5 Tips to Lower TPO Antibodies to Help Reduce Your Symptoms

*This post was most recently updated on January 29th, 2019 with new information.*

Do you have Hashimoto's thyroiditis with elevated antibodies?

Would it surprise you to know that it may be possible to lower these antibody levels and reduce the damage done to your thyroid gland? 

Many doctors seem to blow off the fact that you have elevated TPO or Thyroperoxidase antibodies by saying that it doesn't affect treatment or worse, they don't even test for them. 

It turns out that having elevated antibodies is a big deal because it may affect your treatment. 

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

This article highlights several therapies that I've used successfully in patients to help them LOWER their TPO antibodies, inflammation, and reduce the autoimmune process.

These therapies may not work for everyone with Hashimoto's thyroiditis, but they should still be considered in most cases. 

More...

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 is greater than 5.0 they will slap you on some levothyroxine and call it a day.

If this approach doesn't sound appealing, you are not alone because there may be a better way. 

While TPO antibody levels can be difficult to lower (and may not be possible in all situations), they should still be monitored every few months at a minimum. 

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

Having said that:

It's equally important that you don't hang all of your efforts or success on the absolute level of your antibodies. 

Some people may notice a significant improvement in their symptoms as they follow these therapies while their antibody levels may paradoxically INCREASE. 

This is not necessarily a problem, as anti-thyroid antibodies don't always track well with your disease state. 

Like many things, they can't and shouldn't be evaluated in isolation, but when used with other tests and markers of hypothyroidism, they can provide valuable data. 

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This list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose thyroid hypothyroidism correctly!

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​What is the Normal Range for TPO antibodies?

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

That means nonexistent or < 30 U/mL. 

The reason for this is simple:

If we know that the presence of antibodies indicates potential damage to your thyroid gland, then having those antibodies as low as possible will increase your chances that very little to no damage is taking place. 

You can see an example of the thyroperoxidase antibody reference range below: 

Slightly elevated thyroperoxidase antibodies

As you can see from the image above, the "standard reference range" provided by the lab is anything less than 60 U/mL. 

But, when I look at it, I take it a step further by looking specifically for the "optimal reference range" which I define as anything less than 30 U/mL. 

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

Remember:

Hashimoto's thyroiditis exists on a spectrum of disease severity. 

Before you develop the full-blown symptoms of Hashimoto's you will first start to experience minor symptoms. 

It's much better to catch your diagnosis EARLY so you can prevent the disease state from worsening. 

That's why I prefer to 'tighten' up the reference range and why I consider anything less than 30 U/mL to be healthy. 

And, by the way, this idea of looking at optimal reference ranges over the standard range also applies to all other thyroid lab tests

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 considering with the treatment below. 

It might also be worthwhile for you to undergo a trial of thyroid hormone replacement medication as you might find significant benefit. 

Therapies that May Help Lower 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.

Before we dive in, just be sure to remember that each person is different. These therapies may not necessarily work for you or you may need to make adjustments to them. 

When in doubt, make sure to discuss these therapies with your current physician (and if you aren't seeing the right type of doctor make sure you check out my tips on how to find one here). 

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

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

#1. Get on the Right Diet for YOUR Body


The first, and perhaps most important step, is to take a long look at the foods that you are putting into your body. 

And by that, I am referring to your diet.

Not the type of diet that you get on for a few weeks or days, but a lifestyle shift which helps you continuously and consistently put healthy food inside of your body. 

Maybe you are already eating 'healthy' foods and you think this section doesn't apply to you. 

This type of logic may not necessarily be true, especially considering that there are many types of 'healthy' diets and you need to spend time finding the one that works well for you. 

If you are not already eating a healthy diet (whole 30, real whole foods, paleo, AIP, ketogenic, etc.) then you will probably find a big benefit to switching to any of the diets we are going to discuss. 

If, however, you are already eating healthy but not feeling better, then you may want to consider making changes. 

For a more detailed post on diet and how it impacts Hashimoto's, please see this post

Below you will find information on 4 different types of diets that have worked well for many patients with Hashimoto's.

Spend some time looking at the pros and cons of each to help you determine which diet may be ideal for you.

Autoimmune Paleo Diet or AIP Diet
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 (It's basically the paleo diet without nuts and nightshades) and can be difficult to follow and maintain over a long period of time. 

