How to Lower TPO Antibodies: 5 Tips I use in my Practice

Are you struggling to lower your TPO antibodies? 

Many Doctors seems to blow off the fact that you have elevated TPO or Thyroperoxidase antibodies by saying that it doesn't effect treatment...

It turns out that is definitely NOT true. 

Not only does having TPO antibodies present in your serum indicate you may have inflammation and autoimmunity present, it also changes management and treatment of the patient.

This article will highlight several therapies that I've used successfully in previous patients to help them LOWER their TPO antibodies, LOWER inflammation and reduce autoimmunity...​


Why it's Important to Lower TPO antibodies

In case you didn't already catch this:

Many patients with Hashimoto's are being mismanaged.

For the most part Doctors tend to ignore antibody levels by saying that it doesn't change how you are going to be treated.

If they find your TSH > 5.0 they will slap on some levothyroxine and call it a day.

It turns out that there is definitely a better way...

While TPO antibody levels can be difficult to lower and you shouldn't base ALL of your efforts on lowering them, they should at minimum be followed. 

Trending out antibody levels and monitoring fluctuations can be helpful when assessing which treatment is working and which is not.

Having said that:

You can DEFINITELY still have improved symptoms and have your antibody levels spike up or stay the same. 

Like many things, they can't be used in isolation, but when used with other markers of Hypothyroidism they can provide valuable data. 

​What is the Normal Range for TPO antibodies?

In general you will want your TPO antibodies to be as LOW as possible.

That means non existent or < 30 (with the lab I use).

Please see this example for TPO antibody references ranges:

Slightly elevated thyroperoxidase antibodies

​As you can see in the image above the "optimal range" would be considered < 30, while the "normal range" would be considered less than 60. 

I get worried when antibody levels start to creep higher than 30, but ESPECIALLY if they are higher than 60. ​

A trend of continuing elevation of TPO or thyroperoxidase antibodies over time is also concerning (especially in the face of treatment).

​If you fall into this category (slightly raised) or they are outside of the reference range AND you also have symptoms of hypothyroidism then it's definitely worth continuing with the treatment below. 

In these patients I also recommend a trial of thyroid hormone and evaluation because most do MUCH better after thyroid replacement hormone. ​

Tips to Treat and Lower your TPO or Thyroperoxidase Antibodies​

These are tips I've used and tested on many patients with Hashimoto's in my office and I'm going to go over which ones work best, how you should consider using them and how they actually help.

Remember that each patient is different, so don't just blindly try these therapies without consulting your physician.

Some are medications, some are supplements and others are related to lifestyle interventions but the point is this:

I've seen each one of them lower thyroid antibody levels in patients that I've treated...​

1. Get on the Right Diet for YOUR Body

​The FIRST step you should take when trying to lower or treat your elevated TPO antibodies is changing your diet. 

While diet is usually NOT enough to lower them all by itself (I have seen this a handful of times) it will ALWAYS help.

Likewise it's going to be impossible to change those levels without also addressing diet - so consider this the necessary first step.

For a more detailed post on diet and Hashimoto's please see this post. ​

When changing your diet it's always best to tailor your diet to your needs and medical conditions. 

I'm going to go over 4 diets below that I've seen work for many patients:

Autoimmune Paleo Diet to Reduce TPO antibodies​
AIP foods to avoid

The AIP diet is VERY effective at lowering TPO and thyroperoxidase antibody levels.

​You can see a case study here which also shows how it can help with weight loss. 

The AIP diet has a lot of popularity on the internet because it can be so effective, but I definitely do not recommend it for EVERY patient. 

It is a very restrictive diet ​(Basically paleo without nuts and nightshades) and can be difficult to follow and maintain. 

There are also several patients who feel good on the diet, but are unable to reintroduce foods after being on it for several months due to tolerance issues.

Typically I recommend this diet for patients who have failed less restrictive diets or for those who have a history of multiple autoimmune disease. ​

One of the benefits to going on the AIP diet is the amazing online community, free recipes and help that you can receive. ​

Thyroid diet 4 week plan side bar
Elimination Diet to Reduce TPO antibodies​

The elimination ​can be very powerful at reducing antibody levels as well. 

You can do this diet 1 of 2 ways:

Test yourself using delayed IgG food sensitivity testing and remove only food groups that you react to.

Or remove the most common food allergies and monitor your symptoms upon reintroducing those food groups.

