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Hashimoto's doesn't just affect your thyroid. It impacts your ability to absorb nutrients, which can make just about every single one of your symptoms worse. Here's how.
Hashimoto's is an autoimmune disease that results in chronic inflammation. That inflammation negatively impacts your stomach and your gut. When this happens, it starts to spill out the very nutrients that you need to feel better. If you've ever felt like your treatment is just not working, then you are probably deficient in one or more of these nutrients.
Number one, vitamin B12. One of the most overlooked connections in Hashimoto's is with B12. You already know that Hashimoto's is an autoimmune disease, but what you may not know is if you have one autoimmune disease, you're more likely to get another. There are several that cluster together with Hashimoto's, but one of the most common is one called atrophic gastritis. If you have this condition, your body attacks your stomach, which kills off the cells that are responsible for creating an enzyme called intrinsic factor. And your body needs this enzyme in order to absorb vitamin B12. This is a problem all on its own, but it gets worse when you realize that there is a huge overlap in the symptoms of hypothyroidism and the symptoms of vitamin B12 deficiency. Some of those include fatigue, brain fog, depression, anxiety, and irritability. Having both of these makes diagnosing and treating the other much more difficult. The good news is that the solution is actually very simple. Take 1,000 micrograms of each of the following: methylcobalamin, adenosylcobalamin, and hydroxycobalamin. This high dose and combination is enough to brute-force absorption if you have atrophic gastritis, and it bypasses any problems that might occur with methylation defects.
Number two is selenium. Your thyroid gland has the highest concentration of selenium compared to any other tissue in your body, and it needs that selenium in order to protect itself against the inflammation that occurs when your body is constantly creating thyroid hormones. When your selenium level is low, thyroid gland inflammation increases, which causes a drop in your free T3, a rise in your reverse T3, and a rise in your thyroid antibodies. Research actually backs this up. Studies consistently show that replacing low selenium in patients with Hashimoto's drops thyroid antibody levels by up to 40%. If you think you don't have enough selenium, here's how to fix it. Supplement with selenium as selenomethionine or selenium glycinate complex at a dose of about 75 to 200 micrograms per day. For even better results, combine selenium with zinc. Selenium will provide the protection that your thyroid gland needs, while zinc helps your body create more thyroid hormone. These two minerals go hand in hand, but make sure you give them 8 to 12 weeks in order to feel an effect in your body.
Number three is zinc. Zinc plays an important role in T4 to T3 conversion and how that T3 interacts with a thyroid nuclear receptor. When your zinc is low, that receptor cannot take the correct shape, which impairs T3 binding to it. Practically speaking, this means you can have completely normal T3 levels, but that T3 can't interact with and impact your cells. Signs that you don't have enough zinc may include things like hair loss, a sluggish metabolism, low free T3, and poor immune function, meaning you're getting sick all the time. A semi-reliable way to assess your zinc status is to ask yourself this question: Am I always getting sick? If the answer is yes, then zinc may be a problem because your body needs it for a healthy immune response. The relationship between zinc and your thyroid is considered bidirectional. What this means is that as zinc levels fall, your thyroid function will fall, which means you will absorb less zinc, which means your thyroid gets even worse, and that cycle continues and continues and spirals downward. If you don't think your body has enough zinc, here's how to fix it. Take between 5 and 15 mg per day of zinc citrate or zinc glycinate. Some people recommend that you take zinc picolinate. I do not. Studies show that it is no better than the forms of zinc I just mentioned, and in fact may bind so tightly to zinc that your body can't separate them. For best results, I recommend taking lower doses more frequently and always with food so it doesn't hurt your stomach. Like selenium, make sure that you allow 8 to 12 weeks for its benefits to take effect.