One of the downsides to using this diet is that some people end up restricting their diet so much that they develop an intolerance to healthy foods and have trouble re-introducing them back into their diet. 

Typically I recommend this diet for patients who have failed less restrictive diets or for those who have a history of multiple autoimmune diseases on top of their Hashimoto's thyroiditis. 

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

Elimination Diet

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

In a nutshell, the elimination diet works by removing certain food groups that may be perpetuating inflammation in your body. 

As you remove these foods, you will most likely start to feel much better. 

You can do this diet 1 of 2 ways:

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

Food intolerance testing, while potentially helpful, is certainly not 100% reliable or accurate. 

Often, people will find that they are 'reactive' to MANY different types of foods and food groups which don't necessarily reflect reality. 

I rarely use these tests nowadays because I find that teaching patients how to monitor their body and how they are feeling to be much more effective. 

#2. Remove the most common food allergies and monitor your symptoms upon reintroducing those food groups.

You probably have a good idea which foods you should or shouldn't be eating and if you remove these food groups for 6-8 weeks you'll probably be surprised how well you feel. 

And you can always reintroduce them back into your diet to see how your body reacts. 

From there, it's just a matter of trial and error until you figure out what your body does well on. 

Gluten Free, Dairy Free, and Soy Free Diet

Perhaps one of the best shotgun approaches to changing your diet is by going gluten-free, dairy-free, and soy-free. 

If you aren't sure where to start then you may want to start here. 

While not everyone with Hashimoto's will need to stay off of these food groups long-term, it's still a great place to start. 

I don't believe that everyone with Hashimoto's HAS to be gluten-free forever, but I do find that foods containing gluten can exacerbate and perpetuate inflammation in the gut and temporarily removing them for a short period usually helps most people. 

SIBO and Low FODMAP's Diet

The last diet I want to mention is the low FODMAP's diet

This diet is designed to be low in certain types of carbohydrates because these carbohydrates can accelerate the growth of potentially negative bacteria in your GI tract. 

Many patients with Hashimoto's also suffer from gut related issues such as constipation, SIBO, fungal overgrowth, irritable bowel syndrome, and so on. 

This diet can be very helpful for people with these conditions. 

By improving your gut function you may be able to reduce inflammation and autoimmunity and ultimately help treat your thyroid as well. 

Before you jump into this diet, however, you will probably want to confirm that you have some intestinal issues which warrant its use and you may need a doctor to help with that. 

#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 (1). 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 how Testosterone, DHEA and androgen levels interact with your immune system. 

It is currently felt that higher (or should I say 'normal') levels of testosterone may help prevent the onset of autoimmune disease and is protective against these diseases. 

This also means that people with LOW testosterone may be at increased risk for developing Hashimoto's thyroiditis. 

And this certainly holds true in my experience, as I often test each and every patient with Hashimoto's for both testosterone and DHEA. 

My experience suggests that most women with Hashimoto's also tend to have lower than normal testosterone for their age. 

If you are someone who has both Hashimoto's AND low testosterone, then you may benefit from the use of testosterone cream or gel. 

The goal when using testosterone is only to help balance out your levels and get you back to 'normal', not to give you more than you need. 

Using testosterone in this way makes it a very safe and effective treatment for both men and women. 

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

With all of these benefits, you may be wondering if you need testosterone replacement therapy. 

The way you find out is simply by testing both your testosterone and DHEA-S. 

You can do this with a simple blood test: 

Low normal testosterone levels

Once you have your tests in hand, all you need to do is look at your result and compare it to the reference range. 

I find that women with testosterone (free or total) in the bottom 1/3 of the reference range often benefit from taking testosterone. 

As you take testosterone you may want to shoot for a serum total testosterone in the 200-300 ng/dL range. 

As you take testosterone, make sure you monitor both your symptoms and your total and free testosterone levels. 

You can get testosterone through gels, creams, pellets, or injections

Beware of using DHEA by itself if you have low testosterone!

DHEA can become converted to either androgens (testosterone) or estrogens based upon the preference of your body. 

You may take DHEA to try and push your androgens up, but your body may take that DHEA and create more estrogens instead. 

#3. Consider Using Vitamins & Minerals


The use of certain vitamins and nutrients may help improve your immune system and help reduce thyroid antibody levels. 

