Is it possible to live well with Hashimoto’s Disease? YES, YES, YES, and YES.

Here are 4 of the most well-researched supplements.

Written by Nikolas R. Hedberg, D.C., D.A.B.C.I., D.A.C.B.N.

Hashimoto’s Disease is an autoimmune condition in which the immune system attacks the thyroid gland. Chronic inflammation caused by Hashimoto’s Disease then damages the thyroid, which produces less of the hormones your body needs to fulfill various functions. A majority of hypothyroid sufferers have Hashimoto’s Thyroiditis.

Is it possible to heal Hashimoto’s Disease? Yes, absolutely.

Today I’m going to go over research abstracts and talk about four of the most well-researched supplements for Hashimoto’s Disease.

1. Zinc

J Am Coll Nutr 1994 Feb;13(1):62-7

Title: Zinc supplementation alters thyroid hormone metabolism in disabled patients with zinc deficiency.

After measuring serum free 3,5,3′-triiodothyronine (T3) and free thyroxine (T4) in 134 persons, TSH-releasing hormone (TRH) injection test and estimation of Zn status were conducted in persons with low free T3.

After oral supplementation of Zn sulphate for 12 months, levels of serum free T3 and T3 normalized, serum rT3 (Reverse T3) decreased, and the TRH-induced TSH reaction normalized. Serum selenium concentration was unchanged by Zn supplementation.

Zinc may play a role in thyroid hormone metabolism in low T3 patients and may in part contribute to conversion of T4 to T3 in humans.

Zinc is required for the production of T4 and the conversion to the active form of thyroid hormone known as T3 (triiodothyronine). T4 (thyroxine) is the inactive form of thyroid hormone and does not become active until it converted into T3. T3 enters your cells and fires up the energy-producing parts of your cell known as mitochondria. Zinc is required for healthy T3 receptors in your cells so even if you have enough T3, it won’t work optimally if you are deficient in Zinc. TSH-releasing hormone (TRH) is normally made by the hypothalamus in the brain and it signals the pituitary to make more thyroid-stimulating hormone TSH. Reverse T3 can create hypothyroidism because Reverse T3 is an inactive form of T3 and it can bind to thyroid receptors and cause hypothyroidism. You want your Reverse T3 levels in a healthy range otherwise you may still have symptoms of hypothyroidism even though your lab tests may look normal.

Ann Nutr Metab 2007;51(2):188-94. Epub 2007 May 30.

Title: Effect of zinc supplementation on thyroid hormone function. A case study of two college females.

Zinc is crucial for proper thyroid hormone metabolism; zinc deficiency may result in decreased thyroid hormone levels and resting metabolic rate (RMR). The purpose of this investigation was to assess the effects of zinc supplementation on plasma zinc, serum ferritin, plasma total triiodothyronine (T(3)) and thyroxine (T(4)), serum free T(3) and T(4), and thyroid-stimulating hormone concentrations, and RMR in zinc-deficient, physically active women.

Two zinc-deficient female college students (ZD1 and ZD2) were supplemented with 26.4 mg/day of zinc (as zinc gluconate), and the above parameters were analyzed at 0, 2 and 4 months.

Zinc deficiency was clinically corrected in both subjects, while serum ferritin concentration declined to classify both subjects as borderline iron deficient (ZD1 = 15.3 and ZD2 = 15.3 ng/ml at 4 months). At 4 months, total T(3) concentrations increased in ZD1, while all thyroid hormone concentrations increased in ZD2. RMR increased in both subjects by 4 months.

Zinc supplementation appeared to have a favorable effect on thyroid hormone levels, particularly total T(3), and resting metabolic rate RMR.

Since thyroid hormone controls metabolism, resting metabolic rate RMR is an excellent marker to look at for thyroid function. Ferritin is how much iron is stored in the body. Iron and zinc will compete. Why did they administer only 26.4 mg/day of zinc in the study? Once you begin to take more than 30 mg/day of zinc then you can start to cause a copper deficiency and also an iron deficiency. Copper is very important in the body and you don’t want to create a copper deficiency by taking too much zinc. At the right dosage, zinc is one of my favorite supplements for thyroid dysfunction. Zinc is important for a healthy immune system, so in the case of the autoimmune disease Hashimoto’s not only does zinc supplementation improve thyroid hormone levels but it also helps balance the immune component.

