In Part 1 of this article, “How to Reduce Thyroid Antibodies“, I discussed why thyroid antibodies are so important as an early warning for Hashimoto’s, what their significance is in Hashimoto’s, how to test for them, and how to properly monitor them.

In my view, knowing your antibody numbers early on is a better screening test than knowing your TSH level. Thyroid antibodies are going to be the first indication of a thyroid problem in many cases. They can be elevated for as many as 10-15 years before a change in TSH is even detected. The presence of thyroid antibodies also means that there is an active destruction going on against your thyroid. The antibodies test is an easy test to do. Part 1 tells you what test you need to do and how to interpret the results.

I also discussed a tool you can use to help determine the aggressiveness of your condition. The Thyroid Event Amsterdam (THEA) Score is a score that can help assess how quickly Hashimoto’s can progress to hypothyroidism (or if you’re already there, to other kinds of autoimmune conditions).

The best way to reduce the aggressiveness of the condition is to reduce your thyroid antibodies.

We can make people feel better and even dramatically reduce their thyroid antibodies by removing their triggers. This is my favorite corrective action to take, as it is truly addressing root causes. This action is recognizing and removing the antigens or triggers that are setting off the autoimmune process in the first place. Additionally, in case root causes can’t be found or eliminated, there are other strategies that can be used to modulate the immune response against the thyroid that will be discussed in this article.

So, let’s begin with discussing triggers as the initial corrective action to take to reduce thyroid antibodies.

There is a lot of research relating to common triggers as well as anecdotal evidence (results that I have personally seen). I’ll review the most common culprits and how addressing these triggers may make you feel better as well as reduce your thyroid antibodies.

After I discuss common triggers, the next corrective action I’ll talk about will relate to reducing oxidative stress — specifically, utilizing antioxidants to reduce the oxidative stress in the thyroid gland. This is going to be very helpful for most people with Hashimoto’s.

The third action I’ll discuss is going to be oral tolerance. This is a strategy to help make a person’s body become a little more tolerant of itself.

The fourth action I’ll discuss is taking advantage of immune modulation. We know that the immune system is out of balance in Hashimoto’s and that there are certain substances that we can give to people to help balance things out a bit.

Finally, I’ll talk briefly about immune suppression and target removal.

Note that the further you get down this list of 30 actions, the more advanced some of the interventions can be — in particular, some of the immune modulation and suppression actions, but I include them for your information.

The mechanisms of corrective actions to reduce thyroid antibodies are:

• Trigger reduction
• Reducing oxidative stress (antioxidants)
• Oral tolerance
• Immune modulation
• Immune suppression
• Target removal

Let’s begin with the first one: trigger reduction.

Reducing Key Triggers

There are many antigens which have been identified as triggers of Hashimoto’s, including:

Toxins – Numerous environmental toxins have been found to be triggers, such as:

• Iodine excess
• Copper toxicity
• Mercury (amalgams)
• Arsenic
• Fluoride
• Other heavy metals
• Mold
• Medications
• Endocrine disruptors
• Radiation
• Nickel toxicity
• Breast implants
• Implant surgery
• Other surgery

Infections – Infections are common triggers and often are the issue if dietary interventions are not making you feel better. These are oral and gut infections, as well as a number of bacterial and viral infections, that are commonly seen in Hashimoto’s:

• Mouth Infections
  • Abscessed teeth
  • Root canals
  • Periodontitis
• Gut Infections
  • Food poisoning
  • Blastocystis hominis
  • SIBO
  • Yeast
  • H. pylori
  • Dysbiosis
  • Bacterial infection
• Other Infections
  • Lyme disease/tick bites
  • Mycoplasma
  • Streptococcus
• Viral Infections
  • Epstein-Barr virus
  • Herpes
  • Hepatitis C infection (and treatment)
  • Cytomegalovirus (CMV)
    

Emotional and Physical Stress – This can include emotional stress such as social rejection, life events (divorce, trauma), sexual abuse, etc. Physical stress can include blood sugar abnormalities, excess exercise, sleep apnea, sleep deprivation, etc.

Nutrient Deficiencies – Common examples include Selenium, Vitamin D, low calorie diets, B vitamins, Iron/Ferritin, Iodine and Zinc.

Food Sensitivities – Gluten, dairy, soy, grains, eggs, and nuts/seeds/nightshades are the most common.

Blood Transfusions – We know when a person gets a blood transfusion, they are going to be exposed to antigens that were in the donor’s blood. Blood transfusions have been found to increase the rate of autoimmune disease, including Hashimoto’s.

Hormonal Shifts – Puberty, pregnancy and perimenopause are three of the most common times when a woman may be diagnosed with Hashimoto’s. Researchers used to think that pregnancy was a trigger because of fetal cells that got into the maternal thyroid gland; however, further research has shown that the babies’ cells within their mothers’ thyroids are actually protective!

So let’s start with a few of the most common triggers.

1. Removing Gluten

In 2015, I did a survey of my readers consisting of 2232 people having Hashimoto’s. In that survey, 88 percent of people felt better off of gluten and 33 percent had a reduction in their thyroid antibodies on a gluten free diet.

Gluten is a protein found in wheat, barley, rye, and processed products that may contain hidden traces of gluten. Along with dairy, gluten was a huge trigger for me. When I finally took the plunge and removed both from my diet, it took just 3 days for symptoms that I had experienced for almost 10 years to completely vanish.

There have been studies that have shown that people with subclinical hypothyroidism (remember my earlier discussion: stage 2 is where you start to see thyroid antibodies, and stage 3 – subclinical hypothyroidism  – is where you’ll start to see an elevated TSH and some mild thyroid symptoms), showed improvements when following a gluten free diet for a year. In one such study, 71 percent returned to normal thyroid function; and 19 percent were able to normalize their thyroid antibodies.

Another note about gluten is that it is often the cause of intestinal permeability. (So, you have 2 of the 3 conditions necessary to develop Hashimoto’s.)

You can read much more about gluten here.

2. Removing Dairy

For me, getting off dairy meant no more irritable bowel syndrome, bloating, reflux and carpal tunnel. I’ve seen many success stories relating to clients and readers feeling better, even going into remission (Read Crystal’s Hashimoto’s Success Story about dairy) when they have removed dairy from their diet.

In my survey, 79 percent of respondents with Hashimoto’s felt better when they went off of dairy, and there was a 20 percent reduction in antibodies.

 3. Removing Soy

My clients and readers have reported an increase in palpitations, nervousness and thyroid antibodies after consuming soy.

In my 2015 survey, 60 percent of respondents felt better when they removed soy from their diet, and there was a 34 percent reduction in antibodies.

Studies have shown that soy intake can interfere with levothyroxine absorption. One study connected soy fed babies with higher rates of thyroid antibodies later in life.

I recommend skipping tofu, miso and soybeans in order to support your thyroid. Better yet, cut out all processed foods, as soy is often a hidden ingredient in these products!

4. The Paleo Diet – Removing Grains and Processed Foods

Two diets that I like for reducing thyroid antibodies and improving how people will feel are the Paleo diet and the Autoimmune Paleo diet.

Prior to these diets, I usually have people start by removing gluten. Removing one thing is just easier, and the removal of gluten often makes many people feel much better right off the bat. The Paleo and Autoimmune Paleo diets are increasingly more restrictive.

Keep in mind that the best diet  will depend on what food sensitivities they have, as well as if they’re having issues with blood sugar, intestinal permeability, ongoing chronic stress, infections, or toxin exposures.