It's always a good idea to ensure that you have an optimal level of ALL nutrients in your body at any given time, but there are certain nutrients which play an important role in both regulating your thyroid and your immune system. 

Two of the most potent nutrients include Zinc and Selenium.

Many hypothyroid patients find that they are deficient (even just slightly) in either or both nutrients. 

And this deficiency can lead to poor thyroid hormone conversion, immune dysregulation, and other symptoms

These nutrients work by helping your body in the following ways:

Zinc helps: 

Selenium helps: 

My experience suggests that most people who are deficient in one are also deficient in another. 

And testing for deficiency with blood tests is not always accurate so the best way to approach supplementation is often to take both together. 

I find that using them together tends to provide the best results. 

My personal recommendation is to use both together (along with other nutrients designed to enhance thyroid function) found in this supplement.

Feel free to use other supplements if you prefer, I just recommend what I know works. 

In addition to Zinc and Selenium, you'll also want to look at your Vitamin D status. 

Vitamin D is another nutrient involved in regulating your immune system and it is well known that patients with Hashimoto's frequently suffer from Vitamin D deficiency. 

How to fix this problem is not quite clear, however. 

My personal recommendation is to use a low dose of Vitamin D and try to get the rest the "all natural" way through sunshine

#4. Improve your Gut Function


I mentioned earlier that many patients with Hashimoto's also suffer from gut-related issues. 

I want to take a second to expand on that here. 

Your gut is the center of thyroid hormone conversion, neurotransmitter production, and immune system education.

Any problem in your gut may, therefore, affect and alter any of these systems. 

There are many gut-related issues that you can suffer from, but I find that patients with Hashimoto's tend to experience two conditions which are often underdiagnosed: 

  • SIBO or Small Intestinal Bacterial Overgrowth
  • Yeast Overgrowth

Studies have shown that up to 54% of hypothyroid patients suffer from SIBO (10).

Not only that but having SIBO can increase your risk of developing autoimmune disease and can potentiate inflammation if it's already present (11).

​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?

​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 as most people experience a combination of these conditions. 

SIBO and other gut issues may also cause food intolerances and other symptoms such as constipation. 

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

In some cases, herbal remedies may not be enough and you may require antibiotics like Rifaximin or antifungals like Diflucan as well. 

If you aren't sure where to start with your gut health then using a probiotic is always a safe bet. 

Certain probiotics can help balance bacterial concentrations in your gut, can potentially help with weight loss, and may promote immune balance as well. 

#5. Consider using LDN (Low Dose Naltrexone)


LDN anti inflammatory agent

In this case, I saved the best for last.

I've found low dose naltrexone (or LDN for short) to be particularly helpful in lowering antibody levels, reducing inflammation and reducing chronic pain.

​What is LDN?

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

It is conventionally used to treat alcohol addiction, but in LOW doses it can help modulate the immune system and may treat certain autoimmune diseases. 

It was first used to help patients with HIV back when there were very few treatments available, but it has since been tested in many other medical conditions and found to be quite effective.

The mechanism of action is not well understood but it probably works by temporarily increasing endorphin production. 

LDN has been shown to be beneficial in the following ways:

​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 you find it stimulating.

Your 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.

Conclusion

​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 or questions below!

References (Click to Expand)

This post was most recently updated on August 1st, 2019

Dr. 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.

160 thoughts on “5 Tips to Lower TPO Antibodies to Help Reduce Your Symptoms”

  1. 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!

    • 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.

      • 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?

  2. 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?

    Thanks!

    • 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.

  3. 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

    • 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.)

  4. 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

    • 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.

  5. 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

    • 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.

        • 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.

      • 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…

        • 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.

    • 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!

  6. 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. 🙂

  7. 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

    • 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.

  8. 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.

    • 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.

    • Hi Stacy,
      I am in similar situation my antibodies never seem to go below certain level trying selenium ,zinc supplements. How did you manage your thyroid in pregnancy and does tpo , tgbn antibodies have and effects on fetus?
      How did you sail through pregnancy ? I am also trying to stay of gluten and sugar finding it so hard I end up not following that on certain days.

    • I believe it’s the NDT that’s keeping your antibodies elevated. That’s what my naturopath told me. When on T4 only my anti-tpo was around 134. Now it’s in the 400’s and won’t come down ever since I started Naturethroid or NDT. The only reason why I stay on NDT is it keeps my weight down but other than that I don’t like it at all.