Typically I will recommend removing the most common food allergens and then move to testing if symptoms do not improve. ​

Gluten Free, Dairy Free and Soy Free Diet to Reduce TPO antibodies

​Going gluten free, dairy free and soy free should be the FIRST place you start (if you don't know where to start) in treating high TPO antibody levels. 

This by itself is enough for many patients to notice significant improvements. ​

SIBO and Low FODMAP's Diet to Reduce TPO antibodies​

SIBO and the Low FODMAP's diet can be particularly helpful in patients who ALSO have irritable bowel like symptoms in addition to elevated TPO antibodies.

In these instances treating the underlying cause is usually necessary to help reduce antibody levels. ​

2. Consider using Testosterone or DHEA

​DHEA and/or Testosterone can be VERY helpful in reducing antibody levels.

If you notice 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 felt to occur has to do with Testosterone, DHEA and androgen levels.

The less testosterone you have = the more likely you are to develop autoimmunity and Hashimoto's.

In my experience of testing MANY patients with Hashimoto's I can attest that the vast majority ALSO have low free and total testosterone in addition to low DHEA.

​Adding these androgens to your treatment regimen can help in the following ways:

How do you test for low Testosterone?

Check your Free and Total testosterone in addition to DHEA-S. 

Low normal testosterone levels

​If your ranges are in the lower 1/3 of the "reference range" I would consider adding either or both of these therapies. 

A goal to shoot for would be in the high normal range, or even as high as ​200-300 total testosterone in the serum for women. 

3. Consider the use of Zinc and/or Selenium

Some supplements can also have a very powerful impact on lowering TPO and thyroperoxidase antibody levels.

Two of the most potent nutrients include:

Zinc and Selenium. 

​Some hashimoto's patients will need supraphysiologic doses of these nutrients to suppress antibody levels so I don't always recommend basing treatment off of lab values alone. 

How are they helpful?

Zinc can help with the following:

Selenium can help with the following:

​Both of these nutrients can be used in combination to provide a nice, powerful BOOST to your immune system and can help to lower TPO antibody levels. 

I recommend using this type of Zinc and this type of Selenium.

4. Improve your Gut Function

​When you have hypothyroidism and gut issues I'm specifically referring to two very common and under diagnosed conditions:

  • SIBO or Small Intestinal Bacterial Overgrowth
  • Yeast Overgrowth

​I'm specifically referring to these conditions because they are often missed completely and they have a huge effect on the immune system and gut function. 

Another problem is that as much as 54% of hypothyroid patients have SIBO.

​Not only that but having SIBO can increase your risk of developing autoimmune disease and can potentiate inflammation if its already present

​Now let me ask you this:

When was the last time your Doctor asked you about SIBO or mentioned it to you?

Do you see the problem now?

thyroid metabolism reset poster for side bar

​As many as 54% of you may have this condition and you probably don't even know it!

If you have any of these symptoms you will want to get evaluated:

  • 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
  • History of Vagal nerve dysfunction

​If you are experiencing any of these symptoms I do recommend looking into further testing for SIBO or yeast overgrowth. 

In many of my patients who have ALL or MANY of the above symptoms AND a history of Hashimoto's or Hypothyroidism I will usually recommend TREATMENT first and then testing to confirm eradication.

I've found that these supplements tend to do the best for treating both SIBO and yeast overgrowth:

​In some cases you may require antibiotics like rifaximin or antifungals like diflucan

5. Consider using LDN (Low Dose Naltrexone)​

LDN anti inflammatory agent

In this case I saved the BEST for last.

I've found LDN or Low Dose Naltrexone to be particularly helpful in lowering antibody levels, reducing inflammation and lowering chronic pain.

​What is LDN?

LDN is an opiate blocker (meaning it sits on the receptor and blocks opiates from binding to cells). 

It is conventionally used as a rescue medication​ for patients who have overdosed on narcotics, but in LOW doses it can help modulate the immune system and reduce autoimmune diseases. 

It was first used to help patients with HIV back when there were very few treatments, but it has undergone significant research since that time and has shown benefit in many conditions.

​LDN helps with the following:

​How do you use LDN to lower TPO antibodies?

The dose ranges from 1.5mg to 4.5mg.

I typically recommend patients start with 1.5mg taken at night unless patients find it stimulating.

The dose can slowly be increased and most patients land somewhere between 3.0-4.5mg.

How do you know if it's working?

I've found that about 50% of patients find improvement when taking LDN.

Some however don't realize how much benefit they get from LDN until they stop taking it.

