The Role of Vitamin D Deficiency in Thyroid Disorders | Chris Kresser
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The Role of Vitamin D Deficiency in Thyroid Disorders

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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.

Note: This will be my last post until the end of August. My wife and I are going up to the Sierras to hike and soak in the hot springs for a few days before the big acupuncture licensing exam next Tuesday. The day after that we head to southern Mexico to surf and relax on the beach for a couple of weeks.

I won’t have time to respond to comments while I’m away, but please do leave them and I’ll answer when I come back. I’ve got a few more articles in the thyroid series, and next up after that will be type 2 diabetes & metabolic syndrome. Have a great August!

Vitamin D is all the rage. It seems like every day another article is published in medical journals or the mainstream press about the dangers of vitamin D deficiency, and the benefits of supplementation. In this article we’re going to discuss the impacts of vitamin D on thyroid physiology and wade into the increasingly murky topic of vitamin D supplementation – specifically as it relates to thyroid disorders.

Vitamin D deficiency has been associated with numerous autoimmune diseases in the scientific literature. Vitamin D plays an important role in balancing the Th1 (cell-mediated) and Th2 (humoral) arms of the immune system. It does this by influencing T-regulatory (Th3) cells, which govern the expression and differentiation of Th1 and Th2 cells.

Vitamin D deficiency is also specifically associated with autoimmune thyroid disease (AITD), and has been shown to benefit autoimmune-mediated thyroid dysfunction.

Vitamin D has another little-known role. It regulates insulin secretion and sensitivity and balances blood sugar. This recent paper showed that vitamin D deficiency is associated with insulin resistance. And as we saw in a previous article, insulin resistance and dysglyemcia adversely affect thyroid physiology in several ways.

“Okay, big deal,” you say. “I’ll just take vitamin D supplements or get more sun.”

Not so fast. Research over the past two decades has identified a variety of mechanisms that reduce the absorption, production and biologic activity of vitamin D in the body.

  • Since vitamin D is absorbed in the small intestine, a leaky and inflamed GI tract – which is extremely common in people with low thyroid function – reduces the absorption of vitamin D.
  • High cortisol levels (caused by stress or medications like steroids) are associated with lower vitamin D levels. They synthesis of active vitamin D from sunlight depends on cholesterol. Stress hormones are also made from cholesterol. When the body is in an active stress response, most of the cholesterol is used to make cortisol and not enough is left over for vitamin D production.
  • Obesity reduces the biologic activity of vitamin D. Obese people have lower serum levels of vitamin D because it gets taken up by fat cells.
  • Not eating enough fat or not digesting fat properly reduces absorption of vitamin D. Vitamin D is a fat-soluble vitamin, which means it requires fat to be absorbed. People on low-fat diets, and people with conditions that impair fat absorption (like IBS, IBD, gall bladder or liver disease) are more likely to have low levels of vitamin D.
  • A variety of drugs reduce absorption or biologic activity of vitamin D. Unfortunately, these include drugs that are among the most popular and frequently prescribed – including antacids, replacement hormones, corticosteroids, anticoagulants and blood thinners.
  • Aging reduces the conversion of sunlight to vitamin D becomes.
  • Inflammation of any type reduces the utilization of vitamin D.

“Okay, fine,” you say. “I’ll just get my vitamin D measured, and if it’s low, I’ll take supplements.”

If only it were that simple. We now know that certain people with normal serum levels of vitamin D still suffer from deficiency symptoms. How is this possible?

In order for circulating vitamin D to perform its functions, it must first activate the vitamin D receptor (VDR). The problem is that many people with autoimmune disease have a genetic polymorphism that affects the expression and activation of the VDR and thus reduces the biologic activity of vitamin D. Studies have shown that a significant number of patients with autoimmune Hashimoto’s disease have VDR polymorphisms.

In plain English, here’s what this means: if you have low thyroid function, you might be experiencing vitamin D deficiency even if your blood levels of vitamin D are normal. It also means that, if you have a VDR polymorphism, it’s likely you’ll need to have higher than normal blood levels of vitamin D to avoid the effects of vitamin D deficiency.

“Okay, I get it,” you say. “I may need higher vitamin D levels than the average person if I have one of those genetic defects. So tell me what my levels should be!”

Well, this is where we venture into murky territory. The question of how high vitamin D levels should be is very difficult to answer in the case of someone with autoimmune thyroid disease. Studies suggest the optimal 25(OH)D level is 35 ng/mL for the average person. Some researchers (notably Dr. John Cannell and colleagues at the Vitamin D Council) have suggested that 50 ng/mL should be the minimum level.

The bulk of the evidence, however, doesn’t support that claim. For starters, the other authors of the study Dr. Cannell used as the basis for his 50 ng/mL recommendation came to a very different conclusion from the same data. In the paper they published in the American Journal of Clinical Nutrition, they wrote that their data confirmed the previously acknowledged optimal level of 35 ng/mL – not the 50 ng/mL suggested by Dr. Cannell.

