10 reasons why Hashimoto’s patients don’t get better

10 reasons why Hashimoto's patients don't get better

Often times mainstream doctors don’t test for thyroid antibodies because it won’t change how they treat you with Hashimoto’s. The only solution they have is thyroid hormone replacement medication, but Hashimoto’s is more than a thyroid condition. It is an autoimmune disease.

It is a pleasure to include Dr. Datis Kharrazian at Hypothyroid Mom. He is a leading expert in chronic illness, autoimmune disorders, and complex neurological disorders.

Written by Dr. Datis Kharrazian, PhD, DC

There is not one easy fix to successfully managing Hashimoto’s hypothyroidism, an autoimmune thyroid disease. As many people have learned the hard way, using thyroid hormones to get TSH within lab ranges certainly doesn’t guarantee a fix for most people, although it can help. Hashimoto’s is a multifaceted autoimmune condition that involves many mechanisms. To truly manage your autoimmune Hashimoto’s hypothyroidism, it’s important to understand the factors that contribute to it.

10. Immune Reacting Fillers in Thyroid Hormone Replacement

Many thyroid supplements use corn starch or modified food starch that contains gluten. You need to make sure your thyroid hormones are gluten-free and free of corn starch if you react to corn. If your medication is in capsules make sure the capsules are gluten-free. Otherwise you could be taking hormones every day with dietary proteins that stimulate your autoimmunity.

9. Taking Immune Enhancing Supplements

Nutritional supplements can either help or flare up your autoimmunity based on an individual’s T-helper dominance (whether you have a TH-1 or TH-2 dominance). Supplements such as echinacea, green tea, acai, astragalus, licorice, and a variety others can either help or aggravate autoimmunity depending on your dominance. If you are unaware of this you may be taking supplements that promote an autoimmune response. Please refer to Chapter Three of my thyroid book, Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal for more information and lists of supplements and herbs to be aware of.

8. Fixating their focus on thyroid hormone replacement only

Many thyroid patients believe that if they could only figure out the perfect version of thyroid hormones (natural versus bio-identical or T3 versus T4) they can correct all of their symptoms. Unfortunately, Hashimoto’s hypothyroidism is a complex autoimmune disorder and thyroid hormone replacement is only one part of a large puzzle.

7. Increasing Stress

Emotional stress activates pathways involving the inflammatory immune messengers IL-6 and TH-17. This activity creates an autoimmune flare-up. Unhealthy relationships with your spouse, co-workers, or friends can promote autoimmune flare-ups, as can a bad work environment, or other significant and chronic lifestyle stressors. If you have Hashimoto’s you need to create a healthy emotional environment for yourself. Bad personal relationships or poor work environments can be detrimental to Hashimoto’s patients.

6. Not Strictly Gluten-Free

You are either 100 percent gluten-free or you’re not gluten-free. Choosing to eat gluten-free only when it is convenient is not a gluten-free diet. If you are not strict about your food being 100 percent gluten-free when you eat out and you continue to consume condiments that have gluten, regular beer, and foods fried in fryers that use the same oil for breaded foods, then you are still being exposed to gluten. Gluten is a major trigger for most Hashimoto’s patients and many cannot improve until they are 100 percent gluten-free.

5. Not avoiding gluten cross-reactive foods

Although a strict gluten-free diet is a great place to start, if you are still eating foods that cross-react with gluten you may not recover well. Cross-reactive foods have proteins similar in structure to gluten and can trigger the same immune response as if you were eating gluten. The most commonly ignored cross-reactive food is milk (casein), followed by rice, corn, sesame, and gluten-free oats. In fact, it is best to avoid all grains and adopt a diet such as a Paleo diet when you have Hashimoto’s.

