Vitamin B12 and thiamine are important for neurologic function and hormonal balance. Research shows that supplementing with thiamine can help combat symptoms of autoimmune disease, including chronic fatigue. In one clinical study, when patients with Hashimoto’s were given 600 milligrams per day of thiamine, the majority experienced complete regression of fatigue within a few hours or days. (18)

Hypothyroidism (overactive thyroid) is a condition in which the thyroid gland produces an abnormally low amount of thyroid hormone. Many disorders result in hypothyroidism, which may directly or indirectly involve the thyroid gland. Because thyroid hormone affects growth, development, and many cellular processes, inadequate thyroid hormone has widespread consequences for the body.
Most physicians diagnose hypothyroidism by simple blood tests that measure the level of TSH (thyroid stimulating hormone), which is made by the pituitary gland in response to thyroid hormone and the body’s needs, and indicates thyroid status. As levels of thyroid hormones fall, the pituitary releases TSH to stimulate the thyroid to produce more hormone. Clinicians may also measure circulating levels of T-3 and T-4, which are the thyroid hormones themselves. Low levels of T-4 and high levels of TSH reveal an underactive thyroid. Other variants of hypothyroidism can exist. Patients can have no symptoms and normal serum thyroid hormone levels, but elevated TSH. Others can have symptoms, but normal TSH and T-4 levels. Patients with either of these variants may benefit from supplementation. In addition, someone with a temporary illness might have a completely normal thyroid but high TSH, a condition called “sick euthyroid” which usually resolves without any intervention.
Much of the iodine in the average American diet comes from dairy products, according to a 2008 study by researchers from the Food and Drug Administration. But our consumption of dairy has been on the decline for decades: During the years between 1970 and 2012, there's been a 60-gallon drop, largely because we're drinking milk less often, say the researchers.
Those with hypothyroidism may want to consider minimizing their intake of gluten, a protein found in foods processed from wheat, barley, rye, and other grains, says Ruth Frechman, RDN, a dietitian in the Los Angeles area and a spokesperson for the Academy of Nutrition and Dietetics. And if you have been diagnosed with celiac disease, gluten can irritate the small intestine, and may hamper absorption of thyroid hormone replacement medication.
Physicians hesitated to use l-thyroxine monotherapy over concern that it could result in a relative T3 deficiency, despite growing discontent with potency of natural thyroid products (39) and reduced cost of l-thyroxine, such that the 2 treatments were approximately equivalent (36, 41). The seminal discovery of peripheral T4-to-T3 conversion in athyreotic individuals largely obviated this concern (42). This laid the foundation for the corollary that treatment with l-thyroxine could replace thyroid hormone in such a way that the prohormone pool would be restored and the deiodinases would regulate the pool of active T3. Within a decade there was a major transition toward l-thyroxine monotherapy as first-line therapy (Appendix Table and Figure) (38).
The most common treatment I use is Armour thyroid, (9) a prescription drug made from desiccated (dried) porcine thyroid. It contains the full spectrum of thyroid hormones, including T4, T3, and T2 (10). That last one – T2 – is a little-known product of thyroid metabolism that actually may be very important. The right dose ranges from 15 to 180 milligrams, depending on the person.
Hypothyroidism occurs when the thyroid gland doesn't produce enough hormones. This can happen after the surgical removal of the thyroid gland, if infants were born with congenital hypothyroidism, stress or simply if the thyroid gland is tired of working and is not functioning well. If these hormones are not produced adequately, symptoms like cold intolerance, constipation, fatigue, weight gain, dry skin, goiter and even depression can occur. (See Hypothyroidism Symptoms for more symptoms)

“Excess iodine is generally well tolerated, but individuals with underlying thyroid disease or other risk factors may be susceptible to iodine-induced thyroid dysfunction following acute or chronic exposure. Sources of increased iodine exposure include the global public health efforts of iodine supplementation, the escalating use of iodinated contrast radiologic studies, amiodarone administration in vulnerable patients [amiodarone is a drug used to treat heart rhythm problems], excess seaweed consumption, and various miscellaneous sources.”  [Leung]


