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Basics of Immune Balancing for Hashimoto’s


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

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

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

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

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

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

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

Removing Autoimmune Triggers

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

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

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

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

Enhancing Regulatory T Cell Function

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

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

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

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

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Reducing Inflammation

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

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

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

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

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

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

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  1. It seems to me that autoimmune has become a blanket term for we-don’t-know. SOMETHING has got to be causing this. IOur bodies aren’t built like animals in a perceived trap, gnawing off it’s own foot. Of course, autoimmune then also means, we-don’t-have-to-cure-it, but we can give you these nifty pills for the rest of your life.

  2. A comment above claimed that only people with celiac can benefit from a grain-free diet. But there are a growing number of studies that point to: increased inflammation with grain consumption for whatever reason; immune reactions to various grains; and many autoimmune antibodies that are not typically tested for, which could explain many symptoms and conditions that will go undiagnosed.

    Meanwhile, many people experience being disabled from overwhelming [Hashimoto’s and sometimes other] symptoms after consuming grains. It’s not a whim or an imaginary experience any more than any of your experiences. We’ve literally tested it over and over again. In my case, I rigorously tested one food at a time for a few days at a time, eating only one thing for a few days to see how I felt. When I felt bad, I eliminated that food permanently from my diet. When I felt good, I kept it in my diet. If I ate or took something new, I introduced it without making any changes. I noticed that when I took a break from all grains or grain-derived ingredients, I was able to think more clearly, sleep better, remember better, be more energetic, and have better moods. When I had even a trace of grain vinegar, or many vitamins and meds, I had joint and muscle pain all over my body, chronic injuries, I couldn’t think straight, and my moods were all over the map. It doesn’t matter what anyone thinks, this still occurs when I and many others consume grains.

    It can be frustrating to hear that others feel quite certain that our diets are pointless or dangerous, when eating grains is what is dangerous for our health. It’s similar to hearing someone tell a sober addict to take drugs, or someone with a profound allergy to eat their allergen.

    • Maybe this is being caused by the chemicals put into the soil as fertilizers that the plants absorb or possibly the chemicals sprayed on them while they are growing….again being absorbed….and then they are eaten…would like to see some study done on grains that are grown organically without chemical additives.

  3. I have hashimotos and in 2014 got a great doctor who knows how to treat the thyroid. It only took me 5 years and 7 Endos and 3 internal medicine doctors. NONE of them would do the required tests NONE. Also all of them did not want my TSH lower then 2.4 really it should be 0.1 or lower. The higher the TSH means you need thyroid hormones!!! They all go by the TSH test.

    I went gluten free for 1 year and found out that if you have Hashi’s that DOES NOT mean you have to go gluten free.

    There are Only 3 Science-Backed Reasons for Some People to Avoid Gluten

    There are three conditions where people generally need to be on a gluten-free diet:

    Celiac disease.
    Wheat allergy.
    Gluten sensitivity.

    But the question is, should we all be shunning gluten or this just a convenient way for marketers to make us carbophobic and for compulsive dieters to restrict a whole food group?

    “Unless you’re gluten sensitive or unless you have celiac, there’s no good reason to go gluten-free, and you might even become malnourished,” says Beth Kitchin, an Assistant Professor and Nutrition Sciences Patient Educator at the University of Alabama at Birmingham. “Gluten is not an evil protein. It’s good for you as long as you’re not sensitive to it.”

    Gluten is not a trigger for me. so I keep away from all chemicals, organic foods, all my home cleaners are made from scratch to my soaps and shampoo. That has helped greatly also getting off of Synthroid and going on WP Thyroid. What people do not realize is the exposure to EMF is going to make your thyroid worse it happened to me. Wifi is your thyroids enemy and so are smart meters.

    • My TSH cannot be measured in the lab, it’s that low. You don’t want them too low either. That means you have hyperthyroidism.

      • When TSH isn’t measured it means that it’s suppressed due to too much medication. I went on T4 and T3 therapy and it happened to me. In retrospect, the Dr should have started me on lower dose of T3 not the other way around and then start to reduce it. It would have save me 6 months of agony and follow ups.

    • Trying to find someone who will properly treat me is where I am right now. Tired of feeling crazy and having doc’s look at me like I am! How did you finally find someone? Is it a GP, Naturopath, endocrinologist? I’ve got to find someone to help me get this hashimoto’s controlled.

      • Try 7.5 cc of sea Adine daily. It’s a dulse sea weed iodine combo to assist the thyroid. Buy from swansons on line. It’s a start. Change diet. Limit sugar. I’ve been battling this for years. It takes diligence. God bless

        • FYI—Unfortunately Dulce (seaweed) is not the answer for Hashimotos. Totally caused a severe immune response!