4. Ignoring their brain health

The most common form of collateral damage in chronic Hashimoto’s patients is accelerated brain degeneration. Brain degeneration leads to identical symptoms of hypothyroidism, including fatigue and depression. I strongly suggest all thyroid patients become experts in identifying and supporting their brain health by referring to my second book, Why Isn’t My Brain Working?blankblank

3. Ignoring insulin sugar spikes

Surges of insulin that follow eating or drinking something sugary or starchy (sweet coffee drinks, desserts, bowls of pasta or rice, bread, etc.) trigger the inflammatory TH-17 activity, which promotes autoimmune flare-ups. Eating sweets throughout the day or overeating promotes insulin surges, which can be identified by symptoms of fatigue or sugar cravings immediately after eating. If you have those symptoms after eating it means you are not managing your insulin levels and your Hashimoto’s autoimmune response will be hard to tame.

2. Missing meals

When blood sugar gets too low it raises the inflammatory messenger IL-6 and promotes autoimmune flare-ups. Symptoms of low blood sugar are most noticeable between meals or if you skip meals and include shakiness, blurred vision, crankiness and irritability, and loss of function. If you feel a jump in your function and energy after eating it confirms your blood sugar was low—when your blood sugar is stable the only thing you should feel after eating is not hungry. Constantly skipping breakfast and missing meals will aggravate your autoimmune response and promote autoimmune flare-ups.

1. Passive attitude

The passive patient does not question or challenge her doctor. If you are a passive Hashimoto’s patient and you do not take your health into your own hands you may not fare as well as the person who educates herself. The conventional model is based only on lowering your TSH with whatever thyroid medication your insurance plan or doctor prefers. Once TSH is within lab ranges, this model has nothing more to offer except to check your TSH once a year. It takes time and effort, but the thyroid patient who wants to feel better needs to roll up her sleeves and master the various mechanisms of Hashimoto’s. The more you understand Hashimoto’s the more likely you are to successfully manage your health.

About Dr. Datis Kharrazian, PhD, DC

Dr. Kharrazian’s first book Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal? created an international explosion of interest in his detailed review of the scientific literature regarding thyroid disease and his clinical model of patient management. Dr. Kharrazian is one of the most sought after educators in natural medicine, laboratory analysis, and nutrition. Patients from all over the world fly into his practice located in San Diego, California to understand his perspective regarding their condition and to apply natural medicine alternatives to help them improve their quality of life.

Thank you to Dr. Kharrazian for permission to include this important article that first appeared on his thyroid website thyroidbook.com.

READ NEXT: Hashimoto’s Thyroiditis: The Power of ‘I Believe’

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I appreciate every share! Thank you.

About Dana Trentini

Dana Trentini founded Hypothyroid Mom October 2012 in memory of the unborn baby she lost to hypothyroidism. This is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. Hypothyroid Mom includes affiliate links including the Amazon Services LLC Associates Program.


  1. Where to start. My journey started with a visit to the doctor about lumps in my breast. I do not have cancer but atypical cells. I started to eliminate coffee, sugar, alcohol and felt/saw a reduction of the sizes of the cysts. I’m 53years old and was attributing much of my health issues to menopause.
    I was diagnosed with Hashimoto’s 3 years ago by a Naturopathic doctor. I eliminated gluten and dairy immediately and I was very deficient in vitamins as I was not absorbing nutrients. I was already taking Levothyrozine for two years and seeked a naturopath because I wasn’t feeling better. After more than a year I felt moderately better. I didn’t have extreme tiredness, but still tired. I’m always uncomfortably cold. This year I started experiencing numbness and blueness in my hands and fingers. It’s an icy hot feeling. I still lose a lot of hair. My skin is dry. My IBS is the same. Mornings are a worry I’m always running to the bathroom.
    I see a Holistic Dietician so I can keep my diet in check. It seems like I’m experiencing new issues over this last year.
    I usually sleep well but the last two months I’ve had more insomnia then normal. My weight is steady but I have to work hard. I use to be a very active person and I find myself becoming less and less able to get up and exercise. If I do exercise my body is sore longer. My joints are in pain – ankles and hips shooting pain in my hips that immobilizes me (this is new over the last 5 months).
    I’m not the same worker I use to be. I cannot handle pressure and stress. I feel like I’m having mini anxiety attacks. My thoughts are disorganized, I forget often, I cannot handle the work load. This makes me sad. I know I’ll need to take on a job with less stress eventually to focus on my health.
    I go back to my GP and explain what I’m experiencing they do blood work but tell me I’m stable and not much has changed. My next step is to change doctors and go through the diagnosis process.
    Thanks for sharing your stories.