A Paleo diet eliminates all grains and all processed foods. After eliminating grains and processed foods, a Paleo diet replaces these with nutrient-dense foods thought to have been eaten during the Paleolithic Era: nuts and seeds, vegetables, fruit, and eggs. Meat, a caveman staple, is also allowed, as is fish and other meat products (organ meats).

Depending on the particular Paleo plan you are following, dairy may also be allowed, but I do not recommend it, as you’ve seen earlier it is a highly reactive food for most people. Other food items of controversy on a Paleo diet include eggs and sweet potatoes. Note that many people have food sensitivities to eggs, although I include them in my own diet.

While there aren’t studies that point to a Paleo Diet as a means to reduce thyroid antibodies, in my survey, 81 percent of respondents felt better on a grain free or Paleo diet. Corn, in particular, was noted as a large sensitivity.

And as mentioned above, 88 percent of those surveyed felt better on a gluten free diet.

A Paleo diet has helped many people with Hashimoto’s feel better by improving symptoms such as fatigue, joint pain, brain fog, bloating and gas.

5. The Autoimmune Paleo Diet (AIP) – Further Restrictions

Although the Paleo diet has helped many people feel better and even recover completely, the Autoimmune Paleo diet (AIP) can be even more successful for some.

On a personal note, this was one of the key dietary protocols on my own healing journey. But it isn’t easy to just jump into, and I consider it a more advanced intervention.

In my survey, 75 percent of my readers and clients reported significant symptom reductions on an AIP diet, with almost 40 percent seeing a reduction in thyroid antibodies.

You can read an overview of the AIP diet, including the foods it allows and restricts, best practices and other information, here. The diet is more restrictive, so I generally suggest people go on the Paleo Diet first.

6. Addressing H. Pylori Infections

Chronic infections are the triggers that get the least amount of attention, yet identifying and treating them can result in a complete remission of Hashimoto’s. Additionally, some of the infections can be progressive, leading to more and more symptoms, if not identified and treated accordingly.

A variety of bacterial infections have been implicated in triggering autoimmune thyroiditis, including , the same bacteria that causes ulcers; (associated with Lyme disease), and .

(H. pylori) is a gram-negative spirochete-shaped bacteria that burrows into our stomach lining and secretes urease, which neutralizes stomach acid. The byproduct of the urease and stomach acid is toxic to epithelial cells, as are the other chemicals produced by this bacterium, leading to damage to cells, a disruption of tight junctions, and inflammation.

When I initially removed gluten and dairy from my diet, I felt so much better, and most of my symptoms went away. But I still tested positive for thyroid antibodies, so I had to dig deeper into my other root causes. That ended up being gut infections! And yes, initially it grossed me out, but then I realized it was a common trigger.

In 2015, 80 percent of my clients who hit a plateau with nutritional intervention, and who took the gut tests that I recommended, tested positive for at least one gut infection.

I’ve had numerous readers and clients with Hashimoto’s report that their symptoms were greatly improved following treating the H. pylori Infection. Most of them showed a reduction in thyroid antibodies following the eradication of H. pylori. A few have even gone into Hashimoto’s remission!

 7. Eradicating

This protozoal parasite is one of the most common I have encountered in people with Hashimoto’s. It is especially prevalent in those clients who develop Epstein-Barr Virus. When I did an analysis of BioHealth 401H stool test results in 2015, some 35 percent of people had tested positive for “Blasto”.

It was also an infection that I had to deal with before I felt completely well.

Blasto often presents itself with the presence of hives and IBS, two conditions that are seen in Hashimoto’s. It has also been connected with intestinal permeability.

Eradicating this infection has helped many of my clients eliminate or reduce their IBS systems, food sensitivities, and thyroid antibodies. There is some research that details a reduction in thyroid antibodies after removal of the parasite as well.

8. Resolving SIBO (Small Intestinal Bacterial Overgrowth)

SIBO is an overgrowth of bacteria in the small intestine. While this is not technically an infection, SIBO does have a bacterial component and can be a trigger, consequence, or exacerbating factor for Hashimoto’s.

According to a study published in 2007, SIBO can be present in up to 54 percent of people with hypothyroidism.

I have seen people with Hashimoto’s resolve symptoms like IBS, restless leg syndrome, low ferritin, and low B12 by treating SIBO; and in some cases, I’ve also seen thyroid antibodies get reduced — and even go away — with SIBO treatment.

9. Addressing Yersinia Infections

You may have never heard of this infection before, but its antibodies are found in people with Hashimoto’s fourteen times more often than in people without Hashimoto’s.

Yersinia membranes bind TSH. Remember I talked about molecular mimicry? Infections like Yersinia can induce antibodies against sites that recognize and stimulate TSH receptors. At least one study found that Yersinia antibodies were more prevalent in people with thyroid disease.

Read more  What Foods To Avoid With Hypothyroidism

How do you contract Yersinia? It is an infection found in contaminated meat (commonly found in pork), poultry, dairy products and seafood.

10. Mercury Removal – Dental Amalgams

Research has shown that mercury found in dental fillings does accumulate in thyroid tissue, and in one study, the removal of dental amalgams decreased thyroid antibodies in patients with autoimmune thyroiditis.

Amalgam fillings (usually referred to as silver but actually containing 50 percent mercury by weight) are the major source of mercury exposure, accounting for two-thirds of human mercury exposure.

Many of the symptoms of mercury exposure overlap with those seen in Hashimoto’s, including digestive issues, fatigue, joint pain and hair loss. You can read about one woman’s experience with amalgam fillings as her Hashimoto’s trigger, here.

If you have Hashimoto’s and amalgam fillings, I encourage you to take the MELISA (Memory Lymphocyte Immunostimulation Assay) test. This test can detect hypersensitivity to metals and environmental toxins to help you determine whether removing your fillings should be a priority.

Reducing Oxidative Stress (As a Mechanism to Reduce Thyroid Antibodies)

The next section covers a few ways to reduce oxidative stress. People with Hashimoto’s have increased oxidative stress, so this can be a beneficial strategy to reduce thyroid antibodies and feel better.

11. Iodine Restriction to Reduce Oxidative Stress

Iodine restriction has been shown to reduce oxidative stress, and according to various studies, some people have been able to lower thyroid antibodies by restricting their iodine intake. Take note, however, that others have reported that taking increased iodine has lowered their antibodies. This just underscores the point as to why finding root causes is so individualized.

In my survey, 356 people tried  and out of that group, 25 percent said that it made them feel better; and 28 percent said it made them feel worse. Forty-six percent said they saw no difference, although this doesn’t mean their thyroid antibodies weren’t affected in some way.

Iodine is a very controversial subject, but I put it out there just in case it can help you. Having said that, I’d start with removing common triggers before I look at modifying iodine intake. There are also other actions you can take that reduce oxidative stress that have had better results, such as taking selenium.

12. Selenium as an Antioxidant Manufacturer

Nutrient depletions are very common in Hashimoto’s, often due to intestinal permeability issues.

One particular nutrient that is depleted in Hashimoto’s is selenium. It is a trace mineral that is involved in the manufacturing of antioxidants like glutathione peroxidase. Glutathione peroxidase helps with the removal of the cells affected by oxidative damage.

A dosage of 200 mcg per day has been found to reduce thyroid antibodies in clinical trials. In some studies, selenium cut the antibodies significantly within six months.

In my survey, people taking a selenium supplement helped 63 percent of respondents feel better. Thirty-four percent saw no difference, while 3.5 percent felt worse.