What’s more, some recent studies have shown that higher isn’t better when it comes to vitamin D. A study in the American Journal of Medicine found that, in most people, maximum bone density occurs at 25(OH)D levels between 32-40 ng/mL. When levels are pushed above 45 ng/mL, as recommended by Dr. Cannell, bone density starts to decrease. Another study published in the European Journal of Epidemiology found that South Indians 25(OH)D levels above 89 ng/mL were three times more likely to have suffered from heart disease than those with lower levels.

If you’ve been following this blog for a while, you know that we don’t put too much faith in epidemiological studies. They don’t prove causation. They only show a relationship between two variables. But the relationship of vitamin D to calcium levels also provides a plausible mechanism by which high 25(OH)D levels could increase the risk of heart disease.

Complicating the matter further, recent work by researcher Chris Masterjohn suggests that the harmful effects of vitamin D toxicity are at least in part caused by a corresponding deficiency in vitamins A & K2. The fat-soluble vitamins A, D & K2 work synergistically, as Masterjohn has described in his Cod Liver Oil Debate article and a recently published scientific paper.

Masterjohn’s hypothesis, which has been confirmed by others, raises the possibility that the higher levels of 25(OH)D that were linked with lower bone density and heart disease may be safe if vitamin A & K2 levels are sufficient. Unfortunately, there is no clinical evidence (that I’m aware of) that helps us to answer this question.

“Okay, okay,” you say. “Just tell me how much to take already!”

I wish it were easier to answer this question. Really, I do. I think about it a lot for my own patients.

The research is clear that 35 ng/mL is the minimum level for optimum function for healthy people. But people with autoimmune thyroid conditions aren’t healthy.

They often have GI disorders, inflammation, stress, excess weight, VDR polymorphisms and other factors that impair their production, absorption and utilization of vitamin D. This suggests that the minimum 25(OH)D level for those with AITD may be significantly higher than for healthy people.

My current approach with these patients is to do a cautious trial of raising their serum levels to a range of 60-70 ng/mL. If their symptoms improve at this level, I will then switch them to a maintenance dose while watching for clinical signs of vitamin D toxicity. These include kidney stones (also a sign of vitamin K2 deficiency), low appetite, nausea, vomiting, thirst, excessive urination, weakness and nervousness. I will also monitor serum calcium levels, because elevated calcium in the blood is a sign of vitamin D toxicity and a significant risk factor for cardiovascular disease (especially in the presence of vitamin K2 deficiency). Calcium levels above 11-12 mg/dL (or 2.8-3 mmol/L) are indicative of vitamin D toxicity.

I will also make sure these patients are getting adequate amounts of vitamin K2 and vitamin A in their diets. Sources of vitamin A include organ meats, cod liver oil and full-fat milk and cream from grass-fed cows. Sources of vitamin K2 include fermented foods like natto, hard cheeses and kefir as well as egg yolks and butter from grass-fed cows. I may also use a vitamin K2 supplement (MK-4/MK-7 combo) if patients can’t tolerate fermented foods.

Finally, if you’re interested in finding out if you have a VDR polymorphism that could be affecting your metabolism of vitamin D, Genova Diagnostics has an Osteogenomics panel that tests for them. I’m not sure how much value this test has clinically, however, since it doesn’t provide any information about how the VDR polymorphism affects vitamin D metabolism in each specific case. That’s still something that would have to be figured out using the “trial and error” process I described above.

In time we can hope that the explosion of research being conducted on vitamin D will lead to more clarity on the question of appropriate serum 25(OH)D levels for people with autoimmune diseases. For now, we have to make our best guess based on clinical results and anecdotal reports.

212 Comments

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  1. I have been taking levothyroxine ever since i was 22 and I am 34 now. Just recently I have found out from blood test that I have Vitamin B12 and Vitamin D3 deficiency. When I took My vitamin b supplement, vitamin d and levothroxine together, I had bad constipation and headache. So I called up my pharmacist and she told me never to take any medicine together especially when you have any kind of complication. I also googled and found out this site that talks about it, http://drugsdetails.com/can-i-take-levothyroxine-with-vitamin-d/ So guyz, Listen and feel your body, Don’t just blindly follow everyone. Now Today I feel much better.

  2. I had a tsh and vit d drawn my tsh was .391 and my vitamin d was 11.1 we waited 6 weeks and redrew it and my tsh is now normal at 1.18 and my vit d is now 9.8. we initially thought that my vit d was lower due to night shift, but now I’m on night shift. Im just wondering what is going on with my body. I’m extremely tired a lot and I’ve gained a massive amount of weight in the last year…

    • Candace, if you ever find out please let me know. I am tired constantly and my general practitioner just says lose weight, lose weight……I would exercise and did exercise just too tired to move now.

      • Something to think about-if you are constantly drop dead tired, you might have a CMV virus like I did which acts like mono. Check your iodine levels and supplement if low. Also, I took lysine, 500 mg twice a day for the viral issue.

    • Just curious if you have had your other thyroid levels checked? T3s and T4s?
      If I had a Th of over 1.0–I would be symptomatic with hypothyroid. Please make sure your endo is performing all thyroid panels/ antibodies and not just TSH.