    • Hi Della. You are naming so many symptoms of Ehlers Danlos Syndrome. Mast Cell Activation Disorder, Ryenolds Syndrome, brain fog, POTS, are all part of EDS. You will want to see a doctor who specializes in EDS in your area. (I have EDS Hypermobility) I hope this gives you some answers.

  2. Faye Coleman says

    I’ve been following Anthony Williams, Medical Medium. Many have reported improvement and even getting off medications. I’ve seen a big difference in my digestion since starting the protocol.

  3. Pam says
    September 20. 2019 9:26 PM

    I was dx with Hashimoto several years ago, but was never told I needed to be on a gluten free diet. My weight is hard to know what size I’m going to be from one day to the next. I have natural curly hair & now it had gotten thin & not curly now. The last time I went to my Endocrinologist he told me most of my thyroid is almost all gone. I also constipated alot of the time & I don’t sleep good even with a sleeping pill. I wake up with a headache most mornings. My feet hurt & other joints hurt also. I’m pretty sure I have arthritis but not been dx yet. Will changing my diet make that much difference?

  4. I feel better on a primarily vegan diet, with seafood here & there. No nightshades, corn, gluten. I have Lyme too. Haven’t tolerated most legumes or grains, other than rice. Blood & how I feel, slowly improving. Keto, paleo di dnt help me.

  5. Teena Linder says

    I have just been diagnosed with Hashimoto’s. I’m researching a lot, trying to wrap my brain around this. I have told doctor after doctor that I haven’t felt the same after my daughter’s birth, (my second pregnancy). They have all pretty much shrugged. I have been plagued my whole life with depression. I have PTSD. I am a mosaic. And I really don’t know where to start. So…where do I start???

    • You just described me right now!

    • I have hashimoto’s. years i felt sick and drs just said i was depressed and lazy for gaining weight & not excercises. Keep in mind i am no dr but ill tell u what i did. I read & watched youtube videos. u can do it if u really set ur mind to get better.
      1. Know u will feel better if u work hard, It took me 2 yrs . have hope
      2. Vitamin D, Selenium and Collagen very important supplements
      3. No – gluten, grains, corn, tomato, eggplant, alcohol, sugars, dairy, no banana, Soy sauce, gravy. Read labels carefully
      4. Yes- Eat organic, grassfed- protein, broth, berries, spinach, kale, limon, lots of water.
      Hope it helps and hope you feel better soon.

      • Thank you….I have been fighting this for years and no one ever mentioned diet….I went gluten free but a little better but not good… I see I need to eliminate all grains, sugar and night shades

  6. Debragale Palmer says

    I have been diagnosed with Hashimoto’s hypothyroid, then Multiple Sclerosis, then, Cerebral Vasculitis, and I am a chronic pain patient due to many bone fractures, (approx, 80 ) from abuse, then a car accident. I am 63. I feel like my current primary care doctor is using me for a case study or something. I desperately need a thyroid hormone, and perhaps some low dose corticosteroids, like prednisone or its’ safer equivalent. Half of my very thick hair has fell out within 6 months, and my skin is rough, subsaharan dry, and has many scars and other trauma from incessant hives and itching. I need some relief; I am under unbelievable stress from bullpoop family issues, I am also denied the Valium I took for 30 years ” because it “isn’t good” for me. I have tried oils, music, imaging, diaphragmatic breathing techniques as recommended in a course I took within my pain management group in Cognitive Therapy, by the most wonderful Psychologist in metro Atlanta, Dr. Sarah Rose, who has returned to private practice now. Since I was forced off Valium, I also haven’t slept over 3 hours for over 3 years. I take the occasional Ambien. It is good for 3 hours sleep sometimes. Since our bodies heal when we sleep, it is no wonder that mine is falling apart. Please, does anyone have suggestion(s), like this much longer makes me feel that I cannot fight much longer. My knees are arthritic, and mobility will soon be a serious issue. I AM NOT a woman of wealth or means. What Medicare pays is IT.