I have found that when clients and readers take selenium supplements, not only can it lead to them feeling better, but it can also lead to a reduction in anxiety, antibodies and other symptoms.

Note that gluten and grain free diets are associated with deficiencies in selenium… another reason to focus on a healthier diet and supplementation when needed to ensure you address these common Hashimoto’s deficiencies!

13. NAC to Strengthen Your Body’s Defense System

N-Acetyl-Cysteine (NAC) supports healthy levels of glutathione, a key component of the body’s antioxidant defense system.

Research has shown that people with Hashimoto’s disease have lower levels of glutathione. In a study done in 2010, NAC and 15-Deoxy-Prostaglandin J2 (a fatty acid compound with antioxidant and anti-inflammatory properties) exerted a protective effect against autoimmune thyroid destruction Significant associations were seen in the levels of glutathione, as well as TSH and thyroid antibodies. Researchers concluded that the maintenance of a minimal oxidative load was essential to safeguard thyroid cell function.

I have seen benefits using 1800 mg per day of N-Acetyl Cysteine, and recommend Rootcology’s Pure N-Acetyl Cysteine, which is free of potential reactive ingredients and harmful fillers. As an additional bonus, NAC is also associated with helping with heavy metal detoxification.

14. Thyroid Medications to Prevent Oxidative Stress

As you whittle away the triggers and root causes of why you are displaying unhealthy thyroid antibody levels, you and your clinician may also opt for thyroid medications as well as some of these other corrective actions below.

Studies have shown that in euthyroid and subclinical hypothyroidism, (remember, as discussed earlier, this happens during stages 2 and 3 of hypothyroidism, with stage 2 being the “early warning” stage), thyroid medications such as levothyroxine can reduce thyroid antibodies.

As part of my recommendations, if you have concerns in this area, taking antioxidants like selenium, glutathione and NAC become even more important, as they will help reduce oxidative stress.

15. Photobiomodulation (Use of Low Level Laser Therapy)

Low level laser therapy has shown to be capable of reducing about 50 percent of thyroid antibodies over the course of 10 targeted treatments. It directly reduces oxidative stress in the thyroid gland.

In one study in Brazil, all patients who received low level laser therapy were able to reduce their levothyroxine dose, while 47 percent were able to discontinue it and have normal thyroid function during the 9-month follow-up.

This and other research on the use of laser therapy can be found here. Presently, this therapy is still considered experimental, but progressive practitioners are starting to use it.

16. Myo-Inositol to Reduce Oxidative Stress (And Anxiety, Too)

Research has shown that anxiety, depression and a general feeling of being “unwell” are early signs of an autoimmune attack on the thyroid, and can be correlated to thyroid antibodies, even when the TSH number is still normal.

The most common type of anxiety disorder reported in people with thyroid antibodies is obsessive compulsive disorder (OCD).

OCD is also more common in Type A personalities (like me and many other pharmacists; and likely many of you out there too), so my own OCD tendencies definitely used to flare up with rising thyroid antibodies and then reduce as my antibodies dropped.

Research has found that Myo-Inositol can help with PCOS (polycystic ovarian syndrome), OCD and anxiety. As an added bonus, Myo-Inositol has been found to reduce TPO antibodies, reduce TSH, and also balance blood sugar.

In a study that combined treatment using Myo-Inositol and selenium, researchers found that the combination resulted in decreased TSH, TPO and TG antibodies, as well as improvements in thyroid hormones and a feeling of personal well-being.

Please note, if you have kidney disease or are taking diuretic medications or herbs with diuretic properties, please check with your practitioner before taking Myo-Inositol. During one of my guinea-pigging adventures, I decided to try Myo-Inositol while trying an antiviral protocol that included Cleavers, a diuretic herb… and almost fainted. Myo-Inositol may not be properly cleared when the kidneys are overworked, such as in kidney disease or while taking diuretics. #thingsIlearnedthehardway

Oral Tolerance Strategies (To Reduce Thyroid Antibodies)

Now, let’s talk about how focusing on addressing oral tolerance can help reduce thyroid antibodies. Oral tolerance is basically inducing immune non-responsiveness through introducing an antigen by the mouth.

17. Thytrophin PMG as a Decoy

I’ve seen people reduce their thyroid antibodies by taking this supplement. While it doesn’t address a root cause (trigger), it seems to help minimize the effects of the immune system attacking itself.

According to the manufacturer of this supplement, Thytrophin acts like a decoy of sorts. It seems to distract the immune system from your thyroid gland while you work on addressing triggers, intestinal permeability, and all of your other root causes. It may prompt the immune system to attack the Thytrophin PMG versus its own thyroid gland, and allow the thyroid tissue to regenerate.  

18. Moducare to Address Adrenal Balance

Moducare is a supplement that helps promote a normal balance of the adrenal hormones (our stress response), such as cortisol. When the adrenals are out of balance, the rest of the body quickly follows suit. This is especially significant for Hashimoto’s patients because stress is often a major contributing factor, and the adrenals and immune system work so closely together.

Readers and clients have been able to improve their adrenal function, as well as reduce antibodies, using Moducare.

19. LDN (Low Dose Naltrexone) to Stabilize Immunity

In my 2015 survey, 38 percent of respondents that tried Low Dose Naltrexone (LDN) felt better. But the amazing stat related to these individuals is that they had spectacular results. Of those that felt better, 48 percent were able to reduce thyroid antibodies, 61 percent saw an improvement in mood, 66 percent had more energy, and 40 percent had a reduction in pain.

The theory about how LDN works is that it likely increases endorphin activity, and may also increase the number of endorphin receptors and/or the sensitivity of the receptors. All of these activities can result in stabilizing the immune system.

Many people have been able to eliminate their symptoms and reduce the dosage of their thyroid medications using LDN. I’ve seen women with thyroid antibodies in the 1000s IU/mL range that were able to reduce them down to about 100 IU/mL!

LDN is not a supplement and requires a prescription, and as with many things, it won’t work for everyone. At the beginning of my own thyroid journey, I tried using LDN just briefly, but it didn’t make me feel well, and I became very irritable, so I had to stop using it. To learn much more about LDN please go to this article.

Immune Modulation Strategies to Reduce Thyroid Antibodies

20. Systemic Enzymes

Systemic enzymes act as natural immune modulators, helping to bring our immune system into balance.

There has been a lot of research done on systemic enzymes coming out of Europe. There, the enzymes are a popular pain medication alternative for arthritic diseases and inflammatory conditions such as Hashimoto’s.

Systemic enzymes can reduce antibodies to both foods and the thyroid by breaking down circulating immune complexes that are formed in autoimmune diseases. They can also aid in tissue repair by reducing inflammation.

One particular blend of systemic enzymes, *Wobenzym, was the subject of a study that found that when given with levothyroxine, Wobenzym resulted in a greater reduction of thyroid antibodies than in those patients only given levothyroxine. Those patients taking Wobenzym also had a reduction of thyroid symptoms, a normalization of their thyroid ultrasound, and a reduction in inflammatory cells found in the thyroid.

For more info on the above research utilizing Wobenzym, please review the article here.

*Wobenzym N is the formulation that was studied, however, I’ve also seen similar clinical benefits with Wobenzym PS.

21. DHEA to Increase Stress Tolerance

Our body’s adrenal response is very tied to our immune health, and low levels of the hormone DHEA (Dehydroepiandrosterone) may predispose some individuals to developing autoimmune diseases. Plus, chronic stress leads to a reduction in DHEA.

