even taking my meds, my doctor asked if I was miss a lot of them. I take them like clock work because if I miss one that same day at about 2pm I am no good. I just want to sleep. Also I take my pill on an empty stomach and I don’t eat till about 2hrs later) and we increased the dose. That increase only lasted about a month. I just got the call that my tests came back low not as low as before but we took the tests faster this time then before. We are going up to 200 now. I’m so tired of this. I’m asking to go to a specialist but I don’t know if it will be approved. Your help would be greatly appreciated. Thank you.

        • Janice says

          Well, I can’t say if my thyroid was removed for the reason you spoke of, but I did have mine remove. My doctor, Dr. Hunter, whom I’m sure has passed on, said the youngest person he had ever did surgery on for removal was 12 yrs. old. I was only 4 yrs. old. I do have the hypothyroid and because of no medical ins. and no $ I have not been able to take my medicine. I have actually lost weight, which was needed, sleep lousy, but tired a lot. I know I should be taking it but until I can afford to get them what are the long term effects (if any) of not. Otherwise, I feel fairly good. I am now 52 yrs. old.

          • KAREN says

            I also have no insurance. I am on Natur throid 65 mg and just had my Rx filled at Walmart – 3 mos for $17. They have a discount for no ins. be sure to mention it.

            • Melissa says

              Actually, they have the generic version of synthroid called Levothyroxin, if that is something that works for you, it only costs $10 for a 90-day supply. The generic list is available to everyone, even without insurance. You can ask them for the generic prescriptions list.

        • nuttmegs17 says

          Vanessa – did you ever get this resolved? I am running into the same thing where I feel better initally and then several weeks later crash and feel just as bad as before I was taking it.

          • Kellie says

            Hey nuttmegs… I’m searching madly for info on people like myself who do thyroid interventions that work, and then leave them crashed… please let me know if you find anything!

        • lorraine crowder says

          just a suggestion: I had my thyroid removed 35 years ago and it seemed that my synthroid 200 just wasn’t working anymore, at least that is what I told the doctors. They tested and said it was OK. I was also having some trouble with my stomach and seeing that it is not working properly , how would my synthroid be able to be absorbed properly.
          I have been on a lot of antibiotics over the years , for numerous problems, chronic sinus infections, yeast constantly…..and even if I ate a properly sized meal, it felt like I was never full and always hungry. Question: What would cause this…..suggestion; Parasites…..they rob you of any nutritional value from your food, so you may eat enough , and the right foods, but if they rob you of your nutrients…vitamins and minerals , how could a person possibly expect their bodies to function properly. If the parasites are quite invasive…they can migrate to other organs as well……Liver cleanse….Parasite Cleanse….garlic….etc. I had horrible stomach pain when eating and instead of taking acid reducers..the next time I started taking Organic Apple Cider Vinegar( with mothers listed on label) just before I ate anything. Amazingly..It wasn’t that I had too much acid in my stomach…but rather..It seems I didn’t have any. Even my hair started growing healthily again. If you start this protocol, buy some ph test strips and check your urine, you will find it will bring your ph levels back up to normal. Strange but true…….Interesting huh. I couldn’t get any answers about why my thyroid pill wasn’t working effectively ….so the next place to look was the area where it was processed in the body…….I’m not a doctor …just another person with a similar problem..iNCIDENTLY, I had been bitten by a tick, infected with Borrelia Burgdorferi …around the time my thyroid started malfunctioning. Maybe , just out of curiosity check out the symptoms list for lyme disease and it’s co-infections.. Then call Dr. Murakami in Hope BC for what to do next,, should you find similar symptoms to yours in the check list. The endoctrine system is complex and connected in some fashion to all functions in the body. There is help ,if this is the case

        • Dr. P. A. Smith says

          Vanessa,
          I am amazed! Did you say that your thyroid was surgically removed because you had Graves disease?
          Best….I had Graves disease years ago also.

      • says

        re: Hashimoto’s disease / Antibodies / MS

        Dear Dr. Kresser,
        I’m 47 and have been diagnosed with MS since May 10, 2006 and have been taking Tysabri. I just recently tested positive for the JC Virus and going soon to be tested for the Varicella Zoster. They have taken me off the Tysabri. When I was in highschool I was told that I was Hypoglycemic and given Iodine to treat. As I was very young and no real symptoms I discontinued the iodine. You mentioned that Hypothyroid / Autoimmune disease Hashimoto’s can attack the thyroid but other areas. I’m curious if this Hashimoto’s may have been in my system and caused damages to my Mylen sheeth (Brain Lesions) or activated the JC Virus in my system, therefore causing damages and spinal fluids to indicate Multiple Sclerosis. I’m going through tests to determine if PML exists and get a green flag to start a new MS treatment Gilenya. Do you think my neurologist should run the blood test for the Hashimoto antibodies? I do plan on asking him about it, but just wanted to see what your thoughts are on this

        • Bev says

          Hi Cathy

          My husband also has MS and would never use Tysabri (thank goodness youre off it) and Gilenya is also a pretty dangerous drug. To my knowledge 11 people so far have died as a result of taking it. Please consider using LDN. My husband has used nothing but LDN for 7 years and is well and his MS is totally stable. No new lesions and no flares. Non toxic and affordable. There are literally thousands and thousands of people all over the world taking LDN for various autoimmune diseases, MS people making up a huge percent of those. You have nothing to lose and everything to gain.

          • says

            Thanks Bev,

            I do like the reviews I’ve been reading on LDN since Dr. Kresser recommended on May 8th. I never heard of LDN until he mentioned it here. Sounds so much better compared to the side effects and risks I’m reading on Gilenya. I’ll let you know what I decide and follow up here in the next couple months. Thanks again!

          • says

            I have been on nothing but LDN exclusively for many years for my RRMS, following serious side effects from both Copaxone and Tysabri. My MS has remained stable, and there has been no additional development of MS lesions on my brain MRI’s since I started. All previous brain MRI’s have shown new development of MS lesions. Coincidence? Perhaps. But, I don’t think so. I have been following this conversation because I have just had a TSH result of 8.1. I started on supplements today. My FBS was 127 (I’ve never had elevated sugars before.) A1C was 5.5. Triglycerides 225. That’s why I was interested in your topic. Thank you for this wonderful information.

            I must tell you — in the area where I live, it would probably have been easier for me to have procured street drugs. Only one physician in our entire area will give LDN. My uncle had MS — LDN got him on his feet again, after many months of not being able to bear weight. I learned about it by following the course of his disease.

          • Joni says

            My neurologist at UT Southwestern-Dallas/
            MS Clinic will not entertain the idea of using LDN. Instead, they only encouraged and explained the three new oral drugs. Sigh….. all while going through the worst exacerbation ever in my 24 year history with MS.

            • Joni says

              My neurologist at UT Southwestern-Dallas/
              MS Clinic will not entertain the idea of using LDN. Instead, they only encouraged and explained the three new oral drugs. Sigh….. all while going through the worst exacerbation ever in my 24 year history with MS.

            • Joni says

              My neurologist at UT Southwestern-Dallas/
              MS Clinic will not entertain the idea of using LDN. Instead, they only encouraged and explained the three new oral drugs. Sigh….. all while going through the worst exacerbation ever in my 24 year history with MS.

              By the way, I am seeking a new appointment with another neurologist who is open to other therapies–such as LDN. I am also hypothyroid and using Armour and a small amount of liothyronine. I suspect that my recent MS flare is due to thyroid (mis)treatment when other doctors (including UTSW) insisted that I get off all thyroid meds, so I did that for about 6 months. New labs after that showed me hypo again so back on the thyroid meds. My symptoms have improved however I suspect this current horrible MS flare is partially due to improperly treated hypothyroidism, and stress of course. (I survived 3 layoffs in 6 months time!)

        • Sunshine says

          Did you know that there is a doctor in Hope BC ( Dr. Ernie Murakami ) that has tested MS patients for lyme disease ( also shows lesions in the brain) they tested positive and were treated and left their wheelchairs. True Story. Last April, of 2013 he lectured on this at the Medicine Hat Lodge ( Sammis Room) He has recently advocated for the laws to change in the treatment of lyme disease.There are many co-infections associated with Lyme Disease . I f you check out
          Check out Murakami centre for lyme disease awareness there is a number for you to talk to him directly.. Make sure you check out the sumptoms list for lyme disease . You may be surprised..

      • Sunshine says

        I am especially interested in the under-conversion of T4 to T3. I was told ,after I asked the physician directly ,if this was happening. He said yes, it seems to be the case, but I don’t know why. So ,I did some researching and am thinking of adding Cytomel to Synthroid 200. What is your take on this. And do you need T4 ( via Synthroid) if you have had your thyroid removed or could you just take T3 ( Cytomel ) ? or do the body functions in other parts of the body need the T4 irreguardless ??
        Thank you

      • Lorraine says

        Chris
        I love reading your posts. Especially interested in the problem with converting T4 to T3. Any information would be appreciated.

  4. barbara lochner says

     
    Yes, I have been tested multiple times with no indication of antibodies.
    Further.  I have been on 4.5 mg LDN (low dose naltrexone) since May, 09.  If you are not aware, LDN modulates the immune system and has positive effects on Hashi for the obvious reason that it is autoimmune.  In my case, during this time my Armour 60 was increased to Armour 75 (compounded).  In my opinion, I should move up to Armour 90 as I have almost no eyebrows, eyelashes, body hair, etc.  My doctor disagrees as he thinks my numbers for TSH, T3 & T4 are perfect.  So far, he’s winning.
    Apparently I’m in a small and lonely group but will look forward to your article re non-Hashi hypothyroidism.
     

    • says

      Apparently in the good old days before all these fancy Thyroid tests you mention above were developed, thyroid specialists used to prescribe Thyroid medication in accordance with the symptoms (fatigue, reflexes etc.). A lot of the facebook groups I peruse e.g. Stop the Thyroid Madness and Thyroid Association of New Zealand think that’s a good idea and it’s a shame that it’s no longer being done. I think those groups recommend your FT3 and FT4 be in the upper third of the normal range.

  5. says

    What a fantastic post!!

    Thyroid is so complex. Adrenal issues, omega-3, omega-6, vitamin D, estrogen, etc appear to all play in as well. I look foward to your thoughts!!  I agree that none of the testing for auto-antibodies nail the problem. We can have auto-antibodies to ANY of the deiodinases, lack a mineral or vitamin B for conversion T4 to T3, or thyroid receptors are can be blocked. Also, I’ve been very curious about the role of rT3. So many things are appear to put humans into ‘hibernation’ where rT3 is formed and all metabolism slows…

  6. says

    I have a question. I was diagnosed with Hypothyroidism in 1997 and have been on Synthroid since then.  My doses started at 75mcg then escalated to 100, 125, and here in the last 6 months I have gone from a steady 200mcg  to 212 mcg and just recently 250mcg.  I am concerned as to why the sudden increase in my dosage.  I know that the levels must require this, but why?  Just wondered if you could advise. Thanks,

    • Chris Kresser says

      Sherry,

      I’m sorry, I can’t answer specific questions about individual cases. Thyroid physiology is complex. I would have to do a thorough intake and evaluation to know why you are needing that kind of increase. One possibility, as I discussed in this article, is that you have Hashimoto’s and your immune system is increasingly attacking your thyroid. This would cause a worsening of your disease in spite of increased doses of thyroid hormone. I’ll be covering this in the next article.

  7. Mario says

    Chris,
    While I would agree that iodine is not a alone solution, it’s far from inefective. Here, in Brazil, all water have chlorine and fluor. Greenpeace have analyzed the dust on houses here and, like USA, there is too much contaminants, bromine among others. A high iodine dose have been proved to help us to excrete this endocrine disruptors.
    But, it’s not a solution per si. I, for one, have been eating a lacto-paleo diet, extracted all my mercury filled amalgams, take 50mg of Lugols, 100ug of selenium, 4000 UI of vitamin D3 when I can’t get it from sun and take 4.5mg of this FANTASTIC medicine: LDN (www.lowdosenaltrexone.org).
    My antibodies are getting lower and lower every time I measure it. The only time it rised was right after I extracted my amalgams. Rised for 3 months and then started again to lower.
     

    • Chris Kresser says

      Mario,

      Iodine may be a solution for people who have hypothyroidism caused by iodine deficiency, but it will make things worse for Hashimoto’s patients. Why? Because iodine upregulates TPO, which is the enzyme that Hashimoto’s patients are producing antibodies to. This means that iodine will increase the autoimmune attack of the thyroid in these people.

      Population-based studies demonstrate that as iodine intake increases, the incidence of autoimmune thyroid disease increases commensurately. This is a little known fact in the alternative medicine community.

      • says

        So good to see you have written this, Chris and explained why. You’re absolutely right that so many of the alternative medicine community haven’t “gotten” this. I’ve copied your explanation and will put a link to this page on the sites I have as Facebook friends.

      • Brooke Isbell says

        I have always heard to stay away from Iodine for this reason. However, after reading much from Dr. Brownstein, I am learning that yes, iodine uptake alone is like adding gasoline to a fire…but when taken in conjunction with the supplements calcium, magnesium and selenium, it does not increase the autoimmune attack of the thyroid (as iodine alone does). Are you saying this is false? Taking the iodine has helped me with breast cysts and overall breast health. However, I have to be mindful of the Hashimoto’s. Thank you.

      • Sandra Helena says

        I have Hashimoto’s and I saw a video that the doctor says we can not supplement with organic iodine but we supplement with Lugol. what do you think?
        grateful

  8. Chris Kresser says

    It’s not a myth.  If you understand the physiology of autoimmune thyroiditis, it’s clear why iodine would cause problems.  I will be writing an article on this soon.

    The weight of evidence supports this, Mario.  It’s all over the scientific literature.  I’ll be providing references to these studies in the article.

    Antibody levels are not indicative of the progress of the disease.  For example, low antibody levels may indicate that the immune system is so compromised that it can no longer produce antibodies.  Conversely, there are cases where a patient’s symptoms improve while their antibodies increase (as their immune system gets stronger).

    Basic immunology also tells us that antibodies are not an indicator of tissue destruction. They simply tell the immune system which antigens or tissues to attack.  They don’t do the attacking.  That’s the job of the T-cells.  So high antibody levels don’t necessarily mean more tissue destruction, and low antibody levels don’t necessarily mean less tissue destruction.

    There are so many myths out there about autoimmune thyroid disease.  These are just two of them.

  9. Mario says

    Chris,
     
    I do not agree that there is much evidence of this. Lugol was used in large doses in the past and Hashimotos were not higher prevalent than it is nowadays.
     
    I do not have a compromised immune system. Other than Hashimoto, I never get sick. I do not even remenber the year I got my last flu.
     
    And my T-cells are normal. They rised right after I extracted my amalgams, but now are lower than they were when I was diagnosed with subclinical Hashimoto and started with Lugol.
     
    And, also, I don’t have any Hashi symptoms.
     

  10. Chris Kresser says

    Regardless of whether you agree or not, there is a large amount of evidence supporting the connection between increasing iodine intake and autoimmune thyroid disease.  I will present it in a future article.

    We cannot draw conclusions based on the experience of one person.  Human physiology is far too complex for that.

  11. Vicki says

    Hi Chris!  I love reading your blog.  I am hoping that in this series you will also address Graves’ Disease.  Good luck on your exam.

    • Chris Kresser says

      Some of what I write will be relevant to GD, because it is also an autoimmune thyroid condition. But I’m not planning to address it specifically. Just not enough hours in the day. Check out Elaine Moore’s book and website on Graves.

  12. says

    Can’t wait until the next post. What is going to be the answer? Maybe thyroid hormone replacement agents such as levothyroxine or desicated thyroid extract? No, surely not. Does it have something to do with soy or grains? Give us the answer soon. VBR Hans

  13. Tiffany S. says

    As someone with Hashi’s and excess reverse T3, I’m looking forward to your next article. Good luck with your exams!

  14. jamie says

    Interesting article. There is so much about the body that we do not fully understand. However, I do know, that iodine HAS and DOES continue to help people who are hypothyroid, and even hyperthyroid. I do not believe it is THE only and final answer. I believe that one form of supplement containing iodine is not one-size-fits-all. For instance, my body does best with a liquid Dulse supplement, and others with Kelp, and others benefit from Black Walnut, or something like Atomidine or Lugol’s solution. My thyroid was hyperactive, and taking liquid iodine along with magnesium brought it back to normal. I know a woman who cured her hypothyroid, that she had for more than decade, with iodine. One cannot simply say “Iodine makes autoimmune thyroid patients worse” because maybe for a few, it would cure them. Probably for some people with thyroid issues, iodine will not help them at all, but removing whatever is in their environment that could be toxic to their thyroid will.  Every person is different. Of course, treating the thyroid must involve treating the whole body and lifestyle because everything in the body is connected. I also believe strongly in the Blood Type Diet now, although I was a skeptic of that at first. Type O blood type are more disposed to having autoimmune thyroid disorders and for being hypothyroid. Things are NOT ONE-SIZE-FITS-ALL.

    • Chris Kresser says

      Iodine will help patients with iodine deficiency, but will generally harm those with autoimmune thyroid disease (AITD). I will explain this in further detail in future articles.

      I can’t agree with you on the blood type diet. There’s absolutely no research to support it, and the explanation he offers is based on completely inaccurate information. The most glaring example is that d’Adamo claims type O was the first human blood type, but phylogenetic networks of human and non-human ABO alleles show that the A gene was the first to evolve. You can read more criticism of the blood-type diet all over the Internet.

      • Kirsten says

        What about someone like me who tested low iodine with antibodies in the thousands?
        My Dr has me on a drop of lugal’s per day. Treating my low progesterone with a compound rx for 2 months along with selenium, Bio D & B12, before starting a compounded thyroid rx.
        She also has me using castor oil on a cloth on my thyroid daily.
        I’d LOVE to hear your thoughts! xx

    • Debra says

      the more I study blood type/genetics the more I see the myriad variations possible for every individual alive. No two people really are the same. Also following blood type diet (and knowing some basic prinicples of what to eat and why behind the diff blood types) really works well for me.

  15. jamie says

    Yes, yes there a lot of d’Adamo haters. I did not believe in it AT ALL at first. However have you actually read his book? Such as “Eat Right For Your Type Complete Blood Type Enclyopedia” ? Have you tried the blood type diet yourself? Do I believe that the blood type diet is the right thing for everyone on the planet? No. But I do believe it would help most people. It is not true that there is ”absolutely no research to support it.” You can read more about how the blood type diet has helped people all over the Internet.

    • Debra says

      There is a lot to the blood type diet – people usually only look scantly at the first) so people reviewing it can’t be bothered or just don’t have time to look into it properly. They just reasearch what others have said on the net (who have vested interests)…

  16. Chris Kresser says

    I have read the books and tried it myself.  It was one of the first “special diets” I tried. The fact that it has helped some people doesn’t mean anything on its own.  If they’re switching to his diet from the SAD, for example, we can’t know whether it was his blood-type diet that helped or whether it was simply eliminating junk foods.

    Please show me the research that supports it.  There is only research that supports his classification of foods into different categories, but nothing that supports the idea that people with different blood types actually require a different diet.

    From an evolutionary perspective, it makes far more sense that humans evolved to eat a particular diet.  This diet is the one humans ate for hundreds of thousands of years prior to the advent of agriculture and modern food processing.

  17. jamie says

    How long did you try eating for your blood type? Have you really read the specific book I mentioned?
    I am not Peter D’Adamo. I do not pretend to know everything there is about this diet and how or why it works, nor do I agree with absolutely everything he says. But I believe there IS something to his theories. I myself was astounded by the research in this book. The parallels between blood type, food and disease were impossible for me to ignore.
    http://www.dadamo.com/science_critic.htm
    Thank you very much for your responses and for this wonderful blog.
     

  18. Catherine says

    I was diagnosed with an underperforming thyroid when I was 12 and was never treated. I have now a thyroid that is the size of a 7 year old child. I complained about digestive issues, weak immune system and depression and lethargy. I am taking levothyroxine and have never felt better. Now if this shortens my life so be it but I fell alive .
    I would like to add that I had a grandmother that suffered from hypothyroidism, she had a goiter, she was menopaused before the age of 40 and lived unmedicated a couple month short of 100 years old. She didn’t suffer from dementia and was physically able. I don’t care to live as long and she actually didn’t either.
    So I deducted from that that hypothyroidism doesn’t kill you but makes your life miserable.
    I am skeptical about the thyroxine but I know it made a difference for me.
     
     

    • Chris Kresser says

      No reason to be skeptical about thyroxine. It can be an essential part of successfully treating hypothyroidism. However, if the underlying immune imbalance isn’t addressed, thyroxine won’t be enough for most people. Or it will be for a short time, but it will stop working and the dose will need to be raised. See the other comments for examples of what I mean.

  19. Elizabeth says

    I’m 80 years old. Unfortunately, I’ve had hypothyroidism since early twenties, so I’ve taken the artificial hormone, Synthroid, for so long that it’s the only thing I can count on. I can’t fight the disease by better health alone, which is where the author of this series is going to take it. But, it is a good thing to know for young people, so they don’t ruin their health with an autoimmune disease. This is especially true if it runs in families, such as mine. It can take different forms.

    My great grandmother was hyperthyroid with a large goiter. I wish I had her energy without the other hyperthyroid symptoms.

    • Anita says

      you really would not want what your grandmother has i wouldnt wish that on anyone as i almost died from hyperthyroid 3 and a half weeks ago ive been over active for 20 years and the probs that come with it is just to much for one person let alone my family as i have 2 young kids 12 yr and 2 yr and im still in shock that my life almost came to an end because the thyroid doctor took me off my meds 3 years ago after telling me the meds im on are not life long and that was that untill the 10th of april 2013 thank god i was staying with my mum when i passed out on her bathroom floor my hole body shut down before i got to A&E and died many times on the way to hospital i was in I.C.U for over a week and when i woke up i didnt no what was going on all i wanted was my kids

      • Sunshine says

        I shutter to think of how many practicing physicians , not specialist, are reading minimal testing done for suspected thyroid problems and treating or NOT treating because of being ok with the patient living at the LOW end of the scale on the thyroid chart. I wonder , what would they treat themselves with , if the realized they had hypothyroidism or just as bad ,hyper-thyroidism. Hmmm…..makes you wonder a bit.

  20. Elizabeth says

    I wish I had read through the other comments here because blood type was discussed. I’m type B, so no correlation there.

  21. Elizabeth says

    I would also like to know how Acetyl L-Carnitine effects the thyroid hormones, if you know, Chris. I read something about it. I was taking that and started feeling fatigued, so stopped, and not fatigued now. I was using it to improve my aging mental abilities.

  22. Eva says

    If I remember correctly, for the blood type diet, types O, A, and B (which is almost everybody), wheat should be cut out of the diet.  If a lot of people cut out wheat, it would not surprise me if a lot of them felt better.  Most people do better without wheat, regardless of blood type. 

    As a type A blood type, I am supposed to avoid meat and tomatoes because my supposed ‘weak stomach’ can’t handle them, but in reality, I feel weak and suffer from anemia if I don’t eat lots of meat.  In fact, I can eat tons of meat with zero digestion probs. I can also eat hoards of tomatoes all at once with zero ill effects.  The only thing I can’t digest is corn, although it does not make me sick, just simply does not digest at all (comes out in the EXACT same form as came in which is kinda creepy!)   The blood type diet totally does not apply to me.  Ironically, my physiology works well with what they say type Os should eat.  I would not be surprised if many of the type Os who ate the type O diet did well on the diet by avoiding all those grains.  But I suspect that other blood types would also do much better if they ate like a type O.
       

    • Chris Kresser says

      That’s exactly my experience with the blood type diet (both personally and with my patients). It works for Type O’s, but not for the other types. That makes sense, because the Type O plan is closest to our evolutionary diet.