I had a patient the other day who stopped taking it after 4 months because she thought it wasn't helping and within 1 week she was suffering from worsening joint pain and inflammation which resolved once she resumed taking LDN.

5 Steps to Lower TPO Antibodies

​Wrapping it up

​If you've found that your TPO or thyroperoxidase antibody levels are increased then you will probably need to do some research on your own to find some treatment options.

Most Doctors will tend to ignore these antibody levels so you will likely have to request they order it each time they test your other thyroid numbers.

If you decide to try and treat your antibody levels I recommend using the 5 steps above (but please consult with your Doctor first).

Also, please realize that in order to have the greatest benefit possible you will need to do ALL of the above treatments in order to see a significant improvement.

These techniques have been used by me in the past on many patients to help lower antibody levels and I can vouch that they help (but not for everyone).

While antibody levels are important they are not EVERYTHING. Use these levels as a guide, not as a marker if treatment is working. 

In some patients antibody levels will remain high no matter what you do. 

Now it's your turn

Have you tried any of these treatments to help lower your TPO antibody levels? What has worked for you, what hasn't?

Leave a comment below and I will personally respond!

Dr. 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 61 comments
Daniela - August 1, 2016

Dear Dr. Childs, thank you for this extremely interesting paper. It came to me just in time. This is to ask if the level of TPO antibodies is linked with the inflamations caused by H.Pylori and Candida Albikans. I have them both – recognized in blood tests. No Candida has been localized in other possible locations. In this “Catch 22” situation, I was wondering which of the above inflamations I have to get rid off first? Is it absolutely neccessary to apply the standart treatment schemes with antibiotics and antifungals, together with caprylic acid and a strong probiotic (100 billion bacteria)? Is it possible to apply the mentioned approach first and than to follow the 5 steps, explained in this paper. Thank you in advance!

    Dr. Westin Childs - August 1, 2016

    Hey Daniela,

    There is no specific order to treat these things but yes candida and h. pylori may predispose you to gut inflammation which could lead to elevated antibody levels. Most likely you will need to treat multiple areas if you want to resolve the candida/h. pylori issues.

    I usually do multiple therapies at once but tailor it to what is the most pressing issue based on labs or symptoms.

      Daniela - August 1, 2016

      Dr. Childs, thank you for the answer. In addition shall I understand that I could apply AIP or elimination diet together with the medication protocols of candida/h.pilory?

Tammy - August 1, 2016

Do you suggest testing for SIBO before trying treatment for symptoms?

Kathryn Nguyen - August 2, 2016

Hi, so the idea of the LDN is to sblock the creation or impact of antibodies, but it’s really just physically stopping the antibody damage not necessarily the body’s desire to create antibodies? Is that why patients must continue taking it?

Could LDN potentially be used as a temorary stop gap for symptom management while other factors were improved (diet, hormone balancing, gut healing, etc.) and then LDN stopped only to find the body is no longer sending out troops because there is no battle to fight?

The Jarred article mentions lack of long-term data and limited sampling, but do you know if they have seen LDN used in Hashis patients prove a slowing of new autoimmune diseases from developing as opposed to the rate of increased AI diseases in Hashis patients?


    Dr. Westin Childs - August 2, 2016

    Hey Kathryn,

    I don’t think anyone knows for sure, but it’s probably a combination of both – reducing the creation of antibodies and blocking their action.

    I’ve seen some people use it for short periods of time and get off of it, but usually patients just feel better so they stay on it.

    I’m not aware of long term research on hashimoto’s patients in particular and we aren’t likely to see it unfortunately, so that means we pretty much have to base treatment and recommendations off of anecdotal experiences and expert opinion.

Sara - August 2, 2016

Hello Dr. Childs,

I’ve always had very high antibodies (over 250) bit I’ve never really had symptoms. I’ve only given up fluten, dairy and soy. Should I be more concerned about this even though I don’t experience symptoms?

Thank you

    Dr. Westin Childs - August 2, 2016

    Hey Sara,

    I wouldn’t stress about it but I would definitely make some changes in your life to see if you can influence the numbers. On the spectrum you are way at the other end, but that doesn’t mean you can start swinging to the symptomatic side if you have a life changing event (stress, illness, etc.)

Ewa - August 2, 2016

I noticed that stress is the biggest trigger for me. When j am stressing at work, go to bed late or have an argument with someone, I immidately start to feel worse. Managing stress and sleep is very important too

    Dr. Westin Childs - August 2, 2016

    Hey Ewa,

    Stress is definitely a big deal, you won’t be able to manage hashimoto’s or autoimmune disease in general unless you have multiple ways to cope with stress.