That’s why I have a lot of information on the topic of stress and adrenal support in my first book, as well as an entire chapter on Adrenal Recovery Protocols in my book,

Stress management techniques are helpful in supporting our adrenal stress response, as is supplementation. I have found that DHEA supplementation can be very helpful.

DHEA supplementation increases stress tolerance, lowers the cortisol/DHEA ratio, and protects against cortisol-induced cellular damage. It also has effects on the immune system, increasing Th1 and decreasing Th2 cell production. It may be an effective immune modulation strategy for reducing thyroid antibodies as well.

In one study, DHEA was given to women with premature ovarian failure and Hashimoto’s, and those taking the DHEA, showed a reduction of TPO and TG antibodies.

Please note, while this hormone is available without a prescription in the United States and some other countries, I always recommend using it under the supervision of a practitioner due to potential side effects (cystic acne galore) and contraindications (like a history of certain cancers).

22. Anatabine

I tried Anatabine for three months several years ago when I was in the middle of my root cause search, and it actually lowered my TPO antibodies by about 50 percent. ().

Unfortunately, it was subsequently removed from the market, but I include it here in case it makes its way back. The manufacturer had been marketing it as a supplement but made drug like claims about the supplement, so they were disciplined by the Food and Drug Administration. The last I heard (as of 2014), the manufacturer was trying to make anatabine into a pharmaceutical.

This supplement could be a helpful tool in reducing inflammation and antibodies while searching for your root cause as to why your immune system is imbalanced. It is made from a naturally occurring alkaloid found in the Nightshade plant family (which oddly includes tobacco). Read the article here for the story about that, as well as other info regarding anatabine.

In a study conducted with euthyroid patients with Hashimoto’s, the results showed a statistically significant reduction in Thyroglobulin antibodies with the use of Anatabine. Fifty percent of patients reduced their antibodies by at least 25 points, while 25 percent reduced their TG antibodies by at least 100 points.

23. Vitamin D – An Easy Immunity Booster

If you live in a northern climate and don’t spend much time outside on a daily basis, you are at risk for Vitamin D deficiency. Vitamin D deficiency (due to lack of sun exposure, using sunscreen, or poor dietary intake) is associated with improper immune function.

Vitamin D deficiency is also more commonly found in people with Hashimoto’s. Sixty-eight percent of my readers with Hashimoto’s reported also being diagnosed with vitamin D deficiency—and this deficiency has been correlated with the presence of antithyroid antibodies.

One study found that 92 percent of Hashimoto’s patients were deficient in vitamin D, and another 2013 study found that low vitamin D levels were associated with higher thyroid antibodies and worse disease prognosis.

A more recent study showed that vitamin D supplementation reduced thyroid peroxidase antibody levels in patients with autoimmune thyroid disease.

Vitamin D supplements can improve our mood and can help us reduce thyroid antibodies. I’ve personally found that most of my clients who are in remission from Hashimoto’s keep their levels of vitamin D between 60-80 ng/ml.

You can read about vitamin D, and the benefits of sunshine, here.

24. IVIG – An Expensive Option… b

IVIG (intravenous immunoglobulin) therapy has been shown to suppress thyroid antibodies by using immune cells isolated from blood donations.

Unfortunately, it is prohibitively expensive, has a difficult route of administration, and may cause side effects. So, it is usually reserved for a serious condition called Hashimoto’s Encephalopathy, a life-threatening illness where thyroid antibodies attack the brain. Most of the research available on IVIG is related to Hashimoto’s Encephalopathy.

I do want to point out a “poor man’s IVIG”, though, and that is camel milk! It’s much easier to administer.

25. Plasmapheresis – Plasma Exchange

If you have Hashimoto’s, your plasma contains thyroid antibodies that attack your body’s immune system. A machine can be used to remove the affected plasma and replace it with healthy plasma or a plasma substitute. This is called plasmapheresis or plasma exchange.

Plasmapheresis is known to be effective at removing thyroid antibodies, but it is expensive and carries other risks with it. The benefits of this treatment are also temporary and are typically used in emergency situations (thyroid medication overdose, amiodarone-induced hyperthyroidism, Hashimoto’s encephalopathy, etc).

Read more  7 Foods That Are Good For Your Thyroid

26. Plaquenil – Used in Many Autoimmune Diseases

Hydroxychloroquine (Plaquenil) is a medication that was originally used to prevent or treat malaria. However, during World War II, it was found that this medication was also effective in treating the symptoms of lupus, rheumatoid arthritis and other autoimmune diseases.

Thyroid dysfunction and antibodies have been frequently associated with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).

Plaquenil reduces lymphocytes, the production of auto-antibodies, immune mediators, cytokines, and NK cell activity; and inhibits antigens presenting to B cells, dendritic cells and monocytes.

In one study, treatment with plaquenil significantly decreased the DNA-hydrolyzing activity of thyroid antibodies. Patients with hypothyroidism have a higher level of DNA-hydrolyzing IgG antibodies. Usage of plaquenil resulted in a reduction in these antibodies, as well as improvements in thyroid hormone production and elevated functional activity of the thyroid gland. Plaquenil also improved the clinical state of the patients.

Plaquenil is currently in clinical trial relating to reducing thyroid antibodies, so I will update you all later on the findings.

Please note, this drug does have a lot of potential side effects including: irregular heartbeat, mental/mood changes (anxiety, depression, hallucinations), shortness of breath, blurred vision, arm/leg/back pain, fatigue, and chest discomfort. It may rarely cause serious eye problems, muscle/nerve damage, seizures, or serious allergic reactions. If you have diabetes, your doctor may need to adjust your diabetes medication.

27. Rituximab for Addressing Epstein-Barr Reactivations

Epstein-Barr (EBV) is a virus that initially causes mononucleosis (also known as “mono” or “glandular fever” in the UK), a debilitating viral infection that is common among college students and is known as the “kissing disease” because individuals are thought to be exposed to the virus through the saliva of those who are infected.

The Epstein-Barr virus creates a latent infection in the body where it lies dormant until the right time, when it reactivates and awakens. The reactivated virus has the potential to induce the production of thyroid antibodies and has been implicated in many debilitating autoimmune symptoms.

A 2015 Polish study found the Epstein-Barr virus in the thyroid cells of 80 percent of people with Hashimoto’s and 62.5 percent of people with Graves’, while controls did not have EBV present in their thyroid cells.

Rituximab (brand name Rituxan), is a medication used for rheumatoid arthritis and certain cancers. It may have positive effect on Hashimoto’s as well. A few research reports have suggested that this medication may also induce a remission of Hashimoto’s and Graves’ disease (including Graves’ associated eye disease), as well as an improvement in chronic fatigue syndrome (CFS), which is often connected to EBV.

Please note that Rituximab is associated with very serious side effects that have resulted in death and disability, so again, it’s not my first choice! For more information on the Epstein-Barr Virus, please review this article.

Immune Suppression as a Strategy to Reduce Thyroid Antibodies

28. Corticosteroids for Immunosuppression

Prednisone and prednisolone are common corticosteroid drugs used for immunosuppression. Limited studies have been done relating to the use of steroids in extreme cases of Hashimoto’s encephalopathy, as well as one study relating to pregnant women going through In Vitro Fertilization (IVF). IVF is the process by which an egg and sperm are manually combined in a laboratory dish after extraction of the egg and retrieval of the sperm sample.

In the IVF study, the presence of thyroid antibodies was associated with decreased rates of pregnancy and live birth, and the use of low dose prednisolone helped those women with thyroid antibodies have greater success when going through IVF. Generally, immune suppression steroids can reduce thyroid antibodies, but in my view, only for short-term. When you withdraw the steroid, the thyroid antibodies can flare back up again.