      • Yes, he does. This is first time this Endo has ordered a Vit D level. I have had a parathyroidectomy (one gland) back in 2011 and around 2012 is since I have had this extreme tiredness and fatigue. In March my calcium level was slightly elevated but was back to normal thus last visit in July. He’s done TSH, t3 t4 and it’s an Endo I see but it’s an office of endocrinologist and thyroid center, just recently added the thyroid center to the name.
        I feel as if I am viewed as lazy due to my obesity and that is so not the case.

        • Hi Elaine.
          I know the feeling. I had the same thing!! It is awful when they blame your weight. I had a baby and had gained 60 pounds. Little did I know my thyroid had completely crashed! I could not lose the weight for anything and was absolutely exhausted ie could barely drag myself up the stairs. Awful I thought I was dying.
          Do not let them tell you it’s YOU being fat and lazy. You know when something is wrong with your body! I was still incredibly symptomatic (depression, hair loss, plantar fasciitis, joint pain, hip pain, brain fog, weight gain all with a “normal” level of thyroid hormones. But had extremely low ( but in range) t4 and t3. I take 5 grains of armour a day now and Vitamin d in winter. I try to eat a lot of iron
          I beg you and Candace to find an endo/ naturopathic that will treat your symptoms and not just your tests…. We are being kept sick by unknowledgable doctors ( including endocrinologists) that think we are lazy…I have now lost 40 pounds since taking armour. I hope you can begin to feel better.

          • Hi I’m researching endocrinologist/naturopath gp’s for an under active thryroid but struggling to find one; do you know of any? I did have a referral to an NHS endocrinologist but he has refused to see mr unless I take levothyroxine first. I want to know if there’s another more natural route? Look forward to hearing from you.

            • Hi Jeanette
              Thyroid UK can provide you with a list. I haven’t yet been down that road, although I do have that list. I think it is good you are exploring that route first. Best wishes, Clare

          • I’ve had chronic fatigue, massive daunting chronic fatigue for nearly 30 years, since thyroid opp.
            I now and haven’t had a thyroid gland for most of this time.
            I’ve helped it some by using adrenal supplements 3-4 times a day. Last 18 months, no adrenals just DHEA, brilliant, Swanson DHEA Ultra 100mgs, 8, yes 8 a day, first thing in morning only, plus 150mgs Pregnenolone. Lost weight, no more fatigue, i play walking football, got my life back. Delroy Colbert is on You Tube on DHEA, basically saying can’t hurt you, i am taking 8 times recommended dose, very cheap , very effective.
            Reduces cholesterol, tones muscles, it’s made of Yam, non patent able by pharmaceutical companies. So invariable put down, but brilliant.
            if i reduce, less energy, so i stay on 800mg.
            I do use ERFA thyroid, used to use Armour, got fed up with inconsistent supply.Pharmaceuticals trying to block supply again.
            Wicked world we live in, trying to stop people getting well, for profit. Hell will be standing room only! I’m known as a grumpy old git, is it a wonder.

    • In reading a lot of the situations I too are tired, no energy fatigued, and agreed with the doctors to chemically remove my hyper thryoid was probably the best thing to do, now I totally disagree, I believe the medical field of physians have this mentality that totally removing the thryoid is the thing to do, mine was not cancerous, just plan old overactive, I believe that keeping what you have and regulating it is a whole lot better, so far I have been able to keep my job with GODS grace and a good understanding from where I work, This was something I felt I needed to mention and hope this will help someone else, so I feel that if someone is about to have their thryoid removed and don’t need to think and be the last resort before doing this Thanks

    • My Endo keeps hashi pts under TSH of 1. I feel better. I don’t like being too hyper. I get headaches too.

  3. I have Hashinoto,s Thyroididis diagnosed in 20o4 .I have been on 25 micrograms of Levothyroxine since. i was also taking Crestor Statins. A few years later blood tests before a hip replacement revealed Vit D deficiency and osteopenia in my lower spine. I took high dose vit d and levels went up. A year later they had dropped again. i blamed the statins and stopped taking them. Took high dose Vit D over 3 month period, levels up. A year later deficient again. I have heard that the drug company warn of bone loss with long term use of Levothyroxin. Is it interfering with the absorption or production of Vit D from food and sunlight? I am awaiting a bone density scan. PS I lived in the south of France for some of these years and have a very good diet.

  4. I have Hashinoto,s Thyroididis diagnosed in 20o4 .I have been on 25 micrograms of Levothyroxine since. i was also taking Crestor Statins. A few years later blood tests before a hip replacement revealed Vit D deficiency and osteopenia in my lower spine. I took high dose vit d and levels went up. A year later they had dropped again. i blamed the statins and stopped taking them. Took high dose Vit D over 3 month period, levels up. A year later deficient again. The drug company warn of bone loss with long term use of Levothyroxin. Is it interfering with the absorption or production of Vit D from food and sunlight? I am awaiting a bone density scan. PS I lived in the south of France for some of these years and have a very good diet.