Martina - August 3, 2016

It’s so interesting how different that subject is approached in the US via Austria (or Europe). I was diagnosed with Hashimoto’s 3 years ago when I already felt sick and was in severe joint pain, gained about 30kg and had no period for over a year, when doctors told me I might have a “hidden tumor” somewhere until a new doctor had the idea to check my thyroid…

Long story short, I have been on Thyrex (the common thyroid treatment pill over here) from then on. We started with 25 microgramme daily and increased it to 100. Recently my TSH and antibodies god worse, so I had to increase it to 125.

What doctors over here agree with though is, that this isn’t curable and that I would always a have to take Thyrex, even though I would love to wean of it as soon as possible. I’ve been told times and times again that there is no way this is ever going to happen. I think with all the stress, adrenal fatigue is also a problem but I don’t know for sure since no one wanted to test me. With thyroid antibodies over 300, I think that puts a toll on me as well.

Needless to say, I am too exhausted to even socialize and therefore can’t exercise other than walking which makes me feel immensely depressed since that additional weight is also taking its toll on me…

Is there anything I can do? Can I work with a doctor/practitioner overseas if the local ones refuse to help me other than prescribing meds?

Thank you

    Dr. Westin Childs - August 3, 2016

    Hey Martina,

    I have a handful of patients who see private doctors who are able to prescribe them the right medication. I also have some patients from the UK who visit the US and are able to get proper treatment. There are a few ways to do it, but they aren’t necessarily easy.

      Martina - August 3, 2016

      Well, I never asked for easy, I asked for a holistic approach to deal wirh it and feel like myself again!

        Dr. Westin Childs - August 3, 2016

        Then I would recommend you look for a local provider or someone you can consult with online via telemedicine, most likely this will need to be out of pocket.

      niki - August 12, 2016

      i live in Greece and there aren’t doctors here to evan consider something else than the usuall medications .i started to feel tired and deprest after my doughter was born .but it cind of got lost ,i didnt have the time to deal with it but then after 7 years my mother died .suddenly i felt wors .no energy ,nothing .after 2 years i desited to go a young hollistic doctor with a masine you hold two stics and it ‘reads’ your body .and she talled me i had to cut off gluten and make a diet for some time and to check my theroid.and i went to a normal doctor ,he said hassimoto and after my request for something uther then pills he gave me sellinium for six months .well i am taking it for 2 months now and i feel better .but i have a strong instinct i always have and it is telling me it is not enauff .so i guit all sugar ,all gluten (i can see) and ad more helthy foods .but i lost wait witch is something i don’t want sence i am thin and now even more .and i keep losing .what is your opinion ? sould i try thyroxin if the doctor gives me or sould i take something naturall ?do i have a hope of not taking the pill or its ok to take it?will it be for ever or i can take it for a couple of years and it will make me ok and then stop?i am confused…

        Dr. Westin Childs - August 12, 2016

        Hey Niki,

        I’m having a hard time following your post, but I wouldn’t recommend going off of your medication without consulting with your physician. If you want to try lifestyle interventions in addition to medication check out my post on the 10 day thyroid reset diet – it has a bunch of info for you there.

    Daniela - August 3, 2016

    Dear Martina, your story impressed me a lot. The good point is that you are following such an interesing blogs as the one of the wonderful Dr. Childs. Believe me you are on a right direction. The first step in the long healing process of autoimmune disease is to start educating yourself. There are lots of places in the Internet where you could find relevant information as well as full support. In addition to the medical sites and blogs, there are lots of facebook support groups held by people with similar problems.
    Believe me, few months ago I was feeling similarly way like you. The only difference is that I had a chance to find a support group from where to start educating myself about my Hashi. You could search for FB thyroid/Hashi support group in your country. I am sure that through the FB support community you could find the appropriate doctor in your area, just like it happend to me.
    Last but not least, if you want to feel better – get rid of gluten and refined sugars forever. The next step will be to avoid all foods that are with alergic potential – dairy products, soy, eggs. In addition you have to chose the appropriate holistic healing protocol – Paleo, Autoimmunpaleo, elimination diet, etc. If you do this than for sure you will start feeling much better.
    Belive me, you are not alone!