    • Hi Stacy, just read your post and wondering, did you manage to bring you tpo levels down? Did your pregnancy have any influence on tpo and tsh numbers? I have the same situation, tsh levels in range, tpo above 1000.

  9. Hi
    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

    • 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.

  10. 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!

  11. 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
    ESTRADIOL 259 FOLLICULAR 77-921 PMOL/L MID-CYCLE 139-2382 LUTEAL 77-1145
    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

    • 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.

  12. 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?

  13. 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.
    Thanks
    Amanda

    • 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.

  14. 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

    • 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.

  15. 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.

    • 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.

  16. 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.

    • 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.

  17. 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.

    • Hey Jen,

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

  18. 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.
    Thanks!

  19. 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?

  20. 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.

  21. 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!

    • Hey Anjuli,

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

  22. 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

  23. 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?

  24. 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 🙂

    • 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.

  25. 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.

  26. 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.

  27. Hi, I have high levels of TPO antibodies but my doctor said I don’t need treatment and my thyroid is working fine. Can I use ashwaghanda to lower the antibodies? Will this make my condition worst?

  28. Hey there,

    I recently visited a doc who ran a TSH, T4 and Thyroid Perioxidase antibody tests. My TSH was. 04, T4 at 1 and antibody test was 20. He mentioned Hashimoto’s thyroiditis but wants to watch things as my T4 is still within the normal range. I’m OK with that for now but my confusion comes with why my TSH level is so low. When I asked him about this his explanation was that my TSH was low because the antibodies’ eating’ my thyroid were effectively regulating my thyroid function… That T4 was being dumped into my system from the destruction of my thyroid tissue, which caused the normal T4 level, and that because my T4 was normal my pituitary didn’t need to produce TSH.

    I absolutely understand his rational but I’d think that my TSH would then fall within the normal range and not below it. Any thoughts?

    Also, I have to admit I’m uneasy with letting an autoimmune response ‘regulate my thyroid function…

    I already eat a Paleo diet, I have PCOS and a history of autoimmune dysfunction why I’m open to anything, except being complacent when it comes to my health.

    Any insight would be greatly appreciated, thanks!

    Jaime

    • Hi Jaime,

      Generally if your TSH is suppressed it’s due to over production of thyroid hormone from the gland from inflammation.

      • Hello,

        Thank you for your reply and yes, that’s what I thought with the decreased TSH (.04), that is indicative of Hyperthyroidism. But my Free T4 is on the low end of normal at.96 (I rounded up in my initial message) and as I understand it, free T4 is then elevated… Also, if it’s Hyperthyroidism, why are there antibodies present?

        I’m a RN, have worked in the ED and SICU of a level one trauma center for almost 20 years, understand the physiological process well and my knowledge is telling me that this doesn’t make sense. A low TSH and lower t4 I’d indicative of secondary hypothyroidism as opposed to Hashimoto’s. Am I wrong? And do you still see elevated antibodies in secondary hypothyroidism?

        Thank you very much in advance. I truly appreciate your input as I’m not getting many answers from my doc.

        Take care,

        Jaime

  29. My TPO antibodies are >1300. I went gluten and soy free a year ago. I recently had TPO blood test again and they are still >1300. A few times during the year I consumed soy in products by accident but as I was so strict the rest of the time wondering why the antibodies didn’t lower.

    • Hi Gill,

      For best results you need to combine the therapies listed above. One is generally not enough to influence antibodies significantly.

  30. HEllo
    I recently had some thyroid tests done and all but the antibody test were normal. the doctor’s only response is to wait three months and re-test. I have been very fatigued, have brain fog and have trouble losing weight. Should I be more assertive in getting proper treatment or be worried or is it nothing. Thank you so much

    • Hi SG,

      It really depends on your symptoms. Unfortunately many people suffer from hypothyroidism related to Hashimoto’s but thyroid labs remained relatively preserved for quite some time before conventional physicians are willing to treat. If that happens to you then you may want to seek out a provider who is more willing to treat your symptoms and antibody levels.