  23. says

    This is great, now hurry up with the follow-up articles, ‘k?  ;-)  No, really, I am dying to hear what you have to say.  I recently went off synthroid b/c I didn’t want to be on meds.  My TSH went back up but T3 and T4 held steady (I hope i have the right hormone terms there) and my doc said it means my body is fighting hard.  I have been having trouble losing weight, even though I’m exercising regularly and writing down everything I eat and trying to stay away from carbs and sugar.  It’s very frustrating.  I have energy though, so I hate to go back on the meds.  I hope you will have a better solution for me.
     

  24. Jamie says

    Given the discussion in the comments on the efficacy of the blood type diet, I thought this recent commentary by Prof Loren Cordain.
    The History And Characterization Of Blood Type Diets

    Blood type diets were first popularized by Peter D’Adamo, a naturopathic physician, in his best selling 1996 book, Eat Right 4 Your Type1. The inspiration for Dr. D’Adamo’s book came from subjective clinical impressions of his father, James D’Adamo; also a naturopathic physician who first proposed this concept in his book, One Man’s Food is Someone Else’s Poison 16 years earlier in 19802. As a member of Bastyr College’s first graduating class of naturopathic physicians in 1982, Peter became interested in attempting to validate his father’s subjective and personal observations from reviews of the scientific and medical literature – thus the fundamental reason for Peter writing his hugely successful diet book.

    The underlying premise for Peter’s dietary ideas is that ABO blood type is the most important issue in determining healthful diets. He advocates separate diets for people with one of the four most common blood types (A, B, O or AB), and has further subdivided his dietary recommendations into three arbitrary ancestral categories: “African, Caucasian and Asian.” Hence 12 subgroups (4 blood types x 3 ancestral categories) exist – each with differing dietary recommendations. Each blood type diet includes 16 food groups which are divided into three categories: 1) highly beneficial, 2) neutral and 3) avoid. For each of the 12 subgroups differing recommendations exist for the three food categories. If these nutritional recommendations sound somewhat complex to you, I had to re-read them about a dozen times to get the drift myself. Although I don’t want to get ahead of the game, for the observant reader, you may be curious to know how Dr. D’Adamo dreamed up this complex dietary system and if a long trail of experimental human clinical trials exist to support Peter’s recommendations? I, too, had to ask myself these same questions.

    Before we get into the science or lack thereof of the blood type diet, I’ve got to flesh out a few more of the underlying concepts. Dr. D’Adamo believes that blood group O (“O for Old”) was the earliest human blood type and that all humans at one time maintained this blood group before the subsequent evolutionary appearance of blood types A, B and AB (reference 1, pp. 6-13). Accordingly, Peter believes that people with the O blood type had ancestors who were skillful hunters and whose diets were high in meat and animal proteins. For modern people with the O blood type he advocates a high meat, low carbohydrate “hunter” diet, with virtually no wheat, few grains or legumes and limited dairy products. Do these dietary recommendations ring a bell for you, or sound vaguely familiar? Keep this thought in mind, as it may well explain the lasting popularity of Peter’s first book.

    Peter now goes on to explain to us that blood group A (“A is for Agrarian”) “appeared somewhere in Asia or the Middle East between 25,000 and 15,000 B.C.” . . . and “allowed them to better tolerate and absorb cultivated grains and other agricultural products” (reference 1, p. 8). For type A’s, Dr. D’Adamo recommends a mainly vegetarian diet – the diet that he personally follows. However, more importantly he recommends that blood type A’s also avoid wheat and dairy (do these recommendations also sound familiar?) and replace meats with some “highly beneficial” fish and seafood – Hmm, lots of fresh fruits and veggies for type A’s, little wheat or dairy and fish instead of meat? Keep these recommendations in mind.

    Peter next tells us that blood type B, “developed sometime between 10,000 and 15,000 B.C. in the area of the Himalayan highlands – now part of present-day Pakistan and India (reference 1, p. 10). Peter suggests that type B’s have evolved the most varied diet and can include both meats and dairy in their daily menu, but again should avoid wheat. Before we move on to the final blood type (AB) it should be noted that Dr. D’Adamo generally eschews highly processed foods (chips, pastries, candy, ice cream, snack food, fast food, etc.) for all blood groups – once again, does this not sound like another familiar dietary suggestion?

    From Peter’s diagram on page 6 of his book, he indicates that blood type AB appeared first in humans sometime between 500 B.C. and 900 A.D. He characterizes “AB is for Modern” and states “Until ten or twelve centuries ago, there was no Type AB blood.” (reference 1, p. 13). Peter indicates that AB’s are a conglomeration of type A and type B blood types, and consequently their diets should reflect a mixture of the recommendations he makes for these blood groups. AB’s are therefore advised to eat meats, seafood and dairy, and to once again avoid wheat.

    The Reality And The Science Of Blood Type Diets

    The reality of Dr. D’Adamo’s book, Eat Right 4 Your Type, is that it has overwhelmingly become one of the sustained, best selling diet books of the past two decades, and continues to sell well on Amazon and other retail outlets – 14 years after its initial release in 1996. Unfortunately, as I will shortly demonstrate, Dr. D’Adamo’s explanations for the health-promoting effects of his diet have little or nothing to do with ABO blood groups. His claims about the origins of human blood types and the dietary selective pressures which elicited the four common blood types are completely incorrect and have no basis in the current scientific literature. By critically examining the faulty concepts and evidence underlying this book, it becomes almost comical how Peter’s series of errors, incorrect assumptions and conclusions actually ended up with dietary recommendations that may have therapeutic value for about 60% or more of the world’s population. The paradoxical nature of this book (bad science, pretty good dietary recommendations) helps to explain its lasting commercial success.

    Actual Origins of Human Blood Types

    Peter’s suggestion that O is the original human blood type is incorrect. Studies in humans, chimpanzees and bonobos (a specific type of chimpanzee) show that alleles (different versions of genes) coding for the A blood type was actually the most ancient version of the ABO blood group, and was shared prior to the evolutionary split between chimpanzees and hominids five to six million years ago3-5. Hence, Peter’s suggestion that blood type A appeared 15,000 to 25,000 years B.C. in response to dietary changes brought about by the new foods (i.e. grains) of the agricultural revolution is not only incorrect, but off base by about five million years. Now, let’s play a little game of logic and apply the correct data to Peter’s reasoning that “the original ancestral human blood type should be eating a high protein meat based diet.” Since type A is the actual ancestral human blood type (rather than O), if we use Peter’s logic then he – himself a type A – should not be following a vegetarian diet, but rather a high protein meat based diet. These kinds of games of logic – although fun to play – more importantly underscore the fundamental and incorrect assumptions upon which Peter’s book is based.

    The next blood type that appeared in the human lineage was B – which split from A – about 3.5 million years ago3-5, not the recent 10,000 to 15,000 years B.C. origin that Peter has proposed. The O blood type split from A about 2.5 million years ago3-5 and consequently does not represent the oldest blood type as claimed by Peter. The only fact that Peter correctly deduced about the origin of human blood types was that AB was the youngest, but once again he completely missed the correct date, as it was actually about 260,000 years ago3 – not the mere 1,500 years ago that he has proposed.

    So Peter has got all of his blood group origins messed up, his dates wrong, and the evolutionary splits incorrect. Why does this matter and how does it affect his dietary theories? To begin with, even if we were to believe in Peter’s underlying assumptions that diets should be prescribed upon blood types, he would have to completely revamp his original recommendations. Type A’s should be eating a high protein, meat-based diet rather than the vegetarian fare he suggests. But what about type O’s? With the correct evolutionary information, should they now be eating a vegetarian menu? And what about type B’s and type AB’s – what should they now be eating? Most telling of the logical failings of Peter’s blood type diet is the observation that all four of the major blood types had evolved almost 250,000 years before the coming of the Agricultural Revolution 10,000 years ago. Yet Peter would have us convinced that three of the four major blood groups only came into existence slightly before or after the Agricultural Revolution, and as a direct result from dietary selective pressures wrought by Neolithic food introductions.

    So, why has Peter’s book become one of the best selling diet books in the past two decades? Because it works – but only for about 44-62% of the people who adopt it. Remember that for blood type O, Peter advocates a high meat, low carbohydrate “hunter” diet; with virtually no wheat, few grains or legumes and limited dairy products. If we look at the frequencies of the four major blood types for the entire world population, blood type O is by far the most frequently occurring version. It is found in 62% of all the world’s people, followed by A (21%), B (16%) and AB (1-3%)6. In the United States, the four blood type frequencies are O (44%), A (42%), B (10%) and AB (4%)7. So you can see that Peter has essentially advocated a diet similar to the Paleo Diet for between 44 and 62% of his readers. Quite simply, Peter’s diet works for about 44 to 62% of the people who adopt it – not because of their blood type, but because it emulates the same diet that natural selection has designed for us all.

    References:
    1.D’Adamo, P. with Whitney, C. Eat Right 4 your Type: The Individualized Diet Solution to Staying Healthy, Living Longer & Achieving Your Ideal Weight. Putnam’s Sons, New York, 1996.
    2.D’Adamo, J. One man’s food–is someone else’s poison. R. Marek Publisher, 1980.
    3.Calafell F, Roubinet F, Ramírez-Soriano A, Saitou N, Bertranpetit J, Blancher A. Evolutionary dynamics of the human ABO gene. Hum Genet. 2008 Sep;124(2):123-35.
    4.Saitou N, Yamamoto F. Evolution of primate ABO blood group genes and their homologous genes. Mol Biol Evol. 1997 Apr;14(4):399-411.
    5.Lalueza-Fox C, Gigli E, de la Rasilla M, Fortea J, Rosas A, Bertranpetit J, Krause J. Genetic characterization of the ABO blood group in Neandertals. BMC Evol Biol. 2008 Dec 24;8:342.
    6.Mourant AE, Kopec AC, Domaniewska-Sobczak K. The Distribution of the Human Blood Groups and other Polymorphisms. Oxford University Press, London, 1976, p. 6.
    7.Stanford School of Medicine, Blood Center.

     

  25. says

    It is true that the endocrine system is a very complex and if I may say, from my frame for reference, very interesting.  I also find it astounding (and maybe inaccurate) to say 9 out of 10 people with hypothyroid have the autoimmune Hashimoto’s.  This just can’t be!!  But then again, autoimmune dis-ease is so rampant in our society.
    I am an herbalist and cannot disregard that fact the most of these sufferers are women and women have myriad Throat Chakra issues….this should not be excluded.  The emotional variable to any dis-ease should never be left out of the conversation.  With that said, there is also the fact that women are most likely to wear make-up and spray perfumes all over there body, and where else…the neck!!  All these chemicals (endocrine disruptors) in the system are directly correlated to disfunction.  In addition, one cannot ignore the role adrenals play in this situation, with Syndrome X, insulin resistance etc (I know this is another topic altogether).  Diet plays such a huge role, Hashimoto’s or not.  With no antibodies, one MUST look at diet and emotional issues.  And in reading a couple of these posts, it would seem these imbalances are past onto the next generation, which tells me there is not only some learned behavior there, but endocrine system issues from the start. And finally, it’s not only the chemicals we put in and on our bodies that contribute to this, but the deplorable condition of the digestive system and the key role this plays in all our immune functions. I cannot emphasis enough that most every body is deficient in prebiotics AND probiotics and supplementation is crucial. Lastly, mineral deficiencies.  Magnesium, potassium….etc etc.  The SAD diet provides little if any minerals and even if someone eats well (which is relative) assimilation is inefficient due to the digestive flora issues, coated small intestine, and liver/kidney stress do to toxin load.

  26. Karen says

    This is a great article thank you.  I am hypothyroid and have Rheumatoid Arthritis.  I take LDN (low dose naltrexone) to help with my RA autoimmune disease and am so glad to hear others say it helps with Hashi’s. Chris I look forward to your future articles on thyroid disease.

    • Karen S. says

      Karen,

      I don’t know whether this is your case or not – but I would like to tell you what helped me. My father had hypothyroidism – and was diagnosed with RA. He was put on steroids and they didn’t help at all. I too am hypothyroid – and about ten years ago my joints started to swell and ache. I could barely stand up straight. I was trying to lose weight and tried the Atkins diet – what surprised me was that the pain in my joints (hips, back, legs, hands…) hurt less. Long story short I finally figured out that I am intolerent to all grains – wheat, rice, corn etc. When I omit them the inflammation in my joints disappears completely. I am pain free. Occasionally, I cheat – and it takes about 3 days and the symptoms return in full force – and it takes about 3 days after stopping for the symptoms to disappear. I am firmly convinced I would be diagnosed with RA if I didn’t know… (Warning – when trying to quit – the cravings – especially to bread – are wicked). Hope this helps…

  27. says

    Studies show that 90% of people with hypothyroidism are producing antibodies to thyroid tissue.”

    So that is why in my clinic I treat all thryoid and thyroid like patients with sophisticaltd techniqui of Immunology from the Ling Shu, revealed by Dr Nguyen Van Nghi. (search <satas.be>)

  28. Christiana says

    Just received diagnosis of thyroid auto-immune disease. Longterm stress? Adrenals can no longer react properly? Throat chakra-energy centre-Yes Sara! I am not so into chakra thing but the basic background, premises I find to be good starting points: at some point, some time the person who is dis-eased has had to keep their mouth shut, their spirit shut down.
    The doctor started me on 25 mcg of thyroid. Been taking it for one month. I have found that even that little bit helped me get my energy back and stop thinking that I was losing my mind. But I know this is only a bandage. I have got to work with the stress. Diet. Coffee still tastes good but it doesn’t feel good. Habit makes me want to drink it. So now I just am going to leave it out. Even now I notice that liquorice is a no-no. Going to try it again this weekend to double check reaction.
    Everyone is so different but I think one thing we are all the same on and that is a requirement, a need to have some sort of spiritual life…whatever it is. Diet: elimination diet? I don’t think I am going to get much help from the doctors except for thyroid medicine checks so I go to diet. Leave different foods out of diet for a couple of weeks and reintroduce to see what happens. Any one with experience? advice?
    Anybody have any experience with acupuncture?
    I am glad to find this site. I want to understand better what is going on inside this body that feels like it was falling apart at the seams.

    • Chris Kresser says

      I’ll be addressing nutritional strategies for regulating the immune system and reducing inflammation in a future post.

  29. don says

    I had my thyroid removed in 1968 because of thyroid cancer. for years they had me on armor thyroid, 4 mgs, or something. about twenty five years ago they changed me to synthroid. I have never felt great since the change, the doc’s do not seem to want to change me back to armor, they say synthroid is just as good or better. any thoughts about this.

    • Chris Kresser says

      The statement “synthroid is as good or better” than Armour reveals a shallow understanding of thyroid physiology and metabolism. For someone who has problems converting T4 to T3, Synthroid is a terrible choice because it only contains T4. For someone without any conversion problems, Armour may cause hyperthyroid symptoms because it has pre-formed T3. There is no single drug that’s right for everyone.

      There are several considerations when choosing a thyroid medication. I will cover these in detail in a future post. Please stay tuned.

      • Melissa says

        how do you know if you have problems converting T4 to T3? All I know for sure is that my levels are low and i need the synthroid (I have had a thyroid lobectomy). Even when the tests are normal, they have to be at a certain level within the range for me to feel ok, and I occasionally start feeling the symptoms of mroe hunger/etc and ask for my med to be increased slightly, which the docs are generally willing to do as long as the levels stay within the “normal” range after they adjust the meds.

      • Elaine says

        I am very interested in what you will have to say about Armour and Naturthroid. I recently found that Armour has gluten in it and so switched to Naturthroid. I willbe having followup bloodtests in n few weeks. And my hot flashes have not abated.

      • Kristin Bock says

        Dear Chris,

        Thank you for your article. I am especially looking forward to your post concerning thyroid meds. I am a 45 year old female who has been on Synthroid 112 mcg for 18 years due to Hashimoto’s. While it was managing my symptoms OK, I still couldn’t exercise without feeling like I had the flu for a week after. Eight months ago, my doctor changed my prescription to Armour Thyroid 45mg plus 25mcg Synthroid. While we had to adjust the dose a few times, my numbers finally read well at T3=3.6, T4=1.21 and TSH=1.3. However, in the last eight weeks, an all over itch has begun (pruritus) and my hair is falling out like crazy. He doesn’t believe I’m hyperthyroid, however, due to my numbers. Therefore, has me slated for allergy testing. I’d really like to know your take on Synthroid vs Armour!

    • Tina Bricker says

      Keep trying. Find a Doctor that will switch you back. I went through 2 doctors already and am now with a third. I’ll see what happens. Just remember this…it’s your body!

  30. says

    Many years ago, I was diagnosed as hypothroid and prescribed Synthroid. I seemed to have an opposite reaction to the expected one. I gained weight, my hair started to fall out etc. I found a doctor who prescribed something called “thytrophin” .That seemed to work better, so I’ve been taking both for many years. (One to satisfy the doctors and one to feel better.)
    I also had a growth in my thyroid gland and 1/2 of it was removed. The growth was benign and at that point the doctor said that i had Hashimoto’s disease. Now, reading your article I’m wondering how to find out more.
    Are there treatments for autoimmune disease? Are there studies that might clarify some of these things?

    • Chris Kresser says

      Stay tuned. I’ll be addressing your questions in the coming articles. Have you read the second one in the series yet?

  31. Chris Kresser says

    Mario,

    I read the full-text of the China follow-up study Dr. Abraham linked to.  Their conclusion is that excess iodine doesn’t increase the incidence of Graves’ disease.  They didn’t say anything about whether rates of Hashimoto’s increased.

    In any event, there are several other population-based studies that demonstrate this effect, as I’ll share in my next article.

  32. Mario says

    Chris,
     
    I know that most recent population-based studies demonstrate that iodinization increased Hashimoto incidence, including here, in Brazil. That’s a fact. But the level of iodine in these populations are very low, compared to what it used to be, and not very long ago. And Hashimoto incidence is higher than it was when iodine level in those populations was higher.
     
    If iodine was that problematic, Japan would have a much higher incidence of Hashimoto and much worse outcome than they have. Japanese have had allways a very high level of iodine, because of high consumption of algaes, as probably many populations that consumed a diet high in sea food.
     
    The fact is that bromine, fluorine and chlorine compete with iodine. And we ALL are full of this halides these days. The fact that a little iodine increase in some populations is increasing Hashimoto incidence probably is reflecting this fact with iodine displacing these halides and increasing autoimmune flare.
     
    Other possibility is that those populations are low in selenium. As you probably know, there are studies that show that populations low in both selenium and iodine, that supplement either one show a high incidence of hypothyroidism.
     
    Another possibility is that these populations are low in salt. Salt along with iodine is know to increase halide excretion. But, nowadays many people are restricting salt.
     
    Anyway, what I really know is that Dr. Abraham has been researching this for a long time, Dr. Brownstein has sucessfully treated more than 4.000 people (including him and his father), there are many sucessfully anecdotal testemonies on iodine yahoo group and all these facts made me try iodine, with great success.
     
    One last thing, if you know a better way of get rid of halides wihout iodine and without moving to live outside of modern civilization, please let me know!
     
     

  33. says

    Fascinating! I am hoping you can help with a question I have that I can’t seem to find an answer too. It seems easy enough for someone with thyroid knowledge though. I am pretty sure I haven’t had an enlarged goiter, and I have high TSH, with low T4 and T3. All of the writings I have read on Hashimoto’s say goiter and low T4, with no mention of T3, nor stating that you can have Hashimoto’s without an enlarged goiter. Would Hashimoto’s be something I may have (I know you aren’t a physician, but I am just curious if an enlarged goiter and only T4 issues are a must for this autoimmune disorder), or is there another type of thyroid disorder that I may be overlooking.

    It just seems like I will have a better chance to naturally treat this issue and get off of medication if I know the cause. I am otherwise of good health and fitness aside from allergies. Thanks!

  34. Elizabeth says

    I’ve had hypothyroidism for fifty five years, treated with Synthroid. I’ve never been diagnosed with Hashimotos. I don’t think I’ve ever been tested for antibodies. My lab results over the past three years have been 0.01 TSH, free T4 1.39, free T3 2.1. The T4 and T3 have varied a little, but normal. So my endocrinologist is letting me stay on the Synthroid 137 mcg, until I show signs of hyperthyroidism. I went through four doctors trying to find one that wouldn’t lower my Synthroid dosage. I can’t tolerate a lower dosage, I tried about four years ago. Unfortunately, I haven’t found a doctor in this area who will try natural thyroid.  

    One doctor told me I’ve been on synthetic hormones for so long, that I no longer produce any thyroid hormones at all. About six years ago, I was on 150 mcg, and I felt best on that dosage. Before that, my dosage at one time was as high as 250 mcg. I guess the synthetic dampened down my ability to produce my own hormones. I wish I understood my own situation better.

  35. says

    One thing about natural thyroid, according to the doctors, is that the dose is unreliable. Then an odd thing happened. The local pharmacy used to give me enough synthroid  for three months, but then they discovered that it was degrading on the shelf. That is, the old stuff wasn’t as powerful as the new. All of which leads me to think that the synthroid dose is also unreliable.  I really like that thrytrophin. It comes from a company called Standard Process. My dentist gets it for me,

  36. Chris Kresser says

    The idea that bio-identical thyroid products like Armour have unreliable doses is a myth. Armour has a standardized dose of 4.22:1 T4:T3.  It has been tested and confirmed over and over again.

    In fact, as you may be aware, Synthroid was pulled from the market because of unreliable doses and was only re-approved in 2004 I believe.

    • Sunshine says

      I absolutely agree…..I have taken synthroid for 37 years and I have taken perscriptions back after a week because my body told me that it was inferior. Then the pharmacist told me that I had been given a generic form and that I would have to pay more for the snythroid. Imagine…they made the choice to fill out my prescription with generic without even notifying me……I have heard that this goes on more often than not….

  37. Tula says

    I would be curious to know if autoimmune thyroid issues could be a secondary result of other autoimmune conditions. I have had severe rheumatoid arthritis since I was 16 (28 years) and in the last couple of years have had rapid weight gain, extreme menstrual irregularities, and hair loss. According to my doctors, my thyroid is normal. Yet, nothing else seems to account for all of these symptoms.
    I get the brush off when I try to press for more in-depth diagnosis. The GYN blames my medication, the rheumatologist blames my diet (low-carb and < 1000 calories per day), the thyroid specialist found a nodule on the thyroid, but says everything else is normal and since the node has shrunk over the past year, everything is fine.
    Why is it so hard to get anyone to pay attention? I’m hardly a hypochondriac. Having a chronic condition has left me very in tune with my body, so I know when things are minor and can be ignored and also when they’re just not right. It seems like the doctors’ eyes start to glaze over the minute I mention hair loss and weight gain. So frustrating…
     

    • Chris Kresser says

      The short answer is yes. Hashimoto’s is often part of a polyendocrine immune disorder involving multiple tissues. The same is true for other autoimmune conditions. The way to figure it out would be to find a health care practitioner willing to test for antibodies to other tissues commonly attacked by antibodies. Also, as I’ll explain in a future article, many people with autoimmune diseases are gluten intolerant. If you’re not already gluten free, I would highly recommend it.

      • says

        From what I’ve read on some sites, sometimes a low-carb diet mimics starvation and then the body goes into hibernation mode to slow down metabolism. It does that by converting some T4 into Reverse T3 intead of T3. It is possible to have Reverse T3 measured in some laboratories. I think for us here in New Zealand, we have to send our blood samples to Australia. We can do this via the internet, thank goodness.

  38. Jan says

    As someone who was diag. about 2 years ago with hpothyroidism, I take synthroid daily.  Would I do better on the Armour?  I am a nurse, but never see it ordered, always the synthroid.