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

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

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

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

    • Have you gotten her diagnosed yet? My son has hashis. What is going on is the immune system is in the process of attacking her thyroid and so her thyroid is swelling and inflamed. Her Tsh isn’t effected yet but it will be very soon. Because I have Hashimoto’s I knew that my son needed to be treated even though he did not have elevated Tsh yet but had the antibodies. Ask to be referred to a head neck and throat specialist and then ask for an ultra sound of her neck to ensure the thyroid is just enflamed. Be her advocate and demand blood every 30 days until her Tsh hits the magic number. You can also purchase private lab testing online and then take her to a private lab for blood testing if you’d like to monitor her Tsh yourself. It’s about 30$
      Walkinlab.com is who I use
      Please read about soy and the impact it has on the thyroid. Soy is hidden in most processed food and has all kinds of sneaky names. Soy can be greatly beneficial and people who don’t actually educate themselves about if via actual scientific research give it a bad rap bc of the impact they think it has on estrogen receptors. BUT it really isn’t good for hypo thyroid patients. You can read the research about that here…good luck! http://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/soy-isoflavones

    • I would contact a functional medicine doctor if you have not already. It is great to have a good endo and a functional medicine doctor working at the same time.

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

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


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

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

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

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

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

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

    • It can also be because many people on synthroid or medications the like should not necessarily be taking an additional iodine at the same time. It can affect the medication and your thyroid in a negative way is what I was told.

    • Dr. K is going by a study that was done but the study was done using iodine without selenium. That is what the problem was.

      You must use selenlum 200 mcgs per day with idodine. Then you will do fine.

      I have been using iodine and selenium with hashi;s for over 6 months. don’t go by Dr. K. I worked with one of HIS functional medicine doctors…a total failure. Dr. K in my opinion is interested in lining his pockets. His consultation fees are so ridiculously high that only the rich can afford him. And his supplements Apex…just very expensive. And they all push that Supplement Company Apex. I spent close to 8 grand and all I got was a big crash and no explanation. Avoid Dr. K and his following doctors.

      • Chris Kessler is correct.

        Dr. K was influenced by a Japanese study where iodine hiked up the antibodies. I found the study and read it.

        The real issue which is overlooked but very important is that the study was done on people who were Selenium deficient to begin with so adding iodine to selenium defiecient people created a problem not good.

        One must take selenium before starting iodine maybe for two weeks before iodine. One should take the Selenium Methionine form so it get’s utilized and not stored in the body.

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

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

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

    Thanks, Khali

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

      • I disagree completely! What Khali was describing is a Chelation Challenge, which is a quite valid method of finding out the levels and types of heavy metals are stored in the bones and other organs.
        A lab test to ensure the kidneys are working adequately is advised, but other than that chelation is quite safe and we use it in our clinic every day.

        • Chelation is not completely safe. It is used as a last resort, when heavy metals are doing more harm than the risks of chelation. The heavy metals don’t just leave the bones and go right to the kidneys and out. They make pit stops all over the body, particularly the brain.

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

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

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

    here are my Lab Test Results:

    3.6 TSH
    1.24 FREE T4
    3.2 FREE T3
    6.0 TPO

    31.3 VITAMIN-D

    242 SERUM IRON
    265 TIBC
    23 UIBC

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

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

    Any advice would be much appreciated thanks for your time!

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

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

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

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

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

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

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

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

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

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

        • I’ve heard that comment and this article below by Dr. K referenced a lot, and I respect him, but in the long run I don’t see how we can “live peacefully” with something that caused our autoimmune disease in the first place (many of us). In the article below, the emphasis is on not CHELATING if you have chemical intolerance, and also to find out the status of your LEAKY GUT before CHELATING. I don’t think he’s necessarily saying not to get fillings removed (safely). But I may have missed something and I haven’t read all the way through his book.

          Quote: ‘If you are considering chelation therapy you MUST establish whether you have “chemical tolerance.” Chemical tolerance means the immune system has the ability to respond appropriately to compounds such as toxins, pollutants, and dietary proteins – that these compounds do not trigger an immune reaction.’


          Quote from the end:

          How to know whether it’s safe to chelate:

          If you have symptoms of loss of chemical tolerance you should be very cautious of chelation therapy. Below are the concepts I use with my patients. For the best outcomes, you may need to work with a competent practitioner who understands these concepts. You can look for a functional medicine practitioner here.