  31. Dr. Childs, I am at the end of my rope with this disease! I have been on paleo, AIP, Keto and no matter what I do…I cant lose anymore weight. My antithyroglobin
    antibodies are ALWAYS greater than 1000! They never lower….my tpo lowers with diet.I take 3 grains of westhroid per day…split dose. My tsh is 0.1 but I do not feel hyperthyroid! I am exhausted! Always! I have paid to see functional medicine doctors and everything come to a hault. I worry about my health with my thyroid nodules and my moms sister having thyroid cancer plus hurthel cell cancer…that if I dont find help for myself…I will be in the same boat as my aunt. Truthfully..how is ones tsh 0.1 and still feel lethargic?? How is this even possible? I am beyond frustrated and no one seems to want to help me..I just get sent out the door. Any suggestions?

  32. Hello,

    I’ve been seeing a D.O for my primary and she is amazing. She’s has done a lot of this with me. She pulled me off synthroid after endocrinologists put me on this for five years and it did nothing for me. She switched me to naturethroid and that has increased my T4 to T3 conversion. My antibodies were at 1000 and now ate at 431. She removed me from gluten and dairy and has found that I was deficient in iron and ferritin (7), B12, iodine, zinc. She has me on metagenci supplements to address the deficiencies. My testosterone, estrogen and androgen levels are within normal range. Is there anything else I can do to get these antibodies down. 431 is still just too high for me.

    Thank you so much!

  33. Hello,
    My name is Amanda.im 29, and I was diagnosed with hashimotos hypothyroidism 3 months after I gave birth to son, that was 5 years ago. All the specialist told me was to take the meds and try to loose weight. I’ve always been overweight, so I didn’t pay much attention to my symptoms. I just thought I felt bad because of the weight, but no matter what I tried I could never really loose the weight. He started me off taking 125mcg levothyroxine. I’ve been steady at that dose all these years. But recently we have been thinking about having another baby, and in doing research about hashimotos and pregnancy I decided to get my antibodies tested.(they never were apparently) I had already gone off alcohol, and caffeine, and had been taking prenatal vitamins for 3 months when I got the results,,, 565!!! Way too high, especially since everything I’ve read says antibodies can hurt the baby, and possibly terminate the pregnancy. All the while my family doctor is saying ,”yea , go ahead and start trying, ur tsh is fine”!!! I’m so frustrated, my son is already 5, and we’ve wanted more kids for a while now. I’m currently trying gluten free, and soy free diet, but I don’t know how long this will take to lower the antibodies. Should we completely stop thinking about babies right now? If I get pregnant with high antibodies should I be worried? What tests or supplimenta should I ask for the next time I go to the doctor?
    Thankyou for your help and this information,

    Amanda Rodriguez

  34. I just completed 12 weeks of elimination/aip diet, and my antibodies went down about 10%, from 147 to 128. Should I be happy or disappointed? The AIP diet was extremely difficult to stick to, and I don’t know if it’s worth trying to continue. I didn’t see much improvement in my other symptoms.

    • Hi Michele,

      When treating patients I’m less interested in absolute antibody value so much as I am a reduction in negative symptoms.

  35. If the diet, lifestyle changes, and supplements are enough to bring slightly elevated antibodies back into the optimal range, and the other thyroid numbers are normal, does that mean those things are enough to keep Hashimoto’s from progressing? Do you ever see in your practice people who are successful with catching it early, prior to thyroid damage, and then are able to manage it without thyroid meds?

    Thank you!!!!!

  36. Hi, My Thyroid Peroxidase Antibody <60.1 U/mL on 11/11/15 was 3871.5 H, on 1/13/16 was 4539.3 H, and on 2/8/17 was 4797.6 H. I had it tested again today and am waiting on results. My Anti-Thyroglobulin <61 U/mL on 11/11/15 was 180 H and on 1/13/16 was 227 H. They started me on Cellcept and Gammunex-C in March 2016 following Hashimoto Encephilitis diagnosis. I cound never stabilize on synthetic T3 and T4 and have been better after switching to Naturethroid 6 years ago. I've treated SIBO, am on LDN (8/2016), follow GF, LowFodmap, no soy, low dairy, and low histamine (mcas) since at least 1/1/2016. Gammunex-C causes thrush every round (every 28 days) and i take a nystatin rinse. After the antibiotic failed for SIBO treatment, I did low FODMap and incorporated ferments in. Between ferments and LDN, SIBO subsided. They are now talking about putting me on Rituxan. I'm exhausted. I can no longer understand technical or advanced writing and cannot do math, both of which I need for my licensed career. What else should I be doing? I'm 41 and want my life back. I appreciate your feedback.