  5. My daughter is 11 and her ferritin Level is 4
    Her haemoglobin was 9.1 now back up to 11
    But after doing more bloods they have told me her thyroid is 15.7 her b12 is 134 and her vitamin d is 24
    What does this all mean
    She hasn’t been to school for nearly 6 months she sleeps all the time has massive mood swings and fatigue
    Lost loads and loads of weight and she was like a bean pole anyway
    Waiting on a paediatrician at the moment

    • Was the thyroid hormone that was tested TSH? If so, 15.7 could indicate hypothyroidism. Many people feel that TSH isn’t a very good indicator of thyroid health and recommend testing T3 and T4 levels. You will have to specifically ask for these tests but it sounds like it would be a good idea in your situation.

      She sounds like she has hypothyroidism, which many doctors do not thoroughly screen for in teenagers. I became hypothyroid in my teens and it wasn’t diagnosed until many years later. That is not the optimal way to go, so you may need to find another doctor for your daughter.

      Good luck!

    • Interested in your comment about your daughter. What do you mean her thyroid is 15.7? Is that TSH? That is a very high number. TSH should not be used to diagnosis but anything over 3.0 ( and by most educated endos 2.0) is suggestive of hypothyroidism. Before I was diagnosed hypo mine was 5.5 and I could barely function- I thought I was dying. Seriously.
      Your daughters fatigue and very low vitamin d should be investigated these are both indicative of thyroid disease/ dysfunction. Under 30 is deficient. You should ask your pediatrician to test her for the following : free T3, free T4, reverse t3, t3 uptake, thyroid antibodies( test for hashis). For most people with hypo to feel good -their free T3 is in the upper levels of the ” normal range”.
      Please do not take no for an answer. Find someone that will do these tests and understand t3 and t4. If levels are in low normal range and she is symptomatic she is hypo. Find a doc that prescribes natural desicated thyroid for replacement therapy. Do not accept t4 only synthetics ( synthroid) . Been there done that. Believe me. She will get better. Best of luck. It must be really hard. There are many great resources out there for thyroid issues, most docs are not educated, including endos. You can order your own tests, too.

    • have her B12 checked that was what was wrong with my 13 year old daughter, she wanted to sleep all the time had heart racing and would pass out , they wanted to put her on heart meds and one Doctor said have the heart Doc checked her vit B 12 levels i said I do not think so, so he checked her’s and it was so low and she also had eye vision lose also. So please check out B12 there is so many things it can do to our bodys when we are low in it . She has to have a shot .

  6. I would like to add that I spend many hours outside during the spring/summer/fall season. This vitamin D issue is also confusing to me.

  7. Hi,
    I have been on levothyroxine since 1992 for hashimotos/hypothyroid. As of about 5 years ago, my thyroid blood work started coming back that I was taking too much, then they would lower the dose over a 9 month period, which was not fun. Then, 6 months later, too low, so they raised it back up, then too high, etc. , etc. eventually leading to a vitamin D test, which came back that I was deficient and I was put on 50,000 units once a week for a month, then a few weeks later the test came back fine. I had been concerned already that there was no explanation for the thyroid hormone test results all over the place so I went to an endocrinologist. He ran tests, said my vitamin D level was 35, but he wanted it higher and wanted me to take his special vitamins at $30/month and take Lipo lyte injections (which are for weight loss – I am 5’3″. 122lbs). I quit going to him. I recently had both the thyroid and vitamin D tests and again, they lowered the thyroid hormone dose, and I’m back on 50,000 units of vitamin D, but this time it’s vitamin D2 not D3. I’m concerned that someone needs to find the cause for the out of control thyroid hormone after almost 20 years of the acceptable results on the same dose. Is it all about age?

    • I am a Naturopath Dr. I believe that thyroid is all about having a clean gallbladder. When fats and protein can not be digested via the gallbladder then the Vit D numbers go down. One can begin cleaning the gallbladder by eating organic apples, apple sauce and introducing almond butter as the main protein to eat.
      A great way to clean the gallbladder, which is a porous bow tie shaped gland that is housing the parathyroids (Vit D,) is to look up oil pulling and clean the thyroid by swishing the oil, never swallowing it. I believe in flushing the gallbladder with old fashioned cleanses. These cleanses have been around for a long while. A working gallbladder with clear and clean bile ducts, (the vitamin Choline helps clean bile ducts.) equals a sharp receptive thyroid. I should know. I became a doctor to have a baby because my thyroid was flat not producing TSH. My baby is 21 years old and my one fourth of a thyroid and one parathyroid is working perfectly without medicine.

      • Hello. What if you don’t have a gallbladder? Is it the same protocol? What would you recommend? Thank you.

      • Sherry, the thyroid doesn’t make TSH, TSH is what regulates the (healthy) thyroid and is produced by the pituitary.

      • The gallbladder does not contain the parathyroids … they are inside of the thyroid, which is in fact bowtie or butterfly-shaped (the gall bladder is not). And TSH is a pituitary hormone that signals the thyroid to produce t4.

      • The gallbladder is a porous bow tie shaped gland that houses the parathyroid? I hope this was a mistake because if not you are a scary Doctor. The gallbladder is no where near the parathyroid glands.

        • I couldn’t believe I was reading that! Whomever monitors this site needs to delete that crazy answer. No way she is a legit naturopath Dr.! And you’re right, if she IS, then that is scary and I fear for any patients she may acquire!