Emily - August 9, 2016

Thanks for the detailed article! I’m always looking for new information on Hashimotos. I have been treating mine for 3 years and over the last year have quit eating all sugar with the exception of berries once a week. I have also been treating Lyme disease and adrenal exhaustion for the last year. I’m surprised you wouldn’t add sugar to the gluten, dairy, soy recommendation. Can you speak to that? I feel it’s made a huge difference for me. My antibodies were around 300 3 years ago and are steadily dropping. Currently they are at 34 and 1. Thanks again. 🙂

    Dr. Westin Childs - August 9, 2016

    Hey Emily,

    When I see new patients I make it abundantly clear that sugar is off limits so I don’t usually spend time writing about it 🙂 But yes, that is another one of those hard lines for Hashimoto’s patients.

lorraine - August 10, 2016

Thank you for this interesting article.One year on from radiative iodine ablation and on 2.5 net(self medicated as levo was not doing anything) I find m have antibodies of 4000. Feeling very very unwell. I would like to try LDN at some point but wonder how it effects the liver>I have non alcohol fatty liver disease. I have tried hard to heal gut issues,including several courses of goats milk kefir which I would recommend to anyone. Trying to be gluten free but find AP so difficult.dignedoff from

I find in this country as soon as your TSh is deemed ok thats it signed off from doctor and just left. I do feel as if i am dying some days despite my best efforts to get well.

articles like this do help to inform

    Dr. Westin Childs - August 10, 2016

    Hey Lorraine,

    I’m a big fan of kefir and I use it myself on a daily basis. NDT can raise antibody levels if not taken with a digestive enzyme especially in someone with low stomach acid from hypothyroidism. With your issues I would look into SIBO.

Stacy - August 11, 2016

I have been on LDN for at least 6 months now, I am gluten, dairy and soy free (and have tried aip – found it to be really difficult to stick to long term, hut going back on it again soon), I am taking Naturethroid, I supplement with Selenium and glutathione as well as multi and omegas…. And still, after all of this, my antibody levels have never come down below 900!!! I dont even know what my actual count is because the test only goes to 900. (>900) I actually dont experience a lot of the symtpoms that many people do… i feel like my energy is good, I am able to maintain a healthy weight, etc… But I know that antibody levels that high cannot be good. I also just found out that Im pregnant… So I am searching for answers and ideas on how to get them lowered. Any suggestions? Do antibody levels that high mean that my thyroid is being destoryed for sure? I sometimes get hoarse (if I eat something that likely had a hidden irritant in it) but that doesnt happen too frequently. Any advice is appreciated.

    Dr. Westin Childs - August 11, 2016

    Hey Stacy,

    Antibody levels don’t always correlate with clinical disease, they may even go up after initiating therapy but that doesn’t necessarily mean your disease process is getting worse.

Jannie Sommer - August 12, 2016

A lot of great info as I am new here on your page. A maybe quick question 🙂 If one has few antibodies ( just below max) and a TSH around 5 (just above max) is there anything other than food and vitamins you can take or do so you do not have to go on medicin?
I started T4 medication – is there a way back – out of it again you think?
Sorry for my English – i am from Dennark
Best wishes jannie

    Dr. Westin Childs - August 12, 2016

    Hey Jannie,

    You can try lifestyle interventions, stress management, low intensity exercise and some detox I suppose. I would recommend treatment though if you are symptomatic.

lisa - September 5, 2016

if my free testosterone is 1.9 and my total is 29 would you recommend adding testosterone?

    Dr. Westin Childs - September 6, 2016

    I wouldn’t treat based off of your labs alone, but yes those are suboptimal levels.

      lisa - September 18, 2016

      My anti-TPO has been in the 400’s consistently and have tried just about everything to get them down lower. When would you add the testosterone?

Daniela - September 19, 2016

Dear Dr. Childs,
I am with Hashimoto since 2007 and my antibodies have been always out of the normal range. Two and a half months ago I have started AIP as well as a new medical treatment – combination between T4 and T3. My anti-TPO antibodies have been reduced from 115 to 73, but the anti-Tg antibodies are staying the same – about 420. What would you recommend in this case? Am I doing something wrong? Thank you in advance for the advice!

