9 Thyroid Supplements Every Hypothyroid Patient Should Consider
104

9 Thyroid Supplements Every Hypothyroid Patient Should Consider

Would it surprise you to know that it takes at least 13 different nutrients to properly create and convert thyroid hormone to its active form?

Or that by replacing these nutrient deficiencies with thyroid supplements you may be able to REDUCE your symptoms of hypothyroidism?

You're not alone...

If you are considering taking supplements to boost your thyroid function to help you feel better there are some things you need to know FIRST.

​Not all supplements are created equal and everyone out there claims to have the "best product". 

Which is why I created this guide...

​I've been treating hypothyroid patients for years and I've found certain supplements help thyroid patients feel better and I want to share these with you. 

In this article I'm going to go over the top 9 Thyroid Supplements that you should consider using if you have hypothyroidism to help you feel better and get your life back: ​

More...

Do Supplements actually Help Thyroid Function?

​Let's get this out of the way:

YES, supplements can definitely help boost your thyroid function, but not how you think...

Many run-of-the-mill Thyroid Supplements contain all of the nutrients that MIGHT help thyroid function, but that's the wrong approach.

A better one is to find what your body is deficient in and then give back what it needs.

And it just makes sense, right?

If your body lacks Zinc, for instance, then your immune system will function less optimally (1) until you restore those nutrients back to normal levels. 

​And, this isn't made up guys - there are many studies showing how common even basic nutrient deficiencies are and what kind of symptoms to expect with those deficiencies. 

But unfortunately you have articles like these floating around: ​

why you need thyroid supplements

​These types of articles would have you believe that taking supplements isn't helpful and in fact might be harmful. 

And I would agree with that if you take the wrong approach - but if you target supplements to the needs of your body adding supplements to your routine can greatly impact your thyroid function. ​

9 Thyroid Supplements to Help Reduce Improve your Thyroid

Remember when I said it takes at least 13 different nutrients for proper thyroid hormone production and conversion?

I wasn't kidding:​

Nutrients required for thyroid function

The following nutrients are required for proper thyroid hormone production:

  • Iron -> Also improves thyroid function at the cellular level
  • Iodine -> Required for thyroid hormone biosynthesis
  • Tyrosine -> May improve thyroid hormone production
  • Zinc -> Zinc + Selenium boost thyroid conversion in the peripheral tissues
  • Selenium
  • Vitamin E (2)
  • Vitamin B2 (3)
  • Vitamin B3 (4)
  • Vitamin B6
  • Vitamin C
  • Vitamin D

The following nutrients are required for thyroid conversion & thyroid cellular action:

  • Zinc
  • Selenium
  • Vitamin E

A deficiency in ANY of these may cause limited thyroid function leading to quality of life and hypothyroid-like symptoms. 

Does that mean you should just blindly take these nutrients? 

The answer to that is obviously no, and taking that approach may lead to problems...

Instead, use this guide below to help identify if you are low on certain nutrients and find out how to replace them. 

I've picked these 9 Supplements and nutrients because they either directly change thyroid function or because a deficiency in their symptoms may mimic hypothyroidism symptoms. 

#1. Vitamin B12


B12 is #1 for good reason:

Based on studies as many as 40% of patients with hypothyroidism are ALSO vitamin B12 deficient (5).

Vitamin b12 deficiency is common in hypothyroid patients

And that's very concerning when you consider the symptoms of B12 deficiency:

  • Fatigue
  • Shortness of Breath
  • Anemia
  • Neurological changes which can mimic dementia (6)
  • Difficulty with concentration or brain fog

​Do you see the problem here?

Many of these symptoms are also symptoms of hypothyroidism so you may be walking around with both issues contributing to your mental status. 

How to tell if you need it:

How to Supplement with Vitamin B12 & Activated B Complex Vitamins
Why I like it

May Boost Energy levels and reduce fatigue.

May help increase metabolism and fat loss.

Helps improve mood and may increase concentration.

Generally works very quickly (within 1-2 weeks).

How to tell if you Need it

Patients with the following symptoms should consider using B12 + B complex vitamins: 

  • Obesity or weight gain 
  • Fatigue or low energy levels
  • Lack of sleep or insomnia (including difficulty falling asleep)
  • Depression or other mood issues like anxiety
  • Hair loss or a lack of hair growth
  • Low serum B12 levels (less than 1,000)
  • High homocysteine levels (greater than 9.0)
  • MCV (mean corpuscular volume) that is higher than 92
  • High levels of inflammation
Low serum B12 levels
How to Use

  • Take 2 capsules per day of pre-methylated and pre-activated B complex vitamins including Methylcobalamin and MTHF (as quatrefolic). Pre-methylated B vitamins are easier for your body to utilize and are safe to use with MTHFR genetic defects. 
My Recommended Brand and Product:

#2. Adrenal Support


Your adrenal function is intricately linked to your thyroid function. 

