76

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 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 your Thyroid Symptoms​

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:

  • Tyrosine
  • Iron
  • Iodine
  • Zinc
  • Selenium
  • Vitamin E
  • Vitamin B2
  • Vitamin B3
  • Vitamin B6
  • Vitamin C
  • Vitamin D

The following nutrients re required for proper thyroid conversion:

  • Zinc
  • Selenium

A deficiency in ANY of these may cause limited thyroid function leading to the symptoms of hypothyroidism. 

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. ​

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
  • 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

Why I like it

May Boost Energy levels and reduce fatigue

May help increase metabolism and fat loss

Helps improve mood and increase concentration

Generally works very quickly (within 1-2 weeks)

How to tell if you Need it

I recommend checking the following lab tests:

  • Serum B12 - Should be > 1,000
  • Homocysteine levels - Should be < 9
  • MCV - Should be < 92

Patients with the following symptoms should consider using B12 shots: 

  • 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

  • 1,000-5,000 mcg per day preferably taken in Sublingual form
  • If you are severely deficient in Vitamin B12 you may need to use Methylcobalamin injections once per week at 5,000mcg of methylcobalamin every 7 days
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 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 in Hypothyroid patients:

  • 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 deserves 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 or adrenal adaptogens.

Generally for more advanced cases of adrenal fatigue I will recommend adrenal glandulars + adrenal adaptogens.

hormone mastery guide

For less severe cases I will recommend adrenal adaptogens. ​

If you have HIGH levels of cortisol (serum Cortisol levels > 22 first thing in the morning) then I recommend using supplements like phosphatidylserine to help bring down those levels. ​

How to Supplement with Adrenal Support
Why I like it

May boost energy and well being

Almost ALL hypothyroid patients have adrenal problems

May help boost immune function

Most patients experience improvement in 1-2 months

How to tell if you Need it

I don't always recommend testing for cortisol levels prior to treatment in every patient but if you do I recommend checking the following:

  • Serum Cortisol - AM cortisol should be between 14-16, anything less may be a problem (note: normal serum level doesn't rule out adrenal fatigue)
  • Urinary cortisol and cortisone x4 - I recommend using DUTCH testing (you can see an example of the report below)
Increased cortisol causes weight gain
How to Use

  • 1-2 Tablets per day if using Glandulars (preferably taken in the am and at noon)
  • If using supplements designed to lower cortisol like phosphatidylserine then use at night
My Recommended Brand and Product:
Thyroid adrenal reset complex mini image

Adrenal Glandulars (for more severe cases of Adrenal Fatigue)

Adrenal Adaptogens​ (for less severe cases of Adrenal fatigue)

Phophatidylserine - Soy Free (for cases of ELEVATED cortisol)

#3. Zinc

Not only is zinc required in proper T4 to T3 conversion, it is also one of the most common nutrient deficiencies that I see in my office. 

Because zinc is required for proper thyroid conversion low levels of zinc may predispose you to developing higher levels of reverse T3 and limiting thyroid function.

But that's not all zinc does...

Benefits of Zinc:

  • Boosts immune function
  • Increases T4 to T3 conversion
  • Acts as an anti-inflammatory
  • Plays a role in reducing oxidative stress

​If you are going to supplement with Zinc I recommend using Zinc bound to picolinic acid as this form of zinc is shown to have superior absorption over other forms. 

How to Supplement with Zinc

Why I like it

May help boost immune function (especially in Hashimoto's patients)

Helps boost T4 to T3 conversion

Helpful in patients with hypothyroidism + skin conditions

Helpful in patients with elevated ESR + CRP

How to tell if you Need it

In individuals who have Hashimoto's, impaired immunity (multiple autoimmune diseases), multiple skin issues (eczema or psoriasis) or high levels of inflammation I generally recommend treatment without blood tests. If you don't fall into these categories then check the following tests:

  • Check serum copper:zinc ratio
How to Use

  • 20-60mg of Zinc Picolinate per day (Do not exceed 60mg per day)
My Recommended Brand and Product:

#4. Iron

I know I sound like a broken record here but Iron is another HUGE player in thyroid function. 

It's so important I've dedicated an entire post to it that you can read here, which outlines how hypothyroidism is WORSE with iron deficiency. 

​Iron is involved in the production of thyroid hormone (so low iron = low thyroid) and not only that but hypothyroidism promotes iron deficiency. 

Do you see the vicious cycle here?

Low thyroid = Low iron = Worse thyroid function

​What makes matters worse is that most Doctors don't treat just iron deficiency unless you are ALSO anemic. 

Because they interact with each other I rarely ever check thyroid labs without also checking iron studies.

So how do you know if you have iron deficiency?

Check your symptoms (and your labs of course!)...​

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. ​

How to Supplement with Iron

Why I like it

If deficient replacement helps stop hair loss

Helps increase energy

Improves exercise tolerance

Required for Thyroid hormone production

How to tell if you Need it

Do NOT supplement with Iron unless you are deficient based on your labs. Supplementing with too much iron may cause problems due to iron overload. This is definitely a "goldilocks" nutrient where you need just the "right" amount. 