Number four is magnesium. This is probably one of the most common and most missed nutrient deficiencies in patients who have Hashimoto's. It gets tricky for a few reasons. First, Hashimoto's causes chronic stress, and stress is a known depleter of magnesium. The more stressed your system is, the faster you will deplete it. Second, thyroid dysfunction can accelerate the rate at which you lose or spill magnesium from your kidneys. Third, research shows that there is a connection between low magnesium and Hashimoto's, suggesting that the link may be causal. Four, the foods that are highest in magnesium are some of the foods that patients with Hashimoto's avoid the most, like green leafy vegetables. For these reasons, magnesium is not one of those things that you can just take for a couple weeks and call it good. It's going to be something that you constantly have to come back to. When you're low, you'll feel it as symptoms like constipation, muscle cramps, anxiety, poor sleep, and increased sensitivity to stress. If you think your body doesn't have enough magnesium, here's how to fix it. Take between 100 and 300 mg of magnesium every single day. But the form and dose that you take matters quite a bit. Here are the best forms of magnesium for patients with Hashimoto's. If you have constipation, you want to use ozonated magnesium or MagO7. If you're trying to improve sleep or get rid of anxiety, then use magnesium glycinate. If you're trying to directly support your thyroid, muscle mass, or improve your sleep, use ucrosomial magnesium.
Number five is iron. Your thyroid requires iron to create T4 and T3. The enzyme that lives inside of it called thyroid peroxidase is considered iron-dependent. This means when you don't have enough iron, this enzyme works less efficiently. The symptoms of low iron are hard to miss, but they can be confused with other things. The most common symptoms include extreme fatigue, hair loss, shortness of breath, and low T3 and low T4. The reason iron deficiency is so common in Hashimoto's is twofold. First, chronic inflammation in the gut impairs its absorption. And second, Hashimoto's primarily impacts women, who are constantly losing iron from their menstrual cycle. But before you supplement with iron, make sure you check your iron level. The best way to do this is by looking at a lab test called ferritin, not just your serum iron. If you find that your ferritin is less than 60, make sure you supplement with iron or eat more red meat to increase it. My recommendation is to semi-regularly check your iron and ferritin when you check your thyroid labs, something like one to two times per year.
Number six is iodine. This is a point of confusion among many patients with Hashimoto's because most have been told to avoid it 100%, but that's not correct advice. Your thyroid cannot make thyroid hormone without iodine, period. You cannot live without iodine, which means you must get it from some source. The truth is iodine can be problematic, but whether or not it is all depends on how much you take. Take too much, and you can definitely make Hashimoto's worse. Studies do show that high doses of iodine can trigger thyroid gland inflammation and raise antibody levels. But if you avoid it completely, you can also make hypothyroid symptoms worse. The solution, of course, is to take just the right amount. And that sweet spot is around 200 to 300 micrograms per day. That includes food sources like eggs and strawberries and deli meat, as well as cosmetics like shampoos and skin ointments. Most patients with Hashimoto's have no idea of all the places that iodine is hiding. And many of the same people who will tell you to avoid it are getting it from food and cosmetics without even realizing it. Here's how I recommend addressing iodine supplements if you have Hashimoto's. First, never take an ultra-high dose. The maximum amount that you want to take is 1 mg per day. And second, if you do decide to supplement, make sure you always combine it with selenium. That selenium will protect your thyroid gland.
Number seven is vitamin D. I don't think I've ever seen a patient with Hashimoto's who wasn't vitamin D deficient. The only exception are those people who are already supplementing. The reality is most people are not eating foods that are high in vitamin D, and they're not getting out in the sun. But that's a huge problem because vitamin D acts more like a hormone than a vitamin. It plays a direct role in regulating your immune system, and low levels can accelerate the attack on your thyroid gland. Studies also show that low vitamin D is associated with high antibody levels. But if you replace that vitamin D, it can help those antibody levels drop to normal. The symptoms associated with vitamin D deficiency are very similar to the symptoms of hypothyroidism, which is why most patients confuse them. They include things like hair thinning, slow hair growth, fatigue, depression, and muscle weakness. My advice is this, regularly check your 25 hydroxy vitamin D when you get your thyroid labs drawn. If you're low, take 2,000 to 5,000 IUs of vitamin D3, and always combine it with vitamin A and vitamin K2.
Don't stress about trying to address all of these at once. Instead, look at what is bothering you the most. If brain fog and anxiety are causing you the biggest issues, then start with vitamin B12 and magnesium. If hair loss is a problem for you, start with zinc and iron. And if your antibodies are too high and you want to help bring them down, try vitamin D and selenium. And if you're someone who likes the idea of using food to help reduce your thyroid antibodies and increase your nutrient levels, make sure you check out this video next.