To offer some perspective: up to 95% of the thyroid hypothyroidism in the US is caused not by an iodine deficiency, but occurs as the result of an autoimmune disease so avoiding cruciferous vegetables will do little to fix your underactive thyroid, and may deprive you of  valuable healthy benefits such as dietary fiber, and anti-inflammatory, cancer-fighting antioxidants.5
No one diet or plan works for everybody, including the thyroid diet that I’ve described here, as each person has a unique way of healing. There is a saying: “One person’s food is another’s poison.” It’s always worth remembering that just because one diet worked for one person it does not mean it will work for you too. One person could have healed their thyroid by just changing the water filters (by getting rid of fluoride) alone, while another needs to implement five major diet and lifestyle changes to start feeling just a little better. Let’s respect our differences.
A clinical trial investigating symptoms found that patients receiving l-thyroxine monotherapy, even with a normal TSH, displayed substantial impairment in psychological well-being compared with controls of similar age and sex (3). Because some hypothesized that this phenomenon came about only after adoption of l-thyroxine monotherapy, a study assessed combination therapy with l-thyroxine and l-triiodothyronine. Remarkably, the latter study showed that psychological measures improve in patients receiving combination therapy until serum TSH level is normal (6). In another study comparing l-thyroxine monotherapy versus desiccated thyroid, in which both groups had a normal TSH, many patients preferred desiccated thyroid and lost weight (60). Unfortunately, the solution to this complex problem is not as simple as reverting to combination therapy; the more than a dozen clinical trials on the subject have not shown benefit of superiority and preference for combination therapy, as previously reviewed (1, 3, 70).
Constipation is a common symptom of hypothyroidism. Whole-grain foods such as cereal, bread, pasta, and rice are high in nutrients in addition to fiber, which can help with bowel regularity. However, fiber can interfere with synthetic thyroid hormones, cautions Turner. Some people with hypothyroidism choose to avoid whole-grains altogether, but if you do choose to eat them, "the recommendation is to take your thyroid medication several hours before or after eating foods rich in dietary fiber," she says.

I don’t know all your symptoms or health challenges, but if you have thyroid issues and if you are losing hair (alopecia areata?), you may want to consider getting tested for celiac disease. It is quite common for people to have celiac disease and thyroid disease. It’s important not to eliminate gluten from your diet before being tested as it would cause a false-negative test result.


Subclinical hypothyroidism refers to a state in which people do not have symptoms of hypothyroidism and have a normal amount of thyroid hormone in their blood. The only abnormality is an increased TSH on the person’s blood work. This implies that the pituitary gland is working extra hard to maintain a normal circulating thyroid hormone level and that the thyroid gland requires extra stimulation by the pituitary to produce adequate hormones. Most people with subclinical hypothyroidism can expect the disease to progress to obvious hypothyroidism, in which symptoms and signs occur.

Although the implementation of sensitive TSH assays resulted in dose reduction, it also fueled the discovery of subclinical states of hypothyroidism (i.e., serum TSH <10 mIU/L and normal serum free T4); this state is 20 times more prevalent than overt hypothyroidism (64). Hence, many patients with vague symptoms, such as depressed mood and fatigue, are commonly screened and found to have subclinical hypothyroidism. In many cases, this finding prompts the conclusion that the subclinical hypothyroidism is the cause of the nonspecific symptoms, and thyroid hormone therapy is initiated. The patients in whom the cause–effect relationship was incorrect contribute to the increasing number of euthyroid but symptomatic patients (57). The marked increase in prescribing of thyroid hormone with decreasing TSH thresholds amplifies this problem (47).