2. Vitamin D

When was the last time you had your vitamin D levels checked? Why would you want to know your status of this powerful yet too often overlooked vitamin? Vitamin D is not just a vitamin that is important for bone health and the prevention of rickets. It is a prohormone that is essential for modulation of calcium metabolism, cell growth, cardiovascular dynamics, immune/inflammatory balance, neurologic function, and genetic expression. Vitamin D is produced when the ultraviolet rays of sunshine strike the skin. It is then converted in the liver and kidneys to it’s active form. 30 minutes of sunshine on the entire body is required to produce adequate physiologic levels of vitamin D in the body. Full-body exposure to ultraviolet light will provide approximately 4,000-20,000 IU of vitamin D. Most people simply do not get this much sun exposure, especially at higher latitudes. Sunscreen blocks 97%-100% of natural vitamin D production and contributes to a deficiency state. D3 is the naturally occurring form of vitamin D and can be obtained through high quality supplements.

Hormones (Athens). 2016 Jul;15(3):385-393.

Title: Low vitamin D status is associated with hypothyroid Hashimoto’s thyroiditis

A total of 776 patients in whom serum 25-hydroxyvitamin D [25(OH)D], thyroid function, and anti-thyroid antibodies had been measured were analyzed retrospectively. Vitamin D insufficiency was defined as serum 25(OH)D level <75 nmol/L.

The prevalence of vitamin D insufficiency was significantly higher in the 369 patients with AITD (autoimmune thyroid disease) than in the 407 without AITD. Among HT (Hashimoto’s Thyroiditis) cases, patients with overt hypothyroidism had a significantly higher prevalence of vitamin D insufficiency and lower 25(OH)D levels compared with those with euthyroidism (normal thyroid function) and subclinical hypothyroidism or those without AITD.

Vitamin D insufficiency was associated with AITD (autoimmune thyroid disease) and HT (Hashimoto’s Thyroiditis), especially overt hypothyroidism.

Here is another study about Vitamin D and Hashimoto’s.

Indian J Endocrine Metab. 2016 May-Jun;20(3):391-8.

Title: Vitamin D supplementation reduces thyroid peroxidase antibody levels in patients with autoimmune thyroid disease: An open-labeled randomized controlled trial.

This study aimed to evaluate the impact of Vitamin D supplementation on thyroid autoimmunity (thyroid peroxidase antibody [TPO-Ab] titers) in patients with newly diagnosed AITD in a randomized controlled trial.

One hundred two patients with newly diagnosed AITD (TPO-Ab > 34 kIU/L and/or sonographic evidence of thyroiditis) patients were randomized into Group-1 (intervention group) and Group-2 (control group). Group-1 received cholecalciferol 60,000 IU weekly and calcium 500 mg/day for 8 weeks; Group-2 received calcium 500 mg/day only for 8 weeks.

Data from 100 AITD patients, 93% having Vitamin D insufficiency, were analyzed. TPO-Ab titers were highest among patients in the lowest 25-hydroxyvitamin D quartile. At 3 months follow-up, there was significant fall in TPO-Ab in Group-1 (-46.73%) as compared to Group-2 (-16.6%).

Vitamin D supplementation in AITD may have a beneficial effect on autoimmunity as evidence by significant reductions in thyroid peroxidase antibody TPO-Ab titers.

3. Selenium

Did you know that the thyroid gland has the highest concentration of selenium compared to any organ in the body? Selenium is found mainly in high-protein foods such as meat, fish, shellfish, eggs, and Brazil nuts. The content of selenium in foods is dependent on the soil concentration of selenium which is very low in some areas.

Thyroid. 2007 Jul;17(7):609-12.

Title: Effects of 12 months treatment with L-selenomethionine on serum anti-TPO Levels in Patients with Hashimoto’s thyroiditis.

We studied the effects of selenium (Se) treatment on serum anti-thyroid peroxidase (TPO) levels in Greek patients with Hashimoto’s thyroiditis (HT).

We prospectively studied 80 women with HT, median age 37 (range 24-52) years, for 1 year. All patients received 200 mcg Se in the form of l-selenomethionine orally for 6 months. At the end of the 6-month period, 40 patients continued taking 200 mcg Se (Group A) and 40 patients stopped (Group B). Serum thyrotropin (TSH), free triiodothyronine (FT(3)), free thyroxine (FT(4)), anti-TPO, and anti-thyroglobulin (Tg) levels were measured at baseline and at the end of each 3-month period.

There was a significant reduction of serum anti-TPO levels during the first 6 months (by 5.6% and 9.9% at 3 and 6 months, respectively). An overall reduction of 21% compared with the basal values was noted in Group A. In Group B, serum anti-TPO levels were increased by 4.8% during the second 6-month period.

Our study showed that in Hashimoto’s thyroiditis patients 6 months of Se treatment caused a significant decrease in serum anti-TPO levels, which was more profound in the second trimester. The extension of Se supplementation for 6 more months resulted in an additional 8% decrease, while the cessation caused a 4.8% increase, in the anti-TPO concentrations.