  8. Im happy i found this article!
    I have hypothyroidism for 23 years & struggle with Low Vitamin D the past year. My Dr wants me to take 50,000 iu
    of compounded Vitamin D 1x a week for 12 weeks. I’m starting to rethink this after reading that vitamin K2 can help absorb it.
    I’ve been taking 5,000 iu daily with no vitamin K2 & wondering if I should start there. My D total was 32.8

  9. First of all, this is an excellent article.

    I have the same problem as reported in the article. My vitamin D levels drop very rapidly as soon as stop the intake of medicine, possibly due to hypothyroidism. The question is should I be taking Vitamin D medicines all my life or is there another way out?

    • In order to keep Vitamin D levels up you either need to get sunlight exposure or take Vit D3 or maybe both. After a person gets to optimal D3 levels some folks opt to get plenty of sunlight in summer and then take a supplement in winter depending of course on the climate where you live. Also research the role of cholesterol in the conversion of Vit D.

    • True but u must understand that due to low vitamin D u have thyoride …just focus ur vitamin D …I am sure u don’t take need medicine of thyoride ..its my personal experience…..

  10. I`ve been recently diagnosed with Iron deficiency and vitD deficiency and I`m on heavy monthly periods of 5 days per month, which I think makes my deficiency even worse. Thanx for your article and comments.

    • Iron anemia will prevent you from converting T4 into T3. Few hypothyroid people or their doctors know this. Both conditions have similar symptoms such as hair loss and fatigue so many times people blame their thyroid when what they need is to increase iron intake and not increase their thyroid meds.

      • Could you give some references for this? It’s very important information – if true – so I would like to check it.

    • Hi Mimi,

      Try taking a sublingual B12 METHYLcobalamin supplement of 5000 micrograms. I take Natural Factors that I buy on Drugstore.com. Chris also has a page on B12 deficiency that you should look at.

      • AnnF
        Be careful with the B12. I found out I’m D deficient & when I did, I found out that my B12 was extremely high from taking to much supplements. I was taking them thinking that I was in need of B12 because I was so tired. Instead, after seeing a doctor to get blood work because I was still so exhausted, I found out my vitamin D levels are extremely low & my B12 was extremely high. I still need to go back to get my thyroid checked. Supplements are not always the answer. It’s just best to get some blood drawn & find out for sure what the real issues are. God luck.

        • Hi, what form of b12 do you take? If it is cyanocobalamin ( in most supplements) some people cant covert this and it builds up in blood. Try taking a methlcobalamin, or a b complex with methyl- b vitamins.

  11. A nutritionist just told me the other day that high vitamin D levels negatively effect thyroid function in people who are hypothyroid. Do you have any idea where this idea is coming from? are there any situations where this might be true?
    I’m one of those with a fairly high vitamin D need due to poor immune function, chronic infections and inflammation, high cortisol, poor absorption and dysbiosis. I also take Cod liver oil and she said I should take fish oil instead. If I took fish oil, I probably would run into trouble with the 5,000 IU I take daily. I maintain my levels between 80-90 ng/ml. My serum calcium is within optimal levels.

    • Hi Rosanna,
      Ugh! Don’t take fish oil! There are a lot of problems with it. Stay with good old Cod Liver Oil. Just about everyone in the world takes Cod Liver Oil. I have been taking Carlson that I buy from Drugstore.com. It is not in capsule form, but you know, it really isn’t bad, and doesn’t repeat on me. (BTW, I don’t work for Drugstore.com, I just buy a lot of stuff from there. A LOT of stuff.). If your levels are too high, ditch the D3 supplement. I think that your absorption rate is actually pretty high, but your cells might not actually be able to use it.

      I think maybe you should have some genetic testing done to see if there is something wrong there. I have been having increasing problems over the years, and now I have hyperthyroidism. I am definitly going to heve genetic testing done…just as soon as I find out where, how, and which.

  12. Hi am 32yrs old i did write on here before as got a underactive thyroid then got diagonized with vitamin b12 defincency and vitamin d and had ask if my thyroid had caused theses now they think i might have also autoamine hepertits i dont know really how much more i can take i seem to be getting more and more defincency dont know what to do ? Do you think my thyroid caused all this or my body just nature falling apart thanks

    • Hi Lisa,

      How much Vtamin B12 are you taking? A lot can happen to B12 in your body beforeyou can use it. I think you should switch doctors. Autoimmune hepatitis? Give me a break. Get a genetic test done and see what’s what. I mean, there could be something wrong with your liver, but if there is, it is more than likely a genetic malfunction. One vitamin deficiency, especially B12, can cause others. It can also cause ALL kinds of problems, some of which never really go away.

      On Chris’ B12 page, I wrote a list of supplements I have been taking, and except for my apparent recent hypothyroidism — I just was told today — I have been feeling pretty good. I also added B2 recently.