    • Carol Labelle says

      To anyone on this page who has autoimmune conditions such as Hashimo’s, fibromyalgia, CFS, MS, and arthritis please check out the LDN RESEARCH TRUST in the U.K.
      The website has a lot of current research, and they also have a Facebook page. Low Dose Naltrexone acts as an immune modulator. It can bring down antibodies for people with Hashimo’s. I have a thyroid issue but it falls in T3 periferal resistance. I am so greatful I found a doctor willing to let me take dessicated thyroid. LDN has been a HUGE game changer for me. Thanks for this article. I can see I have work to do in terms of tightening up my diet!
      If anyone wants to contact me they are welcome to do so.

    • Hi Debragale, have you tried CBD oil for the pain? I suffer from chronic pain and wean myself off Lyrica and Cymbalta due to stomach issues. The oil helps me a lot and it’s something natural and affordable. Good luck to you and hang in there!

    • Your body does hurt and the longer it is untreated to worse it hurts. I was very sick and finally found relief from Vitamin C therapy. It also had Other vitamins and minerals. I try to stay gluten free and I take a thyroid supplement with vitamins and minerals. It’s a daily task to stay positive and make myself rest. I have difficulty with sleep also. I’m 62 and it took several years to find the right doctor. I use a DOM. Doctor of Oriental Medicine.

    • I am an RN and have practiced for 30 years. Your sleeping only 3 hours a night is very unhealthy for you. Have you tried yoga and meditating ? The app Calm is a true blessing and also try a white sound machine. You will become diabetic if you do not get more sleep. Hope this helps! Karin

  7. Hello. I am 45 years old. I was Dx with type 1 diabetes in 1977 at the age of 4. I have had Multiple Sclerosis since age 34. Now it appears I may have Hoshimotos. I am overwhelmed with the dietary restrictions among the three. Is there a comprehensive support group for those with more than one autoimmune disease? The dietary restrictions seem to have common threads. Gluten, for example, seems like it should be avoided across all three diseases. I am also trying to learn to keep all three from spiraling out of control. It’s like spinning several plates on sticks- trying to keep them from breaking.

  8. Been doing so much research and reading on hashimoto. Looks like gluten free is the way to go! Where do I get started. Also, good or great supplements needed. Help! Have had this for 13 yrs and feel its effects every day.

  9. Lois Cavanaugh says

    Is it true that half a thyroid can perform at whole thyroid]function ?

    • I have half a thyroid. I wish I would have let them take it all out. I was advised to take it all out, but I fought them and said the mass is on the left and the right is ok so leave the right and now I have been diagnosed with hashimoto 5 years later. Wish I would have let them take the whole thing out

    • No. Your endocrinologist should be putting you on high doses of thyroid med to supress the entire thyroid. I now have hashimoto’s because my surgeon was an ENT for my thyroid cancer in 2014 and dropped the ball. I wasnt seen by the right people. Now they are playing with fire trying to get things under control. I also have been dx with fibromyalgia since the cancer surgery as well. Ugh. Im a mess. Make sure you do your research

  10. Abeer bolger says

    I had hypoid for a long time knew i have hyper I’m not losing any weight I ganded 55 pound !! I’m doing everything I can to loss weight I’m working out eating right i’m also going through menopause I know that playing a part factor in it I also have Hashimoto’s
    I eat good work out and can’t drop a pound I really need some help and I’m hopeing you can figure this out with me
    This is making me sad I was alway in shape I rought kickboxing for 15 yrs and I’m also a personal trainer so I know what to do but my bodu isn’t working. Please answer me if you can help me
    Abeer Bolger

    • Gary Schambachgmail.com says

      Please contact me.
      Gary Schambach 513 658 5092
      Henderson NC 27537 mm

    • Abeer, please consider the ketogenic diet. I have Hashimotos and in menopause and have lost 35 lbs pretty easily with no excercise. Just google it. There is plenty of info out there. It also got rid of joint pain. God bless you.

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