    • Chris Kresser says

      There are several factors that determine which thyroid hormone is best for each person. I’ll be writing about them in a future article.

  39. sharon williams says

    I had a total thyroidectomy and was diagnosed with Hashimotos in june 2010.  Since the thyroid was totally removed how does this affect the hashimotos?  My doctors seem very content ordering Synthroid and testing TSH and T4. Doctor says will take about a year to get on right dose of Synthroid and thinks all symptoms will subside.  Should I be on a gluten free diet?  I am very bloated and cannot lose weight also have bad joint pain and pain in bottoms of feet.  My blood sugar is also high but doctor feels it will go down once meds regulate. I am extremely tired all the time and have temperature fluctations with profuse sweating. 

    • Chris Kresser says

      Removing the thyroid gland is somewhat akin to removing chewing gum from a shoe. It’s nearly impossible to remove the whole gland, because it is so close to the trachea / voice box and other important anatomical structures. What this means is that, if you have Hashimoto’s, autoimmune attacks on the thyroid can persist even after thyroidectomy. Therefore all of the information in these articles still applies to you.

      • Christine Bonilla says

        Hello:

        Thank you very much for your research and insight. I have been told I had a large thyroid since I was a teenager, I’m 35 now. After many, many, many years of frustration and doctors who just kept blaming things on depression–the number go-to diagnosis when doctors can’t figure things out– I was diagnosed with thyroid cancer at age 30. When my thyroid, lymph nodes, and 10 large tumors the size of golf balls were removed, I had to have radiation treatment to kill off my thyroid. It has taken me years to find the right Endocrinologist, just last February 2013, that told me I had Hashimoto’s disease. Let me tell you I fit all of the symptoms of Hashimoto’s disease, down to my feet, hands, joints and unbelievable long menstrual cycles, which began in 2009.

        I was so happy that I had a name for my symptoms, and when my doctor finally gave me a higher Synthroid, something I had been fighting for, for a long time, I thought okay my symptoms will be gone now, right? No, not exactly. Although I do slightly better with the increased Synthroid I am still having problems. Again, I was told it’s depression. Let me just say, I’ve felt depression before, especially on my long menstrual cycles. It’s like everything is bland, or unexciting. There’s always something wrong and dissatisfying–SNL’s Debbie Downer for sure. However, my symptoms and mood were more related to frustration with my health. Anyway, I thought they would go away with the increase in of Synthroid but they haven’t.

        After reading your blog I’m wondering if I still have Hashimoto’s disease even though my thyroid is gone and it was zapped with radiation because I am still feeling most of the symptoms.

  40. Meredith says

    I’ve found your series on the thyroid very interesting.  My question is that I was diagnosed with hypothyroidism 7 yrs. ago, but have never tested positive for the antibodies that would indicate it is caused by hashimoto’s.  I’ve researched, but I can’t find a cause for the hypothyroidism.  BTW, I was on Synthroid for a few years, then took myself off of it – never felt any different on or off.  I just had bloodwork done – TSH was high at 8.9, Free T4 on the low end of normal at .98 (range of .82-1.77).  New doctor recommends restarting synthroid, although they aren’t pushing it.  But they did recommend an ultrasound of my thyroid, although she (nor any other past doc.) feels anything unusual upon exam.  Do you have any insight for me as to what could be causing the hypothyroidism?  I hate to treat without a real understanding of the cause.  My symptoms are not severe – some fatigue,but not unusual, don’t like the cold.
    Thank you!

  41. Dulce Leon says

    I had hashimotos thyroditis AND papillary thyroid cancer.  I ahs a total thyroidectomy.  My question is this:  Since hashimotos attacks the thyroid cells and gland, is it not possible that even after a thyroidectomy, that the hashimotos could continue to attack thyroid cells in the wholw body since thyroid cells are found in the entire body?  I worry about this because it makes logical sense that hashiotos would attacj thryroid cells where ever they are which is the entire body.  Has anyone done a study of this?  Is this even medically conceivable?  Can you answer my question so  that I can understand this better and not have anxiety over what else is happening in my body?  Thank you for any help or guidance that you can probvide.

  42. Chris Kresser says

    Thyroid “cells” aren’t located throughout the body.  All cells do have receptor sites for thyroid hormone, though.  That’s not the same thing.

    However, a thyroidectomy is a bit like scraping chewing gum off the bottom of a shoe.  They rarely remove the entire thyroid gland.  It’s very close to other important structures in the throat so they have to be very careful.

    This means that, yes, if you have Hashimoto’s, it’s entirely possible that your immune system will continue to attack what’s left of your thyroid gland.  That’s why it’s so important to address the autoimmune component.

  43. Dulce Leon says

    but thryoid cells are what allows all cell metaboloism.  which means to me that thryoid cells are located throught the body in order for cell metabolism to take place.  Am I wrong about thryoid cells and cell metabolism?

  44. Chris Kresser says

    Yes.  Thyroid cells are in the thyroid gland.  Thyroid hormone is present throughout the body. Most cells have receptors for thyroid hormone.  That’s how thyroid hormone regulates metabolism.

  45. Dulce Leon says

    ok so the RECEptors  and thyroid hormone are what is throughout the body but not thryoid cells.  Am I correct?  In that case hashi’s would stay within the thryoid gland.  Correct? 

  46. Chris Kresser says

    The immune attack in Hashimoto’s is focused on the thyroid gland, but many Hashi’s patients also have antibodies to other tissues.  And of course the effects of Hashimoto’s are systemic – the entire body is affected.

  47. Patricia Kieley says

    Could someone please help me by answering one question. I was diagnosed with Hashimotos over 7 years ago and have been taking synthroid since then. The usual thyroid blood test (T3 ) has been performed intermittently since that time (during physicals, or when I had symptoms that I thought might be related to Hashimotos) and it always comes back “normal” according to my PCP. I suffer from depression – am being treated with medication – but have been through an especially difficult 2 years. I have many symptoms right now that are present in both depression and hypothyroid disorders and it’s become necessary for me to figure out what exactly is wrong because I seem to be getting worse rather than better. It’s ression or thyroid related, since so many are identical. My hair is falling out and I’m gaining weight despite not eating. My question is this: is their another blood test that will give an accurate picture of what is going on with the Hashimotos and if it is the cause of my worsening condition? I keep reading that the standard blood tests (T3, T4) do not give the complete picture and that if symptoms are present more examination is needed. My doctor doesn’t seem to give this view any credence and I always feel like a hypochondriac when I bring it up. Should I forget the PCP and see an endocronologist? Is that the only way to get to answers that I need? Any advice that makes sense would be greatly appreciated.

    • Anonymous says

      an endocrinologist may not be any more enlightened than the jerk you’re currently seeing…. i wish you good luck in finding a better doctor — they’re few, but they’re out there.

  48. Chris Kresser says

    Patricia,

    The problem isn’t necessarily the tests you’re getting. It’s how they are interpreted. Watch this video to learn more about what I mean.

    Also, remember that Hashimoto’s is an autoimmune disease affecting the thyroid. To treat it properly, the immune system must be addresses since it – not the thyroid gland – is the underlying cause of the problem. Unfortunately, the conventional model doesn’t recognize this even though it’s abundantly clear in the scientific literature that this is what’s happening.

    You’re best bet is to find a functional medicine practitioner that understands these issues.

  49. renee says

    I just found this article while researching Hashimoto’s. Have you continued on this subject? I am in desperate need of more answers. Thank you.

  50. renee says

    I have to tell you that finding The Healthy Skeptic put me on the right path in finding the cause of my Hashimoto’s! By what you post here, I am sure that you are familiar w/ Dr Datis Kharrazian? You and he have put me on a road to recovery! Once I was diagnosed w/ Hashimoto’s I began my research finding you, then, Dr Kharrazians book. My doctor had no intention of testing me any further once he diagnosed me w/ the immune disease. He simply put me on Synthroid and sent me on my way. As I researched, I discovered that my symptoms [and I had just about every one] subsided during the summer. Mainly my hair loss! In reading Dr Kharrazians book I had the doctor test my vitamin D levels. Well, as I suspected, I AM deficient in the vitamin and now on 50,000 units 1 day a wk for 8 wks, then 1000 units a day after that. Now, the next step is to find out WHAT is causing my deficiency.
    Thank you so much for your website and blog! And a quick note to your readers: TAKE CHARGE OF YOU OWN HEALTH! Listen to your gut! You know your body!! If you suspect something is wrong MAKE your doctor do the tests! Don’t settle for what your doctor “thinks” the problem is! And if your insurance won’t pay for it the testing, YOU PAY FOR IT! Your family and loved ones love you and need you healthy!!
    TO HEALTH!!
    Again, THANK YOU!!

  51. Chris Kresser says

    Renee,

    Thanks for sharing your story. I’m so glad this information has helped you to recover your health. That’s my purpose in doing this, so it’s wonderful to hear from folks like you.

    • says

      In our province of Canterbury in New Zealand at a latitude of 43 degrees south, all of the population are deficient in Vitamin D at some time of the year and 50% of the population are deficient all of the time, including me. I’m on the same weekly dose as you but expect that I will need a maintenance dose of a similar level i.e. 50,000 i.u. a week or 7,000 i.u. a day. I’ve discussed with my menopause specialist when we should get my Vitamin D level retested and she and I have agreed that after 6 months on this dose, it will be a realistic time to find out what it has done to my abysmally low Vitamin D level which was around 13ng/ml or whatever unit is used in the USA. It started out at 30mmol/L in our units and I would like it to end up at around 80mmol/L as a minimum and 120mmol/L as an optimum.

      Anyway, my main point is that beyond a certain latitude, Vitamin D deficiency is endemic in a population. Our cousins, the chimps get around their problem by nibbling on skin cells when they’re grooming their buddies/rellies in the troop!

  52. Candy says

    I am curious about your article stating that all Hashimoto’s is due to autoimmune disease. I was diagnosed about a year ago after much encouragement from my trainer who saw me doing all the workouts but getting zero results. She too has thyroid issues and she encouraged me to get my results from my general doctor as well as my gyno…both of whom told me “your test results came back normal”.

    On a hunch and and based on my TSH running around a 4 and my symptoms, I made an appointment with an endocrinologist. She did the tsh test as well as tpo…and the tpo antibodies came high… i think 132 out of 0-30 scale. On synthroid I went and a year later… I am starting to feel like a pin cushion experiment, constant retesting of my blood to find the right dose! I went from 25 to 50 to 75 to a combination of 75/50 mg and now I have been switched to armour (1gr). Of course since the switch, some of the terrible symptoms I was having before being on synthroid have returned including my arms falling asleep at night, very itchy skin, edema and headaches.

    A few months ago I suspected the autoimmune relationship, so off to my NEW doctor I went and got the anti-dna, complement C3 and ana blood tests, which all came back normal. So frustrating! My new doctor even checked my pth levels and ordered a scan for my thyroid…which was also “normal”.

    So my question is… If there’s an obvious autoimmune relationship, why isn’t it showing up in my results?

  53. Chris Kresser says

    Candy: Hashimoto’s is an autoimmune disease, by definition. If you have Hashimoto’s, you have an autoimmune disease. It’s that simple.

    The TPO antibodies that were measured by your doctor indicate that your body is producing antibodies to an enzyme in your thyroid gland. This is autoimmunity, i.e. the body is attacking itself.

  54. Chris Kresser says

    They did. Your TPO antibodies were positive. That’s autoimmune disease.

    The other markers are not specific to Hashimoto’s and may or may not be elevated in people with that condition. For example, I have Crohn’s disease which is an autoimmune disease, but I never test positive for any of the serum autoimmune markers.

  55. Sisi says

    OK Now I am confused. If I had a total Thyroidectomy and they found Hashi’s, Can I still have Hashi’s and can it be reaking havoc in my body?

  56. Chris Kresser says

    Yes. A thyroidectomy is like removing gum from your shoe. It’s very difficult to get all of it out without damaging the surrounding structures, so inevitably some of the thyroid gland is left behind – and it can be attacked by the immune system.

  57. Cynthia says

    I am glad to see this blog post is still active. I was diagnosed with hashi’s 10 years ago and went undiagnosed for about 4 years. And only in the last 2 years do I feel like I am on the right track towards better health.

    I have heard all the excuses I can handle from doctors. Things like “This is a lifestyle issue” and “You’re a complicated case” (I have 2 other rare auto-immune diseases, Sarcoidosis and Takayasu’s Arteritis, diagnosed 1.5 years after the hashi’s was diagnosed.) I have a new doctor and during one of my recent visits I told him I don’t want to hear about lifestyle changes and that if I had a nickle for every time I’d be a rich woman. I think he might be working up to a “You are complicated” because of the battery of tests he ordered, the other diseases have resolved themselves, I’m not worried.

    The information that has put me on the right track I’ve been able to find at the following websites:

    http://www.stopthethyroidmadness.com
    http://thyroid-rt3.com
    http://nthadrenalsweb.org

    The people in some of the posts above are still struggling with inadequate doctors, testing, the interpretation of those tests, and medication.

    The thyroid and all of its complications are a tangled web, but one that I believe can be untangled with the help of posts such as this and the websites mentioned above. This is a great series of articles on the thyroid and I can’t wait to dig into the rest of the blog.

    Thank you!

  58. Jeanne says

    I found this interesting. I had never heard of Hashimoto’s before. I have had my thyroid tested for years, suffering with fagtigue, dry skin, brittle nails, hair loss, allergies, intestinal issues, the list goes on. I have had a goiter since I was 18. My thyroid tests always come back on the ‘low side of normal” so my PCP refuses to treat me for low thyroid because it is technically normal. I have always asked what if normal for me should be higher! About 15 years ago they did a scan which also came back normal. Now, as I learn more I am glad they didn’t medicate me but am looking for nautural remedies to help. Any suggestions?

  59. Elizabeth says

    The more I read about hypothyroidism, and people’s experiences, plus my own, the more I think there is a huge disconnect between the reality of what people are experiencing and the medical establishment–specifically Endocrinology. It would seem hypothyroidism isn’t an isolated disease, but involves more of the endocrine glands. And doctors practice according to what they are taught to, which is just not helpful enough for far too many sufferers of this disease.

    My subscription for Synthroid is causing my test to show I’m getting too much TSH. My endocrinologist has let me stay on this dosage because it has cleared up so many of my problems, but he is leaving it up to me, largely, to let him know if I start getting heart symptoms such as palpitations. This is a terrible quandry for me, partly because of my age, 80.

    • Jo says

      Elizabeth,

      Your post is interesting. I am 53 years old, have Hashimotos, and heart palpitations and associated insomnia were the reason for visiting my doctor. I haven’t been able to get rid of the palpitations, but have found sugar and salt at bedtime to give me a good night’s sleep, generally, indicating a lowering of blood glucose at night while sleeping (or not).

      I am interested that your dose of thyroid hormone is keeping the palpitations at bay. Is it that a higher dose will put you into a hyperthyroid state and cause palpitations? Or are you taking enough hormone to prevent the palpitations? I believe it is adrenalin/stress hormones causing the palpitations in the hypothyroid/hashimotos condition.

  60. sandra says

    After I got EBV, my thyroid just dive bombed. I believe now that I had HYPER thyroid… for years before that… but.. after the EBV.. everything just got worse. my last antibody test was 578… range is 0-5. I do my best to just be thankful..but .. i have to admit.. with stress… all these symptoms of hashis and hypo.. along with a SLEW of other autoimmune disorders..( UC, psoriasis,shingles, PC) as well as Low iron sats, migraines.. off and on pvc’s.. and being EXTREMELY sensitive to whatever i take for it.. i think i am starting to lose hope. I just had my blood drawn today again.. due to the Westhroid that i take being upped.. well.. somethings just not right now.. the company also started putting a coating on it.. (they stated that people were complaining about the smell and taste)… well. since i started taking the westhroid WITH this new coating.. its not working like it was before.. plus.. i was taking 1/2 grain twice daily.. now.. they put me on 1 whole grain daily. uggh.

  61. christine says

    I had a total thyroidectomy 3 years ago. Felt terrible on Synthoid, now on Armour and starting to feel some results. I have terrible gerd, low iron and very low vitamin D. No improvements with supplements. I had the radiation pill which the doctor says kills all remaining thyroid tissue. Could there be any remaining active thyroid tissue? My funds are limited so I feel overwhelmed with the do list for more labs and more supplements that I read about in Dr. K’s book. Not getting any help from endo or family doctor. Advice is to continue Tagamet and deal with the gerd…. take the iron and get some sun. So confused on what to focus on first. Doctors say I have had the test for gluten and I’m not sensitive. As in one of your posts….should I first focus on removing this completely from my diet?

  62. renee says

    @christine try looking for a practitioner in your area who has studied under Dr. K. try this link:
    http://thyroidbook.com/contact-and-clinic-info.html. in the comment box tell them what state you are in and they will send you prac. info in and around your area. you may have to travel.
    i have taken myself off gluten and white sugar as much as possible and i have gone mostly organic. i have a grinder/press coming so that i can start juicing. my next step is emulsified vit. D [better absorbed]. just a few ideas for you. i haven’t found the cause of my hashi’s yet but i am saving pennies to see a doc in my area who studied w/ Dr. K. good luck

  63. christine says

    Thank you Renee for the input. I will get serious about the gluten and sugar. I haven’t heard of emulsified vit. D. Will try this also. I did find a doctor in my area that lectures for Dr. K. Hopefully will have enough money soon to be able to afford her. Thanks for the boost. It helps to talk to people who understand how you are feeling.:)

  64. Ingrid Müller says

    Well, I am reading very interestedall issues about Hashimoto. I was diagnosed many years ago… and I just took my L-Tyroxin 75 mg and took it as natural. So until now…. travelling and experimenting other kind of food like sea weed salads and maki sushis more than 2 times a week, I got pain (join / muscle – I even do not know the difference); area surronding my eyes hurt; when I stand up in the morning I fell like “90 years” old and I am 50!!!! Everything hurts! Nail breaking and hair is falling – first I was looking for high blood pressure problems since I started medication 3 months ago and for the first month I had to change medicantion because I got problem on m throat…… today…. thinking about that, it was not the blood pressure medicine but rather my imune system. I will be off gluten – it is a pitty that it takes 6 months to get rid of all side effects of gluten ingestion – I am so curious what my body / imune system will react. Now I am putting all over my place small notes to remind me not to eat bread – cakes and flour stuff and think Gluten free. Thanks for all information. I do hope I am on the write path! Ingrid

  65. Mary Ann says

    I understand how the thyroid effects many components of the body – ie the brain. A few years ago my world turned upside down when I took Chantix to stop smoking. My entire hormonal system went wacko, I entered menopause and my thyroid shutdown. Nothing seems to be helping me to lose the weight I gained. I have been on Armour Thyroid, P-Thyroid and now back on Armour Thyroid. I have often wondered if I began to take the nicotine logenzes if this would reverse some of my symptoms. thoughts?

  66. Elizabeth says

    It is sad, Mary Ann, to gain that weight and not be able to lose it. Until I found my present endocrinologist, I went through doctors who totally judged my thyroid needs by my TSH number. Every time they lowered my Synthroid, I gained ten pounds. Over a period of ten years, I gained forty pounds. Not one doctor will prescribe Armour for me.I finally just said no, I will not lower my Synthroid further. I have no signs of hyperthyroidism, only hypothroidism, so my endocrinologist is letting me stay on my present prescription.

  67. Christina Taylor says

    Hi, I came across your website, and I’m very hopeful in your knowledge. I need help. I have been through the ringer, literally. I was diagnosed with Hashimoto’s in December of 2010, but I didn’t know about it until July of 2011. When I first went to my doctor in november 2010, my blood tests came back showing I was hyperthyroid, which made complete sense, because that’s all the symptoms I have. Then in December it came back hypo and positive for hashimoto’s. This didn’t make sense to me. The only symptoms I have of Hashimoto’s is I am tired all the time, my hair was falling out until I went gluten free, and I have low blood pressure. But I have all the symptoms of hyper still. I have extreme weight loss, I don’t sleep well, and my biggest issue is I have diarrhea (chronic). I went to my doctor who is new in July complaining that it has gotten worse, she tells me that she is also a natural path so I got excited (finally someone to listen to me) well she put me on some herbs that half don’t work, they make me so sick. I am currently on a probiotic 3 times a day and peppermint oil after dinner. She told me that I should not get treated for my Hashi’s because it would make all my hyper symptoms worse. I really need to know if this is true. She then told me that my thyroid and GI issues are seperate, so she sent me to a GI specialist to rule out Crohns, so I’ve had an endoscopy (ruled out celiac, but I’m still gluten free) and a colonoscopy (he says there is no crohns) and he ordered blood work to check for infections. He is also ordering a small bowel series to see if I have any ulcers. I have had sooo many tests, everything comes back normal except for the Hashimoto’s, that has stayed the same. All my symptoms have gone away each time that I am pregnant and yes I have had 3 successful kids without any issues, which I have been told is a miracle because with Hashi’s your not supposed to be able to. I need this chronic diarrhea to go away, I was tested for sensativities and I am trying to stay away from my trigger foods, but it hasn’t helped one bit. I have been at it for 3 months now. I want to know what med would be best for my situation, or what I should be doing. I’m sooo lost. But from what it sounds like on here that synthroid at a low dose might actually help me, is this true.

    • sisi says

      Hashimoto’s is when your body thinks that your thyroid is a foreign body and attacks it continously. As it progressess, you will have hypo/hyper thyroid symptoms until the thyroid gland becomes atrophied or shrunken but by that time you have been through hell and back. There is no cure for hashi”s except to remove the thyroid. It is an auto immune disease. I would go to a good Endochrinlolgist (not all are created equal) and talk about removing the thyroid. Thyroid hormones are throught the body in every cell. Your stomach issues are probably do to a thyroid inbalance. I am not a doctor but just a patient who has been through what you have been through. There is no point is suffering when your thyroid must come out at some point or another. As far as your stomach issues (bloating, pain, burping, gas, nausea) I have two suggestions. Thyroid controls the body’s core temp including thatt of the stomach which must be at a certain temp to do its job. here are two quick fixes that WORK. Have someone get a small towel and wet it in ice cold water and place it on your stomach. You will feel the cold and react to it which is excellent and what is needed. The cold towel will absorb the heat of your stomach and lower it’s temp. Repeat this several times but IT IS IMPORTANT that you do not touch the cold towel because your brain will brace itself and you won’t have that physical reaction of the change in temp that the towel brings to your hot stomach. The second thing is to put 1 tablespoon of vinegar in half a glass and drink it before each meal. It is not that the stomach has too much acid but the opposite, it does not have enough so the vinegar will provide that. You will never have to spend $ on an antacid again. Try this and let me know how it works for you.

  68. renee d says

    Oh no no no!!!!! HASHIMOTO’S CAN BE PUT INTO REMISSION!! Once you find out WHAT IS CAUSING IT!!! DO NOT RUN OUT TO THE DOC TO HAVE YOUR THYROID REMOVED – PLEEEEEEEAZE!!!

    I will not diagnose (Christina) but I will say that it sounds like you may have Leaky Gut Syndrome (LGS). I was just recently diagnosed w/ it and told that LGS is the cause if my Hashimoto’s, I was put on a strict healing diet and have lost 15 lbs in 2 months!!

    As stated, I am not diagnosing anyone, just talking out of experience. There is an underlying cause to your Hashimoto’s! Your body doesn’t just attack itself for no reason!

    I more than highly recommend getting the book Why Do I Have Thyroid Symptoms When My Lab Tests Are Normal by Dr. Datis Kharrazian. I found mine on Amazon. And it put me on the road to what conventional doctors won’t take – HEALING!!