As your TSH increases (hypothyroidism) your cortisol levels will rise as well (7) leading to adrenal fatigue. 

Aside from that, I've never met a hypothyroid patient who also didn't have adrenal problems!

Symptoms of Adrenal Fatigue (or adrenal-related issues) in Hypothyroid patients include:

  • Constant fatigue despite sleeping 8 hours at night
  • Feeling "wired but tired"
  • Experiencing a crash around 2-3pm each day
  • Getting your "second wind" at night around 10pm
  • Difficulty falling asleep
  • Racing mind and thoughts
  • Inability to tolerate stressful events
  • Cravings for salty/sugary foods
  • Always getting sick or having a weakened immune system

Adrenal fatigue and its treatment deserve an entire blog post but for now, I will distill it down to this:

There are two ways to approach fixing adrenal problems with supplements. You can use adrenal glandulars (#1) or adrenal adaptogens (#2).

These supplements should always be combined with lifestyle changes including stress management, diet, and exercise

You can identify the presence of adrenal-related issues by assessing for serum cortisol (alternatively, you can also check salivary cortisol but I typically don't recommend this route for these reasons). 

Your cortisol level can help guide you and help you determine what type of treatment you need for your adrenals. 

For instance:

Low cortisol can be addressed with adrenal glandulars and adrenal adaptogens, while high cortisol can be addressed with phosphatidylserine (8) and adrenal adaptogens. 

Note: It isn't always necessary to check for your cortisol prior to using adrenal supplements as sometimes your cortisol level may not "match" your symptoms.  

Adrenal adaptogens are plant-based compounds which help you increase your stress tolerance by "nourishing" the adrenals. 

They are often combined with vitamins and nutrients which form the building blocks for hormones such as cortisol and adrenaline. 

Of the adaptogens, Rhodiola Rosea may be the most stimulating for the body which peaks around 30 minutes after ingestion (9). 

Adaptogens can also be combined with adrenal glandulars

Adrenal glandulars, or desiccated adrenal gland, contain portions of animal adrenal glands which contain hormone precursors and vitamins specific to the adrenal gland. 

Treating your adrenals has a compounding effect in which it can potentially improve both your thyroid function and your adrenal function. 

How to Supplement with Adrenal Support
Why I like it

Many hypothyroid patients suffer from both thyroid and adrenal problems. 

Ideal to help promote increased energy and well being. 

May help improve stress response system in your body. 

Most patients experience improvement in 1-2 months. 

How to tell if you Need it

The presence of the symptoms listed above may be sufficient to consider treatment. You can also order both serum cortisol and/or salivary cortisol to see your absolute cortisol levels if desired. 

How to Use

  • 1-2 Tablets per day (You can combine both glandulars with adaptogens or use one or the other based on your needs/symptoms.)
My Recommended Brand and Product:

Adrenal Glandulars (for moderate to severe adrenal fatigue): 

Adrenal Adaptogens (for less severe cases of Adrenal fatigue and for those suffering from stress + anxiety):

#3. Zinc


Not only is zinc required in proper T4 to T3 conversion, it is also common for people to have deficiencies. 

Because zinc is required for thyroid conversion (T4 to T3 conversion), low levels of zinc may predispose you to develop high levels of reverse T3 and which may limit thyroid function (10).

But that's not all zinc does...

The other benefits of Zinc include:

  • Enhanced immune function (11).
  • Increases T4 to T3 conversion.
  • Acts as an anti-inflammatory agent.
  • Plays a role in reducing oxidative stress.

A severe deficiency in zinc may result in hypothyroid symptoms which can be reversed with supplementation (12). 

Zinc deficiency is also associated with hair loss and alopecia, a troubling symptom that many hypothyroid patients face. 

Supplementing with zinc may help to improve thyroid function (if you are deficient) and help to reduce hair loss and improve hair quality. 

Testing for Zinc in the serum or plasma is not recommended as many people with "normal" values still present with symptoms. 

The best way to confirm and treat zinc deficiency is with a trial of zinc supplementation, in fact, this is considered to be the "gold standard" (13). 

If you suspect that sub-optimal Zinc levels may be contributing to your hypothyroid symptoms then a trial of zinc may be appropriate

How to Supplement with Zinc
How to Use
  • Zinc can be combined with other thyroid enhancing supplements such as Selenium. These supplements tend to work better when used in combination with one another. When supplementing with Zinc look for Zinc Citrate or Zinc Picolinate
My Recommended Brand and Product:

#4. Iron


I know I sound like a broken record here but Iron is another huge player when it comes to your thyroid.