Nonetheless, it could be useful in certain cases.

Target Removal as a Strategy to Reduce Thyroid Antibodies

29. Thyroidectomy  

Having your thyroid surgically removed eliminates thyroid antibodies… as there is nothing left to attack. However, removing the thyroid does not remove the autoimmune disease. I’ve seen countless times when people have had their thyroid glands removed due to thyroid disease (most commonly Graves’, nodules and thyroid cancer, though occasionally Hashimoto’s as well).

I generally do not recommend this strategy for Hashimoto’s. There are so many other ways to feel better with it. In some cases, people with co-occurring Hashimoto’s and thyroid cancer may wish to follow this approach. Nonetheless, I still recommend working on all the other interventions mentioned above to prevent the progression of autoimmunity. Read my article about thyroidectomy for Hashimoto’s for more information.

Emerging Solutions

30. Stem Cells – An Emerging Solution?

Stem cells have recently become a potential option for people with autoimmune disease. In stem cell treatments, one will receive an infusion of cells that can go to fix a damaged organ. In the case of Hashimoto’s, some have reported a reduction of thyroid antibodies and thyroid tissue regeneration. Please note, using stem cells may actually increase the risk of autoimmune disease, while using your own stem cells has been reported to help autoimmune disease.

In the future, I will write more about the possibilities relating to stem cell use.

Final Thoughts – You Can Reduce Your Antibodies!

I often receive messages from readers who say that they’ve tried everything and are hopeless. I want to let you know that there is a hope and that there are so many strategies that can help. I’ve highlighted just 30 of the 100+ strategies I’ve identified with my clients over the last few years.

As you can see, there are many interventions and corrective actions that you can currently take to reduce your thyroid antibodies and feel better. And there are other strategies that are still emerging. Some focus on root causes and others do not. I share strategies in my weekly newsletter, be sure to subscribe HERE.

My books and go into specific details on how to reduce your antibodies (and symptoms!)

If you have a genetic predisposition, close relatives with Hashimoto’s, and/or symptoms, consider starting by getting your thyroid antibodies tested. (Better yet, get the full thyroid panel.)

If you are just starting your Hashimoto’s journey, I suggest you begin at the top of this list, implementing some healthier dietary strategies and choices. Think in particular about food sensitivities. My 2015 survey consistently shows that dietary changes and the removal of food sensitivities can make people feel better, faster… and reduce their thyroid antibody levels.

Bump up your Vitamin D, remove fluoride, evaluate the non-thyroid related medications you take that may be affecting your thyroid, and look around to clean up your environment from endocrine disruptors.

Take one step at a time. The good news? Many of these steps will make you feel better very quickly!

Remember to check back with me on a regular basis to keep up-to-date on emerging research. Print off this info and discuss with your physician, too.

References

1. Sategna-Guidetti C, Volta U, Ciacci C et al. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. . 2001;96(3):751-757.     doi:10.1111/j.1572-0241.2001.03617.x.
2. Bell DS, Ovalle F. Use of soy protein supplement and resultant need for increased dose of levothyroxine. . 2001;7(3):193-4.
3. Fruzza AG, Demeterco-Berggren C, Jones KL. Unawareness of the effects of soy intake on the management of congenital hypothyroidism. . 2012;130(3):e699-702. doi: 10.1542/peds.2011-3350
4. Aghili R, Jafarzadeh F, Bhorbani R, Khamseh ME, Salami MA, Malek M. The association of Helicobacter pylori infection with Hashimoto’s thyroiditis. 2013;51(5):293-296.
5. Rajič B, Arapović J, Raguž K, Bošković M, Babić S, Maslać S. Eradication of Blastocystis hominis prevents the development of symptomatic Hashimoto’s thyroiditis: a case report. 2015;9(7):788-791.
6. Lauritano EC, Bilotta AL, Gabrielli M, et al. Association between hypothyroidism and small intestinal bacterial overgrowth. . 2007;92(11):4180-4.
7. Chatzipanagiotou S et al. Prevalence of Yersinia plasmid-encoded outer protein (Yop) class-specific antibodies in patients with Hashimoto’s thyroiditis. 2001;7(3):138–143.
8. Shenkman L, Bottone EJ. Antibodies to Yersinia enterocoliticain Thyroid Disease. 1976;85:735–739. doi: 10.7326/0003-4819-85-6-735
9. Sterzl, Ivan I. Removal of dental amalgam decreases anti-TPO and anti-Tg autoantibodies in patients with autoimmune thyroiditis. 27(25):0172-780X.
10. Joung, Ji Young JY. Effect of iodine restriction on thyroid function in subclinical hypothyroid patients in an iodine-replete area: a long period observation in a large-scale cohort. 2014;24(9):1050-7256.
11. Gärtner R, Gasnier BC, Dietrich JW, Krebs B, Angstwurm MW. Selenium supplementation in patients with autoim­mune thyroiditis decreases thyroid peroxidase antibodies concentrations. 2002;87(4):1687- 1691.
12. Mazokopakis, Elias E et al. Effects of 12 months treatment with L-selenomethionine on serum anti-TPO Levels in Patients with Hashimoto’s thyroiditis. 2007:609-612.
13. Rostami R, Aghasi MR, Mohammadi A, et al. Enhanced oxidative stress in Hashimoto’s thyroiditis: inter-relationships to biomarkers of thyroid function. . 2013;46(4-5):308-12. doi:10.1016/j.clinbiochem.2012.11.021.
14. Poncin S, Colin IM, Decallonne B, et al. -Acetylcysteine
    and 15 Deoxy-Δ12,14-Prostaglandin J2 Exert a Protective Effect Against Autoimmune Thyroid Destruction in Vivo but Not Against Interleukin-1α/Interferon γ-Induced Inhibitory Effects in Thyrocytes in Vitro. . 2010;177(1):219-228. doi:10.2353/ajpath.2010.091253.
15. Lee HS. The natural course of Hashimoto’s thyroiditis in children and adolescents. 2014;27(9-10):0334-018X.
16. Höfling DB. Low-level laser in the treatment of patients with hypothyroidism induced by chronic autoimmune thyroiditis: a randomized, placebo-controlled clinical trial. 2013;28(3):743-53.doi: 10.1007/s10103-012-1129-9.
17. Nordio M, Basciani S. Myo-inositol plus selenium supplementation restores euthyroid state in Hashimoto’s patients with subclinical hypothyroidism. . 2017;21(2 Suppl):51-59.
18. Pegel K. MODUCARE® – A Brief History And Mode Of Action. Published in 2002. http://www.moducare.com/wp-content/uploads/2016/05/moducare-summary-of-research.pdf. Accessed February 1, 2018.
19. Kvantchakhadze RG. Wobenzym® in the complex treatment of autoimmune thyroiditis. 2002;4(1):114.
20. Ott J et al. Dehydroepiandrosterone in women with premature ovarian failure and Hashimoto’s thyroiditis. 2014.
21. Schmeltz, Lowell R. Anatabine supplemen­tation decreases thyroglobulin antibodies in patients with chronic lymphocytic autoimmune (Hashimoto’s) thyroid­itis: A randomized controlled clinical trial. 2013:0021-972X.
22. Wang J, Lv S, Chen G, et al. Meta-analysis of the association between vitamin D and autoimmune thyroid disease. . 2015;7(4):2485-2498.
23. Mackawy AMH, Mohammed AB, Mater AB. Vitamin D Deficiency and Its Association with Thyroid Disease. . 2013;7(3):267-275.
24. Chaudhary S, Dutta D, Kumar M, et al. Vitamin D supplementation reduces thyroid peroxidase antibody levels in patients with autoimmune thyroid disease: An open-labeled randomized controlled trial. . 2016;20(3):391-398. doi:10.4103/2230-8210.179997.
25. Antonelli A, Alberti B, Melosi A. Changes in markers of autoimmunity in patients with Hashimoto thyroiditis treated with intravenous immunoglobulins. Preliminary results. . 1992;141(9 Pt 2):37-42.
26. Cornejo R, Venegas P, Goñi D, Salas A, Romero C. Successful response to intravenous immunoglobulin as rescue therapy in a patient with Hashimoto’s encephalopa­thy.< 2010;2010:bcr0920103332. doi:10.1136/bcr.09.2010.3332.
27. Drulović J et al. Hashimoto’s encephalopathy: a long-lasting remission induced by intravenous immuno­globulins. 2011;68(5):452-4.
28. Nupur G, Arpeta G, Maria S, Robert TY. CALMING THE STORM – ROLE OF PLASMAPHERESIS IN THYROTOXIC CRISES. Presented as part of The Endocrine Society’s 95th Annual Meeting and Expo; June 15–18, 2013; San Francisco, CA.
29. Boers P, Colebatch J. Hashimoto’s encephalopa­thy responding to plasmapheresis. 2001;70(1):132. doi:10.1136/ jnnp.70.1.132.
30. El-saadany H, Elkhalik MA, Moustafa T, et al. Thyroid dysfunction in systemic lupus erythematosus and rheumatoid arthritis: Its impact as a cardiovascular risk factor. . 2014;36(2):71-78.https://doi.org/10.1016/j.ejr.2013.12.003
31. Nevinsky, G. Effect of different drugs on the level of DNA-hydrolyzing polyclonal IgG antibodies in sera of patients with Hashimoto’s thyroiditis and nontoxic nodal goiter. 2001;7(2):201.
32. Janegova A, Janega P, Rychly B, Kuracinova K, Babal P. Rola infekcji wirusem Epstein-Barr’a w rozwoju autoimmunologicznych chorób tarczycy. . 2015;66(2):132-136. doi:10.5603/ep.2015.0020.
33. Kurozumi A, Okada Y, Arao T et al. Induction of thyroid remission using rituximab in a patient with type 3 autoimmune polyglandular syndrome including Graves’ disease and type 1 diabetes mellitus: A case report. . 2015;62(1):69-75. doi:10.1507/endocrj.ej14-0152.
34. Gul Mert G. Hashimoto’s encephalopathy: four cases and review of literature. 2014;124(4):302-6. doi:10.3109/00207454.2013.836706.
35. Litwicka K et al. In women with thyroid autoimmunity, does low-dose prednisolone administration, compared with no adjuvant therapy, improve in vitro fertilization clinical results? . 2014.
36. J Surg Res. 2015;198(2):366-370. doi:10.1016/j. jss.2015.03.094.
37. Anita A. Kurmann et al. Regeneration of Thyroid Function by Transplantation of Differentiated Pluripotent Stem Cells. . 2015. DOI: 10.1016/j.stem.2015.09.004.