  69. sisi says

    I’m sorry to disagree with you renee but hashimoto is an AUTO-IMMUNE DISEASE like diabetes, lupus etc. and IT CANNOT BE CURED. Whoever told you that hashi’s can be cured is lying or misinformed. It will in fact destroy the thyroid gland progressively. No one knows the cause of Hashimoto’s because it is in and of itself an immune conflict with your body. It will continue to destroy your gland and you will feel the symptoms of your thyroid not working and it will progressively get worse. FIND A GOOD ENDOCHRINOLOGIST not a regular doctor since they don’t know anything about the thyroid gland. Once you have 1 auto immune disease it is reasonable to suspect that there maybe another. For me it was Vitiligo but it could be any number of autoimmune disease.

  70. renee d says

    I know that I didn’t use the word cure :) And I disagree w/ you saying that someone should have their thyroid removed. That should be a last resort. I will say again, when someone has an autoimmune issue there is a cause. The thyroid is one of the least studied parts of the human body. There are only a select few who specialize in it. Maybe you should get the book I suggested. There is alot of information that I think you’ll be surprised about :)

  71. Christina Taylor says

    Thanks for the advice guys. I go in next week. Renee, My doctor who I just found out is more of a natural path than a doctor told me about leaky gut. Ok, here is my take from the research that I did: Do Not play into their hype. Ok, yes changing your diet and getting tested for things you are sensative to is the BEST thing to do for your health, but I actually disagree with you as far as “Autoimmune just don’t happen”, In my case it is hereditary and yes they do develop. They do not start from what you are eating. I have eaten fruits and vegetables my whole life and never had issues until 12 years ago and it has slowly gotten worse. And yes, I did take my natural paths advice, I am off gluten, milk products and everything else that came back as a sensativity including yeast products. I have to live this way for 90 days and then she says we can test them one by one, well here’s the kicker….. I”M STILL SICK. When she told me I would feel better right away. It has been sooo frusterating to have to run to the bathroom every 10 minutes for several hours everyday. I have been on this starvation diet for 2 months now and it’s not working. I am also taking a probiotic and fish oils and peppermint oils. And it’s still not working. I’ve been working with a GI specialist for the last month trying to figure out if it is my intestines or if it’s just related to my thyroid. I’ve done legitimate research and have found that Hashimoto’s when not treated can lead to crohns and other autoimmune diseases because it controls the core of your body. And what an autoimmune disease is… Is where you have normal cells that go haywire and start tagging good cells as bad ones and then starts attacking them, which leads to attacking organs. Now where your food that you eat come into play is that most processed foods are bad for you and feed the bad cells which makes them multiply and spread even farther. So yes, changing your diet will help to make you feel better because it is no longer feeding the bad cells (or malfunctioning cells). But just like what the others are saying though is that once the damage is done, it’s done. Your organs don’t grow back. Just changing your diet doesn’t make the cells go away, I’m proof of that right now! Everything I eat is going straight through me, and I’m eating everything and only the things that this guy talks about in this book your talking about, so there is no link as to the food you eat is creating your illness. Yes it can cause digestive issues if you are allergic to it, but it won’t cause your body to attack itself. If you have a genetic prone or it’s in your blood somewhere then you’re going to get it at some point in your life. You can however put it in remission and have the damage put off for some time and that is probably what your case is, you are just the lucky one that can do it naturally and it worked. But for people like me who need to extra help from medication or doctors, this is what needs to be done. I agree that we do need to take charge and be stern with our doctors to get the right diagnosis and the right treatment though, but I wouldn’t put in too much of myself into this new, “it’s leaky gut syndrome” I think more natural paths are using it as their own way of saying “I don’t know what is wrong with you, but lets try cutting alot out of your diet and see what we can find with that”, it’s the same as the GI’s saying oh it’s just IBS. They don’t know what is wrong. but I have a feeling and a very strong hope that they are connected and that all I need is a beta blocker that will allow me to eat without the urgency to get all foods out of my system right away.
    I just wanted to know if anyone out there has ever had the same problem with hashimoto’s? I keep hearing that with hashi’s you’re supposed to be constipated, you’re supposed to be over weight, ect. Well I’m not and I need to know if it’s normal. I’m tired of living this way.

  72. Christina Taylor says

    Oh, sisi, I will try those things and let you know. I’ve wondered about vinegar, since it has healing properties in it. I didn’t know about the body temp thing though, thanks. I will definately try these things.
    Also, renee, this book, I think it was mainly for people with the symptoms and normal test results. All my tests are coming up not normal for Hashi’s so I don’t fit into that catagory.
    Sisi, I would like to know more about your story if you don’t mind, since you said you’ve had similar stuff to me. I’m hoping it will go away if I can get my hashi’s under control or out. I would really like to get it out, since the specialists have such a hard time regulating it for very long and everyone I talk to say it’s easier to regulate it if it’s taken out. My mother in law had hers removed and she felt tons better after, but she had all the classic signs of hypo, not like me who suffers from all hyper but blood comes back hypo.

  73. sisi says

    after my second child was born, I began to gain weight eventhough I watched what I ate and walked 7 miles a day. My friend convinced me to go in for a check up. They found a nodule in my thyroid. they did blood tests and a biopsy and they both came back normal. They gave me the option of surgery. Since I was gaining allthis weight and I had noticed things like forgetting things, stomach problems, my hair falling out, arm and leg cramps and many other wierd things and my children were 3 and 5, I decided that I could not live knowing there was something inside my thyroid that wasn’t supposed to be there. I remember that somedays I was exhausted and other days I was going a mile a minute. In hindsight what was happening was that I was hypo one day and hyper the next. My thyroid was malfunctioning and this is what the thyroid does when it is pooping out. It goes back and forth between hypo and hyper until it stayed hypo. So I decided on a thyroidectomy. It turned out to be cancer and Hashimotos which had atrophied my thyroid gland and it was not functioning. In my case (because my body is very sensitive), they had a very hard time after surgery leveling me out. But most people do fine after the surgery. Before any of this thyroid stuff began, I got Vitiligo (loss of pigment) which is an autoimmune disease. (that is why I said that if you have one autoimmune disease you will probaby have a second one as well. All autoimmune diseases do not have cures. They are managed but never cured.) Like you, I had and have GI problems especially horible and painful gas. I know that before surgery I was exhuasted and had diahrea often. When the thyroid is hypo, then everything in your body slows down but when it is hyper, everything speeds up which is the reason you have diareah. Unfortunately, I did not do well on synthroid and I take the natural form of thyroid hormone (armour thyroid). The problem with thyroid is that most doctors focus only on blood tests even though the patient doesn’t feel well. In some people, like you and me, the bloodtests and even a biopsy will come back normal even though your thyroid is blinking out. Hashimotos doesn’t go away until the gland that it is attacking is removed. The surgery is a breeze but the recovery is a little tough and sometimes a little long but once you are level with thyroid hormone, then everything returns to normal. You need to read a book by Dr. Broda (can’t remember the name). This book will educated you on thyroid down to the nitty gritty. There is a way to know if your thyroid is malfunctioning. Take your temperature every morning before you even blink. you must move as little as possible. Do this for one week. you will see that if hypo your temp is below 98.6 and if hyper it will be above 98.6 on average. They used this method in the 50′s and it is still valid. You must remind the docs that your blood tests cannot be relied upon. Tell them often (they tend to not hear you). Only after surgery and thyroid hormone is given that you can rely on the blood tests. Also, thryoid problems are hereditary so start asking mom or dad if anyone else in the family has had problems. Thyroid hormones are found through out the body and even your brain. It controls the speed at which each cell in your body rotates. If hypo your cells are rotating slowly and if hyper they are rotating fast. Why is this important? because thyroid problems manifest themselves in every section of the body from skin to brain. It controls body temperture and metabolism. It is found in abundance not only in the thyroid but in the brain, spinal cord and stomach. It is the only hormone that gives you symptoms that have nothing to do with your thyroid and will mimic many other disordersfor example GI problems, depression, skin moisture, limb pain, foot pain, eyesight, tendons, muscles well you get the idea. It can show up as so many things and can easily be misdiagnosed ESPECIALLY if your blood tests are coming up normal and you feel like crap. The most important decision is to find a GOOD endo. Mary Shoman (google her name) has a website full of info AND how to find a good endo from patient referral. If you decide not to take out your thyroid, eventually you will be permanently hypo since hashi is destroying the gland and then have no other choice but to take it out but like I said by then you have suffered with 15 symptoms that mimic other disorders. This is why I said it is better to take it out and have your thyroid regulated by taking a hormone pill. If you have specific questions you can ask me but if you read Dr. Broda (just google his name and the book will come up) all your questions will be answered.

  74. melanie says

    Chris – my daughter is currently about 13 weeks pregnant. Her thyroid was irradiated years ago & she has taken daily medication since. Her OB-GYN – whom she visited when she was about 6 weeks pregnant, did not seem too concerned about her thyroid – or much of anything else, either. This caused her to switch to a different OB-GYN, who appears to be much more competent & supportive & who performed a battery of tests. Two weeks ago, her test results started to come back in, & her doctor’s office called my daughter & asked her to come back because her thyroid numbers “were so high, they thought it was probably a lab error.” Upon retesting, the numbers came back the same, & her doctor set her up for an emergency meeting with an endocrinologist. Given all I’ve read about the fetus’ dependency on the mother’s thyroid during the first 12 weeks of pregnancy, needless to say I’m concerned – as well as confused. Will this have already had a detrimental impact on her child? What kind of questions should she be asking? What else should she be doing? Thanks so much!

    • Chris Kresser says

      Melanie: That is a concern. Autoimmune thyroid disease frequently gets triggered during or right after pregnancy, because of the profound immune shifts that occur. It sounds like she may be experiencing either Hashimoto’s thyrotoxicosis or Graves’. She should have her antibodies (TPO, TG and TSI) tested immediately and take action to bring the hormone levels back into range. This is what her endocrinologist should be suggesting. Feel free to set up a free 15-minute consult at http://chriskresser.com/appointment to discuss.

  75. renee d says

    Christina, the title of the book is a bit deceiving. I have been diagnosed w/ full blown Hashimoto’s. And as I stated above, Dr Kharrazian’s book set me on the right path. He explains the many causes of Hashimoto’s. For example here are a few: gluten intolerance, insulin resistance, polycystic ovary syndrome, vit. D deficiency, chronic inflammation/infections/viruses of digestive tract, environmental toxins.

    I’ll say it again, GET THE BOOK ;) And whoever here told me to not see a regular doctor, well, I don’t :) I see a person who specializes in Hashimoto’s and Fibromyalgia [sp?]. He has been to most of Dr Kharrazians lectures and follows most of the same principles.

    I wish you the best w/ your health!!

    • Jo says

      Renee – this blog is old but if you do see this will you please reply? I am keen to find out about your improvement. I have just began on the fibromyalgia road and anything you can suggest will be much appreciated. I live on an island under Australia (Tasmania) and finding a knowledgeable person here seems impossible. I hope to get a reply form you and to continue some communication, plz.

  76. Christina Taylor says

    Sisi, Thanks for the tip, I will definately take my temp everyday now. I have been questioning whether my thyroid was going back and forth everyday, I actually wonder if it does that throughout the day actually, because some days I’ll wake up feeling great but then by lunch or after feel like crap, and then other days it’s the opposite, i’ll wake up feeling like crap and then have a burst of energy for several hours and then feel like crap, but I always feel better everyday at about 9pm at night. It’s the weirdest thing. I did take my blood pressure this morning and it was 98 over 68, That is really low, and I don’t know what I should be doing. But I agree with you about how eventually it needs to just come out. I just hope my doctors listen to me, I get the worst luck with doctors. I have been seeing a natural path and she even has been a pain to deal with at times. So I might be switching general doctors again, we’ll see. Did your stomach issues go away after you had it taken out? I can handle everything else that is wrong with me, it’s my constant stomach issues that I am soooo sick of. Thanks

  77. sisi says

    Yeah the thyroid blinks in and out while in the process of completely not working so that is what you are feeling with the ups and downs. Believe it or not, eating oranges at my lows helped me a lot. Like I said you MUST find a good ENDO and what makes a good endo is one that listens and takes into account your input. Drinking cinnamon or coffee will help with the low blood pressure. Make cinnamon tea (use real cinnamon) 1 cup and see if that doesn’t help with the blood pressure. You need to leave the naturalpathic doc and find an endochrinologidt not just a reg. doc because they know nothing about thyroid. after my thyroid was taken out I had a lot of problems but ONLY because I couldnot tolerate synthroid and had to go to a natural thyroid hormone called Armour. Bother your doctors and don’t let them bully you. THIS IS YOUR LIFE AND YOUR BODY and they are there to help, so be strong even to the point of being obnoxious. ONce your thyroid is taken out and your hormones are level you will no longer have diareah since it is cause by your hyperthyroid state. YOU MUST drink a lot of water until this resolves so that you do not become dehydrated. Also, many of us are lactose intolerant to some degree or another. My GI issues went away somewhat when I started doing the towel thing that I mentioned earlier and they completely went away when I had to have my gallbladder removed aabout 6 yrs after my thyroid was removed. Once you are stable, many of the symptoms will just disappear and you will be healthy again. You need to keep a diary right now of what you are eating and pay attention to how your stomach and blood pressure reacts to them and eliminate them from your diet. I do not consume anything with milk. I do not eat beans. My diet right now is mostly protiens with a little carbs but since you are hyper right now it should be the other way around. More carbs than protien so you don’t lose an enormous amount of weight until you become healthy again. Don’t worry. This does not last forever even though it feels like an eternity for you right now. Everything will fall into place once you have the correct amount of thyroid hormone in your body. Don’t give up and don’t think that this is how you will feel forever because this is not true. You will be OK just pay attention even to the littlest symptom like your legs cramping or feeling like there are spiders crawling on your cheek. All of this, although little symptoms can drive you crazy. Write them down so you don’t forget to tell the doc. When you go see the ENDO, make sure you have a list written down of all your symptoms and when your feel them or what makes it worse or better. Just remember that you have to fight for your well being even if you have to change ENDO’s 3 times till you find one that will listen. Like I said before the best way to find an ENDO is by patient referral so use the website of Mary Shoman to help you in your search. my email is sisi62@msn.com and you can email me anytime for support. I will be happy to help in anyway I can.

  78. Michelle (Ireland) says

    I had a total thyroidectomy due to hyperthyroidsm and graves disease in August 2010. I take 150mg Eltroxin daily. I am tired 24-7 my arms ache and I generally feel bad. Are there any energy supplements I should be taking?

    • Geliza says

      Try going Gluten-Free. I have Hashimotos and Graves disease, take thyroxin and had these same symptoms among others, since going GF the pains in my arms have dissappeared (after only a few days), I have much more energy and generally feel very much better. Other symptoms, (IBS type) have also gone, going GF was meant to be only a trial, its not been 6 weeks yet since I started, but I will definately be keeping it up, even though its a nuisance having to read all the food packets and trying to find a decent bread I can eat, i’m going to stick with it. I hope it helps you too.

      • Ingrid Lutzkat-Müller says

        Hi Geliza,
        I do have the same and I am going on GF almost one year so I found out how to make my own bread…. of course it is not the same… but it works very well:
        - 500g Linseed (grinded)
        - 5 eggs beaten
        - 1 tsp. salt
        - 1 tsp. baking powder or soda bicarbonate
        - aprox. 300ml water

        mix all and baked 375 F/180C for aprox. 30-45 minutes. Make the toothpick procedure to see if it is done.

        Hope you enjoy like I do when I’m craving for a “bread”

        Regards
        Ingrid

        • Geliza says

          Thanks very much for the recipe, I shall certainly try it, I am in the process of trying out different ones.

          I found one that looked really good, on the net, but when I tried it out it didn’t quite work out, from the fotos its the nearest I have seen to real bread. I could give you the link but it is in spanish, suffice to say it’s bread made with mandioca, (yuca, tapioca) starch, and the process is much more complicated than your recipe.

          • Ingrid Lutzkat-Müller says

            Thank you Geliza – but I am so tired of trying recipes….. he he he…. now I found this and I think for me the Linseed is just perfect (until someone find out it is not good for your health…he he he) Thank you again! (PS no problems with spanish – I speak a little). Ingrid

  79. Pam says

    Hi Chris –

    I have Hashimoto’s and have had it most of my life. I was always told that my enlarged red blood cells were due to my thyroid problems and that there was nothing I could do about it. Is that true? Is this a type of anemia? I am curious if this is a common symptom you have seen in your research and if there is anything I can do about it.

    Thanks, Pam

    PS I also posted this on your podcast questions

    • Chris Kresser says

      Macrocytosis is a common complication of Hashimoto’s. To treat it, you need to treat the Hashimoto’s itself, which means addressing the immune dysregulation. Thyroid medication only replaces the thyroid hormone. It doesn’t address the immune issues.

  80. toni says

    Hi
    Just discovered your forum. Great info! I was diagnosed with celiac 2 yrs ago and have been on a strict gluten free diet. I had adrenal fatigue (low cortisol levels about 7 for 8 am) and fluctuating high TSH levels. My free t3 and free t 4 have always been in upper 1/3 and 1/2 of range respectively. Antibodies have always been negative. Recently again my TSH is 4.53 free t4 1.1 (range .74-1.83) and free t3 3.74 (range 2.28 -4.81). SO since free t3 and free 4 seems to be ok but TSH is high, should I try .5 grain armour to see if I feel better? The thyroid is working hard to keep levels normal but why is this happening?
    On a side note my liver enzymes have been in upper limit AST is 41 (range 8-39)ALT 48 (range 9-52).
    I have been struggling with low motivation and energy for 3 years now..any feedback would be greatly appreciated!

  81. Pam says

    Hi Chris –

    I am getting a prescription for LDN thanks to your informative podcasts. In researching LDN in various user groups, some people talk about LDN not being as effective if you have candida overgrowth. Have you found this to be the case with your patients? Have you seen anything about it in your research?

    Thanks! Pam

    • Chris Kresser says

      I’ve heard that, but I haven’t observed it in my practice – and I think candida is often misdiagnosed or overdiagnosed.

  82. jennifer says

    Hi Iam 29 yrs old in 2009 had thyroid cancer followed by radioactive iodine and total thyroidectomy . Tsh has been normal last 2 months have felt awful have no energy and excessive sleepiness. Tsh was just checked last week now is 47.60 Have been on same doage for a year. What could be the problem

  83. renee d. says

    Jennifer your doctor should be testing more than your TSH level. What meds are you taking? If you are on Synthroid, that is synthetic and is only T4. If you are hypo, you aren’t converting T4 to T3 so you need a med that will provide you w/ T3 as well. I am talking out of experience as Synthroid was NOT the drug for me. I did my research and insisted that my doc write me a script for Nature Throid which has T4 and T3. I feel like my old self again! Also, watch what you eat as you could be insulin resistant. Cut out any refined sugar which is in just about everything, eat low glycemic fruit if you have a sweet tooth and stay away from rice, pasta, bread and potato’s. An organic diet consiting of veggies, lean meat or beans [for protein] is a good way to help you feel better too. Also, have your Vit. D level checked as it is a hormone not a vitamin. I hope that helps. I went thru hell before I started my research. Good luck and if I can help…………

  84. says

    Bejeesus! A TSH of 47.60…I hope the decimal point’s in the wrong place. Everyone seems to be using the same unit of measure (mU/L) so I guess it’s has high as it sounds.

  85. renee d. says

    Meg you sent me a message about the LGS diet. I don’t see your comment here. If you are still interested I can email it to you. There is a PDF file that is too large to post here.

  86. Sylvia says

    I have a question. I am currently waiting on another endo visit; but I have a month to wait. I have Hashimotos. I also developed a toxic adenoma (approx 3″ in diameter. I had both the adenoma and total Thyroid removed 1 year ago (I am 38). I actually tested negative for both hashi’s and Graves antibodies the day before my surgery (it was believed I had both? My mother has graves). I recently tested my antibodies and they were 2,300+. I feel horrible, and I feel like there is a new lump in my throat forming. Anyone ever experience a Hashi’s tumor post Thyroidectomy??? It feels very much the same; the weird pain at times in the mass. *sigh* Ideas? Tips? My doc tested many other antibodies and they were all negative. My insulin production is slightly elevated and I’m experiencing bouts of Hypoglycemia (my daughter is Type 1 Diabetic so we have meters everywhere).

    • Sylvia says

      **** Also autoimmune disorders are rampant in my family. Besides the diabetes with my child, and Hashi’s for me so far- my mother has Lupus, antiphospholipid syndrome, short bowl syndrome, Graves, and something with her bone marrow as well (not sure what, that’s a new development theory)

  87. Eva says

    Hi Chris,

    First off, thank you so much for your skeptical health blog. You are a rare voice in a field filled with superstition, miracle cures, and snake oil salesmen looking to make a quick buck on the vulnerable.

    About me: I am 24 years old, just got diagnosed with hypothyroid after around 3-4 years of being “borderline.” I’ve had conflicted feelings about this diagnosis because in one way, it ties together all these other health problems that I have been having (and that I feel like I am too young to have :( ), namely: polycystic ovaries/irregular menstruation, constant low energy and fatigue, serious anxiety/panic disorder, and what I recently found out was mild scoliosis (causing constant pain in the joints on my right side). Honestly, reading all this on your blog has made me feel rather hopeless…autoimmune diseases are so serious and I was unprepared for the thought that I will be dealing with a lifetime of serious problems.

    I just wanted to find out from you if there is any hope in handling this disease. I haven’t yet found out if I have Hashimoto’s or not, but of course chances are that I do. I am at the point in my life where I am preparing for graduate school. Do you think that I need to take some time off to address these health problems before I get lost in the world of grad school (high stress, overwhelming responsibilities, little free time, etc)? I know this is a strange question, but this all really worries me. I’d appreciate your perspective on what it takes to begin managing it.

    • Chris Kresser says

      Eva: hypothyroidism (and Hashimoto’s) are treatable, and it’s entirely possible to live a full and happy live with the proper care. Identifying whether you have Hashimoto’s, or iodine deficiency, or both, or perhaps another cause of thyroid hypofunction is the most important step. From there, the next steps become more clear. Best of luck.

  88. Melissa says

    Hi. I had some questions and was wondering if you had any insight as to what might be going on or some other things that I should be checking for. A few years ago, I had an enlarged thyroid. The doctors drained the fluid out, tested it, and when it filled back up decided that the best course of action was to send me straight to the surgeon. I didnt know any better so I had half my thyroid removed, and now have hypothroidism as a result. No doctor seemed to think it was important to find out why my thyroid was acting up in the first place. A little over a year later (had a child in that time) i started having a multitude of symptoms: fainting, dizziness/lightheadedness, chest pains, extreme fatigue, hard time loosing weight, tingling/numbing in hands/feet. for about the last 2.5 years now I have had all of these symptoms and have had just about every medical test known to man done, everything comes back normal. I have been a guinea pig for so many medicines because the doctors don’t know what else to do so they just throw medicines at me to try. Because my thryroid was the first thing to go wrong, i’ve begun to look into that more on my own and have really been wondering if that’s where everything went wrong, and because the doctors I had at the time decided to just cut out what was causing a problem instead of trying to fix the problem, it really didnt solve anything. Any help or tips or advice you can offer to me would be greatly appreciated. I am so tired figuratively and literally from doctors trying to tell me everything is fine because the tests come back ‘normal’. Thank you.