  37. Love your articles! I took myself off of gluten and dairy and my TPO went from the 300s
    to 83.
    Just recently started LDN but have used it in the past.

  38. Thank you for all of the information you have shared. My doctor has tried to put me on LDN several times and I have resisted because I don’t like prescription drug side effects. Can you go over some of the long term side effects of LDN. also, I read that a side effect to selinium was developing skin growths( may not be true), is there a safe but effective dose you would recommend.
    Bless you for all you are doing.

  39. Hello,
    Thanks for the interesting article. With regard to LDN, I read something that is rarely written about–If a person should need emergency surgery, the LDN would not have time to clear the body (as opposed to a scheduled surgery since it deals with the opioid receptors) and the person on LDN would not respond to the anesthesia (which seems like it could be quite horrific). Are you willing to respond to this concern? Thanks!

    • Hi Sue,

      The answer to your question is quite complex but the short version is that it shouldn’t interfere to any real degree. It sounds like the kind of thing that is propagated on patient message boards and not really grounded in science.

      Induction with anesthesia is generally done with a combination of medications including potent narcotics, benzodiazepines and muscle relaxers. Anesthesia is then maintained with different medications or gases such as isofluorane, desflurane or sevoflurane – all of which work through different mechanisms. Anesthesia can also be maintained through propofol if necessary which works by influencing GABA receptors and blocking sodium channels. The point is that narcotics have a place in anesthesia but they certainly aren’t front and center.

      In addition, high doses of narcotics would simply out compete binding sites by naltrexone and make the the medication far less effective. Also, naltrexone, as far as opioid blockage is concerned, is metabolized rapidly which is why it must be maintained through infusion in overdose situations.

      I would suspect the reason that no one talks about it is because it’s not an issue.

  40. Dr. Childs,
    I have been following a paleo diet for the last 5 months as well as supplementing zinc and selenium. I was recently disappointed to find out that my TPO increased! I have to be super careful because I have had weight loss surgery and I am now slightly underweight. I did have gut issues but now is mostly resolved. I feel like I have had improvements in my overall health so I don’t understand why TPO is rising. It was 176 in June and now in September it is 202. I do not have a Dr. who knows anything about this stuff really so I am basically on my own. Would you suggest I increase my zinc and selenium at this point?

  41. My bloodwork in April, 2017, showed my thyroid peroxidase antibodies at 195. On April 26, 2017 I began to eat gluten free. My recent bloodwork on Sept 21, 2017 showed a number of 18. I asked my primary care doctor. on August 31, 2017, how I could reduce my antibody number. She replied that I couldn’t reduce that number. I asked her if the number would ever go down and she replied no.

    I am angry that doctors give answers that are incorrect and their egos do not allow them to admit that there are alternatives to conventional medicine.

    My 92% reduction of the thyroid antibodies has to be attributed to my gluten free diet. I was not taking any new medication and I was not exercising because of my psoriasis on my legs.

    Don’t put your doctor on a pedestal. They are not always giving you information outside the western conventional medicine box.

    • Hi Linda,

      Thanks for sharing your story and I’m glad you were able to impact your health by changing your diet. Just remember that many other factors can influence antibody levels ranging from stress, lack of sleep to diet and even exercise.

  42. Hello,

    I am a nurse and have a question. I am 53, very healthy, vegan, and a exercise every day for the past 30 years. The only issue I have is I developed post pardum thyroiditis 20 years ago. I have been on Synthroid .1 since that time until this past April 2017. In April, my yearly TSH level was .11mlU/L. My synthroid dose was decreased to 88 mcg at that time. After that decrease in dosage, I felt awful! No energy, couldn’t get out of bed…I dragged through the day! I also gained 10-12 pounds on my normally slim body.( ANd I did not change what I ate!) My AP referred me to endocrine. In September, 5 months after i changed my synthroid dose to 88mcg, my TSH level is 1.0 mlU/L ( nl .3-5.50) , my free T4 is 1.38 ng/dl ( normal .76-1.7), and my Thyroid Peroxidase AB is 635! ( nl under 30). I only list the normal lab values as I know that each lab can have slightly different normal levels :)….Anyway, I want to know what you would advise in this situation.

    THANK YOU!!
    Joanie

    • Hi Joanie,

      This may not necessarily be primarily related to your thyroid, it might be related to menopause or changes in progesterone/estradiol levels. It would be worth evaluating both.