— Update: 12-02-2023 — cohaitungchi.com found an additional article How to Recognize & Lower Thyroid Antibodies: 5 Simple Approaches  from the website dremina.com for the keyword how to lower antibiodies in hashimotos hypothyroidism.

If you have Hashimoto’s hypothyroidism (HH – also called Hashimoto’s thyroiditis), you may be wondering how to lower your thyroid antibodies and manage the symptoms of thyroid dysfunction in your body.

The thyroid antibodies include both anti-thyroperoxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb). 

Many doctors seem to dismiss the presence and importance of thyroid antibodies by saying that it doesn’t affect treatment, however, there is fact-based evidence that this is definitely not true. 

Not only does having thyroid antibodies present in your blood indicate you have inflammation and autoimmune disease present, it also changes the management and the treatment plan for the person affected. 

First – let’s look at what autoimmune Hashimoto’s hypothyroid is and how it differs from basic hypothyroidism.

Second – I’ll briefly highlight five therapies that I’ve used successfully in patients to help them LOWER their TPO antibodies, LOWER inflammation and REDUCE autoimmune disease. 

What is Autoimmune disease?

Our immune system is designed to defend the body against foreign invaders by producing antibodies that direct blood cells to destroy unwanted pathogens.

Sometimes the immune system malfunctions and attacks the body’s own cells and tissues and this is known as autoimmune disease.

Why this happens is still not clearly understood, but certainly environmental toxins, genetics and endogenous factors have been identified. Autoimmune disorders often affect blood cells and vessels, muscle and joint tissue and endocrine glands.

The thyroid gland happens to be the most commonly affected organ and is vulnerable to autoimmune disease due to its complexity.

Thyroid hormones regulate metabolism, including utilization of carbohydrates, proteins, and fats – which in turn direct cellular activity and stimulates organs including the heart and brain.  In fact, the thyroid gland is your premiere metabolic hormone.

Grave’s disease and Hashimoto’s disease are both autoimmune diseases of the thyroid.

Hyperthyroidism is usually characteristic of Grave’s disease, while Hashimoto’s disease most often features hypothyroidism. In essence, the thyroid is not slow or sluggish at putting out hormones, instead our immune system has identified thyroid cells as foreign and harmful and starts to attack them. 

What is especially unique to autoimmune thyroid disease verses non-autoimmune thyroid disease is that patients can fluctuate between hypothyroid and hyperthyroid symptoms and even experience symptoms of both conditions simultaneously.

So a person can initially experience irritability, anxiety, restlessness – a hyperthyroid state or a “thyroid storm” – before crashing into a hypothyroid state. What is worse, this can happen repeatedly!

Hashimoto’s hypothyroidism (HH) is the leading cause of hypothyroidism in North America.¹ It is one of the most common organ-specific autoimmune disorders of the thyroid, among Graves’ disease, trophic thyroiditis, and postpartum hypothyroidism. 

Hashimoto’s hypothyroid symptoms are variable for a few reasons:

First

There is great variability in the level of thyroid gland destruction and disease manifestations. One study found that approximately 90% of the thyroid must be destroyed in order for the disease to display any symptoms of hypothyroidism at all.

Another study found that elevation of autoimmune antibodies may precede diagnosis of any clinical symptoms of autoimmune disease by 2 to 7 years. 

Second

In addition to thyroid gland destruction, the difference in circulating antibodies present is also a factor in HH symptomatology.

There is a correlation between an increase in blood antibody levels and development from a normal thyroid state to a hypothyroid state.

Read more  Evaluation of Xerostomia and salivary flow rate in Hashimoto’s Thyroiditis

However, the rate at which those who progress to displaying obvious symptoms of hypothyroidism is not dependent on specific levels of antibodies present. 

As a result, this makes diagnoses more difficult and as treating physicians we need to place greater emphasis on the clinical symptoms a person presents with, regardless of lab results. 

Third

The third reason why clinical symptoms in HH vary is that those diagnosed with HH have a higher incidence of comorbid autoimmune diseases. These include celiac disease, rheumatoid arthritis, vitiligo, diabetes mellitus, Addison’s disease, and pernicious anemia.

In fact, evidence supports that celiac disease is five times more common in those with HH vs. the overall population and 57% of those diagnosed with pernicious anemia have thyroid antibodies.