    • Ingrid Lutzkat-Müller says

      Dear Melissa, I really hope you find soon out what is wrong with you and your Tyroid. I can only write about myself and I still do not know if all what I have done was/is the right for me…. but since I am feeling well I do believe I did it right:

      - cut off all grains and dairy;
      - use only olive oil extra virgen over cooked veggies (I dio not heat oils)
      - use ghee (Butterschmalz) as fat for almost everything;
      - Eat eggs and meat (chicken, beef, duck, fish) in every meal
      - Eat at least 200g veggies….better 300g for each meal (even mornings)
      - avoid any industrialized product
      - Eat fruits but not too many (2 a day)

      One year has passed…. I can walk without problems again…. I could not so tired I was…. Now once in a while I use some butter, heavy cream and eat some rice (very seldom). I lost weight (10 kg) and feel great. I do hope that was the right thing I did…I am still a little afraid that the missing grains / dairy can harm my health…. but up to now…. it only made me feel better and better!

      I wish you all the best! (I did not mentioned: I do have Hashi…. but even that is changing for better)

  89. Sarah says

    I wish I’d known all this a long time ago. I was diagnosed with hypothyroidism at age 4 with a bone age of 9 months. My TSH test came back borderline, and apparently a low-grade deficiency was enough to retard my growth that much. My doctor pretty much guessed that maybe a low dose of Synthroid would help, and with that I grew twelve inches in twelve months. Throughout the years afterward, though, as long as my TSH test came back “normal” I was told I was fine, any residual fatigue, depression, malaise, whatever was in my head or would pass soon enough. Or maybe, it was suggested, I should be on an antidepressant. I was on Lexapro for two and a half years, beginning with my third pregnancy. It didn’t help, and it took a long time to break free of it (several months to find a slow-enough tapering-off schedule and six months on that schedule). I don’t want to take another anti-depressant, but if it would help to take a supplemental dose of T3 (like Cytomel or its generic form) or a different thyroid medicine with T4 & T3 combined, I’m all for trying that.

  90. Elaine says

    I have just found this wonderful website. I have ME/CFS as well as hypothyroidism (Hashimotos I assume though I am in the UK and it’s never been called that to me).

    I have taken synthetic Thyroxine for nearly 20 years so is it too late for any improvement now? I have changed my diet in the last 2 yrs (to try and improve the ME/CFS), and on reading the articles it seems I am doing it almost as well as I can already as I am on a Paleo(ish) diet, and gave up gluten a year ago, which has ended my horrible stomach pain, and have solved my acid issues with kefir. I have even been to acupuncture weekly for a year.

    I have just started on LDN ….. more to help with the ME/CFS than the thyroid though it seems it could help with that too. Sadly, I have sensitivity issues and get terrible stomach pain on it, so can only tolerate a tiny dose every other night at present.

    Would be grateful for your view if it’s all too late for me having been on the synthetic Thyroxine for 20 yrs, and if my ME/CFS and thyroid is likely to be improved too with what I am doing?

    There is no advice via my GP in the UK – they have no understanding of these things at all. I am getting a little help with a private GP who specialises in ME/CFS and who has prescribed the LDN for me.

    • Chris Kresser says

      Elaine: there’s another way of administering LDN that you might want to look into. You can take it in transdermal form as a cream. Skip’s Pharmacy in Florida can prepare it that way. I’m not sure if you can get order it from Florida since you’re in the UK, but you may want to consider that. I don’t think it’s too late for improvement, and I think LDN will probably be helpful for both your thyroid and ME/CFS if you can get on a solid dose.

  91. Elaine says

    Thank you Chris – I really appreciate your response. I did not know of the transdermal LDN and I am now looking into that possibility.

    I wish I had known what I know now (I am almost 60) when I was your age, but I probably wouldn’t have listened then! I suspect that my autoimmune issues were triggered by my last pregnancy when I had Immune Thrombocytopenic Purpura, though luckily not until the last few weeks. My Hashimotos didn’t appear until around 10 yrs later. I also have had issues with Lichen Planus since then, also thought to be autoimmune.

    Looking back I can track the medical history now, (also have had gastritis now healed by the diet), but at least I can do my best for my old age. I was into healthy eating too, and thought I was doing the right thing, but the gluten was probably the worst thing I was eating then without knowing it.

  92. Melissa says

    Hi. I posted a couple months ago up there and was things are only getting worse. I’ve been getting more and more fatigued, and my memory seems to be going. More of an absent-mindedness, but I feel like I can’t remember anything unless I write it down, and even then, sometimes I forget to look at the paper I wrote it down on to remember what was written.

    Please, if you could offer some advice to me. As I said in my last post, because everything started to go wrong when I had an enlarged thyroid and my doctors decided to remove half of it instead of find the cause of they hyperthyroidism, I really wonder if this is now one of two things. 1) whatever was wrong in the first place finding a new way out since the thyroid was partially removed or 2) negative/downfalls or continuing problems related to hypothyroidism caused by the thyroid removal.

  93. Mark says

    Hi,

    I’ve read your posts on iodine and selenium. I have come across this research (see link below) that suggests that iodine and selenium have no combined effect (although I may have grossly misinterpreted this). Would you care to comment?

    http://www.ajcn.org/content/90/4/1038.abstract

    My interest in iodine is not in using it for thyroid problems (although from what you and others say I will have problems if I take it with too high a dose). I have a few cherry angiomas, I’ve seen that this may be caused by bromine poisoning which iodine supplementation can help:

    http://www.iodine-resource.com/cherry-angiomas.html

    However, I suspect that we may be getting into the realms of snake oil here…

    Thanks in advance for any reply.

  94. Elaine says

    Thank you again for mentioning the transdermal LDN (above) – I am pleased to say that it’s now available in the UK too via Dicksons pharmacy. I started using it on Saturday, and so far, so good! Also my recent annual thyroid results are already moving in the right direction, so maybe a year’s acupuncture has helped too, along with the better diet.

  95. Glen Nagy says

    Are there functional lab ranges for all the thyroid test online somewhere? I have only been able to find the TSH functional range of 1.8-3.0. Would the functional range for antibodies be different for someone on a gluten free, sugar free diet since gluten and sugar can cause increases in autoimmune activity?

  96. Kerry says

    Thank you for all your information on this site and in your podcast. I just deleted a looong comment to you and instead post the question below:

    Do you have a link to a list of definitive tests to ask our health care providers? I want to figure out if my Hypothyroidism is Hashi’s and if that and my Crohn’s, very early menopause, Asthma, Fungal and Yeast issues all could be pieces of one autoimmune puzzle.

    I see you recommended to someone else the test for antibodies (TPO, TG and TSI) but anything else I should be asking for? Reverse T3? Anything? I will be seeing an endocrinologist for the first time in 2 weeks. FYI, primal for a couple months now and asthma and allergies are noticeably better!

    Thanks in advance.

  97. Erin says

    I have Hashimoto’s but it’s not following the typical path. I have never taken thyroid meds yet I keep having bouts of hyperthyroidism and then go back to euthryoid. I’ve only ever been slightly hypo….then back to major hyper periods that only last about a month. Now I think I’ve figured out the underlying cause. I was recently diagnosed with hemochromatosis but that’s also not following the typical path. My iron and iron staturation are high yet my ferritin is normal so again, no one will treat me. I didn’t have a period for a year and a half from lactation induced amenorrhea. I can only imagine what my iron levels were like during that time, yikes! But after a year of extremely heavy periods that often came every 3 weeks, my iron saturation was 102%. My dr thinks it’s unrelated but I’m thinking having all that iron in my thyroid may be what is causing my body to attack it. And my periods may be what are causing me to feel like I’m constantly going back and forth. I really don’t know what to do about it though.

    • says

      Erin,

      Why don’t you get your thyroid antibodies checked? You could be like me and have both Hashimoto’s disease and Graves’ disease. One causes hypothyroidism, one causes hyperthyroidism. I bounced back and forth for seven years until I finally got my thyroid removed to save my sanity.

      How hyper did you get? Did you have rapid heart beat? Be careful, that can be really serious.

      Here’s a pretty good post on ferritin as it affect thyroid levels if you haven’t seen it yet: http://www.stopthethyroidmadness.com/ferritin/

  98. says

    DEAR SIR,I STAY IN INDIA AND SUFFERING FROM HYPOTHYROIDISM AND TAKING 2 TABLETS OF ELTROXIN PER DAY 200 MICROGRAMS.IN SPITE OF REGULAR TREATMENT MY TSH LEVELS ARE <0.005 i.e. SHOWING HYPERTHYROIDISM BUT I AM SUFFERING FROM WEIGHT GAIN AND LETHARGY ,MUSCLE PAIN,HAIR FALL ,DROWSINESS ALL SYMPTOMS OF HYPOTHYROIDISM .PLEASE ADVISE ME OTHER LINE OF TREATMENT SO THAT I CAN WORK PROPERLY

    • says

      Dr. Deo,
      It takes a while for symptoms to catch up to blood levels. Best to be patient and don’t overdose yourself on thyroid hormone, that can be very dangerous.

      What is your pulse rate?

  99. Robin says

    I have had hypothyroidism since age five. I have seen a specialist since my pediatrician suspected something was up. Hypothyroidism for me is mainly a genetic issue; seeing as it runs in my family. I am now sixteen and have had no side affects or anything up until this past year and a half. I take Levothroxine 200mcg tab. I am starting to have more and more frequent leg cramps (Normally waking me up early in the morning like clock work. Bringing me to tears because of the pain. And then I can’t walk for the next two days.) Also, my blood pressure has been out of the roof averaging at 170/90 (One time it was 190/100.) Luckily it hasn’t gotten quite that high again. My Dr. has told me to cut down on carbohydrates, to continue my exercising, and to avoid salt. I have been doing this but my BP is still elevated about the same. Hypothyroidism is from my mother side. High blood pressure is from my fathers side. My dad has been on since he was 20.

  100. Robin says

    I have had hypothyroidism since age five. I have seen a specialist since my pediatrician suspected that something was up. Hypothyroidism for me is mainly a genetic issue; seeing as it runs in my family. I am now sixteen and have had no side affects or anything up until this past year and a half. I take Levothroxine 200mcg tab. I am starting to have more and more frequent leg cramps (Normally waking me up early in the morning like clock work. Bringing me to tears because of the pain. And then I can’t walk for the next two days.) I am trying Bananas, but nothing seems to work…any advise? Also, my blood pressure has been out of the roof averaging at 170/90 (One time it was 190/100.) Luckily it hasn’t gotten quite that high again. My Dr. has told me to cut down on carbohydrates, to continue my exercising, and to avoid salt. I have been doing this but my BP is still elevated about the same. Hypothyroidism is from my mothers side. High blood pressure is from my fathers side. My dad has been on BP medicine since he was 20. His Dr. told him to lay off the same thing and his BP levels did not change either. My Dr. has told me to monitor it. I have and I’m seeing no changes. My check up is next month. I already know shes going to send my to a cardiologist and to see what they say. Any ideas on how to lower my BP? I can’t be mad all of the time it stresses my body out. Also, I have a biopsy done on my thyroid nodules. Happily they all came back benign. :) And my thyroid is starting to effect my swallowing and stuff so my specialist says it might need to be taken out. She said it was my call. It needs to be done because of me, well, not being able to swallow very well, but also because it could be cancerous later on. And if its taken out that risk will leave. I am deciding whether or not to have it by the end of this year. If I understand correctly, but if I don’t someone please let me know. Also, I don’t know what to expect I’ve never had a surgery like this before. Can anybody tell me what to expect? Here are some of my questions: Will I have a scar? How long will I be bed ridden, if at all? How long will I have a bandage? Will they put me in a neck brace to help keep me from tearing it open? When I wake up from the surgery will I feel anything? What risks are there concerning infection etc…?

  101. Robin says

    Please ignore previous comment it did not contain all my paragraphs, as i see. I have had hypothyroidism since age five. I have seen a specialist since my pediatrician suspected that something was up. Hypothyroidism for me is mainly a genetic issue; seeing as it runs in my family. I am now sixteen and have had no side affects or anything up until this past year and a half. I take Levothroxine 200mcg tab. I am starting to have more and more frequent leg cramps (Normally waking me up early in the morning like clock work. Bringing me to tears because of the pain. And then I can’t walk for the next two days.) I am trying Bananas, but nothing seems to work…any advise? Also, my blood pressure has been out of the roof averaging at 170/90 (One time it was 190/100.) Luckily it hasn’t gotten quite that high again. My Dr. has told me to cut down on carbohydrates, to continue my exercising, and to avoid salt. I have been doing this but my BP is still elevated about the same. Hypothyroidism is from my mothers side. High blood pressure is from my fathers side. My dad has been on BP medicine since he was 20. His Dr. told him to lay off the same thing and his BP levels did not change either. My Dr. has told me to monitor it. I have and I’m seeing no changes. My check up is next month. I already know shes going to send my to a cardiologist and to see what they say. Any ideas on how to lower my BP? I can’t be mad all of the time it stresses my body out. Also, I have a biopsy done on my thyroid nodules. Happily they all came back benign. :) And my thyroid is starting to effect my swallowing and stuff so my specialist says it might need to be taken out. She said it was my call. It needs to be done because of me, well, not being able to swallow very well, but also because it could be cancerous later on. And if its taken out that risk will leave. I am deciding whether or not to have it by the end of this year. If I understand correctly, but if I don’t someone please let me know. Also, I don’t know what to expect I’ve never had a surgery like this before. Can anybody tell me what to expect? Here are some of my questions: Will I have a scar? How long will I be bed ridden, if at all? How long will I have a bandage? Will they put me in a neck brace to help keep me from tearing it open? When I wake up from the surgery will I feel anything?

    • Iingrid says

      Dear Robin, I am so sorry you have to pass through all of this…. I have hashimoto and since I cut almost all carbs like sugar, grains, reduce fruits, milk I got much much well. First it was hard because I loved pasta, rice and etc…. hardly ate eggs, red meat and so on…. since I changed my intake everything got better. For an idea I eat in the morning 2 scrabled eggs, some fruit; lunch salmon /hering or chicken or beef (some 140g) and a lot of veggies like green beans, broccoli, carrots, kale, red onion, red bell pepper and so on…. I eat 300g veggies for 100g meat so I have a good amount of food for lunch and dinner and I am not running after sweets anymore. I steam everything and do not heat any oil. I cook with clarified butter or just butter. OK I used fresh cream…so I make my own ice…. blueberry eis; mango ice and so on…. I hope you try this kind of “diet” for one month and see if things change for you-…. for me it is wonderful! Even hot flashed got away…..!!!! See for paleo diet…. avoinding grains, milk, legumes like (pinto-kidney-black beans, lentils)… after a while you can introduce them again…but sporadicaly…. your doc was probably right: reduce carbs!!!!! Wish you all the best and if you ttry it…let me know…. Regards Ingrid

    • Karen says

      Hi, Robin,
      I too am sorry that you have to go through this, it’s not fun but it does seem to be treatable. I had surgery in ’03. You can’t see the scar at all. I was up pretty fast after the surgery, a couple days, and that may only have been because I still had the lymphoma and so the cancer was making me weak. I was 53 and you’re young so you’re probably going to be even stronger and heal faster than I did. No neck brace or anything like that, don’t remember how long the bandage was on, it didn’t seem to matter.
      I also had severe leg cramps similar to yours for years after the surgery but as I got healthier they went away. I still get one every once in awhile but there’s usually a cause – too much exercise or not enough is the major cause for me. If you’re not getting any exercise now and can begin, work into it slowly so as not to aggravate the cramps. I also use a hotpad on the cramps and that helps tremendously. I make them but you can just put uncooked rice in a big sock and tie the end, about 2/3 full of rice. Microwave till it’s hot but not so hot it burns your skin.
      I agree with Lingrid that diet also has a huge affect. I too cut out most carbs (in the form of grains), alcohol, and all dairy except butter and it has helped a lot. That change also helped me get my weight down to where I wanted it. This is just my experience, perhaps yours will be different. Good luck to you.

    • Carol says

      It was the easiest surgery I’ve ever had. You really won’t feel too badly. There will be a scar for several months. I’m much older and mine lasted less than a year, you should heal sooner. I wore a scarf until it wasn’t noticeable. You can’t see it today.

  102. Karen says

    Hi, Chris, this is going to sound like the alltime dumb question, but I can tell from reading your site that you’re going to know the answer and I need to know this. In 2003 my windpipe collapsed from a lump on my throat which was thyroid lymphoma. After emergency surgery that removed half of the thyroid, then chemo and radiation, the lymphoma went away & after 8yrs, the doctor stated that the clinic felt that this particular cancer would probably not return. At that time, I asked my doctor if I had Hashimotos but his response was vague. I figured it didn’t make any difference because I see him every year and feel pretty good. But lately I’ve felt my energy is down and now, after reading your site, I see that it does matter a great deal whether I have/had (does it go away after the lymphoma goes away?) Hashimotos. So my question to you is, does my having had thyroid lymphoma mean that I have/had Hashimotos? Does it go away if my system is balanced or is it a permanent diagnosis? (I take 60mcg levoxyl & 4mcg liothyronine daily) Thanks so much. I am really getting a lot out of your site, it is so clearly written. I’ve been studing hypothyroidism since ’03 and I still have tons of questions.

    • Chris Kresser says

      You can’t know from that information alone, but when there’s cancer it’s more likely an autoimmune mechanism was involved. The way to find out is to get your thyroid antibodies tested – TPO and thyroglobulin.

  103. abby shahn says

    I always thought that leg cramps indicated a calcium deficiency. Could it be parathyroid trouble?

    • Karen says

      I wish I knew more about it. I did research way back when and couldn’t find anything. All I know is that the cramps were horrible at first but as the years went by, they got a lot less. I guess that could mean my parathyroids could have been stressed and then as I worked on my health and got stronger, they healed (does that happen?).

      I didn’t take any calcium, I had already tried every form and they all hurt my stomach badly. Now I take cod liver oil (for the V.D that makes calcium in food more accessible?) but only for about a year, so that’s not why they got better. They’re not totally gone. I often feel certain muscles in my thighs, calves and ankles start to pull if I turn or twist a certain way and I know I better straighten out fast or I’m gonna get a burner.

      Conscious relaxing helps a lot. Sometimes I think mine are mostly from muscle clenching, at least now. I never had a single cramp until after the thyroid surgery, tho I had been on synthroid for a month and that’s one of the side effects, I believe. It could have been that kicking in, and maybe that’s why they’re still around. I was on a higher dose then, 125 as compared to 75mcg now.

  104. Lynne says

    Hi Chris,

    I have Hashimotos since 2007 and am 6 weeks pregnant. Why is it bad to leave the thyroid in a euthyroid state i.e. mine is 0.015. Are there any repercussions to me and more importantly my baby?

  105. Gabriele says

    Hi Chris,
    I have read your information on Heartburn and how low stomach acid is associated with Graves disease. I was diagnosed with Graves disease 12 months ago, along with high cholesterol and a 15% blocked artery, which was picked up while investigating symptoms of aterial fibrilation and irregular heart beat. I am taking 5mg Carbimazole daily and my TSH receptor antibodies have come down to 3.0 U/L.
    I was hoping to find more information on Graves disease on your website with possible ideas of treatment. I will embark on a low carb diet and will be taking apple cider vinegar and milk thistle to help restore my stomach acid levels. I can’t take HCL as I am on 100mg Aspirin daily for the AF (only read this on your website after I had already ordered HCL online).
    Is there anything else I can try to help me restore my thyroid levels back to normal.
    Also suffering from weight problems (100kg), but am hopeful that this all has to do with low stomach acid/high carb diet and will start loosing some weight soon.
    Thanks for your wonderful website and information.

  106. Kim says

    I am a 27 y/o female – 3 weeks ago I was told I had a TSH of 100. Starting with no knowledge of hypothyroidism, I’ve been continuing to educate myself and have found this site very helpful – so thank you.

    Background: I was prescribed 50mcg of Levothyroxine. I was told only about my TSH level. I now understand why testing T3, T4, and antibodies are also important. I also understand that the “best medication” depends on the individual, and the cause of the hypo.

    Questions: Since starting medication, I’ve felt an energy increase, which was positive. Now I’ve noticed my hair shedding like crazy (not a symptom previously). When this is a symptom of hypo and also a side effect of the drug, how do I tell which one is the main cause? My other question is knowing my next step: when TSH was the only testing done, do I push for finding the root of my hypo? Thus hopefully leading to finding the correct medication for myself? Personally interested in health/wellness myself, I feel inclined to learn more before settling on a generic drug. Thank you so very much for your time!

  107. says

    Wow! what a great post! Thank you for making it so easy to understand. It’s amazing how many people have the disease without them knowing what causes it. I got diagnosed with Hashimoto’s 8 years ago and no doctor ever told me that it’s an autoimmune disease. Now I am taking matters into my own hands and try to get to the root of the problem.

  108. says

    Hey Chris,

    Thanks for this wonderful post about hypothyroidism. Your U.K. adversary reminds me of why women in London protested outside the NHS for better testing and more medication options. Here is a post by U.S. thyroid guru Mary Shomon on the subject of the terrible care that U.K. thyroid sufferers get: http://thyroid.about.com/b/2010/04/29/sarah-myhill-loses-first-round-with-backwards-british-general-medical-council.htm

    One thing you might revise, though, is the free T3/ free T4 subject. The new doctors are now being educated that total T3/T4 uptake tests are obsolete. Only the older, less informed doctors use the uptake tests. An entire panel including TSH, free t3 and free t4 can now be had for $79 without a prescription from places like “Any Lab Test Now,” a national lab-testing franchise. My internist is a Washington University trained doctor, she is totally hip to T3 augmentation (Cytomel) and reverse T3 testing…in no way is she a maverick (she won’t prescribe Armour or ERFA, etc.).

  109. Connie says

    I had my thyroid ablated nearly 30 years ago with radioactive iodine due to Graves disease. For nearly 25 years, my PCP had my medication dialed in with a combo of Synthroid and Cytomel. He then retired and I had to find another doctor who was clueless and decided to reduce my Synthroid because of the test numbers. After about 1 month, I began to experience typical hypo symptoms, but she wouldn’t change my RX because of the numbers, regardless of my symptoms, but I don’t have a thyroid to be “acting up”. I have “fired” her and will be looking for another PCP ,. I am transitioning to a Paleo lifestyle and don’t consume much gluten anyway. I have read your articles on thyroid, but they all seem to point to someone who has a thyroid. ANysuggestions for someone without a thyroid??? thanks

    • Chris Kresser says

      Removing the thyroid is like removing gum from a shoe. In most cases, some tissue remains even after the surgery. As long as there’s tissue there, and as long as the body is producing antibodies (which it is in Graves’), you are still subject to an autoimmune response. I’d suggest investigating low-dose naltrexone and finding a practitioner to work with on autoimmune issues.

      • Emily says

        Regarding the analogy of removing gum from a shoe, most thyroid cancer patients undergo ablation (RAI), so can Hashimoto’s linger even after a successful ablation?

  110. Julia says

    Please correct me if I’ve read this incorrectly, but basically you are saying there is no hope for those of us with hashimotos and hypothyroidism. Did I read that right? I’m 26 and was diagnosed at the age of 24. My mom was diagnosed at 40. If this fatigue and brittle hair continues, I’m not quite sure what to look forward to in the future – that is, unless stem cell treatment truly finds its way to the public. Otherwise, your article is perhaps the most depressing news I’ve heard in a while.

    http://www.nature.com/news/thyroid-is-latest-success-in-regenerative-medicine-1.11574?WT.ec_id=NEWS-20121016

    • Chris Kresser says

      That’s absolutely the opposite of what I’m saying. My point is that determining the cause of the problem (in this case Hashimoto’s as the cause of hypothyroidism) is the most important step in successfully treating it. Conventional medicine does not treat people with Hashimoto’s any differently than they treat people with hypothyroidism from other causes. But in functional medicine, discovering a patient has Hashimoto’s completely alters the course of the treatment plan. We then focus on regulating and balancing the immune system above all else, because that is what’s causing the decline in thyroid function.