Sue - November 4, 2016

Hi Dr

I love your article so helpful .Ijust did my hormones blood test i need you opinion please im 45 years old mom for 2 boys.Having hypo thyroid for 5 years

TPO 133 Was 300 it is dropping down by taking selenium and zinc and good diet
Cortisol AM: 524 RANGE 135-537
Cortisol PM 190
progesterone 28.2 nmol/l
DHEA-S 1.8 <6.7

I was on Cortisol manger for 3 month before doing the blood test. I stoped cortisol manger for 2 month and back with this results.They were lower than befoe taking cotisol mander

your recommendation please Dr
Do i need to go back to cortisol manger or need cream that you talk about in your article?
Thanks for your help
Sue from Canada

    Dr. Westin Childs - November 4, 2016

    Hey Sue,

    I can’t give personal advice because you aren’t my patient and I would point out that understanding which supplements to use should be dictated by a combination of symptoms + lab results.

Bill - December 10, 2016

Thank you, Doctor, for giving us access to your professional expertise. I have TPO-Ab 200 and Tg 42, male age 60. Treated diagnosed Graves with 5mg Methimazole for a year (2009), ~.5mg for several years, nothing for last 2 years, as T4 and TSH had stabilized. T4 is now falling to 1.0, so I’m apparently entering Hashis. I plan to start Selenium from your link above to lower antibodies, though in the past just a trace of an opened selenium capsule would allow me only 4-5 hours sleep per night. Question 1: does the thyroid ever recover from antibody damage, if antibodies are successfully lowered? (Is it too late for me to start Selenium now?) Question 2: Given my condition, what is the big deal with sugar? Is honey or other forms okay for me? I probably have 35g sugars from oatmeal-nut cookies per day, but otherwise a really clean Feingold diet. I hear/read much hysteria about sugars even for people without thyroid issues; what’s the big deal? Without sugar throughout the day I have trouble thinking and I have real trouble with hypoglycemia if I go too long without food. I’m running out of things that I CAN eat, so how do I make it without sugar?

amanda brennan - January 3, 2017

Hi Dr Child’s
I desperately need your advice!my husband and myself are trying for a baby over the last year with no success.I am on clomid and metaphormine as they say I have polycystic ovaries.I have been taking these for four months now!my day 3and 21 bloods keep are all coming back normal exact my tpo’s are 360!all the doctors are telling me to overlook this but i feel that this may be the problem.what can I take or get prescribed to reduce these tpo’s!I am getting very frustrated and would really appreciate your help.

    Dr. Westin Childs - January 3, 2017

    Hey Amanda,

    I would also recommend that you be properly evaluated with a complete thyroid panel, low T3 (even in the face of a normal TSH) may indicate sub optimal thyroid function and optimal thyroid function is necessary for conception.

Jessica - January 18, 2017

Hi Dr.westin

Exactly one year ago my world was turned upside down. I Almost want to say from night to day I became ill and it only continues to get worse day to day. I first noticed 2 alopecia areata spots then I noticed weight gain and muscle loss then very oddly started having cellulite all over my body along with bad muscle fatigue and weakness and daily anxiety depression fatigue. After seeing every kind of doctor I can think of and testing several different things I’ve gathered my own conclusions that show I have low testosterone low platelet and white blood cell slightly high antibody in my thyroid height rt3 and low t4 and low vit d . I’ve been having the hardest time finding a doctors to help properly diagnose and treat me.im from Houston TX is there any way you can recommend your services local or someone to help me! Any response would be life saving

    Dr. Westin Childs - January 18, 2017

    Hey Jessica,

    Thanks for reaching out, unfortunately I don’t know anyone that practices like me in that area. The best advice I can give you is to look outside of the insurance model and the conventional PCP’s and/or endocrinologists – they will all treat you the same way.

Avery - January 19, 2017

I’ve been struggling with infertility so I decided to order my own labs since I have always suspected my thyroid despite 2 different “reproductive endocrinologist” telling me that this can’t be the issue since my TSH is in normal range. I got a full panel done on my own and it showed TSH: 3.97. freeT3: 3.0. free T4: 1.1. TPO antibodies over 400; thyroglobulin antibodies 3; and ReverseT3: 13. I have already started gluten free diet despite being ridiculed and made fun of by friends and family, they say it’s ignorant since I do not have celiac. What else can I do to decrease my antibodies so that I can eventually go on to have a safe pregnancy? I’ve seen studies showing thyroid antibodies increase risk for neurodevelopmental issues in fetus, increase risk of miscarriage, etc even with a “normal” thyroid. I want to lower the antibodies as quickly as possible. What can I do besides gluten free and possibly selenium supplementation? What would be the best type of thyroid supplement to help me with this goal? NDT? Synthroid? Compounded t3/t4? I have a family doctor that is willing to work with me but he does not know the best course of action and neither to the obgyn or RE’s I’ve seen….i have no diagnosed health conditions other than unexplained infertility ( have had HSG, exploratory surgery, etc all normal, hormones normal, no pcos) and take nothing but a prenatal.