It's so important I've dedicated an entire post to it that you can read here, which outlines how hypothyroidism is worse in the presence of iron deficiency.

In a nutshell:

Iron is involved in the production of thyroid hormone from your thyroid gland. 

Low levels of iron, therefore, worsen existing thyroid function (make your symptoms worse) (14). 

In addition, as thyroid levels fall (even slightly) your body will have a difficult time absorbing iron in the intestinal tract. 

This sets you up for further iron deficiency and worsening thyroid function

Do you see the vicious cycle here?

What makes matters worse is that most physicians don't treat iron deficiency unless it also is causing anemia (low red blood cells). 

It's certainly possible to have an iron deficiency which doesn't cause anemia but which impairs thyroid function in your body (15). 

To identify this problem all you need to do is ask for basic "iron studies" with your next set of blood work. 

Once you have these labs you will want to focus on your ferritin level which tells you how much iron you have stored in your body. 

Low levels of ferritin are associated with iron deficiency and impaired thyroid function. 

You can also identify the presence of iron deficiency by assessing your clinical symptoms.

List of symptoms associated with Iron deficiency:

  • Fatigue and weakness
  • Shortness of breath (worse with exertion or exercise)
  • Pale skin (especially in the creases of the hands)
  • Dizziness or a sensation of lightheadedness
  • Intolerance to exercise
  • Cold hands and cold feet
  • Brittle nails and hair loss (Iron deficiency is a VERY common cause of hair loss)

​Again, notice the similarities between iron deficiency symptoms and symptoms of hypothyroidism. 

Often times it's difficult to differentiate between these nutrient deficiency syndromes and hypothyroid symptoms unless you know to CHECK the labs - and most Doctors won't do this unless you ask. ​

Once you have identified the presence of low iron you can begin treatment with over the counter iron supplements (but just be sure to do this with physician supervision as too much iron can be harmful). 

How to Supplement with Liquid Iron & Iron Capsules
How to tell if you Need it

Ensure that your labs are in the "optimal" ranges if they are not then you can consider supplementation: 

  • Serum Iron - Middle of the reference range
  • Ferritin - 70-80 is the "optimal" range (low ferritin is associated with hair loss)
  • Percent Saturation - 35-38%
  • TIBC - Middle of the reference range
Low iron levels in hypothyroid patients

(Examples of suboptimal iron/ferritin levels)

How to Use

If you have hypothyroidism then you may want to use Liquid iron over tablet forms. Iron tablets may cause or worsen existing constipation while the liquid form is often better tolerated. Liquid iron also contains certain cofactors required for the absorption of iron in the intestinal tract (16). 

Take liquid iron away from food and other supplements. Take your iron with Vitamin C or a glass of lemon water. Do NOT take your iron with your Thyroid hormone medication as it may impair absorption. 

  • 1-2 tsp of Liquid iron per day titrated based on Laboratory results - do NOT supplement without checking your labs
My Recommended Brand and Product:

Start with liquid iron for increased absorption:

If you don't tolerate liquid iron you can use iron capsules: 

#5. Magnesium


Magnesium is another big player for hypothyroid patients because hypothyroidism causes dysregulation of magnesium metabolism. 

Hypothyroid patients may actually have normal serum and RBC magnesium levels but studies have shown decreased intracellular amounts of magnesium (17) in these patients.

​That means you can't always trust our limited laboratory tests when evaluating if you are deficient! (The same can be true of other serum 'nutrient' tests, which is why I don't always rely on them). 

These studies also show that both magnesium and zinc appear to be lower in hypothyroid patients due to increased clearance of both nutrients in the kidneys (18).

​One thing is for sure: 

You really don't want to be deficient in this nutrient - because a deficiency can cause a number of symptoms ranging from heart problems (19) (arrhythmia) to nervous system disorders.

What's more concerning is that many patients have suboptimal levels of this nutrient, even in the USA (20):

Prevalence of magnesium deficiency

​So how do you know if you should supplement with Magnesium or if you are deficient?

Follow the signs...

Symptoms of Magnesium deficiency include:

  • Muscle cramps or eye twitches
  • Anxiety or agitation
  • Restless leg syndrome
  • Sleep disorders ranging from insomnia to REM disturbances
  • Poor nail growth
  • See the full list here
How to Supplement with Magnesium
How to tell if you Need it

Magnesium comes in several different forms. Depending on your symptoms you can identify which magnesium works best for you: If you suffer from constipation Iyou may benefit from using magnesium citrate. If you have low serum levels and hypothyroidism you may benefit from Magnesium glycinate. If you have Depression or anxiety you may benefit from Magnesium threonate. 