      • Leigh says

        Hi , love these posts. I’m a 39 year old, who at 19 discovered large goiter, and had Right side thyroid removed. Never given any medicine for thyroid. Later after having kids, hit a very bad patch . Hair loss , felt like crap, no labido. Doctor ran thyroid said levels normal, he was perplexed since to him my symptoms were hypothyroid, decided to have thyroid sonogrammed found two small nodules on left side. At that time too small to operate, he ordered a dye test to see if nodules might look suspicious(cancerous) and he said they looked low risk advised me to have follow up sonograms every year to check for growth. Since then my youngest daughter was diagnosed for severe autism, you can imagine my health problems took a back burner for some time. I believe it has been 8 years since last sonogram. Meanwhile I’ve had numerous female problems all my life cysts on ovaries fibroid tumors in uterus menstual periods that have always been irregular and extremely heavy, my monthly llasts 7 to 9 days. And 4 years ago I went to a new doctor told him of my history and also my moms hypothyroid issues, told him I had gained forty pounds in 2 years and felt so tired all the time that I thought my thyroid function needed to be tested, he tested said normal, arrrg! Honestly I wanted to choke him. He believed my symptoms are due to stress. Also had strange sores like rash have had for 4 years now and doesn’t go away. Then ran across an article for hashimotos and eureka I think this might be what’s wrong with me. So off to another doctor to have all thyroid panel and antibody test done. Which I can assure you the other doctors didn’t run on me. So my question is this does anyone think NOT being on thyroid mess after the first goiter found at 19 could be why I grew nodules on left side and feel so terrible now?

      • Gina says

        What is your recommendation for treating Hashimoto’s? How do you get your body to stop attacking the thyroid hormone?
        I was just diagnosed as “sub-clinical” Hashimoto’s in October 2013. I am new to researching and learning a lot, but it is terribly confusing. I realize I have had several symptoms for years but it was not until I gained 15 pounds in 3 weeks that I knew something was wrong. Then when I strictly followed a diet and increased exercise for 2 weeks following the weight gain and did not lose a pound, I made an appointment with a dr.

        I was on 30 mg Armour, Vitamin D, DHEA, B12, testosterone, progesterone, and pregnenalone. All of these were extremely low or not even registering on the blood tests.
        It has now been 8 weeks and I have noticed NO changes in how I feel. I went back to dr yesterday and levels had increased but were still low. She said she did not need to test the antibodies again or the reverse T3, etc. She only tested TSH, T3 and T4.

        I am reading everything I can find, but there is a lot of conflicting information and what works for one person does not necessarily work for another. I just want to know how to get the immune part healed so I can lose this weight (now up to 20 pounds). It is causing major depression and almost become an obsession.
        Thanks!

  111. christy says

    can TSH levels just decrease from one month to the next significantly? for instance my TSH last month was 3.1 and in a trip to the ER for racing pounding heart rate recently, a TSH was drawn and is now 4.7 and dr. is trying to put me on levothyroxine without doing any extensive testing to find the cause. my symptoms of fatigue, tiredness, bruising and wounds that dont heal , anxiety , depression and all have been the issue for some time now. I have recently been told that I have tested positive for ANA.. is there a possible reason besides hypothyroid for such symptoms?

    • says

      Hey Christy,

      If you want to find out whether your hypothyroidism is due to Hashimoto’s disease (the great majority is), you could ask for an anti-TPO test that will measure the antibodies in your blood. Your positive ANA could well be because you have autoimmune thyroid disease but it usually just points to autoimmune issues in general; it will be raised in any number of diseases. Unfortunately, those with autoimmune thyroid disease (or any other autoimmune disease) are much more likely to come down with another autoimmune disease of some kind.

      If your doctor refuses to order the test, you can visit a naturopath, they are usually quite up to date on these things. Or you can order and pay for the test yourself, it’s not that expensive, about $49: https://directlabs.com/OrderTests/tabid/55/language/en-US/Default.aspx

      It is very likely that low thyroid is caused by Hashimoto’s disease (an autoimmune disease), that is, by far, the most common cause of it, especially for someone like you who has had symptoms for such a long time. All low-thyroid patients are treated with thyroid medication, and levothyroxine is the go-to. Most patients to fine on it, although some benefit from the addition of a T3 only drug (Cytomel) or from natural desiccated thyroid which contains all the thyroid hormones. I suspect that the different treatment plan that Dr. Kresser is referring to is the addition of an autoimmune protocol diet and supplements, like antioxidants and fish oil that decrease inflammation. I have found the paleo diet a godsend for reducing my inflammatory response, but there are other good ones such as the GAPS diet, This page offers an overview that looks pretty right-on to me, except for recommending fruit juices…that’s probably way too much sugar, and sugar, even natural sugar, can promote inflammation: http://nutrition.about.com/od/dietsformedicaldisorders/a/antiinflamfood.htm

      Actually, you might consider yourself fairly lucky that your doctor is willing to treat you even though your TSH is under 5.0. Although some people in the AACE tried to get the normal TSH lab range narrowed from (.5 – 5.0) to (.3 – 3.0), it was voted down by less progressive members.

  112. Melanie Bong says

    Hello Mr.Kessler,

    first – thank you for all this great information!
    At the moment I am suffering from a acute or subacute thyroid inflammation. The blood-test is still in work. My doctor says the inflammation has to be treated with strong anti-inflammatory medication for the next 6 month in order not to come back. Is there any alternative way to reduce the acute inflammation?

    Best regards from Germany,
    Melanie Bong

  113. ken says

    Hello,I’m a pro athlete 37 yrs old,out of the blue I was diagnosed the graves disease,I believe it was because I was taking T3 CYTOMEL which is greatly used in sports and Hollywood for weight loss about (125-150MCG’S a day as high as 200 at times,and liquid version) am I correct that this caused this ? so I was on Tapazol for about 1 1/2 yrs,but never felt good I always felt I had a slow thyroid,so now Im on Synthroid 50 mcg for 6 weeks,Felt better for the 1st 4,now feel terrible again and gaining about 8-10lbs a month with out vigorous exercise..I want and need to feel better I have found the huge debate of T3 and Armour some say T3 is needed some so no..here are my latest labs
    T4 12.3 (4.5-12.0)
    T3 UPTAKE 31.4 ( 22-36%)
    T7 3.9 (1.08-4.08)
    TSH 1.59 (0.35-5.5)
    Any help would be great ,and the proper tests to get,full panel ? should I get antibodies tested ?
    thank you very much

    • Megan says

      Hey Ken – you need more tests. Cytomel wouldnt cause graves disease as graves disease is an autoimmune thyroid disease that is diagnosed usually through antibody tests. You could most definitely give yourself hyperthyroidism though. Chris has other great thyroid articles you should check out. One in particular addresses the T3/T4 “natural” versus “synthetic” debate.

      • ken says

        I for sure had graves always had symptoms of hypo…I can not find that article ?? and thank you for the reply..now if anyone could answer..if your on T4 but feel better is it because its not converting to T3? only thing I seem to get from T4 is faster heart rate..but ALL other symptoms of SLOW THYROID..

  114. E Eastman Jr says

    I have been dealing w/ Hashimoto’s or over 4 years now. I have been dealing with very bad health the whole time. I have severe leg pain & weakness, also am very fatigued all the time, I have had many episodes where i can barely walk due to the pain. I am on 137mcg levothyroxine. I have had numerous tests, a mri showed that i had just 1 lesion on brain also. My neuro doctor doesn’t seem very concerned about this and my last visit to him he pretty much said he is giving up and doesn’t know why i am having all this pain. I am @ my wits end with feeling this way & no doctors can figure out or even care what i am going through. Is this all caused by my hashi’s or should i be concerned about other things? I am a 40 year old male and before this I had perfect health.

  115. Charlie says

    I would like to know if it is even possible to have Hashimoto’s disease or a thyroid autoimmune disease with out a thyroid. I had a thyroidectomy 10 years ago, but fit the symptoms of these autoimmune diseases. One ENT tells me I can and do have Hashimoto’s, another has told me no and that it is impossible to have an autoimmune disease without a thyroid. Please give me info on this, so that I can understand and know what I should do.
    Thank you

    • Megan says

      Hello Christopher,

      Read some of the earlier comments :) Dulce Leon asked a similar question. The answer as Chris put it is that having a thyroidectomy is a lot like scrapping gum off the shoe – its almost impossible to remove all traces of the thyroid tissue, therefore you can still produce antibodies that could attack what is left of the thyroid. If you run a test for antibodies and are still producing them, its a problem. I suggest finding a naturopath or someone into integrative medicine that will run multiple tests and help you manage your thyroid condition.

      Diane Sanfillipo has a great book called practical paleo that has an autoimmune protocol which is great to follow if you have autoimmune disease.

    • Chris Kresser says

      Yes, it is absolutely possible to have autoimmune thyroid disease without a thyroid. Megan did a good job of answering your question; the autoimmune process underlies the thyroid condition and doesn’t stop when you take the thyroid out.

  116. Anamika says

    Chris

    I have had multiple miscarriages before having my healthy baby in 2012. I am on 25 mcg levothyroxin even after the baby and before the baby + during pregnancy -the dose remained same. I feel sluggish, I have knee/joint pains, muscle stiffness, lazy, memory loss. I got my detailed thyroid bloddwork done which came normal just a week ago. I need to know, why I feel this way, shall I get myself checked for Hashimoto’s? Or shall I get thyroid scan,ct scan or any xray done since i feel phlegm in my throat mostly and a little pain in the throat area. I do not have difficulty swallowing at all.

  117. Gerry says

    Hi Chris, I was diagnosed with Hashimoto’s about 5 yrs ago. I also have a multi nodule thyroid with nodules on both sides. I have annual FNA’s and they have come back non cancerous. My endocinologist wanted to remove my thyroid last year due to the nodules causing me discomfort (the only reason for the surgery). I decided not to have the removal as I did not want to go hypo and be on medication when my thyroid levels were more on the hyper side. I just wasn’t ready to have my thyroid removed and felt there should be something else I can do besides surgery. I have not been prescribed any medication but all my symptoms are hypo – hair loss, fatigue, weight gain, dry skin, constipation, I could go on and on. My endo had the wait and see attitude or else just whip my thyroid out and medicate me. I have since moved and I’m in the process of looking for a new doctor. Should I go with an endocrinologist, I didn’t have any luck with my last one, or search for a different doctor? I do think that Hashimoto’s is genetic as my Mother had thyroid problems but was never diagnosed properly (long story, health system in Ireland), my sister had most of her thyroid removed about 20 yrs ago due to nodules and she now suffers from Chron’s disease. She has never been tested for Hashimoto’s, but is showing symptoms of other autoimmune disease including Celiac disease and rheumatoid arthritis. Is it better to go ahead and have my thyroid removed as due to the Hashimoto’s my immune system will end up destroying it anyway? I realllllly don’t want surgery and would like to keep my thyroid in place in the hopes that there will be some kind of break through in the future for Hashimoto’s. Yes, the nodules are bothersome but I can put up with them for now as they aren’t growing.

  118. robert says

    If i took RAI to switch from HYPER to HYPO, does it follow that i may not have the AUTOIMMUNE issue because its not my body that killed my thyroid but rather the RAI?

    • Chris Kresser says

      The primary cause of hyperthyroidism is autoimmune (Graves’), and RAI doesn’t address the autoimmunity — it just kills the thyroid.

  119. Kim says

    I have been dealing with hypothyroidism for 5 years. I have been tested for Hashimotos at least twice and have been told I do not have it. I did test for an autoimmune disease at 1:164 titer homogenous. However, further tests for autoimmune were negative. I have been told it is my normal to test positive and to not have the test run again unless I have worsening symptoms. I have 2 siblings and a nephew who have been diagnosed with celiac disease (blood and biopsy). I have tested negative with blood tests for celiac but an IgG ELISA came back as positive, IgA negative. I take vit. D for a deficient (16) level and take Tirosint for thyroid. I have 2 siblings with psoriasis and numerous other relatives with hypothyroid and psoriasis. I have what I think is extreme fatigue, bowel issues (I would say it is IBS), achy joints and very dry eyes- I started restasis this summer. The rheumatologist suggested that the dry eye is my thyroid, the medication for my depression (zoloft for 18 years) causes my dry eye and I am one in 20 percent who test positive for autoimmune but don’t have any autoimmune!!
    I am very confused. I am 51 and menopause has begun. I feel like most dr. would like for me to ride out my menopause and then I will miraculously feel better. Why are the dr’s giving me no definitive answers? or are there none? Do I have food allergies? I did a skin test and a blood test which I have read are not good indicators of food allergies. FRUSTRATED.
    Thank you for your articles they are giving me the insight and courage to continue to find an answer. Insurance and money are major obstacles for a lot of us in this situation.

  120. LaDonna says

    Hello Chris

    I am a 50 yr old white female. I was diagnosed with Cutaneous Limited Scleroderma with secondary Raynaulds Phenomenon. Since there is no cure for my Scleroderma or Raynaulds my doctors can only manage my symptoms with a variety of medications. I was just recently diagnosed with Hypothyroidism. They haven’t told me that it is Hashimoto disease as of yet but they have put me on Levonthroxine 0.05 mg per day. I also have Gastro problems associated with my Scleroderma. I have extremely dry skin, and hair loss that we associated with Scleroderma and a consistent chill throughout my body along with 2nd stage Raynaulds. I’m on 100mg Viagra daily to help the hands and feet. I also take a 400/500 Calcium & Vitamin D supplement twice daily without it I cannot keep my Vitamin D level above 18. I have difficulties swallowing which they associated with my Scleroderma and have had my first esophagus stretching. It helped some but not as much as it should have.

    My question is how to control the Hypothyroidism along with fights the affect of my other two major illnesses? Is it going to possible to have all of or some of these illnesses under some type of management since there are no cures for them? While fighting to control one or two am I damaging the other? Is there a proper diet to help maintain a happy medium between them all?

  121. Jeff S says

    Hi Chris and Others:

    I’m a 59 yr old male who has been Paleo for more than 2 years and for the most part have been doing fine. However, over the last couple of months, I started having a feeling like food was stuck in my throat and some tenderness near my Adam’s apple. Went in for a Dr’s visit and my thyroid was definitely tender, so the Dr. ordered a Thyroid panel. Got a call today saying that my thyroid is inflamed (their words) and that I should go see a thyroid Dr. I have a copy of my report, but am not sure how to read it. So any insights appreciated.

    The report has TSH+Free T4; CBC with Differential/Platelet; Comp. Metabolic Panel; Thyroid Antibodies; Thyroxine; T3 Uptake; Triiodothyronine; and Sedimentation Rate-Westergren. I have posted some of the results below (mostly those that I think pertain to the Thyroid and a couple of items that showed up high.) If I should list anything else, let me know.

    Test 1: TSH+Free T4

    TSH: 2.200 uIU/ml (range: .450-4.500) T4, Free (Direct): 1.38 ng/dL (range: .82-1.77)

    Test 2: CBC (Too many items to list, but everything seems to be within range)

    Test 3: Comp. Metabolic Panel (mot things in range, but listed a couple that were high)

    Glucose, Serum: 90 mg/dL (range: 65-99) BUN: 27 mg/dL (this was flagged as high. Range: 6-24) Creatine, Serum: 1.15 mg/dL (range:.76-1.27) BUN/Creatine Ratio: 23 (flagged as high. Range: 9-20) Calcium, Serum: 10.3 mg/dL (flagged as high. Range: 8.7-10.2)

    Test 4: Thyroid Antibodies

    Thyroid Peroxidase (TPO) Ab: 60 IU/mL (flagged as high. Range: 0-34) Antithyroglobulin Ab: <20 IU/ml (range: 0-40)

    Test 5: Thyroxine (T4)

    Thyroxine (T4): 9.3 ug/dL (range: 4.5-12.0)

    Test 6: T3 Uptake

    T3 Uptake: 30% (range: 24-39)

    Test 7: Triiodothyronine (T3)

    Triiodothyronine: 90 ng/dL (range: 71-180)

    Test 8: Sedimentation Rate

    Sedimentation Rate-Westergren 6mm/hr (range: 0-30)

    Am setting up an appointment with a Thyroid Dr. that my Dr. recommended. But in the meantime, does anyone have any comments/insights. Is the TPO high enough to worry about?

    • irexx2 says

      Autoimmune thyroiditis is inflammation driven. I think you will find treatment method beyond hormonal supplementation will be to suppress the inflammation process with only marginally effective drugs until the gland is totally fried.
      But there’s hope!. It’s 2013 after all and science continues to progress. See the latest human trial results on using a small molecule alkaloid anatabine citrate. ‘Rock Creek Pharmaceuticals Report Positive Initial Results of ASAP Human Thyroid Health Study Showing Benefits in Immune System Support’

      Anatabine supplementation suppresses several pro-inflammatory molecules (cytokines) in the blood. And suppresses NFKB and STAT3 activation.

  122. Toni says

    hello Jeff s
    It appears you have hashimotos which is an autoimmune disease. Usually a gluten free diet is recommended. Test should be run for a celiac panel as well to rule out celiac disease. Usually with a thyroid panel you want to test FREE t3 , FREE t4, TSH as well as both anitbodies. Reverse T3 can also be tested if one suspects that might be an issue. This happens when body converts the active T3 into the inactive reverse T3 so the body can not use it . Usually the reason why some people develop reverse t3 issues is due to low iron and cortisol. Free t3 and reverse T3 should be done from the same blood sample when testing for reverse t3 issues. The treatment from my understanding for hashis is thyroid meds to suppress your TSH so your own thryroid gland is not under attack. In Hashis, the body starts to attack its own thyroid gland. I hope that helps answer your questions a bit. I have read quite a bit on thyroid issues but I am no expert. Chris might want to comment on this as well.
    Take care and wish you all the best.

    • Jeff S says

      Hi Toni
      I have been gluten free for more than 2 years–I’m fairly strict Paleo (very strict on the grains/gluten side). The tests that were done were ordered by my regular doctor. He has told me I should now see a Thyroid Dr. The two he has recommended don’t have any openings until March, unfortunately. Will try to insure they do the tests you suggest.

  123. irexx2 says

    GLEN ALLEN, Va., Jan. 7, 2013 /PRNewswire/ — Star Scientific, Inc. announced today the preliminary results of the Company’s ASAP (Anatabloc Supplementation Autoimmune Prevention) Human Thyroid Study that analyzes the impact of anatabine dietary supplementation on thyroid health.
    excerpted;
    The title of the study is, “A Multi-Site, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Trial to Evaluate the Safety and Potential Effects of the Dietary Supplement Anatabine on Antithyroid Autoantibodies and Thyroid Function in Subjects with Autoimmune Thyroiditis”.
    ‘Dr. Paul Ladenson, senior endocrinological consultant for the study, stated, “Data from this rigorously conducted, placebo-controlled, double blind trial show that anatabine-treated subjects had progressive decreases in circulating thyroglobulin antibody levels, which became significant by the end of the trial. Current treatment for autoimmune thyroiditis is limited to end-stage disease when irreversible gland damage necessitates lifelong thyroid hormone replacement. The prospect of a novel nutritional or pharmaceutical intervention that could preserve thyroid health represents an encouraging advance.’

  124. Carol Lynch says

    Is there any connection between Hypothyroidism and alcohol intolerance? I am unable to drink even small amounts of alcohol without becoming sick. I have just started seeing a homeopath and have started a gluten-free/dairy-free diet to deal with healing the gut, inflammation, etc. My endocrinologist dismissed any connection to my thyroid. I would like to be able to enjoy a nice glass of wine now and then!

  125. Karen S. says

    @Carol:

    My whole life I was unable to tolerate alcohol, and would become flushed and tipsy after only a couple of sips. Fast-forward many years, and I discovered I had severe adrenal fatigue (cortisol levels undetectable most of the day, then higher at night, when it shouldn’t be). A 24-hour saliva panel revealed this, plus secondary hypothyroidism — years of blood testing yielded nothing but frustration and “your thyroid is perfectly normal,” even though I was a poster child for its symptoms.

    Addressing the adrenal deficiency with natural methods (healthy, undamaged forms of dietary cholesterol, plus high-quality, non-synthetic vitamin B and C supplements and physiologic, not pharmacologic, doses of sheep-sourced adrenal cortex at the beginning), helped to bring my cortisol back without the use of synthetic drugs, plus it brought my thyroid numbers up to normal levels. Undiagnosed adrenal deficiencies are behind a lot of thyroid issues. Addressing the thyroid without taking the adrenals into account can be dangerous — if the adrenals are exhausted and slowed way down, they cannot accommodate a higher-functioning thyroid.

    Most of the thyroid’s T4 hormone is converted to active T3 through an enzyme in the liver. If the liver isn’t functioning optimally for any reason, this will be compromised. A chance meeting with a TCM practitioner revealed a sluggish liver that was affecting my thyroid as well as my ability to metabolize alcohol. I ended up moving out of a big, polluted city and doing a total 180 with my lifestyle, drinking clean well water, producing our own food and not eating anything processed. I can now drink wine with meals (not a big drinker, but once in a while I enjoy it) and don’t get flushed anymore. I was surprised at the time, to learn that my liver was overloaded, as I never drank, did drugs (prescription or otherwise), smoked, or ate a lot of junk. I was told that a polluted environment, tainted city water, and stress were enough of a burden on the liver to cause problems.

    I don’t know if such a drastic lifestyle change is feasible or even necessary for you, but wanted to share my experience, whatever it’s worth.

  126. says

    Can anyone help. Hypo and hashi for many years. Been on synthroid 100 for long time. Taking cytomel for almost a year. I have never ever felt good as a matter of fact I feel worse every day. I’m severely lethargic. I am not able to think anything over like my brain is broken I’m depressed I can’t seem to gain weight I actually get thinner. I have crazy periods I have no sex drive I have no tolerance for for loud noises I’m always cold even in summer. My anti thyroid whatever it’s called is in the 500s I have a large goiter where I feel constriction. I need help the drs say I’m fine but I’m so not fine I feel terrible. Help!

    • garyc says

      Sissy,
      Have you heard of Anatabloc? Many are reporting significant positive benefits even before this study result was released last month.
      http://www.pharmaceuticalonline.com/doc.mvc/star-rock-creek-pharmaceuticals-asap-thyroid-immune-system-0001
      Rock Creek Pharmaceuticals Report Positive Initial Results Of ASAP Human Thyroid Health Study Showing Benefits In Immune System Support
      The study is a three-month, five-visit, double-blind, placebo-controlled study of the impact of anatabine dietary supplementation in humans with autoimmune disease of the thyroid. The study was conducted at nine sites and builds upon previous epidemiological and animal experimental studies. Initial results for all study subjects suggest that dietary supplementation with anatabine ameliorates the immune system’s targeting of the thyroid gland in autoimmune thyroiditis.

      • Honora says

        I finally found references to abstracts dealing with the subject of molecular mimicry and explaining the mechanism. A lot of research was done on this in the late 1990′s. It’s worth a read. The link is on a multiple sclerosis site: http://www.direct-ms.org/molecularmimicry.html

        It looks as though certain viruses cause the body to release antibodies that in turn target specific tissues e.g. thyroid, that have similar amino acid sequences. This is exacerbated by also consuming foods that have similar amino acid sequences to both the virus and the target organ affected e.g. anti-gliadin antibodies against wheat agglutinin. For the MS people it can be dairy, grains and beans and the viruses from memory were quite a few such as rotavirus and Epstein-Barr (glandular fever). But it’s better that it is read rather than what I’ve written here as it’s only recall.

    • Geliza says

      I have Hashimoto and am on synthetic thyroid replacement too, and the best thing that has worked for me is going on a gluten-free diet, I had a lot of your symptoms but after only a few days without gluten I started to feel human again. Its been almost a year now and I feel like my old self like before Hashi struck, It may take longer than a few days for you, and it may not help all your symptoms, but going gluten free for a week or a month can’t do you any harm, so I advize you to at least try it and see as it may help you.