  13. I have had hypothyroidism for 32 years. Even with the synthroid I have not had any increase in energy and my weight has gone up even though I am as physically active as I can be. Three years ago I was put on B12 injections weekly and continued that until a couple months ago when it finally showed up normal so I am now trying once a week. Also when the b12 came back good my vitamin D was very deficient (9). I have been taking very high doses of Vitamin D weekly for over a month and I am still very very tired, sleepless, my skin is horribly dry, my depression is back full force and I also have anxiety and sometimes panic attacks. I am at my wits end. Oh yeah, and last fall I found out my thyroid is completely covered in nodules. No surgery is recommended at this point but it may be in the future. HELP!! I need some energy. I work 5-6 days a week for the USPS so I need some stamina!

    • I was on synthroid, eltroxin, levothyroxine for 30 years, no change in horrible fatigue and itchy skin, always zonked out. I switched to dessicated thyroid almost a year ago with amazing difference after about 2 months and a few dose increases. Get off synthetic thyroid replacement which your cells do not properly know how to absorb (thus the reason you never feel better) and use dessicated. I wish people/doctors would talk more about dessicated but it’s cheap and can’t be patented so pharmaceuticals never mention it anymore. 🙂 hope that helps

    • Dear Wanda,

      Be careful supplementing with Vitamin d3 and having thyroid.
      After supplementing with Vitamin d3 i crashed and felt better and recovered after i stopped supplementing.Sunlight gave me no problems.

      • I work 6 days a week and getting out into the sunlight is a big problem. I do try to get out on Sundays but it doesn’t seem to be enough. I am now on natural thyroid (switched 2 weeks ago). I am hoping and praying this will help me with my issues. I am at my wits end with all of this. I just want to feel like doing something. My husbie and I enjoy dancing and with the tiredness and pain associated with all my issues I just don’t feel like dancing more than one or two dances a night. I just don’t enjoy much of anything anymore. I do my best to smile and go on but it is getting very hard. I was diagnosed with hypothyroidism at the age of 14 and it has been an ongoing problem. I am now 46. I just want to enjoy life.

        • You might need to prioritize. All you really need is 20 minutes of sunlight to generate the vitamin D your body needs for the day and you can get that even if you work. Walk for lunch. There is some evidence to suggest that sitting in artificial/work light all day further depletes the body of vitamin D so if that is true, sunlight is needed even more.

          • Well, not so much artificial light as fluorescent light. Unfurtunately, Congress is trying to phase out incandescent bulbs, which really don’t cause problems. Thanks, Congress.

          • Individuals with dark skin need more time in the sun at least 30 minutes or more. I have recently read that placing mushrooms in the sun increases the Vit D that is absorbed when you eat them.

        • I need advise. I have always been healthy. I am not a large person. When I went for routine blood tests a yr ago,my vitimam d level was 15 calicum normal.dr put me on 50000 units of d for 3 months. Then 2000 units. It did not take to it al very wel,butI did it as told. When I went back to see this dr I asked him if I needed it checked again answer no. He said I am sure your levels are fine now. That was a yr ago. This past May I went to a new dr hedid routine blood tests. My calicum levels were vey high vitiamin d also more follow up same bloodwork following month. Calicum high, d high. Again rechec followig month cal cium higher vitiman d low. This dr did a pth and it was very high. I have been diagonsed with primary hyperparathyroidism. My question could all that vitiman d that I took have caused this? Thanks

    • Wanda – I’ve been hypo for 15 years and here’s some things we’ve figured out that helped me feel better (both of my parents are hypo). If you have some control over your schedule, get up at the same time* every morning and take your medication, natural or not, with one full glass of water, and then GO BACK TO BED FOR AN HOUR. If you have a lot of time allowed in your morning, eat breakfast after that hour and then sleep for one more hour. (I cannot always do this but it helps a lot on vacation.) That hour of sleep after the medication will not feel very heavy; if you can manage the hour after breakfast, it may feel like the best sleep you’ve ever had.
      *This may mean you get up at 5 a.m. to take a pill. It’s fine.

      Then get up, do your stuff, and at least 3 to 4 hours later, eat lunch and take all your vitamins or supplements; I’m on 1 little tab of D3 at 2000 IU (but I’m lab-tested deficient, don’t overdo this), 600 mg of Calcium that also has another 400 IU of D3 (you may need more or less Calcium than I do; I’m 35), and a super B complex plus C that helps with the depressed feelings (I’m not clinically depressed but you do feel sad about having low energy, right?). Take those with food and get some sun for 10 or 15 minutes at the same time.

      Enjoy the rest of your day doing whatever you want, then go to sleep at the same time every night.

      I hope this helps!

    • Hi Wanda,

      The thyroid specialist should really have a look at you. Meanwhile, coconut oil, ginger, raw garlic, turmeric, pumpkins, brazilian nuts, plenty of fish (fish with limited exposure to toxins ie mercure), blackcurrent juice should provide some reliefs for a hypothyroid. Google the food you want to eat to check its effect on the thyroid, some foods decreasing the thyroid activity.

          • Thanks. I bought some Coconut Oil, but it’s so coconuty, that I haven’t used it on anything yet. I’ll have to try harder ’cause it’s better than Turmeric. Blech!