Magnesium citrate table
How to Use

  • Start with 100-200mg per day taken at night, continually increase the dose until symptoms subside. 
My Recommended Brand and Product:

Magnesium Glycinate - This is a highly absorbable form of magnesium: 

#6. Selenium


I'm sure you've heard about Selenium if you have hypothyroidism and especially if you Hashimoto's thyroiditis. 

Why?

Because not only is Selenium involved in the T4 to T3 conversion process (21), there are also some studies that show that supplementing with Selenium can help reduce TPO antibodies (22).

How does selenium help improve these processes?

Selenium is a trace mineral which forms the backbone of a specific set of proteins known as selenoproteins. 

These proteins catalyze important functions such as the creation of thyroid hormone and the creation of anti-oxidants in the thyroid gland (23). 

Insufficient Selenium levels may impair the function of these proteins and predispose you to develop low thyroid hormone and thyrocyte damage (damage to your thyroid cells). 

Studies have shown that supplementing with Selenium may help improve thyroid function and reduce thyroid antibodies by providing your body with this important mineral. 

Selenium helps boost t4 to t3 conversion and reduces autoimmunity

​Sound pretty good right?

And, that's not all...

Selenium is also a powerful anti-inflammatory agent (24) and using this nutrient may potentially help reduce inflammation (and autoimmunity) in certain patients. 

You can find more information about symptoms of Selenium deficiency and an in-depth analysis here and how Selenium helps improve your thyroid here

How to Supplement with Selenium
How to tell if you Need it

All patients with hypothyroidism and Hashimoto's thyroiditis should be evaluated for Selenium deficiency and treated if necessary. Like Zinc, a trial of selenium may be the best way to determine if you will benefit from using it. Doses of at least 100mcg per day have been shown to be effective (25). 

How to Use
  • The average amount of Selenium required for humans is around 70mcg per day and you can safely supplement with 50 to 150mcg per day
  • Use no more than 400mcg per day of Selenium because it is possible to become toxic. 
  • Selenium can be combined with other nutrients such as Iodine and Zinc for enhanced results
My Recommended Brand and Product:

#7. Probiotics


What do Probiotics and Thyroid function have in common?

A lot, it turns out.

For starters, about 20% of T4 to T3 conversion occurs in the gut (26).

In addition, inflammatory conditions in the gut (27) predispose the body to develop autoimmune diseases and worsening thyroid function. 

​So how do thyroid function and the gut play together?

It turns out that thyroid hormone helps the body produce stomach acid (which helps with digestion) as well as promoting peristalsis - the slow movement of the GI tract.

Low thyroid hormone promotes low stomach acid which promotes intestinal issues.

Low thyroid hormone also promotes a sluggish GI tract which predisposes the body to develop SIBO and yeast overgrowth syndromes. 

Both syndromes cause inflammation which can promote autoimmunity.

Do you see the cycle here?

Hypothyroidism causing gut imbalances like SIBO

This is exactly why it's so critical to evaluate and treat any GI related issues that you may have because they are either caused by hypothyroidism and/or they are making your thyroid function WORSE.

​I'd be lying if I said that taking probiotics will cure your GI problems, but they are certainly a good place to start...

 How to Supplement with Probiotics
How to Use

  • 1 packet daily x15 days of 300 billion + multi-species probiotics then switch to a daily probiotic for maintenance dosing. 
  • Ensure that your probiotic has several species of bifidobacteria (28) and lactobacilli species (29) as these species are the most well studied. 
My Recommended Brand and Product
  • Use at least 100billion CFU/serving daily x3 months after introductory high potency probiotics. 
  • Continue using probiotics daily (and pulse on the weekends as necessary). 

#8. Proteolytic Enzymes


Enzymes make their way into the list because of how important they can be in helping your body break down nutrients but also medications. 

As you already know, low thyroid = low stomach acid (30) = poor digestion.

But what you might not be aware of is how difficult it can be to break down certain medications (even thyroid hormone) when you have low stomach acid.

For this reason, in patients who have BOTH hypothyroidism (or Hashimoto's) plus GI related issues, I recommend that they also take enzymes to help with digestion.

In fact, I have seen some patients with Hashimoto's who start taking NDT cause a temporary spike in antibodies as a result of this poor digestion. 

Remember:

The inability to break down food products completely results in abnormal absorption of particles that your body isn't used to seeing which may influence autoimmunity (31).

How to Supplement with Enzymes
Why I like it

May help reduce acid reflux or GERD.