    Dr. Westin Childs - January 19, 2017

    Hey Avery,

    In order to get results beyond what you see written here you will really need to work with someone on a 1-on-1 basis who understands what I’m talking about. There is no substitute for guided help when it comes to medicine and health because each person is so unique.

Laura - January 20, 2017

My TPO antibodies wete at1200 when I was first diagnosed with Jashimoto’s a few years ago. I cut them in half when I eliminated gluten, & they decreased even more when I gave up dairy & soy. I’ve been following the AIP protocol, been supplementing with zinc & selenium, & my antibodies are a little over 100. While they have been decreasing, it’s been going very slowly over the past year. Do you think I should just continue what I’m doing or should I try LDN? I’m not sure if it’s worth it since my antibody levels are much better, although still not optimal.

    Dr. Westin Childs - January 20, 2017

    Hey Laura,

    When it comes to treating Hashimoto’s I care much less about the absolute value of antibody levels and more about the symptoms of the patient, so instead of laser focusing on your antibodies (which don’t necessarily correlate with disease progression or severity) it’s far better to let your symptoms guide you.

Jen - January 20, 2017

Hello. I was dx in September 2016. My antibodies are in the 600’s. also,i had low dhea, progestrone and testostrone levels.at my 3 month check my testostrone level went up from 13 to 15 and tpo went down almost 500’s. I was wondering can you supplement both testostrone and dhea? I just started testostrone troche 30 days ago, along with an increase in my NP thyroid. About a week ago, I noticed a change in my energy. I am not aure of it is a combo affect of splitting my NP and or the low dose testostrone troche,but is nice to have energy ALL day long.

    Dr. Westin Childs - January 20, 2017

    Hey Jen,

    Yes, supplementing with DHEA and testosterone is fine assuming you tolerate both and are not converting much of it to estrogen metabolites.

Jackie - February 1, 2017

Hello, I am diagnosed with Graves Disease with high T4 and T3 levels as well as high antibody levels. Do the therapies you describe also apply to Graves Disease. I saw my endocrinologist today and he is unaware about any diet or supplementation to reduce my antibody levels. I am very interested in what I read on your page. I just want to confirm that it applies also to hyperthyroidism.

Mary Jane Pranger - February 3, 2017

I just had my yearly checkup for Hashimotos and my TPO was 202. When I was diagnosed in 2012 it was 288 went down to 198 in 2013 then up to 214 in 2014, down to 179 in 2016 and now is back up to 202. I take 600mcg of selenium (as selenium yeast) a day, a Centrum, magnesium, fish oil, synthroid and 2000IU of vitamin D3. My practioner suggested selenomethioine; should I try that? What are other tips to reduce the inflammation?

Mary - February 15, 2017

Hello Dr. Childs,
Thank you for your article.
I was diagnosed with Hashimoto’s at the age of 11 and no endocrinologist has ever attempted to treat my symptoms. Thankfully my mother worked at a health food store at the time and through her own research quickly put me on zinc & selenium which helped tremendously. I have been on and off of that combination ever since then.
I was fascinated with the chart in your article (foods to avoid). That was very eye opening to me. I eat eggs and yogurt almost daily. I have noticed a reaction when eating nuts so I have completely eliminated them from my diet (i.e. I would develop cystic acne over night after eating even a hand full of nuts- again, a type of inflammation).
I am now 30 and pregnant and am just wondering what I can do about my diet to ensure I am still receiving all the nutrients I need while working on lowering my TPO count (I always have over 800).
Thank you for sharing your knowledge with many of us with this condition who may feel lost or a bit helpless. It is much appreciated.

Anjuli - February 28, 2017

Thank you Dr! This is such an informative site, thank you for doing this! My antibodies started coming down last year through elimination of gluten/dairy/soy (from 2,800 to 1,200 in 3 months), but they’ve recently jumped back up to over 3,000. I’ve noticed that I’ve been reacting to foods I didn’t used to – I feel like I’m getting backed into that AIP Paleo corner. The more I eliminate, the more sensitive I become.

Before going full AIP Paleo, I’m going to look into your suggestions for better management (Switch from synthetic T3/T4 to WP Thyroid, Immune/allergy testing, insulin resistance test, DHEA/Adrenal testing and LDN.) Would you recommend this approach prior to going full AIP?

Thank you again!