            • The following should decrease the inflammation: Oil rich in omega 3 (Salmon, trout), Flaxseed oil, fish oil, borage oil, Pineapple + turmeric, Grass fed meat…

              The following will increase the inflammation and might need to be avoided: Oil rich in omega 6 (safflower, sunflower, corn, peanut, soy), Refined sugar

              • Hugo,

                Thanks. For some reason my inflammation is really down this past week. It could be the new asthma medicine I’m on, but as soon as it starts up again, I’ll remember your list.

                Is it just the oils, or can peanuts and corn themselves cause inflammation? I eat each about five or six times a month. Also, does it have to be pineapple and turmeric? I like pineapple, but turmeric, yeesch!

                As of this writing, my body is composed of 87% refined sugar, so…

    • Please read the book, Jennifer’s Way. I just finished it, and found that there is a connection between low functioning thyroid, Vitamin D, and other issues based on silent celiac disease (where you have neurological symptoms or none at all). Your intestines are damaged and you can’t absorb nutrients like vitamins, etc. The damage from gluten is not a fad, it is a serious issue.

  14. I appreciate the article. I was concerned by your statement about epidemiological studies and lack of ability to assess causality. There are a myriad of different types of epidemiological studies. Studies on prevalence and correlation where the risk factors and outcomes are assessed simultaneously can only identify correlations and do not elucidate causality. However prospective studies where the risk factors are assessed at baseline and patients are followed to track a specific outcome can in fact shed light on causality. Any study that evaluates the impact of an exposure on a subsequent outcome has the potential to quantify causality. Of course you always have an issue of whether all co founders have been captured but this is a separate issue to address. Epidemiological studies can assess causality.

  15. I am a 28 year old woman with 2 kids.. The problem I have is a fast heart rate, excessive sweating, no appetite, weight loss, and a couple other problems… I had my thyroid checked and results came back multi nodular goiter .. So my levels were checked but they are normal.. What is wrong with me.. Oh yea I have no sex drive or pleasure when I have sex it’s like no feeling.. Please help.. I’ve told all of this to my doctor but they said I’m normal..

    • Have you had your adrenals or estrogen levels checked? I assume not by reading your post. These 2 things can cause excessive sweating with higher heart rate along with other symptoms.. Seeing that you also have orgasm issues I would see a ob/gyn get your hormones checked. I am thinking definitely a estrogen problem. If your dr won’t listen to you find another who will.

      • Excessive sweating can be from progesterone being too low. It can also be from having a hypoglycemic episode or from not consuming enough electrolytes.

    • Hey! I have hypothyroidism, and I’m having some of the same issues you are. Get a copy of your results, and go see a specialists. The specialist I was seeing, said someone around the age of 25 should have TSH levels around 1.25 not 3. 3 is normal range for those that are older.

    • get rechecked. sometimes the levels are not accurate. do it a few times within several months. you can be hypothyroid and not have the levels show up. also iodine deficiency might be part of it.

    • you should go and see a holistic dr. There are so many test that need to be done to diterman thyroid function and if your dr isn’t doing all of them then you’ll never know if your thyroid is functioning normally or not.
      It sound to me like you have hyperthyroid.
      Go see an other dr. And just remember your body knows how to make a human ( your baby’s) it will know how to heal it self too…
      You just need to find out what you need to change in yor diet or add on supliments
      God be with you! Xx

    • Please see an endocrinologist AGAIN! I went 5 years with tests reading normal until I visited the 3rd endocrinologist and he recognized I had all the symptoms, but my results were reading within range. They were on the higher range. I finally had radiation therapy and I’m doing fine after determining the right dosage of levothroxine. Please don’t stop until you are diagnosed.

    • What you have described is explained by Dr. Brownstein, MD in his book titled, Iodine – Why You Need it and Can’t Live Without it. I recommend you become educated about the need for the correct type of iodine. Do not settled for a skin test. A urine test is necessary to get accurate results. Go to Amazon for the book or just google Dr. Brownstein to learn detailed information.
      Medical doctors are taught that iodine is harmful to the thyroid, but Dr. B explains the need for it very clearly and has hundreds of patients who are living proof that it dramatically improves health and can reverse or greatly lessen thyroid issues.

    • You have a goiter, but your levels are normal? I never heard of such a thing! Go see another doctor.

      A lot depends on your ancestry and your sex, so what is normal for one person may not be right for another. Also, make sure you get enough iodine.

      • I also should have said that I have all those things, and was just diagnosed with slight Hyperthyroidism. Don’t look to Chris’ ebook, he starts with one “title” about hyperthyroidism, then spends the whole book talking about hypo. Unfortunately, I also Googled Hyper, and even though sentences looked right, when I clicked, all the info was for hypo. I don’t mind the weight loss so much, but the shaking (made worse by asthma medicine) and rapid heartbeat, I could do without.