Helps break down food particles.

May help promote normal bowel movements.

Helps promote proper nutrient absorption.

How to tell if you Need it

I generally recommend a trial of enzymes with every meal (and in between meals) if you have Hypothyroidism or Hashimoto's PLUS gut issues (GERD, IBS, IBD, chronic constipation, SIBO or yeast overgrowth). 

It's also worth mentioning that taking enzymes in between meals can help promote the breakdown of immune complexes (30) in the bloodstream. 

So take enzymes WITH food and WITHOUT. 

How to Use

  • 1-2 Capsules taken with meals and in between meals
My Recommended Brand and Product:

#9. Iodine


Iodine is another nutrient that deserves its own blog post - but I do want to give it some well-deserved attention here. 

Stating that iodine is involved in thyroid hormone production is an understatement.

The iodine moiety is what MAKES thyroid hormone active.

In fact, 4 iodine molecules help create T4 and the removal of 1 iodine moiety by deiodinase is what makes thyroid hormone active.

So iodine deficiency = low thyroid by definition.

Iodine involved in thyroid hormone production

​The problem doesn't come with knowing its importance but with supplementing it correctly. 

Iodine is another nutrient you don't want to have too much of, just like you don't want to have too little.

Finding that balance can be difficult.

Another problem with Iodine supplementation is that it can displace other halides (31) which stick on to thyroid hormone molecules but inactivate the thyroid hormone. 

I'm talking about fluoride, bromide, and chloride.

Periodic table of elements and iodine

You can see from the image above that Iodine, Fluoride, Chloride, and Bromide all share a similar structure in terms of their electron outer shell. 

What that means to you is that these other chemicals can displace iodine on thyroid hormone and cause a cellular hypothyroidism with "normal" thyroid labs.

And, when you give a patient who has this issue iodine - it may displace the other chemicals and cause a detox reaction. 

The detox reaction shares the symptoms of bromoderma and bromism (but usually not as severe).

​The detox reaction can present as worsening thyroid symptoms, acne, pustules in the face, nausea/vomiting, irritability, etc. 

These symptoms are often confused with a negative reaction to the iodine itself when in fact the symptoms are due to the detoxification of the other halides in the body. ​

How to Supplement with Iodine
Why I like it

May improve thyroid function

May help detox harmful halides

If deficient will improve other systemic symptoms

Generally works very quickly in deficient patients

How to tell if you Need it

Supplementing with Iodine can be difficult. I have only had 2 documented scenarios in which patients truly reacted negatively to Iodine supplementation and many more patients who have done quite well on Iodine. 

If possible I recommend testing your urinary excretion of iodine prior to supplementation. If you decide not to test yourself then start out at very low doses (~200-300mcg/day) and slowly increase the dose based on your symptoms. 

If you experience the side effects of bromism or bromoderma, then cut your dose and try again after several days. 

How to Use

  • Start at 200-300mcg per day and slowly titrate dose based off of symptoms - discontinue if you experience negative side effects and seek professional help
My Recommended Brand and Product:

For low doses start at 200-300mcg per day:

Thyroid Supplements are only Part of Treating your Thyroid


As I've mentioned above, these supplements can definitely offer therapeutic benefits to many patients...

But they shouldn't be used alone.

Thyroid supplements should be used as part of a treatment plan that attempts to remove all negative stressors from the life and put back in the things which your body lacks.

That means proper diet, stress reduction techniques, the right amount of sleep and exercise are all JUST as (if not more important) than replacing these lost nutrients. ​

For more info on where to start adding in these other areas please see my post here.

To wrap it up:

These 9 Thyroid supplements, if used in the right scenario, can help boost thyroid function and help reduce your symptoms:

  • Vitamin B12 (Remember you need either sublingual or injections)
  • Adrenal Support (Thyroid function and adrenal function are linked)
  • Zinc
  • Iron (You need just the RIGHT amount - not too much and not too little)
  • Magnesium (Magnesium citrate for constipation, glycinate for hypothyroidism and threonate for anxiety/depression)
  • Selenium (Very helpful in patients with Hashimoto's)
  • Probiotics (Preference on soil based organisms if you have SIBO/yeast overgrowth) 
  • Proteolytic enzymes (Helpful in digesting food and breaking down immune complexes)
  • Iodine (Use cautiously) 

Now it's your turn

I want to hear from you!

What supplements have worked for you? Which ones haven't?

9 Vitamins to boost your thyroid and how to use them
Westin Childs
 

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders. He is trained in Internal Medicine, Functional Medicine and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances. You can read more about his own personal journey here.

Click Here to Leave a Comment Below 104 comments