    Dr. Westin Childs - February 28, 2017

    Hey Anjuli,

    Yeah, that approach sounds reasonable and leaves more options open for later, provided you are feeling okay in the mean time.

Sharon Bailey - March 3, 2017

My tpo is 1300>

Meredith Parrish - March 31, 2017

Thank you for sharing your knowledge and what you know has been effective with your patients. All encompassing and very helpful. I was diagnosed with Hashimoto’s thyroiditis 6 months ago and it’s a process, but finding a doctor who has experience with improving and moving the condition into remission is the most challenging I’ve found. Are you available for phone consultations, and if I’m a good candidate, and would you be open to possibly treating me long distance (phone, Skype, labs)? Very motivated to improve my health and a compliant patient. On 1 gram of nature thyroid and have been gluten, dairy and soy free for 2 months, but antibodies are still high. TPOAb 62, and TGA 3.5. Kind Regards, Meredith

Jennifer - April 1, 2017

How often should I be tested for the thyroid panel?

K - April 3, 2017

Back agin 😉 SO, I am currently in an active Graves phase (after remission 4 years ago and thyroid replacement meds for three years). This time around my symptoms are much less physical (not so much cardiac, temperature, tremors) so far and very mental/mood/nuero. I am having very strange “tingling/tickling” in my “brain”, mind restlessness, uncontrollable crying, anxiety, and eye issues. It’s all in my head this time around. My concern is this waiting period my doctor has me in until we can schedule a iodine uptake scan to discuss permanent solutions. We are currently not treating anything, it has been three weeks!

My antibodies are skyrocketed (Hashi and Graves).
Thyroid Stim Immunoglobulin 760% 0 – 139
Thyroglobulin Antibody 7.7 0.0 – 0.9
Thyroid Peroxidase (TPO) Ab. 354 (was 2908.4 years ago)
ThyrotropinSH receptor antibody 11
TSH <0.001 (undetectable)
T3 4.81
T4. 1.64

My concern is the mental/mood/brain symptoms happening.
My question is: Will antithyroid meds (methimazole) decrease the antibodies? Will anything decrease antibodies? Thryoidectomy? How can I decrease antibodies the quickest?

Victoria - April 13, 2017

How is it possible to get LDN if my dr refuses. To prescribe it.
My TPOS at the moment are more than 6000 and tgab was 150
I am trying to lower with diet I am gluten free and don’t eat soy and only dairy I have is in tea and coffee.
I take 200 mcg Levo and 40mcg lihothyronine
I am in the uk.
Thankyou for your amazingly informative article , I have learnt so much from this one article.
It was so very interesting.
I wish I could find a dr who was as fantasticly knowledgable as you are on this horrible and frustrating disease 🙂

    Dr. Westin Childs - April 13, 2017

    Hi Victoria,

    I don’t know of another way to get LDN unless it’s provided through a prescription. You could try calling a compounding pharmacy and asking if they have any providers that prescribe LDN and then trying to find those people.

Liana - April 21, 2017

Hi Dr. Childs: I started off with my first full panel in Jan of 2016. That was taken 5 years post-Dx’d Fibromyalgia. I have been eating totally gluten free for 10 years now with an inconclusive test result for Celiac Disease halfway through this period, and after elimination testing predigested dairy (cheeses, plain yogourt) or butter/ghee does not seem to be a problem for me. I eat Low Carb (approx 50g net)/Moderate Protein/Higher Fat for the past 3 years (almost all fresh unprocessed food) and am 5’8 and 140 lbs with a low-normal healthy Waist to Hip Ratio and Waist to Height Ratio.
I went from 1108 U/ml to 407 U/ml in 8 months with no changes other than adding in supplementation to my regular vitamins/minerals – Selenium 200 mcg, and L-Tyrosine 500 mg per day. Continuing with that, my next panel 6 months later has dropped my TPO antibodies to 328 U/ml.
I also take Zinc, and Copper to balance it.

I will continue with this regimen to drop it lower, but am concerned a bit because all my other Thyroid levels have dropped slightly too (although still within ‘normal’ reference ranges.

Should I be worried about this? It is hard to tell if any issues arising are tied to Hashi’s or to Fibromyalgia. I do not take any conventional medications for either of these conditions right now.

Thank You.

Elaine - April 25, 2017

We all know that BRAZIL nuts is the food that contains the highest amount of SELENIUM which is VERY CRUCIAL to good thyroid function. This list is very confusing as it conflicts with the FODMAPS list and other do not eat lists.


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