A further study in 2007 assessed 104 patients with HH and 184 patients with celiac and concluded that the association was bi-directional.

Symptoms of clinical Hashimoto’s hypothyroidism include:

• Goiter (enlarged thyroid gland)
• Feeling of tightness in the neck (pain is rarely observed)
• Fatigue
• Liver function tests tend to be abnormal in 50% of patients with HH. (In such cases, hypercholesterolemia, poor gallbladder tonicity, and reduced bilirubin excretion may be contributing factors)
• Reduced intestinal peristalsis and disturbances of the transepithelial ion flux can lead to constipation. Bacterial overgrowth from hypomotility can also result in diarrhea
• Dysphagia (difficulty swallowing) & decreased appetite resulting from delayed gastrointestinal motility
• Dry skin 
• Cold intolerance & cold extremities
• Yellow skin
• Coarseness or loss of hair
• Hoarseness of the voice
• Ataxia (loss of balance)
• Memory & mental impairment
• Reduced concentration
• Depression
• Irregular or heavy menses & infertility
• Myalgias (muscle aches & pain)
• Hyperlipidemia: Elevated cholesterol results in decreased clearance of triglycerides and elevated LDL
• Bradycardia (slow heart rate)
• Swelling & Edema – Myxedema fluid infiltration of tissues
• Possible short-term hyperthyroidism symptoms 

Naturopathic Medical Treatment &
Management of Hashimoto’s Hypothyroidism

Diet, lifestyle, supplements and herbs are the cornerstone of treating any autoimmune condition. Additional bio-identical hormone repletion and low dose medications may also be needed.

ONE – Choose the right diet for your body – consider this as the necessary first step

Considering that HH has been linked to malabsorption and celiac disease, any thyroid patient with antibody levels should always eliminate gluten from their diet, no matter what dietary program you follow. While diet alone is usually not enough to lower antibodies completely, it will always help.

I must repeat, this is not a gentle  “avoid gluten” recommendation, this is an absolute must!

Avoiding major food allergens and food  sensitivities are helpful in decreasing allostatic load and lowering the inflammatory response in the body.

A 28-Day Elimination Diet – guided by your naturopathic physician can be helpful. This is a more comprehensive elimination diet of the major food allergens that include gluten, eggs, dairy, soy, sugar, caffeine, and all processed foods. 

In addition, food allergy and sensitivity testing will help to identify inflammatory foods your body reacts to directly. By reducing these foods in your diet, you reduce the immune complexes floating around in your blood stream and thus inflammation goes down.

Finally, many patients have found the Autoimmune Paleo Diet to be helpful in reducing TPOAb.  The AIP diet has gained a lot of popularity across multiple web and social media platforms because it can be so effective, but it certainly is not recommended for EVERY patient. It is a very restrictive diet (basically paleo without nuts or nightshades) and can be difficult to follow and maintain. 

TWO – Treating with Nutrients and Botanicals

Nutrient deficiencies have been associated with general thyroid dysfunction and include selenium, iodine, iron, zinc, vitamin A, vitamin D and vitamin B12 among others. 

Clinical evidence supports the most notable herbs to be helpful in autoimmune hypothyroid include Rosemarinic Acid, Commiphora mukul and Iris versicolour. While there are many, we will discuss just a few below.

Vitamin D 

Vitamin D3 deficiency is common in general, given where we live. While Kelowna is touted for its summer sunshine – living above the 49^th parallel (our Canadian border) – puts us all at an increased risk of vitamin D deficiency.

Low Vitamin D levels are found consistently in Hashimoto’s disease and in other autoimmune conditions.  Vitamin D3 supplementation is suggested for both autoimmune hypothyroid and hyperthyroid disease, due to the immunomodulatory effects of vitamin D3 and the association of vitamin D3 deficiency with many autoimmune diseases. 

While testing your Vitamin D levels in British Columbia is not free (it can range from $85 to $105 with an MD or an ND), dosage is often recommended based on your serum levels tested.

Zinc & Selenium  

Have you looked at your fingernails lately? Take a peak. If you see any white spots, or more than just one – you likely have a mineral deficiency. Zinc is the most common mineral deficiency and critical for thyroid and immune function. 

• Zinc acts as a powerful antioxidant
• Zinc boosts the immune system as a critical co-factor
• Zinc acts as an anti-inflammatory agent
• Zinc helps boost T4 to T3 conversion, and 
• Zinc can help reduce oxidative stress

Selenium helps to boost the immune function and lower TPO antibody levels as well as increase T4 to T3 conversion.

This particular pathway to get from T4 hormone in the thyroid gland converted to T3 hormone in the liver is a metabolically demanding process and thus often low in many patients. 

Two to three brazil nuts a day can easily meet your recommended daily dose of selenium – but the challenge is find these nuts organic and free of mold. 

Rosemarinic Acid is derived from the lamiaceae family of plants that include rosemary, sage, basil and others. Rosemarinic Acid is well-known to reduce TPO levels. Is does so by inhibiting T cell activation and proliferation.

Above and beyond, Rosemarinic acid is also known to induces T cell apoptosis (cell death) of only actively-proliferating T cells. Overall, this plant extract drives T cell activity and reduces inflammation in the thyroid by modulating T cell promotion of proinflammatory cytokine release. 

Rather than takes all these different herbs and nutrients separately, we offer formulated thyroid support that combines the above (and more) to target thyroid antibodies while supporting healthy thyroid function.

THREE – Consider using Bio-Identical Hormone Replacement: DHEA & Progesterone

Before considering the above hormones, we always recommend dried urine hormone  testing to assess your functional and ideal levels to see if supplementation is appropriate for you. 

DHEA can be very helpful in reducing antibody levels. The majority of patients who have Hashimoto’s are women. This is actually true of almost all autoimmune disease (with few exceptions). 

Part of the reason this is thought to occur has to do with lower levels of testosterone and DHEA – our male “androgen” hormones. The less testosterone you have, the more likely you are to develop autoimmunity and Hashimoto’s hypothyroidism.

In my experience of testing many patients with Hashimoto’s, I can attest that the vast majority also have low testosterone levels in addition to low DHEA levels. Adding these androgens to your treatment regimen (or adding in herbs to help build them) can help in the following ways:

• Balance TH1 and TH2 immune response
• Lower autoimmunity in the body (in some cases, suppresses it).
• Boost weight loss & Increases sex drive

Progesterone is always helpful for multiple reasons. Alone, progesterone offers anti-inflammatory benefits, promotes deeper sleep, calms the nervous system, supports thyroid and adrenal function in general. Progesterone hormone is often over-looked and under-tested in conventional medicine 

NOTE: Hormone testing is a good idea, to help guide in dosing. While simple serum hormones can be ordered (free and total Testosterone, DHEA-s and Progesterone), urine hormone testing offers more advantages:

• Collecting over a full day helps to capture a true average value. A blood test may capture your highest or lowest level of the day, as our hormones pulse every few hours.
• Pathways and metabolites are provided so you can see where your hormones flow to and what pathways may be stuck or hindered – this can reveal – what nutrients and enzyme need to be repleted to move through smoothly and resolve symptoms
• Additional B vitamin status, adrenal function, melatonin and methylation markers are often included and provide a “whole picture” approach to your hormone health and underlying thyroid concerns 

FOUR – Improve your Gut Function

When you have hypothyroidism, digestive issues are almost always part of the picture. In addition to the necessary dietary recommendations above, the gastrointestinal issues I’m specifically referring to are two very common and under diagnosed conditions in hypothyroidism:

1. SIBO or Small Intestinal Bacterial Overgrowth
2. Yeast Overgrowth

As many as 54% of people may have this condition and likely don’t even know it! Symptoms include:

• Gas or Bloating – especially 30-60 minutes after a meal
• Chronic constipation
• History of vaginal yeast infections or Intestinal yeast overgrowth
• History of acid reflux
• History of diabetes or concurrent peripheral neuropathy (numbness or tingling)
• History of vagal nerve dysfunction

It is possible to repair your gut health naturally, with naturopathic treatment. Digestive restoration is possible and you can restore balance in the body. SIBO can be diagnosed in our clinic with a simple breath test which tests for certain gasses from unhealthy gut bacteria.