I was concerned about an ongoing “mental fog” and forgetfulness I had – which is one of the symptoms of Hashimoto’s. I was having trouble losing weight and also felt very low in energy. Since following Dr. Osansky’s recommendations I have found that I have a greater sense of calm – something I didn’t expect from the treatment and changes in diet and lifestyle. In addition to getting my Hashimoto’s under control, I have enjoyed other health benefits as well. I no longer suffer from anemia, my Vitamin D levels are normal and my immune system is strong. My thyroid blood tests also improved. Although it’s a commitment and initial expense, it is completely worth it in the long run. Given the alternative (taking thyroid medication for the rest of your life), in my opinion it’s a no brainer. If you give a natural treatment protocol a fair chance you’d be surprised at how much more empowered you’ll feel about your illness and treating it. A natural treatment protocol is an effective solution that puts you in the driver’s seat when it comes to your health. Traditional methods do the exact opposite.
Kale reigns supreme in the land of leafy green vegetables that we often eat raw, but beware if you have an iodine deficiency. “Kale gets a big baddy,” Blum says. “Eat it cooked.” When raw, this dark green leaf steals the iodine from the thyroid gland. If you must, it’s ok to nosh on the green veggie in your salad, but stop at two servings a day. No need to get extra credit on the superfood.
Chromium picolinate, which is marketed for blood sugar control and weight loss, also impairs the absorption of thyroid medications. If clients decide to take chromium picolinate, they should take it three to four hours apart from thyroid medications.23 Flavonoids in fruits, vegetables, and tea have been shown to have potential cardiovascular benefits. However, high-dose flavonoid supplements may suppress thyroid function.24 The Natural Standards Database provides an extensive list of supplements that have a potential impact on thyroid function, so taking precautions and coordinating patient care with a knowledgeable practitioner is prudent.
Hypothyroidism is a very common condition. Approximately 3% to 4% of the U.S. population has some form of hypothyroidism. This type of thyroid disorder is more common in women than in men, and its incidence increases with age. Examples of common causes of hypothyroidism in adults include Hashimoto's thyroiditis, an autoimmune form of overactive thyroid, lymphocytic thyroiditis, which may occur after hyperthyroidism (underactive thyroid), thyroid destruction from radioactive iodine or surgery, pituitary or hypothalamic disease, medications, and severe iodine deficiency.
A cup of cooked white beans serves up 8mg of iron—a mineral that many people, especially premenopausal women, have trouble getting enough of . But getting your fill is important. “If you don’t, it can impair the activity of enzymes that produce thyroid hormones,” Dr. Lee says. (Women aged 19 to 50 need 18mg iron daily, while men and women 51 and older need 8mg .)
The most common cause of hypothyroidism in the United States is an inherited condition called Hashimoto's thyroiditis. This condition is named after Dr. Hakaru Hashimoto who first described it in 1912. In this condition, the thyroid gland is usually enlarged (goiter) and has a decreased ability to make thyroid hormones. Hashimoto's is an autoimmune disease in which the body's immune system inappropriately attacks the thyroid tissue. In part, this condition is believed to have a genetic basis. This means that the tendency toward developing Hashimoto's thyroiditis can run in families. Hashimoto's is 5 to 10 times more common in women than in men.
People with celiac disease who can’t tolerate the gluten found in many baked goods, pasta and cereals often have Hashimoto’s thyroiditis, and vice versa. Hashimoto’s disease is an autoimmune condition in which your immune system attacks your thyroid. Once rare, Hashimoto’s is now the most common autoimmune disease, according to the May 2017 study in the journal Endocrine Connections.
8)  Supplement With Omega 3’s:  Omega 3 fatty acids and in particular the long chain variety EPA and DHA are critical for stabilizing blood sugar, reducing inflammation and taming the immune system.  Consume grass-fed meat, grass-fed butter, wild-caught fish and spirulina to get it in your diet. It is also advisable to supplement with 2-5 grams daily of EPA/DHA along with 200 mg of GLA.  Clinically, I use ProEFA to boost up omega 3’s.

Soy? If you have hypothyroidism, yes. Eating too much soy causes problems only for those with hypothyroidism, which occurs when your thyroid gland does not make enough thyroid hormones, Dr. Nasr says. The main problem is that soy hinders absorption of the hormones such patients are taking. “Some studies show that if you eat a lot of soy, or drink a big glass of soy milk, within one hour of taking a thyroid hormone, it might affect absorption,” he says. “A lot of people depend on those hormones to achieve a steady state.
Iodine is an essential ingredient in thyroid hormone, and thyroid hormone is critical to the growth and development of the bodies and brains of all baby vertebrates (animals with backbones).  Since they need iodine just as much as we do, and they do not have access to artificially iodized salt, how do they get their iodine?  Do they have a secret stash somewhere that they’re not sharing with us? I assume they are getting enough iodine because if they weren’t, they would all be born brain-damaged runts, and many would be infertile if they survived to adulthood.  To the best of my knowledge, wild inland animals are not herds of sterile, stupefied miniatures roaming the landscape in search of iodine…
55. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–3421. [PMID: 12485966] [PubMed]
Having a thyroid condition is no picnic, but you're not alone with this health issue. According to the American Thyroid Association, more than 12 percent of the population may end up dealing with a thyroid condition at some point in their lives. And thyroid issues can be sneaky: Of the nearly 20 million Americans living with the disease, as many as 60 percent don't even realize they have it.

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