      • Thank you for your input…. and yes…I am definitely going through menopause! Multiple hot flashes a day 🙁
        What do you recommend for people going through this phase in their life?

        Thank you!

  43. Hi

    Just got my results yesterday with :

    – anti-thyroglobulin antibodies at 84 UI/mL
    – T4 at 16,1 pmol/L
    – TSH at 0,04 mUI/L

    I’ve been advised to be seen by an endocrinologist but in Mauritius can’t find anyone, am quite desperate as I’ve been on 25mg Levothyrox daily and 50mg DHEA, treating my infertility situation.

    What else can I do to regulate all this? I’ve been recently advised to use Westhroid and Lugol alongside levothyrox for 2 years before removing completely levothyrox. I’ve gone through some research and found that using Wobenzym can reduce anti-bodies, any thoughts on that?

    Do you think using westhroid and wobenzym in parallel can help to regulate my antibodies?

    Am already on a limited sugar and carbs diet, but most of the foods thats on your restricted list is impossible to avoid being where I am, using digestive enzymes can help? I am already detoxing and taking probiotiocs, sprirulina, chlorella, selenium, krill oil psylium to improve my system.

    Thanks for helping out

      • Well I would love to be able to follow the 5 tips listed but if I avoid all the foods in your list, I have nothing left to eat, in Mauritius we have few alternatives and I cannot do otherwise than eat what’s available locally.

        You mention medications/hormones and supplements, do you mean to go ahead what I had already listed in my previous post?

        Thanks for advising

  44. Hello Dr. Childs! Is it unreasonable for a doctor to refuse to check antibodies?!

    I am pretty outraged about it. I requested my antibodies to be checked (after not having any thyroid labs for more than a year) and she outright refused – with this rationalization that knowing that number in no way helps us.

    I was first diagnosed with Hashimoto’s 2 years ago (age 17) when I suddenly gained 30 pounds. Upon testing, TSH and T4 were both extremely low, and TPO at 263. Other thyroid labs like T3 were found normal.

    They decided to check again in six months and both had risen, putting them in normal range. I lost ten of the 30 lbs. A year later, I switched my PCP, and both have continued to rise, with TSH at 4.16 and T4 minimally increased (1.18). I don’t know what’s going on.

    I wish I could be your patient! The crazy thing is that my doctor herself has Hashimoto’s, but she refuses to order labs for anything but TSH and T4, claiming all else is irrelevant.

  45. Oh, to add to the previous comment, is your training as a D.O. (as opposed to MD) part of what makes you so much more aware of the larger implications of the thyroid issue? I’m so frustrated by the doctors’ rigid-mindedness and lack of flexible knowledge that I’m beginning to think each disease should have its own doctor. 🙂 There are specialists, sure, but perhaps we should be whittling it down even further.

  46. When I was diagnosed hashimotos I did a gluten free diet for 6 months and brought my antibodies down from >500 to 80.
    However the doctor then told me they will vary of their own accord so there was no need.

    Can you explain the benefits of reducing them so I can evaluate how to proceed?

  47. hi,
    I recently was told my antibodies are at a level of 1440. The doctor I had always treated me for hypo thyroid, not hoshi. I was put on selenium, probiotic of over 25 billion, synthroid at .88 mcg from .100 mcg.
    and Vit. B12. I have been doing this for a few weeks and don’t feel any better. My throat on the right side doesn’t hurt anymore, but now I cannot sleep. I am going on a now two day excursion of less than 3 hours per night. My hot flashes have gone down a bit. Still having panic attacks, but not as bad. My question is,
    how long will this take to get under control. I am weepy and struggle with every day tasks. My job, I feel I am not giving my all because I am so exhausted.
    All I want to do is rest. I can’t even handle my finances and luckily they are on autopay. I have a lot of things I want to do and I can’t because I feel so bad. I thought it was menopause, which I am sure is contributing, but when they called and told me my antibody levels, I freaked out. I am just looking around for advice. My doctor is good, I am sure. She did an US on my thyroid right in her office. I have slight scaring/lines on my right side….which explains the pain/swollenness. Just looking for other professional advice. I am afraid I will die and I have too much to do yet. everything is a major effort. I am exhausted. I want to sleep but can’t. I have to be to work at 9 am and it is now 3am. I haven’t slept at all yet and am afraid I will be late for my meeting. I am also worried that my coworkers think I am “dizzy” because I can’t remember things like I used to. Thanks for listening.