          1. Despite the quantity of heavy metal compounds that showed up on your standard heavy metal test, you need to order the Cyrex Array 11 Chemical Immune Reactivity Screen. This will tell you whether you are having an antibody reaction to any of the chemicals, which indicates you have lost chemical immune tolerance. If any markers on the test come back positive, do not consider chelation therapy, especially if you are reacting to heavy metals. You should never consider chelation until the test shows your antibody reactions are normal.

          2. Evaluate the integrity of your blood-brain barrier with the Cyrex Array 20 Blood Brain Barrier Permeability test. If it is positive, refer to the nutritional strategies in my book Why Isn’t My Brain Working?, particularly in the chapter on brain inflammation.
          Evaluate for intestinal permeability, or leaky gut, with the Cyrex Array 2 Intestinal Antigenic Permeability Screen and manage with diet, nutrition, and lifestyle. I discuss those strategies in both my thyroid and brain books.

          3. Increase your glutathione levels and glutathione recycling with compounds that support that, such as milk thistle, N-acetyl cysteine, Cordyceps, Gut Kola Extract, S-acetyl-glutathione, etc. For more information, refer to my brain book.

          4. Consider a detoxification program with diet, nutrition, and botanical support. Refer to the chapter on toxins and the brain in my brain book.

          5. After following the protocols, re-evaluate your status with the laboratory profiles to determine whether the chemical immune reactivity, blood-brain barrier and intestinal permeability issues are resolving. Do not proceed with chelation until these tests show your barriers are intact and you’re not reacting to chemicals or metals.

          • Oops, when I was putting the numbers back into my quote (they didn’t come in when I copied), I missed that “Evaluate for intestinal permeability” is step 3.

    • I was just wanting to ask if you were aware of the proper removal of fillings? If that dentist only removed part of your fillings and covered them with white coverings then maybe he didn’t bother to remove them correctly. He and assistants should of been wearing bio-hazard type suites,mask and you should of been covered as well and should of had a covering over face and into mouth to prevent leakage from going into your throat and lungs etc. I read all about this on the internet, just passing it along to you. I wish you the best.

      I got a mouth full of fillings I got while in the Army, what’s funny is since I’m out of the Army I only qualify for medical treatment not dental care. Can’t afford to have them removed. So most likely I’m being poisoned courtesy of Uncle Sam!!! I now have Hashimoto’s along with a list of diagnosis to fill the front page of a notebook paper and am getting more diagnosis as time goes by. Just this month Fibromalgia, Mild Gastritis, Mild Duodenitis, I get cramps and pain from the Gastritits and Duodenitis.

      • Brenda, there are so many of us in the same boat. Sorry to hear about your problems! Isn’t it insane that the Army was willing to pay for a neurotoxin to be installed in your mouth, but now won’t pay to get it out, yet if they just paid the $5-10,000 it might cost to replace them safely, they might save themselves many times that amount in medical costs for the rest of your life! I don’t wish that on you, and I hope you can avoid it, but I’m sure it’s typical. Such a broken system. I have Hashimoto’s, too, and eventually from my research decided it’s largely due to my mouthful of mercury, but so far I don’t have much else (I’m thankful).

        I made some comments above (re: Dr. Kharrazian, one of the Hashimoto’s experts) which might help you. This is one of my favorite mercury sites, especially for sharing with people who know nothing–who don’t know how many of their problems may have mercury at the root: http://www.thenaturalrecoveryplan.com/articles/symptoms-of-mercury-poisoning.html

        I’m convinced that Quicksilver products (hopefully under the guidance of a practitioner) are the best option for detox nowadays–so much easier than Cutler’s protocol and I believe less risky. This is a developing field and I think we really need to stay on the edge of developments. Listen to this great interview by the lead scientist at QS (you can find more on YouTube): https://thequantifiedbody.net/quantifying-your-mercury-burden-dr-chris-shade/

        I’ve been fortunate to find a consultant who works with Dr. Shade and guides people using QS products. She does the right testing (QS tri-test and blood metals) and also factors in your genetics if you do the 23andme testing. I’ve been able to start a regimen even before getting my fillings out. I’m still not sure how or when I’ll be doing that. Some get them replaced one at a time, as they can afford it. If you’re pretty functional right now, that may be an option.

      • By the way, you could come join us at the Hashimoto’s 411 page at Facebook. I’ve learned so much there in the last 2.5 years since diagnosis–I don’t know where I’d be without it!

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

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

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

  16. Hi Dr. Kresser,

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

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

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

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

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

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

    • Carrie, I know it’s been a while since you’ve posted, but I’m curious how your daughter is doing now. Have you been able to decrease her antibodies?

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