  127. Chris Wolfe says

    A retrospective conducted in Germany following 36 women and 2 men showed that treatment with levothyroxine (synthroid) reduced thyroid antibodies by 70% after 5 years of treatment for 92% of these patients. From these results it appears that treatment with thyroid hormone replacement alone does indeed treat the underlying autoimmune dysfunction. There may be more studies out there on this subject specifically but I cannot devote more time at present to research the issue, nevertheless I wonder if any large scale studies have been conducted with this in mind.

    Here is a link to the article http://online.liebertpub.com/doi/abs/10.1089/thy.2008.0008?journalCode=thy

  128. Susan King says

    I have ab negative blood type, severe scolisis, compression of L4-L5, l am also a Gemini, which may affect something, I continually gain weight, I cannot lose no matter what, please can anyone give me some advice.

  129. Emily says

    I am taking carbimazole, for hyperthyroid, and also ferrograd for low in iron, can i possible to drink Barly grass powder.

    my question is will it have bad side effect knowing i got this hyperthyroidism and low iron. if i drink Barly grass.

    Please help, if any one can give me information about this.

    appreciate for any info..

    thanks
    Emily

  130. Cathy P says

    Hi Chris,

    I have hypothyroidism due to my pituitary gland being completely damaged by a brain tumor. I was 9 year old at the time and am now in my 40′s. Up until about 7 years ago I didn’t have much of a problem losing weight when / if I needed to. But now I’m finding it so incredibly hard to lose weight. I’ve been on synthroid or the generic form of it all my life. As I’m sure you know, I have to take many other medications like prednisone to make my body function “normally”. Do you have any suggestions for someone in my case??

    Thanks,
    Cathy P

  131. Deb says

    Hi Chris,
    I was diagnosed as hyperthyroid after I gave birth in 2000, took the iodine treatment and have been hypothyroid ever since. The amount of weight I have gained is astonishing. I am on levothyroxine 175 MCG
    daily and I feel terrible all the time..tired, hair is brittle and falling out, heels are rough, can’t remember alot and my doctor just tells me my levels are fine and I must be eating too much, but I don’t eat alot at all. Now I have been diagnosed with sleep apnea..my life just sucks right now! My question is since I started with hyperthyroid could Hashimoto’s Disease still apply to me? Thanks for any help you can give..

    • Lorraine says

      I had my thyroid out at 20 years old,now 59, I tend to think they may have been in a bit of a hurry to do the surgery. Nonetheless, this is some of what I have done personally to help myself.
      I just started on apple cider vinegar( has to have mothers’) on the bottle. The brand I use is Omega Nutrition organic. Anyway, my hair was falling out, dry, brittle, skin was dry and loosing collagen. I started taking this, about a tblsp. before I ate a meal and one before bed. My hair is growing like a weed and is coming in dark, at 59!, I was always plagued with yeast infections, they seem to have disappeared, back to the hair, IT HAS BOUNCE BACK, I remember the day when I realized something was really wrong with my hair before they took my thyroid out. Now, it’s just startling how healthy it has become. I also added liquid minerals daily. Just thought this might help.

      Take care , Lorraine

      • Lorraine says

        About Apple Cider Vinegar internally….
        It is high in Vitamin B’s
        It absolutely normalized my ph levels within a week, which were non existant on the litmus tests.
        My digestion and elimination has improved dramatically
        No more bloating when I eat
        It kills yeast, bacteria and parasites ( note: probiotics seem to work properly now)

        Apple Cider Vinegar is different than wine or beer in that it undergo’s a different fermentation; giving a different reaction to the body.

  132. Rachel says

    I have been diagnosed with Hoshimotos disease and about 6 months ago had 5 nodules that were growing from six months before. My doctor never advised me on anything I could do to decrease or treat in any way the inflammation. I was introduced to a product that lowers inflammation in the body and other health improving things that is all natural. I had been taking it for TWO weeks and I now have only three nodules and they have shrunk. Is this normal?

  133. Linda Norris says

    Hi Dr Kesser,
    I have been treated for Hashi since mid 1980s. I also had a pit tumor resected in 1985 (prolactinoma) and I wonder if that precipitated the Hashi. Have been on Synthroid since 1980s in gradually increasing doses. A couple of years my GP added Cytomel to my regimen. My doc doesn’t understand that I feel really bad when my TSH is super low…I think his feeling is the lower the better. I now take 200 mcg levothryoxine 1/2 tab M-F and 1 tab Sat & Sun. TSH stays between 1 and 3 which is okay. But I have lots of other auto immune symptoms that I never related to the thyroid issues….bloating, gas, fatigue, mental fog, sluggish, joint aching.

    Thinking I need to look at the gluten issue. I am a South Beach diet person with limited carbs anyway, but have not restricted gluten per se. Feel better with less joint inflammation etc on SB phase 1, but again that is not necessarily gluten free.

    What are you thoughts on this?
    Thank you,
    Linda

    • Geliza says

      From my own experience with Hashi, diagnosed in 2009, and on synthetic thyroid meds, I had all the symptoms you have. After a bout of IBS symptoms last year I decided to try gluten free for this and, like magic, the IBS and all the other symptoms dissappeared, including severe migraines that I had had since I was 11 years old.
      GF may be tiresome, all the checking food packet info and being careful when eating out, but it’s worth it, I feel so much better, now I feel human again, I hadn’t felt really well since the Hashi decended on me so obviosly going to stick with GF forever, I feel 50 again (I’m now 65) ! Not been diagnosed as I’m not willing to eat gluten again even to do the tests!

  134. erin says

    I have hasimoto hypothyroidism and eventhough I am only in middle school I found it very informative… but I am wondering if this could cause anemia, and is it very rare in children under 14 years old. Thanks, UNICORN LOVER!!!

    • Cards says

      Erin,
      Have your parents and your physician look into Anatabloc. A human study completed in January this year showed ‘significant’ results in ‘halting’ the progression of this disease.

  135. Helen says

    Hi Chris,

    Thank you so much for providing all the information!!!

    I’d be very happy if you (or some of your readers) find some time to reply to my message.
    I am 35 years old and am taking levothyroxine 75mcg for about ten years now, but I haven’t really felt a difference when taking it.
    My TSH tests showed 0.68 (in 2010), 0.21 (in 2011) and 0.38 (in 2012) from a morning blood test without taking the medication. Free T4 was 0.9 (in 2012, not taken before).
    Since 2009 I am experiencing fatigue, feeling exhausted, foggy brain, lethargy, depression, cold hands and feet & easily feeling cold in general, menstruational problems, back pain.
    A saliva test showed very low progesterone which I treated with progesterone cream.
    Parts of the menstruational and depression problems improved a lot.

    Can you give me advice how to proceed from here?

    Thanks again!!!
    Helen

    • Tom S says

      Helen,
      This might be of interest;
      Star Scientific Thyroiditis Data Published

      First, preliminary results of the study, yet to be peer-reviewed and published, provide the most compelling evidence yet that Anatabloc is what I’ve said it is — the first effective therapy for endemic autoimmune disorders. While this study demonstrated the first-ever ability to reverse the course of thyroiditis, its importance is in its ability to treat or prevent autoimmune disorder, which plays a role in virtually all age-related diseases, including thyroiditis.

      Second, the famously cautious Dr. Paul Ladenson, one of the top endocrinologists in the world, has gone on record saying, “Data from this rigorously conducted, placebo-controlled, double-blind trial show that anatabine-treated subjects had progressive decreases in circulating thyroglobulin antibody levels, which became significant by the end of the trial.”

      Dr. Curtis Wright, Medical Director for Ross Creek Pharmaceuticals, said:

      “It is remarkable that dietary supplementation is able to help lower the thyroid antibody activity. To see antibodies that may have been elevated for years beginning to come down in a significant way after three months of supplementation is exciting. Given the rate of decline over three months, it is quite reasonable to expect that the effect may continue with longer use, which has already been observed in individual cases. I look forward to following subjects over a longer period in order to establish how profound and clinically meaningful the effect is going to be. The thyroglobulin levels in some patients returned entirely to normal in this three-month study.”
      They are talking about Anatabloc. I take it with good results.

    • neeters says

      You may benefit from changing your levothyroxine to natural dessicated thyroid. Also, for myself while the Progesterone cream did raise my levels in bloodwork, they didn’t make me feel any better. Once I switched to Oral Progesterone (Prometrium) I started feeling way better. Seems that even though you waste a lot of it as it goes through your liver to be metabolized, it seems to act more “slow release” that way and really improved my condition. that, plus natural dessicated thyroid, and now added some bi est estrogen, going gluten/grain free, and I’m way better than before. no more cold hands and feet. even my eyeballs and mouth were cold. not anymore!

  136. bo says

    Hi chris. Found your articles afew days ago. I hope you answer. My tsh was 2.5 and i have all the clinical signs of hypo. The past three yeats have been aweful. I often get headaches at the back of my head and they feel like my brain glitches like a messed up computer or like i go in and out of reality for split seconds when i feel swelling back there. Can hypothyroidism cause this? I wont be tested for antibodies until next week. But thr pain at the base of my head makes me wonder if its related. Thanks!!

  137. Peggy says

    I have always had many alergies, sinus, skin, etc. Could this be a sign of autoimmune disease? In 2008, my hypothyroid was discovered. I went on synthroid 50, and it seemed to work (goiters run in my family). In 2009, my high parathyroid numbers were found to be very high (due to what I called bone pain). I had not had menepause but was already showing early osteroperosis. In 2011, My endocrinologist told me I had a vitamin D deficiency, and hashimoto in 2011. He told me to keep taking Vit D in high dose, and not to increase synthroid, and take randidine for gerd, but not to worry, my blood calcium was OK. I always thought I was cooking, and eating healthy, whole grains, rice, lots of milk, yogurt, olive oil, low fat, etc, but now I think that may have triggered my autoimmune disease, and it may be attacking my whole body. Vitamin D helps with bone pain, but my biggest concern is that I use to be a great multi tasker, and now my short term memory, and word recall is really affecting all of my skills, and I sleep very lightly.

  138. Samantha says

    Hi Chris,

    My thyroid antibodies have twice come back <1. So does that mean I'm positive for antibodies, even though they're low (maybe because I'm gluten free)? Does this mean Hashimoto's? My TSH is slightly elevated and I'm getting on Armour.

  139. Sophia says

    Dear Dr Kresser

    You have an amazingly informative website – Thank you.
    I’m 29 years old, otherwise fit and healthy individual.
    I have recently had blood tests from my GP revealing very high thyroid antibodies but euthyroid (my symptoms were that I felt my neck was swollen in the thyroid region). I would like some direction on what I should do next. I have been to see an endocrinologist who just said I have Hashimoto’s and to come back and see him when I am hypothyroid.
    I am extremely health conscious and just feel helpless that I’m just supposed to wait until I have more symptoms as a result of my thyroid gland being completely destroyed!

    Thank you in advance for any advice!

    • Geliza says

      Firstly I would recommend that you go gluten free as this is recommended for Hashimoto, which is an auto-immune condition, where your immune system has gone crazy and is attacking your thyroid. Whether this will help your thyroid much I don’t know but it may stop you getting more complications. Depends really how much damage your immune system has already done to your thyroid.
      When I was diagnosed with Hashi in 2009 my endocrinologist did not mention a GFdiet to me and even after medication I still had many problems which I was told were my age, I was then 62, In 2012 I had a bout of what I thought was IBS and also eczema and while looking for a solution I came across the GF recommendation. All I can say is it worked like magic for me and I haven’t felt so well for years, I am still on medication but I have been a year on 100mg and sometimes even only 75mg so it doesn’t seem to be advancing. I can’t help thinking that if I had known about gluten in 2009 maybe going GF then I could have avoided all the other problems, maybe my immune system could have righted itself at least partially, or maybe it still can whos to know but GF seems to me to be the right path. Maybe you should also change your endocrinologist if you can but I’ve found that it’s difficult to find one that has any interest in his/her patients welfare!

  140. susan says

    This is an excellent series on hypothyroidism. I’d like to add a possible cause of hypothyroidism to your list. I was born with a “lingual thyroid” and the gland is only partially developed. Tis was revealed in scans and tests when I was 14 but my thyroid levels were normal at the time. I am 36 now. About 7 years ago I was finally diagnosed with hypothyroidism (my TSH was measured at 12 a I was barely functioning!) and given synthroid which has been extremely successful in boosting my thyroid t3 and helping me live normally. I think this possibility should be examined especially for prematurely born people, as I understand that thyroid formation is one of the last functions during pregnancy.

  141. Celeste says

    How do I find a doctor that will do the correct testing? My daughter has hashimoto and I have all the symptoms…loss of hair, dry skin, tiredness, weight gain and depression. My family dr did the normal blood test that came back negative and an endocrinologist won’t see me without a diagnosis. I know I have a thyroid problem. I am in Tampa,Fl. Can anyone recommend someone?

  142. Say T says

    I’m only a senior in highschool, and I recently had been losing my hair, getting sick and gaining weight gradually even though my diet and exercise was the same. I also started to get tired during volleyball games and classes for no reason though I had a great nights sleep the night before. Then I suffered from severe constipation and had blood and urine samples taken to see what was wrong. My doctor told me I had hypothyroidism and prescribed medication, but I have yet to fill the prescription because I dont know what I should and shouldnt take. I decided to go home and research everything I could to figure out how to fix what was wrong with me. I started to double my exercise and decrease my food intake and still my metabolism seems to be slow. My hair is still falling out and my sleep schedule seems to be getting worse. I would like to know what medications I am supposed to take for my hypothyroidism so I can get back to feeling better and get back to playing volleyball.
    Thanks

  143. Trixie says

    I was just told I have high thyroid antibodies and am guessing that I have Hashimoto’s. I have been 3 years off of a cold turkey from a 17 year stint with a benzodiazepine Klonopin. I have been through Hell with this drug withdrawal and recovery. I am slowly tapering Prozac. What I want to know is could the Benzo cold turkey and the Prozac taper be causing this raised antibody test and will my thyroid/body ever return to normal again…I did not have a thyroid problem before I went on either drug…or is this permanent damage…hoping you can help me figure this out. Thank you!

  144. Priya says

    Hi I have hypothyroid as well as pcos and almost 50% of my hair are gone,I hv put on 20kg. In last five years now I hv decided to go to gym n work hard , I am taking eltroxcin125mcg and now I hv started taking thyro max support +cla+l-carnitine daily twice 2 tab each of them.am I doing right please help me I just want to reduce some weight and want my hair back as I am 25 yrs old female, not married and I have been suffering with this please guide what should I do. Pls help

  145. Adriana says

    Hi,
    I really hope that somebody fromthis web site will take few moments to read and to answer to my questions.

    First of all, I am 27, I have TSH, T3 and T4 in the normal range (TSH is near the superior level, but still normal) and Anti-TPO level around 100 (max should be 34). Some doctors told me that I should already start taking diferent synthetic hormones and some that I should still wait until the hormones will not be any more in the range..when I was asking for causes, for diff thinks that I can do for decreasing AntiTPO, everybody was saying the well-known slogan: ‘ This is for live, you cannot do anything against it!’..

    Reading more via Internet, since April I started a gluten free diet, but I would like more guidence here where I am leaving, in Austria.
    If by any chance you can recomand me a doctor in Austria or if you can recomand me anything else (blood tests, books,etc.), please let me know here or via adriana_tan@hotmail.com.

    Thank you and kind regards,
    Adriana

  146. LETHARGIC says

    Greetings,

    I usually just read peoples suggestions on things to try. But I find I’ve exhausted almost every avenue with no luck.

    Everyone is so desperate for help, me included. We would just like one pill, we take it, and everything is cured, and OK. If only that existed…

    Well anyway, my biggest problem is that I’ve always felt “not fully conscious”. It is like I am going through life without living it. Its difficult to explain.

    I have all the other associated symptoms also… Fatigue, droopy eyes, sun hurts my eyes etc etc…..

    My TSH is 1.50 and free T4 is 14.7

    I’m 22 and have been on the doctor rollercoaster since 13.

    I’ve had these symptoms since childhood.

    I decided to see a private endocrinologist 2 days ago, and his suggestion was that I exercise more!!!

    Anyway, if you have some suggestions for me Chris, would be much appreciated.

    Also if anyone relates to what I’m saying I’d be happy to hear from you also.

  147. Dr. Patryce A. Smith~ says

    Hello,
    Am I understanding correctly your expertise is Licensed Acupuncturist? Or did I miss something in your base information?
    Thank you

  148. jessica says

    i have a question hashimotos autoimmune my ths is 150.00 and thyroid peroxidase is 1000 if it does not go down am on synthnoid 175 already ?

  149. says

    i had cancer and had a complete thyroidectomy and I am hypothyroid and I take 300 synthroid and I feel horrible I have severe sleep apnea I have edema in my legs real bad my body hurts I lose hair and so many other problems I have been to several doctors and no one seems to help me I cant lose weight and my thyroid changes all the time and low on vit d I have no energy and mental fog please help any suggestions

    • Gillian says

      I haven’t had a thyroidectomy but am hypothyroid and I still felt like this even after taking synthroid. My doctor said it was just my age (65) and there was nothing more he could do!!! So, after investigating a bit online, I started a gluten-free diet and take vitamin D3 and I am now feeling so much better, I have much more energy, my legs no longer swell up as before and my arms have stopped hurting, maybe it could help you.

  150. Anne says

    I had PIP implants and following removal and new implants 1 1/2 yrs ago I haven’t been feeling well physically I’ve been affected in my lymph glands and can feel the lumps of silicone in my neck and armpits, also been diagnosed with depressionrecently had my TSH levels amongst tests for my thyroid these were high, my doctor wants them repeated in a month then ? start treatment for hypothyroidism. Does anyone know if there could be a connection between my lymph glands being affectected and the risk of autoimmune disease therefore leading to hypothyroidism (complicated I know, my brains trying to work out things)

  151. Judy says

    My husband is 77, still working full time and has had Parkinson’s symptoms for over 10 years. He isn’t on any Parkinson’s meds yet. He is on a lot of nutritional supplements and has had a favorable response to the Coconut Oil Diet. He is on 4.5 mg of LDN for about 1 year. Everything helps a little but then the disease continues to progress. He was recently started on 25 mcg of Synthroid for elevated TSH and low normal T4 and free T4. (One study showed Parkinson’s patients with untreated Hypothyroidism seem to have exacerbation of symptoms which get better when properly medicated. We are hoping that his increased tremor, fatigue and brachycardia will improve once his thyroid is better regulated.) He had been experiencing “flushing” the month before and this disappeared the first month (but no effect on tremor). Starting this second month he is flushing and feels hot from lunch to about 4 PM and getting up more often at night (usually 2, sometimes 3 times). I read recent research that suggested people have less symptoms taking Synthroid before bed rather than first things in the morning. Since he takes LDN before bed, do you know if the two could interact? Also, any known interaction with Melatonin which he also takes in the evening?

  152. Anne says

    If hypothyroid condition caused by an autoimmune reaction , is it possible to test the person for the specific cause of the autoimmune disease, perhaps specific antibodies present, in order to avoid something in future ? Also if it’s been an autoimmune response does it become permanent with a gradual worsening as the response antibody continues to attack affected area, or other areas, or can you minimise or reverse condition by omitting cause, if it was identified. Finally can stress cause an autoimmune response severe enough to trigger hypothyroidism ?? Lots of questions but I would appreciate a medical response, can you tell I’m newly diagnosed and desperate to minimise condition ???

  153. Naomi says

    Loving this site. Very informative. Does anyone have info on being thyroid hormone replacement resistant. I had the iodin ablation done 15 years ago been to the highest dose of of meds three diffrent times three different doctors. All three say I’m replacement resistant. Im 36 and feel and act like I’m in my 80s. I do have a vitamin b12 shot once a month and take iron and vitimin c.im left feeling hopeless. That I’ll ever feel good. And afraid of loseing my mind.

  154. fatty says

    Dr. Chris,

    The condition of my sister with a toxic thyroid goiter really bothered me so much.

    Please educate me her sickness so that I know where to start.

    Thank you!

  155. Tom S says

    Dr. Chris,

    What are your thoughts on human trial results recently released re
    ‘Anatabine supplementation decreases thyroglobulin antibodies in patients with chronic lymphocytic autoimmune (Hashimoto’s) thyroiditis: A randomized controlled clinical trial’

    Objective: The effects of anatabine in patients with Hashimoto’s thyroiditis.

    Results: Anatabine treated patients had a significant reduction in absolute serum TgAb levels from baseline by study end relative to those on placebo (p=0.027); however, there were no significant changes or differences in treatment group means for TPOAb or TgAb. Mean (±SD) TgAb values decreased by 46.2 (±101.1) and 3.9 (±83.9) WHO units for the anatabine and placebo groups, respectively. Significantly more patients had a >20% drop in TgAb in the anatabine than placebo group (p=0.023). Overall the anatabine supplement was safe and well tolerated, although significantly (p<0.05) more patients in the anatabine group reported AEs.

    Conclusions: These results demonstrate an immunological effect of anatabine on TgAb levels. Further studies are warranted to dissect longer-term effects and possible actions of anatabine on the course of Hashimoto’s thyroiditis.

    http://jcem.endojournals.org/content/early/2013/10/31/jc.2013-2951.abstract?papetoc

  156. Michele says

    Hi, I have hypothyroidism, osteoporosis, sponyliolesthesis (decompression and fusion on L5) spinal stenosis, bowel prolapse (bowel resection), bladder prolapse (2 bladder repairs) silent sinus syndrome, depression, memory loss, early menopause (38). Could all of this be related to my immune system? I’m just wondering why all the health problems. I’m 52. I’m. On Synthroid, Fosovance, Wellbutrin. Thanks.

    Michele

  157. Barbara ham says

    After being diagnosed with hypothyroidism 17 years ago I was sent to endocrinologist who tested me for hashimoto’s and test said I had it. However was recently tested and doctor says I don’t have it. Is it possible for this to happen? I have been treated with synthroid then changed to armour then back to t4 and t3 combo.

  158. Sonia says

    Hi, I started reading your book yesterday, and am wanting to start my 30day reset. The problem is, I can’t figure out if my hypothyroidism (not hashimotos) is an autoimmune form, as stated in the book. I have plain old hypothyroidism.

  159. Heidrun Schaller says

    Hi Chris, I have a question. Your link in the sentence starting with “Studies show that 90% of people with hypothyroidism are producing antibodies to thyroid tissue” does not actually take me to any studies but to an article stub of which I can’t read the rest due to a paywall. The article does not actually cite any studies either. It doesn’t even say that 90 % of hypothyroid patients have antibodies to thyroid tissue, it says that “An autoimmune cause accounts for approximately 90% of adult hypothyroidism”, which is not the same thing. I for one have Ulcerative Colitis and I do have hypothyroidism, but no antibodies to thyroid tissue have ever been detected. Now, I know that you think this doesn’t prove that I don’t have Hashimoto’s and maybe it doesn’t, but the thing is that my main problem seems to be in the conversion of T4 to T3. The one sort-of capable endocrinologist I ended up finding after scouring the internet (and after lots of arguing with my former doctor) seems to think that the body intentionally cuts down on the conversion of T4 to T3 (leading to increased production of rT3) when there are certain systemic problems present such as inflammation in the gut. He said it was sort of like taking the foot off the gas pedal to prevent the engine from overheating while you’re going uphill. I think there is merit to that idea. I’m now on naturally desiccated thyroid (50µg T4 and 14µg T3) and while my TSH has plummeted and the fT3 has gone up, the fT4 has actually gone down. It seems like my brain is telling the thyroid to do anything to *prevent* the level of hormones in my blood to rise above a certain level. So basically what I’m saying is that while my hypothyroidism might be caused by my autoimmune disease, I don’t actually think it is Hashimoto’s and I don’t think the article says that either. I would still like to see those studies though.