  • Serum Iron - Middle of the reference range
  • Ferritin - 70-80 is the "optimal" range
  • Percent Saturation - 35-38%
  • TIBC - Middle of the reference range
Low iron levels in hypothyroid patients

(Examples of sub optimal iron/ferritin levels)

How to Use

If you have hypothyroidism then I recommend using Liquid iron over tablet forms of iron due to absorption issues. Liquid iron contains the cofactors required for absorption (vitamin C). 

​Take liquid iron away from food and other supplements. Take your iron with Vitamin C or or a glass of lemon water. Do NOT take your iron with your Thyroid hormone supplement. 

  • 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:

#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 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

​One thing is for sure: 

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

​What's more concerning is that MANY patients have suboptimal levels of this nutrient, even in the USA: 

Prevalence of magnesium deficiency

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

Follow the signs...

List of Symptoms of Magnesium Deficiency:

  • 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

​Magnesium is one of those nutrients I will also recommend that many patients take even if their labs show they have "normal" levels. 

So let me explain how to take it:​

How to Supplement with Magnesium

Why I like it

May help with Depression

May help improve nail growth

Helps reduce muscle pain and cramps

Helps if patients ALSO have constipation

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 I recommend using magnesium citrate. If you have low serum levels and hypothyroidism I recommend using Magnesium glycinate. If you have Depression or anxiety I recommend using Magnesium threonate. Again - I don't always recommend basing magnesium supplementation off of labs, but if you do you can use these numbers:

  • Serum Magnesium - Should be > 2.2
  • RBC magnesium - Should be in upper 50% of reference range
Magnesium citrate table
How to Use

  • Start with 100-200mg per day taken at night, continually increase dose until symptoms subside (you may need up to 2,000mg per day in some cases) - stop if you experience loose stools
My Recommended Brand and Product:

Magnesium Glycinate - Use if you have low serum levels of magnesium or if you are hypothyroid

Magnesium Citrate - Use this form if you have GI issues or problems with constipation

Magnesium Threonate - Use this form if you have issues with depression, anxiety or agitation

#6. Selenium

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

Why?

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

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 and using this nutrient can help reduce inflammation (and autoimmunity) in patients. 

​You can find more information about symptoms of Selenium deficiency and an in depth analysis here

How to Supplement with Selenium

Why I like it

May reduce antibodies in patients with Hashimoto's

Also acts as an anti-inflammatory

Many thyroid patients are deficient in Selenium

Helps boost T4 to T3 conversion (helpful in those with high Reverse T3)

How to tell if you Need it

Selenium can be tricky to dose and use. I've found that certain patients do well with higher doses of Selenium and others who do not. If you have Reverse T3 issues or Hashimoto's I do recommend a trial of this nutrient even if your serum levels are "normal" (some people just need supraphysiologic doses). 

If you decide to supplement with Selenium I recommend no more than 400mcg per day and to start out in the 100-200mcg range. 

How to Use

  • 200-400mcg per day (do not exceed 400mcg per day)
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.

​In addition inflammatory conditions in the gut predispose the body to developing 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 slower GI tract which predisposes the body to developing SIBO and yeast overgrowth.

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

Why I like it

High microbial diversity

Clinical studies showing effectiveness

Helpful if patients have SIBO or yeast overgrowth

Contains soil based organisms

How to tell if you Need it

If you have hypothyroidism or Hashimoto's there is a high chance (up to 50% in some studies) that you have SIBO and or yeast overgrowth.

Patients with these conditions tend to tolerate soil based organisms more than other probiotics - in fact lactose based probiotics can cause bloating and worsening constipation in some patients. 

If you have GI issues then I recommend switching up your probiotic regimen, pulse the doses that you take and never stick to the same probiotic for longer than 2-3 months. 

How to Use

  • Take 1-2 capsules per day up to multiple times per day with meals and in between meals (vary up your dosing)
  • If using Bifidobacteria try to shoot for up to 30 billion CFU's 
My Recommended Brand and Product:

Soil based organisms - For patients with SIBO/yeast overgrowth, chronic constipation or gas/bloating. 

Beneficial yeast - For those with Diarrhea or resistant yeast overgrowth syndromes

Lactobacilli + Bifidobacteria (70 billion CFU) to add to your probiotic regimen:

#8. Proteolytic Enzymes

Enzymes make there 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 = poor digestion.

But what you might not be away 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.

thyroid metabolism reset poster for side bar

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. ​

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 in the blood stream. 

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 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:

For higher doses I recommend these:

Thyroid Supplements are only PART of regaining your Health

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 a part of 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?

complete thyroid supplements guide pinterest
Westin Childs
 

I'm Dr. Childs and I write these posts. I'm a physician that specializes helping patients lose weight, have more energy and FEEL better. My practice focuses on hormone imbalances, thyroid issues and weight loss resistance. My goal is to provide the BEST information out there on the internet that is both actionable and trustworthy. Get my free ebook: Hashimoto's Diet Guide here. You can also find more about my personal journey back to health here.

Click Here to Leave a Comment Below 76 comments