Which form of selenium is best and how much is a safe dose? Sodium selenate and selenite are the most popular forms of selenium but only about 50% is absorbed. In addition, these forms of selenium increase the risk of selenium toxicity. Selenomethionine is the preferred form of selenium supplementation as it is the form found naturally in food and about 90% of it is absorbed. 200 micrograms each day is a safe dose as long as it is in the form of selenomethionine.

4. Ashwagandha

J Pharm 1998 Sep;50(9):1065-8.

Title: Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice

The root extract administered daily for 20 days increased serum 3,3′,5-triiodothyronine (T3) and tetraiodothyronine (T4) concentrations.

These findings reveal that the ashwagandha root extract stimulates thyroidal activity.

Ashwagandha, also known as Indian Ginseng, is a very popular adrenal adaptogen. Since it is an adrenal adaptogen, it will help keep cortisol levels in check. It helps to improve energy, stamina, mood, sleep, and immune function. Here in this study we can see it also helps increase T3 and T4 thyroid hormone levels. Therefore, it is highly beneficial for a sluggish thyroid gland and sluggish metabolism. The vast majority of my Hashimoto’s patients do well on Ashwaganda but it is important to note that  Ashwagandha is a member of the nightshade family and some people are sensitive to nightshades.

Conclusion

Speak to your doctor about supplementation. There are many additional supplements that I use in my practice that are beneficial but they are patient-specific. For example, there are different possible causes of Hashimoto’s and one person’s cause may be different from another. Therefore the supplementation to address the specific cause will be different. However, these 4 supplements below are a great standard stack for many people that have Hashimoto’s. The zinc is going to help with thyroid hormone levels as well as the immune system. The selenomethionine will start to bring down the thyroid antibodies. The Vitamin D will also help balance the immune system. The Ashwagandha will give most people a boost in their metabolism which is usually struggling in Hashimoto’s disease. I’ve included links below to the brand Pure Encapsulations. They are the best products for the money that anyone can buy.

Zinc 30mg

You don’t want to go over 30mg a day, unless you are also taking a supplement that has a small amount of copper in it. For example, 30mg of zinc with 1mg of copper would prevent a copper deficiency. Test your zinc. If you are deficient, I recommend taking 30mg of zinc a day with food for 30 days and then retesting. It may take up to 60 days to replenish your zinc levels. Make sure your zinc supplement has a small amount of copper in it because taking zinc will deplete your body of this important mineral.

Selenomethionine 200mcg

Taking the right form and the right dose is important. L-selenomethionine 200mcg (200mcg should be the total amount of selenium from all your supplements including your multivitamin)

Vitamin D3 1,000 IU

1,000 IU of Vitamin D3 is a very conservative dose. It is extremely important to have your levels checked through a blood test in addition to consistent monitoring of blood calcium levels. Vitamin D cannot be toxic in and of itself but by raising calcium levels to a toxic range which can deposit in tissues throughout the body. This is an extremely rare problem but should be monitored nonetheless. I test and monitor vitamin D levels frequently in my practice and it has become a vital piece of the pie in achieving optimum health.

Ashwagandha 500mg

It is important to mention that Ashwagandha is a nightshade. While many people with Hashimoto’s disease do well on Ashwagandha supplements, some with sensitivity to nightshades may not. Whenever starting a new supplement, always watch yourself for adverse reactions. Our bodies are all different and how our bodies react to different supplements will vary. Common nightshade vegetables, fruits, herbs, and spices include peppers (bell peppers, sweet peppers, chili peppers, jalapeños), tomatoes, eggplant, tamarillos, tomatillos, gogi berries, gooseberries, potatoes, tobacco, cayenne pepper, chili powder, curry powder, ketchup, and paprika spice.

Ashwagandha is also a Th1 stimulating compound. T-helper cells (Th1 and Th2) are a vital part of the immune system. They are lymphocytes that recognize foreign pathogens, or in the case of autoimmune disease, normal tissue. In a well-functioning immune system, both Th1 and Th2 work together to keep the system balanced. In some people with autoimmune disease, patterns show a dominance to either the Th1 or Th2 pathway. If a person’s Th1 cells are already overactive then adding a Th1 stimulating compound could be problematic. Our bodies are all unique. It is important, whenever you begin new supplements, to make a note of those which make you feel better and which make you feel worse. Also start new supplements one at a time, rather than all at once, to help you determine which ones are working and which are not.

About Nikolas R. Hedberg, D.C., D.A.B.C.I., D.A.C.B.N.

Dr. Nikolas R. Hedberg is a Board Certified Naturopathic Physician, Chiropractic Physician, and a Diplomate of the American Clinical Board of Nutrition. His practice is the Immune Restoration Center in Asheville, NC where he focuses on thyroid disorders and autoimmune diseases.

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