Likewise, yeast overgrowth can be diagnosed with a simple in-clinic test.

We take a 5 step approach to treating gut health for patients suffering from both yeast overgrowth and SIBO. This treatment process consists of what we call the 5 R’s:

1. Remove certain foods and stressors to your GI tract
2. Replace harmful yeast and bacteria with digestive enzymes you are deficient in
3. Re-inoculate and help good bacteria thrive with probiotics and other vitamins and supplements
4. Repair the digestive tract after the damage with additional vitamins and minerals
5. Rebalance the body and calm your nervous system by following a routine to promote healing

Once your gut health has been restored, your GI tract will be much better able to process foods. This side effect of hypothyroidism can be repaired with consistent treatment and dietary changes.

FIVE – LDN Therapy  – Helps improve status of the immune system overall

Low Dose Naltrexone (LDN) therapy helps to improve HH by addressing the integrity of the immune system. Based on the effectiveness of LDN in other autoimmune disorders, LDN can reduce the production of thyroid antibodies of Hashimoto’s hypothyroidism.

As LDN is able to modulate the immune system by acting on endorphin receptors, it can subdue the immune reaction and slow down the destruction of thyroid cells. I have also seen when patients take LDN who are also on thyroid replacement medication that they can often lower their hormone dosage as the immune-normalizing effects by LDN slow down the autoimmune process.  

Unlike standard treatment, some patients may not have to take this medicine for a lifetime. Young patients with Hashimoto’s can go into remission through modulating your immune system with LDN. The medication will help them move towards an appropriate immune status, and once the immune system is in balance again, you may be able to discontinue the LDN.  

It is important to note that LDN is considered very safe.  But there are short term side effects which include nausea, sleep disturbances, vivid dreams, and irritability. These side effects normally go away over time (a few days to a few weeks) or can be eliminated by reducing the dosage or tapering the dosage slowly.   

Summary

Supporting the immune system with dietary modifications, nutrients, herbs and low dose BHRT or LDN medication can all help to reduce inflammation in Hashimoto’s Hypothyroidism.

A trend of continued elevation of TPOAb and TGAb over time is concerning (especially in the face of treatment). If you fall into this category (slightly raised Ab or they are outside of the reference range) AND you also have symptoms of hypothyroidism then it’s definitely worth considering naturopathic medicine and the treatments mentioned above, as these are outside the scope and understanding of the standard medical model. 

Each of these approaches has varied mechanisms of action supporting thyroid hormone homeostasis. As mentioned, removing gluten from ones diet reduces the overall immune  dysfunction and inflammatory load of antibody levels; Vitamin D3 and rosemarinic acid play a role in T cell modulation and cytokine response; and so forth. 

Incorporating daily techniques for reducing stress is critical as stress drives inflammation, and depletes healthy hormone levels. Improving digestion, absorption and optimizing your GI health, while ensuring proper nutrition is also important as these elements are all known to interfere with optimal thyroid function.

Lastly, I should mention the important for patients with autoimmune thyroid disease to incorporate aerobic exercise into their lifestyle.

Aerobic exercise induces 5′-deiodinase, the enzyme that stimulates peripheral production of active T3 from T4. While someone may feel too tired or unwell to incorporate exercise, starting slowly and in short durations, can still provide meaningful benefit.

When treated appropriately, restoration of normal thyroid function in early stages of autoimmune hypothyroid disease can be achieved. 

References:

1. Baskin HJ, Cobin RH, Duick DS, et al, for the American Association of Clinical Endocrinologists. AACE Medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002;8(6):457-469.

2. Desailloud R, Hober D. Viruses and thyroiditis: an update. Viro J. 2009;6:5.

3. Xie LD, Gao Y, Li MR, Lu GZ, Guo XH. Distribution of immunoglobulin G subclasses of anti-thyroid peroxidase antibody in sera from patients with Hashimoto’s thyroiditis with different thyroid functional status. Clin Exp Immunol. 2008;154(2):172-176.

3b.  Hutfless S., Matos P  Talor MV, et al. Significance of prediagnostic thyroid antibodies in women with autoimmune thyroid disease. J Clin Endocrinol Metab. 2011;96:E1466-E1471.

4. Orgentec Diagnostika GmbH. Immunometric Enzyme Immunoassay for the quantitative determination of antibodies against thyroglobulin (TG). http://www.orgentec.com/user_images/73/307576124_502e.pdf. Updated August 2005. Accessed February 11, 2010.

5. Calgar E, Ugurlu S, Ozenoglu A, Can G, Kadioglu P, Dobrucali A. Autoantibody frequency in celiac disease. Clinics (Sao Paolo). 2009;64(12):1195-1200.

6. Hadithi M, de Boer H, Meijer JW, et al. Coeliac disease in Dutch patients with Hashimoto’s thyroiditis and vice versa. World J Gastroenterol. 2007;13(11):1715-1722.

7. Duntas LH. Does celiac disease trigger autoimmune thyroiditis? Nat Rev Endocrinol.  2009;5(4):190-191.

8. Kon YC, DeGroot LJ. Painful Hashimoto’s thyroiditis as an indication for thyroidectomy: clinical characteristics and outcome in seven patients. J Clin Endocrinol Metab. 2003;88(6):2667-2672.

9. Greenfield JR, Samaras K. Evaluation of pituitary function in the fatigued patient: a review of 59 cases. Eur J Endocrinol. 2006;154(1):147-157.

10. Daher R, Yazbeck T, Jaoude JB, Abboud B. Consequences of dysthyroidism on the digestive tract and viscera. World J Gastroenterol. 2009;15(23):2834-2838.

11. Delange F. The disorders induced by iodine deficiency. Thyroid. 1994;4:107-128.

12. Pizzulli A, Ranjbar A. Selenium deficiency and hypothyroidism: a new etiology in the differential diagnosis of hypothyroidism in children. Biol Trace Elem Res. 2000;77:199-208.

13. Watts DL. The nutritional relationships of the thyroid. Journal of Orthomolecular Medicine. 1989;4:165-169.

14. Safran M, Paul TL, Roti E, Braverman LE. Environmental factors affecting autoimmune thyroid disease. Endocrinol Metab Clin North Am. 1987;16:327-342.

15. Stangl GI, Schwarz FJ, Kirchgessner M. Cobalt deficiency effects on trace elements, hormones and enzymes involved in energy metabolism of cattle. Int J Vitam Nutr Res. 1999;69:120-126.

16. Tamer G, Arik S, Tamer I, Coksert D. Relative vitamin D insufficiency in Hashimoto’s thyroiditis. Thyroid. 2011;21(8):891-896.

17. Watson RR, ed. Handbook of Vitamin D in Human Health: Prevention, Treatment and Toxicity. Wageningen Academic Publishers; 2013.

18. J Clin Endocrinol Metab. 2002 Apr;87(4):1687-91.