  160. Ben says

    Hi,

    My son is 11 years old but look like 8 years old as he diagnosed hypothyroid (primary level) 2 years back. He is taking thyroxin 100mcg at this stage. Most of the time he doesn’t feel well. i am worried about his poor growth.. Please suggest me what another tests i have to go for him to improve his health and growth..also recommend me diets as well.. Should i send him to the gym or let him participate in regular physical activities (football, tennis, ice-hockey, swimming etc).

  161. Ann Marie Scopilliti says

    Can you please help me understand why, after removing half my thyroid 14 years ago and being diagnosed with Hashimoto, that I now also have Graves disease. I was told back then, I would be on thyroid hormone for the rest of my life, and now, my dose is so small, that the next step is to just go off of it. I’m very confused as to how I can have antibodies for both diseases. My levels have been pretty steady up until this last year, and they started lowering the dose. I’m getting worried that its not heading in a good direction,

    • Gillian says

      I was diagnosed with Hashi hypothyroid in 2009 and also Graves disease because I have what they called ‘hot nodules’, areas that are hyperthyroid, mostly I am hypo but sometimes the hyper has the upper hand so I get hot flushes and other hyper symptoms.Normally I take thyroxin but if I get the hyper symptoms I reduce the dose or stop it altogether for a few days till I feel better. The specialist explained that the two coditions are fighting each other so we don’t know which will win out in the end, every so often I have tests to check how things are going, really I’m hopeful that maybe the two will settle down and my thyroid will return to normal eventually but maybe I will just have to put up with this forever.

  162. Michelle Brown says

    I have been diagnosed with Hashimotos disease & am currently seeing a endocrinologist. She has done ever test imaginable & have been on meds. Levels for thyroid are in range but I am still extremely fatigued, bowl problems, & all the other symptoms that are associated with this autoimmune disease. My life has dramatically been affected by this disease. I had to quit my job as an aerobics teacher for 15 yrs. now I don’t even have the energy to exercise. Weight gain is off the charts. Depression is another big issue & life just sucks! I have been doing more research on this disease & have seen a lot of information on changing eating habits. Yesterday I started eating an autoimmune diet, but still trying to educate myself. I ran across your site & am asking for any advise you can give me. Thank you.

    • Gillian says

      Hi,
      I was diagnosed with Hashimotos in 2009 and
      I was getting the same symptoms as you and started a gluten-free diet and since then most of these problems have disappeared and I have much more energy. It doesn’t work for everyone but you could try it alongside your present diet to see, though maybe your autoimmune diet already restricts gluten?

  163. Carlos says

    Im 24 yrs old and was diagnosed with hypothyroidism one year ago but never took the medicine for the thyroid. Until one month ago I started taking armor thyroid 30mg.
    But came a cross a big problem Im having sexual problems and can seem to get an erection or think about sex i dont know what to do or what test should I get done to help this problem im having?? Any help is highly appreciate thanks in advance.

  164. says

    Good luck bc it’s a long road….Definitely find you an ENT or GP that believes you. I got my ENT to believe that I was having almost all the symptoms(which I was) and it ran in my family distantly which I didn’t even know st the time. I told him my lab work over 10 years had always looked normal, and asked if there is a chance that it could be wrong?! He said an ultrasound of my thyroid would show him definitive answers and if that came up positive then a antibodies test for Hashimoto’s disease would be the next step. I had the symptoms for 10 years and endured horrible symptoms and it made me miserable. I felt bi-polar (extremely moody), lost tons of hair, had dry skin, my thought would swell up & hurt occasionally, etc… I had nodgules on my thyroid, am extremely big thyroid, etc… from the disease. I now see an Endocrynologist and have been finally been properly diagnosed after 10 years of hell. The doctors started thinking I was crazy, but I stuck to my guns and went with my gut. Eventually it paid off lol. I went so long in diagnosed though after a year of treatment I still have many problems and permanent/irreversible damage… Is what I believe. It affected my back and lead to many other problems like Fibromyalgia that I have severe pain all over my body all the time. And have had rods and screws put in my back also bc of these doctors not believing me.

  165. Seda says

    Hi!
    Blood type A says do not eat meat especially red meat then vegetarian diet is also not good for hypothyroid disorders. I eat fish but eating fish almost for everyday makes me wonder about mercury issue. I actually don’t know what to eat exactly:(. but I love coconut oil.

  166. R Hetrick says

    When does Chris Kresser ever answer any of these questions. I wrote over a year ago..no answer…any place we can go to find some help from Chris Kresser? Thank yo!

  167. Georgina says

    Hi all. I am a newcomer to this site and will give you a bit of my history. Diagnosed with UCTD 5 years ago. Hypothyroid 6months ago and just diagnosed with Hashimotos. Have the usual symptoms …. tired, alopecia, raynauds, high cholesterol, blood pressure, weight gain etc. Have just commenced on Armour (having taken Eltroxin for 6months with no improvement in energy levels). My question is… Does Hashimotos come before Hypothyroidism???

  168. Elaine Allen says

    I just switched from Armour to Naturthroid when I found out that Armour has gluten in it. The pharmacist said they cannnot keep track of these companies since they change the formula at random. Is this true and if so, how can we be safe?

  169. Vicky says

    My 5 year old daughter has just been diagnosed by her pediatrician that her auto immune system has killed off her thyroid. She is now taking medication daily and I am looking to gain a better understanding of what is going on. I have asked the doctors hundreds of questions and the only responses that I seem to get are that now she is taking the meds, she will be fine.

    I was quite satisfied with these answers but after looking online, I am now quite scared (infertility, anxiety, depression etc).

    What should I be doing to help her other than the medication her specialists have prescribed? She is a very intelligent girl but since her diagnosis, I have noticed a very distinct change in behavior. Being so young, I definitely do not want to see her spiral out of control before she even reaches puberty!

    Is it a good or a bad thing that we have diagnosed her so young? The reports I have been reading have really got me scared for her, but I am not really sure what I should be doing from here?

    Any advice would be helpful. Thanks..

  170. Anne says

    It took 11 years to find out I had Hashimotos, and it was myself, that figured it out.
    All my doctors kept telling me to stop eating Burger King.
    I do not eat burgers at all. What a bunch of idiots out there.

    I have been on synthroid, different doses, as my TSH levels go up and down like the stock market.

    I am exhausted again, and I sleep most of the day, after sleeping 9 hours every night. I cannot get anything done, and even cooking dinner, is a burden.

    Who wants to go on like this? Not me. There has to be a better way to deal with this chronic disease. I am so fed up, I do not know what else to do, or what they are missing.

    Anyone else, lose weight, then go back to being tired full time?

  171. Debbie Deb says

    I have been dealing with Thyroid issues since I did research on my symtoms and let the physician know to check my thyroid. Amazingly it was out of whack so they put me on levothyroxine. Now I’m having heart palpatations! I keep telling them that I want to know what is causing the thyroid issue and they tell me it just sometimes happens. I will NOT accept that because it just does not happen without a cause. I want to get to the bottom of the autoimmune issue so that I can get better. I’m tired of being sick! I have low vitamin D & Potassium and positive ANA along with Shrunken Thyroid elevated cholesterol. Any suggestions???

    • Anne says

      Deb,
      I also had very low vitamin D, so I now take D-3 2000, at night.
      I also atke Triple Magnesium w/ coconut oil. Coconut oil helps so much with constipation from low thyroid.

      During the day, I started taking CO-Q-10, Green tea complex, and resveratrol. The resveratrol gave me much needed energy, but suddenly, when I went to re-order, the price nearly doubled.

      My TSH levels change every time I get tested, and I am back to being exhausted once again. I get up at 8am, and usually by either 11AM or 1PM, I HAVE to take a nap for like 3 hours! This cannot be normal.

      I am not feeling as good as I should be, and I have notes from an online seminar (it was free) I attended for an hour, through another endocrinologist. I need to get my cortisol levels tested, and also my hormone levels. All these come into play, and need to be addressed.

      This is the most annoying disease, and it took 11 years for me to be diagnosed. Every doctor I have, blamed me for the weight gain.

      I hope you find someone to help you, so you feel better.

  172. Kendall Carter says

    I have been researching as of lately alot about proper diet for hypothyroid disorder. I have been diagnosed with it for about 8 years now and have been on medication. My biggest problem is the fact that I cannot burn fat not matter how much I workout or eat well. I workout 5 to 6 times a week and love to be active which has been helpful because I don’t see the benefits in my size, it would be easy to just stop but I actually enjoy it. I experience brain fog, extreme fatigue, heart palpitations, you name it I experience it. I have recently done a 30 day vegan diet and it has actually made my symptoms worse so I decided to stop that. I just want to be the healthiest I can be and to feel good for once. I will try ANYTHING to help correct my thyroid symptoms. I am big on being natural so I really hate taking medication, I would love suggestions on a new way of eating to help me look and feel my best. Any suggestions would be great!

    • Katie says

      Hi Kendall,

      The biggest three dietary recommendations I have read are (in order of importance, I think):
      1. Gluten free
      2. Soy free
      3. Dairy free

      I would try one or all of these…good luck!

      PS. I don’t think that going vegan is especially good for thyroid disease…there are essential amino acids/proteins we can only get from animal products. I personally do not usually eat meat, for ethical reasons, or dairy, because it doesn’t agree with me…but I do eat eggs and fish, and I have found those two things to be an important part of my diet.

  173. Katie says

    Hi Everyone,

    7 years ago, when I was 16, I was diagnosed as hypothyroid (VERY high TSH) and was told that it was probably Hashimoto’s (my thyroid glands are a bit swollen).

    But I just got lab work done today and my Thyroid Peroxidase Antibodies (TPO Ab) were only 4 IU/ML (within the normal range of <9). I don't think my TPO Ab had ever been tested before, it was only done this time per my request. Does this mean I don't have Hashimoto's!? Any answer would be helpful :)

    PS. In case it matters, my other results were:
    TSH 0.411 (slightly low?)
    T3 2.9
    T4 1.40

    I have been on synthroid (88 ug) for the last 7 years…hadn't really had a problem with anything till about a year ago, when I started feeling exhausted all the time…

  174. Carol says

    I was diagnosed with Hashimoto’s 10 years ago when they removed half of my thyroid. I have a new doctor who tested my antibodies just to make sure I really have Hashimoto’s and she said it was negative. Is it possible for the antibodies to go away or is one wrong. Also my TSH numbers went from 1. something to .0001. But free t4 and free t3 are both 1.27. HELP She lowered my medication from 125mg to 75. I’ve been here before and not looking forward to gaining 30 pounds in a couple of months again and sleeping 12 hours a day. Again HELP

  175. julie says

    I was diagnosed with hypothyroidism 8 years ago and I take levothyroxine sodium 1 tablet .125mg per day but my question is I still feel like Im going crazy I cry all the time always depressed and cant hold a steady job because I feel ppl are out to get me so paranoid. what can I do I need to work. HELP HELP

  176. Arlyn says

    Thanks for this post. Looking forward to part 2…
    I have a question about iodine for hypothyroidism with an autoimmune component (not full Hashimotos) Recommended or not? Thanks!

  177. Melinda says

    I went to a alternative doctor and she told me to stop eating gluten for Hashimotos. I had searched the internet for answers and was surprised that this information wasn’t more available. Gluten causes your intestines to become come permeable, aka leaky gut. Gluten and thyroid tissue are very similar so when your immune system attacks the gluten that leaks out of your intestines and into your body it also attacks your thyroid. My antibodies were very high and after sticking to a strict gluten free diet they were almost normal and all my symptoms went away! One of the keys is healing your gut which means you need to take probiotics and stay away from foods with pesticides which kill the healthy bacteria in your gut. I have cheated on my gluten free diet and felt the effects. I also think avoiding sugar and keeping my life as low stress as possible makes a huge difference in how I feel.

  178. Kris says

    Thanks for all your information! I am interested in how Hashimoto’s (and hypothyroidism in general) relates to menopause and the changing hormone levels. I have Hashimoto’s, I’m 48 and finding that my mood swings and energy levels seems to be connected to the hormones and the Hashimoto’s. I’m trying to switch to NDT from Synthroid to see if that will help.

  179. susan marlin says

    thanks chris – interesting – I have under active thyroid plus pernicious anaemia – and the both of them together try to ruin my health most days and succeed most of the time – am on b12 injections every three months (not enough) and levothyroxine (75mg/day) probably not enough – am knackered all the time – but docs here in Scotland wont budge an inch

  180. says

    Hi Chris, thank you so much for this post. I was diagnosed with Grave’s Disease a few years back and ended up undergoing Radioactive Iodine treatment because at the time I had no idea that there might be better alternatives. I would love to see an article from you regarding people like me who have Hypothyroidism as a result of RAI, and not because of Hashimoto’s. I would imagine there are many parallels to Hashimoto’s in the sense that Grave’s is also autoimmune, and that as such is not actually “cured” with RAI. But I would love to hear any specific insights or advice you have regarding this particular scenario.
    Thanks!

  181. Elaina Parton says

    After seven years of having very abnormally low temps and symptoms of Hypothyroidism and doctors would just say you have no thyroid problem because your TSH is normal. The symptoms which only happened for a few days, maybe only every couple of months were happening everyday and I was so sick and exhausted I had to do something.

    With referrals I saw two Endocrinologists, the first only did TSH & T4, like had just been done. The second said I would be happy to do a thyroid panel, and did. TSH was normal, free T4 high end of range and free T3 at bottom of range. But he said you do not have hypothyroidism!

    They only know how to test for primary hypothyroidism and will not go any further. WHY? I see my tests showing my T4 is not converting to T3 properly.

    I had cancer 12 years ago and went through a year of weekly chemo and Have many on my Mom’s side with Hypothyroism. I could have pituitary or hypothalamus damage. How would I find out if a doctor will not go further?

    Plus, I told my new primary care doctor about trying to get diagnosed and of course do not expect her to take that on, but in talking about tests, she said T3 converts to T4, but I am not going to argue about it with you, go back to your Endocrinologist! Elaina Parton

  182. Donna says

    Is it possible for diagnosed hashimoto’s to continue many years later and develop fast growing lesion near trigeminal nerve area? As of yet negative testing, did not resond to IV steroids, infact grew. R Facial numbness and R sided arm and leg weakness, balance issues. Trying to decide if bx is right thing to do?

  183. Leigh says

    I’m looking for a good endocrinologist for my hypothyroid in the Bradenton/Sarasota area. Anyone live here that can make a recommendation?

  184. Roni says

    If your going to continue to post old postings I wish you would update them!!! I’ve come to the point that since they are not dated at the top I zip down to the comments to see when people have first commented. This is now 4 years old…

  185. Anne says

    I was put on medication with a TSH of 5.8 10 years ago
    Now I take Armour
    My antibodies are high just have been told I have hashimoto’s
    3 small nodules on thyroid lobes. No symptoms.
    FNA inconclusive .
    now what?

  186. Joni says

    My neurologist at UT Southwestern-Dallas/
    MS Clinic will not entertain the idea of using LDN. Instead, they only encouraged and explained the three new oral drugs. Sigh….. all while going through the worst exacerbation ever in my 24 year history with MS.

    By the way, I am seeking a new appointment with another neurologist who is open to other therapies–such as LDN. I am also hypothyroid and using Armour and a small amount of liothyronine. I suspect that my recent MS flare is due to thyroid (mis)treatment when other doctors (including UTSW) insisted that I get off all thyroid meds, so I did that for about 6 months. New labs after that showed me hypo again so back on the thyroid meds. My symptoms have improved however I suspect this current horrible MS flare is partially due to improperly treated hypothyroidism, and stress of course. (I survived 3 layoffs in 6 months time!)

  187. Amy D says

    Thrnks for all this info. I have just been diagnosed with the hashimoto today after two pregnancies having post partum thyroiditis after delivery & now two years of being on levothyroxin. Im at my breaking point with this. Im stuck with no good doctors or treatments… For the last week ive been waking after just falling asleep shaking, anxiety, blurry vision, naseauted, so scared & unable to sleep. Insomnia for days. Im not sure what to do next. Any advice?nks fo

    • Jo says

      Amy D. I too have had the insomnia as you describe it and after 2 years of misdiagnosis and sleeping pills/anti depressants, I found out myself that it is caused through blood sugar issues. Mine is adrenaline compensating for low blood sugar. Some organic orange juice with salt helps. Sugar for blood and salt to decrease adrenaline. All the best.

  188. Laura says

    Chris, thank you for your good work. One thing I seem to find unclear is how to know when your thyroid is completely destroyed from Hashis and how to proceed if it is beyond repair. It may be a simple answer but in my research I don’t seem to find anything explicitly stated. This would be a much appreciated post. Thanks again!

  189. Pauline says

    Hi Chris
    What about non auto immune? I have been tested and found to not have Hashimotos. There seems to be no explanation for my thyroid failure?

  190. MargieK says

    I’ve had Hashimoto’s for about 7 or 8 years. Synthroid has been what my Doctor has been treating me with. Recently my symptoms were bad enough that I went to the Dr, and pushed for testing (normal) and then requested a T3 med (Cytomel) which she gave me.
    I then requested an ultrasound for a feeling of pressure in my throat, this revealed multi-nodules, the largest one over 2 cm.
    So I am getting referred to a ENT Dr. What should I be aware of before this new Dr. starts treating me? Thank you

  191. says

    Suffering from Hypothyroidism for about 2 years now, I have been taking Moringa enhanced products for about two months and I have seen increasing levels in vitamin d(30 points) and good cholesterol(20 points).
    (Moringa is packed with all sorts of vitamins, minerals, antioxidants and inflammatories).

    I have also lost 15 pounds in that same time frame. This is a major accomplishment with all of the problems that hypothyroidism brings to the table.

    Now in order for this to happen, I had to stop taking my prescribed Synthroid because I felt the Synthroid was causing more issues than exactly helping.

    My thyroid is inactive due to taking the RAI twice and this is the part, I would like to receive some advice on. My TSH levels are off and my bad cholesterol is still high which was pretty much expected.

    My main goal is to find a good alternative thyroid medication to resolve this issue. I think once I find a thyroid medication that works better than the synthroid, hopefully that would be the key.

    Thanks.

  192. says

    I have Hashimotos as a hereditary condition as do 3 of my 5 siblings. Shows up at age 45. Controlled fine with Armour. Can I expect other symptoms/issues? I am 65 and have been primal diet for 2 years.

  193. heidi says

    Hi there, I just wanted to give some of you hope out there if you have Hypothyroidism. I had a partial thyroidectomy and was diagnosed two years later with severe hypothyroidism. I am the 10% that is not autoimmune, but caused by surgical removal; however, have experienced the same hurdles and inadequate medical assistance. I have fought for year to educate myself. The long and short of it is, after one year of treatment I am better. I take started out taking Synthroid T4 and still had a miserable quality of life, even after entering the “normal range”. I requested that my doctor add a T3 medication. He recommended Cytomel. Cytomel has changed my life. I reasoned with him why should he care as long as I stayed within the “normal ranges” on T3, T4 and TSH. He could not argue, and hesitantly gave the medication. I was extremely nauseated the first month, but then my body adapted. With each increase the quality of life improved. I take 75mg of Synthroid and 10mg of Cytomel at 5am on an empty stomach. It jump starts my body with the T3 (energy to the cells) and I wake around 7am. I take 5mg at noon. This last visit my reflexes went from reacting hypo to normal. That is a huge deal. I am at the TOP range of the “normal range” now. I was diagnosed with a second chronic illness six months ago (three years after surgery) called arthritis. I fight it every day with 2 hours of stretching/ walking. I am getting healthier, better, and stronger every day. With the proper thyroid levels I am no longer lethargic, my cells are receiving T3 (energy) and ABLE to exercise, focus, and work. I also eat well in order to reduce the inflammation in the body by eating gluten free, sugar free, and dairy free. I have discovered that Cytomel treats Myxedema (all that swelling you get in your face, arms and all over). People thought I was loosing weight when I started the Cytomel, but really I was loosing all that swelling. The tops of my arms have definition again. After my reflexes changed and my body was getting proper levels of thyroid hormone for me, then I started loosing weight effortlessly (remember I also started walking daily for the arthritis and eating right). From what I understand with arthritis is the rest of my life and I will have to fight it daily as it battles me daily to lock up. I went through the five stages of learning to deal with chronic illness and now I am at acceptance. Grieving was the worst part. The loss of who you were and used to be is a hard one. But, it is easier to talk about and share with others now, I accept that I have a different level of abilities and learning to live this new life. I refuse to be miserable. I look for the good in each day and how I can have the best quality of life possible. I am constantly learning more and more about this disease and how to manage it. Vitamin deficiencies are important such as D3, B12, Selenium, and Iron (100-130). We must be proactive, persevere, and live life the fullest of our ability. Where we fall short we have to learn to accept and love ourselves completely regardless of circumstances. When you have a bad day you have the small quiet voice inside that is called courage and say “tomorrow I will try again”. On the really bad days I think about those who have kids with cancer, incurable cancer themselves and dying, and I count my blessings. Fight for you health and don’t ever give up.

  194. jeneekautzer@gmail.com says

    I like your article except for the point where you say alternative doctors will inadequately address autoimmune hypothyroidism. I am a naturopathic doctor and 90% of naturopathic doctors I know would treat the underlying cause of autoimmune thyroiditis from stress, to nutrient deficiencies, sleep disturbance, other related hormone imbalances, high toxin burden, dysbiosis, and food intolerances to start.

  195. Terry says

    I have hypothyrodism and have all the symptons you have indicated when a lower dosage is prescribed for me.. Unfortunateley for me, I have a gland that functions partially. My current doctor relys soley on the lab report and not on symptoms I report. I have tried to explain that I can tell when the gland begins to work and many times when my levels are checked it is on one of those days. Medication is then prescribed based on those labs. After the doctor reduces the dosages, I start having the symptons. Do you have any suggestions. My wieght has increased by 50 lbs over the past 6 months.

  196. Lilly says

    Hello, I am 25 and have been diagnosed with Hashis a couple years ago. I have most of the symptoms there is with it which can be a hard thing to live around. Not that I am surrounded around my looks or anything but we all know that women with hair loss get looked at in a totally different way than men do.. My hormone levels are under control and normal right now with my hormone replacement therapy but I still suffer from some pretty crappy symptoms of brain foggyness, fatigue and hair loss. I have been on spirlactalone for about a year and with that not working, my Endocrinologist wants to put me on finasteride, a pharm made for men. My pharmacist strongly urges that I do not take it, and so far I haven’t. What else can I do for hair loss? How to I treat the underlying problem for it? Can that even be done? Or should I start shopping for wigs and head wraps?

  197. james gore says

    I was taking anatabine and metformin. my thyroid harmone TSH is now very low and the T3 is very high. Either could have caused it. Does anyone know of any information about anatabine affects on normal thyroid.

  198. Hersche Chocolatte says

    Thank you for a brilliant article on Autoimmune Thyroiditis.
    Happy I found this article.

    I’d like to know what is the correct age for menopause? I’ve been told the NEW findings is from 31, I am 43 and was diagnosed as menopausal at 42. My gynae informed me that I would experience earlier aging despite the fact that I feel 27, he also mentioned earlier death etc. I’m saddened as I’ve taken great care of myself and feel life is such a waste of time. I’ve also been diagnosed with hashimotos thyroiditis and on the Paleo diet, bio-identical hormones, selenium, moducare and a whole lot of supplements to reverse the condition, excluding iodine. Should I be taking this? What are the symptoms that one experiences at a later stage of autoimmune thyroiditis?

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