  16. hi chris

    i,am 32 years old i had graves disease 11 years ago they tryed to treat me with carbinzole sorry spelling might be wrong? but i was allergic so they gave me radio iodine treatment and it killed my thyroid and made me underactive .
    i have just been diagnosis with b12 deficiency and vitamin d deficiency. i have had my loading dose of injections of b12 now i just have them every 3 months and i have loading does of vitamin d which are 25,000 iu oral solution once a week for 9 weeks while still taking vitamin d tablets daily ? do you like this vitamin is to high as i was reading your article made me a little worried ? my doctor hasnt really explained if it was the thyroid or not? do you think the thyroid has cause theses deficiency ? also will the thyroid keep giving me more issues like this? be good to actually have some feedback thank lisa

  17. My 17 yr daughter I found out has high calcium levels, low vitamin D. Recently she fell and hit her head, they were saying she has concussion symptoms. However I don’t know how much I agree. This past year going form A-B average to C and D. Trouble concentrating, dizzy/light headed all the time and common stomach aches in the morning. Her pediatrician said she just does not eat well and needs to drink more water. We have been battling her high cholesterol for years, and the just keep telling her to diet and exercise. I had another doctor test her and found that she also has low T3 levels, and after over a year on 10,000 Vit D a day she has gone from 28 to 40. I really hope this new doctor will give us some new answers. She had been battling weight and numerous issues for years.

    • Hello! Before I was diagnosed with hypothyroidism, I had very bad headaches, body aches, stomach aches, etc. It got so bad, I thought I had the flu for a month. It was all caused from the high TSH levels. Since then, they have evened them out. Def get all the bloodwork done!

    • Hi Rita,

      It could be a lot of things. Has your daughter had any xray, MRI, etc. done of her head? It could be a tumor.

      If her cholesterol is high, it could be a clogged artery or vein. I wouldn’t worry too much about cholesterol normally. Studies are finding out more and more that some people are just naturally high, and that their bodies are o.k. with it. However, if she has been on a very low fat diet for most of her life, that could be trouble. Fats are very important for keeping everything running in the body. Make sure she eats plenty of oilve oil. She could also take it in a shot every day. Since she would be taking it for health reasons, buy the imported from Italy kind. She should also take Cod Liver Oil evey day. She should also eat oatmeal in cold weather and oat products like cookies and Cheerios in warm weather. Make sure she doesn’t get overheated.

      It could be allergies. Have her take Zyrtec or some other allergy medicine. I took a homeopathic one by bioAllers this year. I liked the first box, but not the second. See if taking sudafed — the store brand, 30 mg, kind — helps, it could be her sinuses.

      She may need glasses. Have her try 1x readers. I have 20/20 vision, but still need the readers.

      As I said for others, look at my list of vitamins on Chris’ B12 page. Make sure she takes 5000 mcg of sublingual methyl (not cyano) cobalamin, which is B12, B2, magnesium, C, and the D (in your daughter’s case, I wouldn’t worry about it), Iron, and zinc. She should eat foods that are high in iodine.

      You did not specify which kind of stomach ache your daughter had. Is she nauseous, or in pain? I would get terrible pain in my stomach in the morinings as soon as I would drink water, but that stopped when I started taking Magnesium. My son used to throw up mucous every morning until he started taking Zyrtec year-round. Both he and I have serious mucous problems. I get very nauseous from it, and drink Unfiltered Apple Cider Vinegar mixed in water with honey, but after a month or two, I just can’t stand the vinegar anymore.

      Maybe your daughter should cut back on the water and drink a glass of Gatorade a day. I drink quite a bit, and have thought it might be a problem. It is hard to quit, though, I suffer from dry mouth. While I am thinking about it, avoid artificial sweeteners like the plague! They are in just about everything these days, so read labels.

      Well, there are a few suggestions, but I really think it it probably a vitamin deficiency. You should have her genetically tested to see if there is any possible reason why she may not be able to process vitamins.

      Good Luck.

  18. I had postpartum thyroiditis after my first child that resolved. I did not get it again with my second child. Now 2.5 yrs later I have been feeling way off. I feel hyperthyroid symptoms but had my levels checked and the doc said they were normal. I just got the results and it shows my TSH at .6. My T4 at 1.2. Even though this is within range could I still be hyperthyroid?

    • Yes you can still be hypothyroid. Same thing happened to me and it went undiagnosed for over ten years because I didn’t go to a good endocrinologist. I ended up w hashimotos and hypoparathyroidism. You need a good endocrinologist to check for thyroid peri oxidase antibodies, calcium, vitamin d and who will treat symptoms not blood test results.

    • at a the of 6 I feel horrible, sounds like you have an issue, some ranges are different at 4 I was out of the range of normal in some countries, 6 is not normal….

    • I am not sure how they arrive at these numbers, but for vitamin levels, they take a sample of people” take the average, and that is the “normal” number. Whether or not those people were high or low, nobody knows. Very scientific. I have a felling they do pretty much the same thing with most levels.
      If you know what it felt like to be hyperthyroid, then I am sure you are again. Think to yourself if anything about you or your life changed recently. Giving birth for the first time was pretty obvious. If something did change, try to change it back. You might want to see your gynecologist and explain your feelings to him. There might be something wrong or just off.

      Take your vitamins, and eat foods rich in iodine.

  19. What about magneisum?
    I managed to take vitamin D after being 11 ng/ml and B12 deficient, only if I took extra magnesium.
    With high dose of D, I got issues I related to PTH and calcium. When I had taken enough (like 800 mg) before starting D it was better.

    • Hi Jules,

      You were probably B12 deficient first. B12 deficiency tends to throw all the other vitamins out of whack.

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