Hypothyroidism: The Most Important Thing You May Not Know About
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The Most Important Thing You May Not Know about Hypothyroidism


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Reviewed by Christina Graham, MSN, APRN, AGPCNP-BC


This article is part of a special report on Thyroid Disorders. To see a comprehensive eBook on thyroid health, 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. The number of people suffering from thyroid disorders continues to rise each year. (1)

Hypothyroidism is one of the most common thyroid disorders. It’s estimated that nearly 5 percent of Americans age 12 and up have hypothyroidism. (2) 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.

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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 percent of people with hypothyroidism are producing antibodies to thyroid tissue. (3) 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 United States. (4) 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 autoimmunity. 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).

For more on how to balance the immune system and treat Hashimoto’s, check out this article.

Research Spotlight: Health Coaching and Thyroid Health

With the Support of Health Coaches, Diet and Other Lifestyle Changes Reduce Hashimoto’s Symptoms

Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the United States, and sufferers score lower on quality of life measures compared to healthy controls. Additional symptoms can include chronic fatigue, dry skin, hair loss, and irritability, making work and social life difficult. A study published in Cureus, a medical journal known for raising funds via crowdsourcing, indicates that through collaborative healthcare, including health coach support, patients with Hashimoto’s can successfully change lifestyle behaviors to result in improved quality of life and lower symptom burden.

Study Summary

The main objectives and findings of the article were the following:

  • In this pilot study, researchers sought to determine whether the support of health coaches and other professionals could help women with Hashimoto’s successfully change diet and other lifestyle behaviors, leading to improved thyroid function, metabolic profile, and quality of life.
  • Seventeen normal and overweight women, aged 20 to 45, with Hashimoto’s participated in a 10-week online health coaching program that focused on implementing the Autoimmune Protocol (AIP) diet along with other lifestyle modifications, including sleep hygiene, stress management, and increased movement. Participants were also part of an online support community with each other and met with nutritional nurse practitioners and physicians periodically.
  • During the duration of the 10-week program, patients were strictly adherent to the AIP diet about 95 to 100 percent of the time. Although no significant changes in thyroid function were measured after the program, six of the 13 women who were initially on thyroid medication were able to lower their doses. Symptom burden, BMI, weight, and inflammation all significantly decreased. Furthermore, patients reported improvement in all eight subscales of the quality of life survey, including physical, mental, social, and emotional health.

Key Findings and Significance

These findings stress the role of health coaches as change agents. The AIP, Paleo diet, and other similar diets are often discounted for being too “restrictive” and impossible to practically follow. However, participants in this study were 95 percent compliant with the dietary template and lost weight without tracking calories or macronutrients. And the diet resulted in significant health improvements! There is no doubt that the health coaches and online support group played key roles in the participants’ success. The program used in this study is called the “SAD to AIP in SIX”: Standard American Diet to Autoimmune Protocol in SIX weeks.

Although no measures of thyroid function significantly improved after the 10-week program, patients reported significant improvements in symptoms and quality of life, and many were able to lower their medication doses. When patients have support outside the 15-minute doctor’s appointment every six months, they are more able to change behaviors and lifestyles to benefit their health.

Reference: Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis.

Health coaches support people who are trying to make big changes—like adopting a new diet or incorporating yoga into their exercise routine. How do they do it? By developing and honing skills like facilitating change and learning to listen. Find out more about becoming a health coach with the ADAPT Health Coach Training Program.


Join the conversation

  1. 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.
    Thank you very much for your responses and for this wonderful blog.

  2. 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.

  3. 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.

    • 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)…

  4. 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.

    • 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.

      • 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

    • 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.

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

  6. 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

  7. 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.

    • 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.

  8. 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.

  9. 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. 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.

  11. 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.

    • 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.

      • 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.

      • 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.

      • 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?

  12. 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,

    • 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.

  13. 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…

    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.

    • 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.

    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.

    • 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.

      • 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.

        • 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.

          • 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.

            • 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.

        • 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.

          • 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!

        • 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

        • 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.

      • 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

        • I would highly recommend learning more about low dose naltrexone (LDN). It is a new, very promising treatment for MS and other autoimmune conditions. http://ldninfo.org

        • 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.

          • 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!

          • 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.

          • 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.

            • 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.

            • 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!)

        • 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..

        • been on any flouroquinolone antiobiotics such as cipro and levaquin.. If so, you need to check out flouroquinolone toxicity syndrome.

      • 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

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

  16. 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.

  17. 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!

    • 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.

      • 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

        • 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!!!!

          • I had a similar experience, having first diagnosed with Hashimoto’s then later finding the co infections of Lyme. I’ve gotten fantastic results with essential oils and living the laws of health and have my life back but am still working on the Hoshimotos. I wish any one of my doctors had explained it was an auto immune condition 17 years ago! I would have don’t so many things different. I teach exactly what is written here and am so happy more awareness is occurring.

        • 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.

          • 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.

        • 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.

        • 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:
          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!

          • 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.

              • 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.

                • 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!

        • 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.

          • 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.

          • 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.

            • 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

              • 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.

              • 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!

              • 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

              • 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.

              • 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!

          • 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?

        • 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

        • 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.

      • 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?

        • 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.

      • 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.

      • 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.

      • 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.

    • 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.

      • You need to get gluten and dairy out of your diet as quickly as possible as they cause autoimmune disease!

        • 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?

          • 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.

          • 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.

          • I started seeing a nutrition specialist with a masters degree. She had me take the TRIAD test. It measures amino acids, gut dysbiosis, all of your good and bad bateria, and also identifies what you have allergies to. I did not realize I was allergic to diary, cheese and eggs. I ate eggs everyday with an avocado, thinking I was eating healthy. I also had to cut gluten and sugar to decrease inflammation and level cortisol levels for fatigue. Good Luck!

    • 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.

      • How do you feel, Alan?
        Your comment was two years ago, so wondering what happened since.

        Best wishes!

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