Published October 10 2016
Many people with hypothyroidism and Hashimoto’s Thyroiditis take supplements and herbs for their condition. And while there are many different supplements and herbs that can benefit people with these conditions, I figured I’d put together a post where I discuss five of the more important ones. Keep in mind that this doesn’t mean that everyone with hypothyroidism or Hashimoto’s needs to take all of these supplements I’ve listed below, as it does depend on the person. And of course there might be other supplements I didn’t list that some people need to take.
Let’s go ahead and discuss the benefits of these supplements and herbs.
1. Selenium. The reason I listed selenium first is not just because this mineral has a lot of different health benefits. The main reason is because there are many studies which demonstrate the benefits of selenium specific to Hashimoto’s Thyroiditis. One reason for this is because the thyroid gland has the highest selenium content per gram of tissue because it expresses specific selenoproteins (1). These selenoproteins can help to reduce oxidative stress. As a result, numerous studies show that selenium can help to decrease the levels of thyroid peroxidase (TPO) antibodies, and can also improve the ultrasound structure of the thyroid gland (1) (2).
In addition to helping to decrease thyroid antibodies and improve the structure of the thyroid gland, selenium also plays an important role in the conversion of T4 into T3 (3) (4). As a result, if someone has normal levels of T4 but low levels of T3, then one of the factors which can cause this is low selenium levels. Selenium is also an important cofactor in glutathione production. Glutathione is a potent antioxidant that plays an important role in the detoxification pathways.
Dosage: As for how much selenium one should take, many healthcare professionals will recommend 200mcg/day to their patients. Some people can benefit from higher doses, although too high of a dosage can result in a selenium toxicity.
2. Vitamin D. Although most medical doctors who recommend for their patients to take vitamin D do so in order to improve bone health, vitamin D has many other important functions. So yes, while vitamin D can help to improve bone density by increasing the intestinal absorption of calcium, it also plays a role in modulating the immune system and reducing inflammation, which of course is important with anyone who has an autoimmune condition such as Hashimoto’s Thyroiditis. Vitamin D also has neuroprotective effects, and might also have antihypertensive effects. And there is also evidence that vitamin D plays an important role in gut homeostasis and might also help to preserve the integrity of the junction complexes of the intestinal mucosal barrier. I present the research behind these studies in a blog post I wrote entitled “Everything You Need To Know About Vitamin D…and More“.
Dosage: Although most people can take 2,000 to 5,000 IU/day of vitamin D3 without being concerned about vitamin D toxicity, it really is best to get tested. I would recommend testing for 25-OH vitamin D, and if someone has a vitamin D deficiency then taking at least 5,000 IU/day probably is warranted, although there are times when I will give a higher dosage than this for a shorter period of time.
3. Vitamin A. Many people are deficient in vitamin A, and this can cause numerous problems. First of all, the binding of T3 to the receptor is retinoic acid-dependent (5), and so having sufficient vitamin A is very important for improving cellular sensitivity to thyroid hormone. Vitamin A is also important for optimal immune system health, and there is also evidence that vitamin A (along with zinc) can help to heal a leaky gut (6). Although some medical doctors recommend beta carotene to their patients, I usually recommend an active form of vitamin A. And the reason for this is because not everyone can convert beta carotene into active vitamin A, and this is especially true with those people who have a hypothyroid condition.
Dosage: Higher doses of active vitamin A can lead to a toxicity, and so you need to be very cautious. I commonly recommend 5,000 IU/day of active vitamin A to my patients, although it does depend on the person. And even when I do recommend vitamin A, I won’t have them take this high of a dose for a prolonged period of time. Keep in mind that many natural healthcare professionals recommend even higher doses of vitamin A, as some will recommend 10,000 to 25,000 IU/day, although it usually is for a very short period of time, such as a few days or a few weeks. I’m cautious about giving cycling women higher doses of vitamin A due to the potential harm it can cause to the fetus if the woman were to become pregnant.
4. Zinc. This mineral also has many different functions. Like vitamin A, zinc also helps to improve cellular sensitivity to thyroid hormone (7). And I also mentioned how vitamin A and zinc can help to heal a leaky gut.
Dosage: When I recommend zinc to a patient I usually recommend between 15 and 30 mg per day, although some people might need to take higher doses. Taking very high doses (i.e. 50mg/day or greater) for a prolonged period of time can cause a copper deficiency.
5. Turmeric. Hashimoto’s Thyroiditis is an autoimmune condition, which is characterized by proinflammatory cytokines. And turmeric can help to reduce these proinflammatory cytokines (8) (9). There is also evidence that turmeric can increase regulatory T cells (10), which help to suppress autoimmunity. I spoke in greater detail about all of the benefits of turmeric in an article I wrote entitled “Turmeric and Thyroid Health”. There is also evidence that turmeric can reduce goitrogenesis (the formation of a goiter), although other factors such as an iodine deficiency and thiocyanate exposure need to be considered (11).
Dosage: Most people will receive therapeutic benefits from taking 500 to 1,000 mg/day of turmeric. On the other hand, some people do better taking higher doses (i.e. 2,000 to 4,000 mg/day). You also want to make sure the turmeric supplement has something to help with the absorption, such as piperine or a phospholipid complex.
Three Other Supplements Worth Mentioning:
1. Betaine HCL. People with hypothyroidism typically have reduced gastric acid production. This not only will make it difficult to digest proteins, but it also can increase the person’s risk of developing certain infections, such as candida and small intestinal bacterial overgrowth. As a result, many people with hypothyroidism can benefit from taking betaine HCL.
2. Ashwagandha (and other adaptogenic herbs). May people with hypothyroidism and Hashimoto’s Thyroiditis deal with chronic stress. In fact, most of my patients deal with chronic stress, and the reason I know this is because most will put this down on their case history forms prior to consulting with me. I ask everyone to rate both their stress levels and stress handling skills, and many people have high stress levels and low stress handling skills. While the most important thing for these people to do is to improve their stress handling skills, taking adaptogenic herbs can also be beneficial. The reason I specifically listed ashwagandha is because it seems to support the hypothalamic-pituitary-thyroid (HPT) axis more than other adaptogenic herbs. However, if looking for HPA axis support, then in addition to ashwagandha, other adaptogenic herbs can be beneficial such as rhodiola and eleuthero. Getting back to ashwagandha, I need to mention that this herb is part of the nightshade family, and ideally should be avoided in those who are looking to follow a strict autoimmune paleo diet, although I have had patients with Hashimoto’s take ashwagandha without a problem.
3. Thyroid Glandulars. Although most of my patients with hypothyroidism and Hashimoto’s don’t take thyroid glandulars, for some people who need thyroid hormone medication, but don’t want to take synthetic thyroid hormone, and are unable to get a prescription for natural thyroid hormone medication (i.e. Armour, Nature-Throid), taking a thyroid glandular can be a good option. There are different types of thyroid glandulars, and most of these will have nutrients to support the thyroid gland. This can include selenium, tyrosine, zinc, iodine, and sometimes herbs such as ashwagandha. Some thyroid glandular supplements will include small amounts of thyroid hormone, while others will just have glandular tissue without any thyroid hormone.
In summary, there are many different nutritional supplements and herbs that can benefit people with hypothyroidism and Hashimoto’s. In my practice I have found selenium, vitamin D, vitamin A, zinc, and turmeric to be some of the most effective ones. Three other supplements worth considering are betaine HCL, ashwagandha, and thyroid glandulars. This doesn’t mean that everyone with hypothyroidism and Hashimoto’s needs to take all of these, and of course there are other supplements I didn’t list which can benefit some people with these conditions.