  48. Love your blog . Over the past 7 years I have gotten my antibodies down to 139 from 159 – I will try your advice – is my level really high? Do you think it is possible to get it to normal – 35 or 40? Many thanks

  49. My TSH is now 5.3 and i’m convinced from these lab results below and my never ending list of hypo symptoms that I have Hashimoto’s…my GP has made me fight hard for Levoxythyroxine which I am about to start, but what about diet? what can I do to lower my Thyroglobulin antibody’s? i’m reading different advice in different places, which is it that proves a Hashimoto diagnosis? TPO or Thyroglobulin? and how can I lower them with diet?

    ENDOCRINOLOGY
    Thyroid Function
    THYROID STIMULATING HORMONE 4.07 mIU/L 0.27 – 4.20
    FREE THYROXINE 13 pmol/L 12.00 – 22.00
    TOTAL THYROXINE(T4) 83.8 nmol/L 59.00 – 154.00
    FREE T3 4.48 pmol/L 3.10 – 6.80
    THYROGLOBULIN ANTIBODY
    *
    232.000 IU/mL 0.00 – 115.00
    THYROID PEROXIDASE ANTIBODIES 10.6 IU/mL 0.00 – 34.00

    thanks!
    Helen

  50. Dear Dr. Childs: I just listened to your video about lowering Thyroid antibodies and I noticed that you were mainly dealing with hypothyroid problems and mine is hyperthyroid problems. I just had a test done and my thyroid antibodies number was 54. Tsh is 0.006 and T4 is 4.33. The doctor put me on 10mg of Methimazole. I don’t feel my doctors have explained much so I wanted to know if the diets you mentioned would help my problem. My antibodies level are high like you mentioned but my other numbers are running fast instead of slow. Any information you give me would be greatly appreciated. Thanks so much! Sandy Bates

  51. I have been diagnosed with Hashimoto’s but several doctors have refused to treat me for hypothyroidism because they say my levels are “normal.” I’ve been losing my hair for 1/5 years now, it is brittle and dry, and my skin is terribly dry.

    Can you prescribe meds and where are you located?

  52. I started having pressure hives about a year ago and I have been to over a dozen different specialists. None of them thought to check my thyroid because my TSH was always normal. It turns out my antibodies were over 1000 (not sure exactly how many because thats the max the lab would show.) I was on prednisone and antihistamines for over 6 months just to stop the itching. A couple of days after I started taking T4 medication the itchiness went away and my TSH has dropped from 3.4 to 1, but my skin still turns bright red at the slightest touch. I also just started taking selenium about a month ago. I’m a bit confused because some doctors tell me T4 medication will drop my antibodies while others say it T4 meds will only drop my TSH and selenium is the only way to drop my antibodies. I will try every step you mention on this article. Do you suggest anything else I could try?
    Thank you

  53. Hi, I used the AIP and compounded T3/T4 to get my numbers to a good place last year. Since December I went off the AIP – I guess because I was feeling so good at the time. But over the holidays I over-indulged and have had fairly stressful time and everything fell apart. Now my TPOs have shot from 321 to 2300! Have you ever seen this? If course I am back on the AIP. What is the biggest dose of Zinc and Selenium I should take?
    Thanks so much.

  54. Dear Sir
    I am old 44 year and I recently discovered that my Anti TPO> 5000,and other hormones are:
    TSH=1.74
    Free T3=3.61
    Free T4=11.61
    My doctor is not advising me nothing, just lets wait and then we will prescribe medication. Please tell me what to do?
    best regards

  55. Dear Doc – Thank you for your article. I am resistant to the “leaky gut” theories as they seem like the trend right now, and I do not have any food allergy symptoms. I do have a diet with plenty of dairy (for protein-not a big meat fan) and who doesn’t like bread (gluten). My PCP and I have been working for over a year to get my Hashimoto’s under control. Getting off synthetic meds was the best thing I’ve done since being diagnosed. Currently my T3=127, T4=7.0, Free T3=3.5, FT4=0.7, TSH=3.020, which is better than it’s been for a long while. Here is the shocker: Anti-TPO-Ab=683! Which is up from the 483 from 10/2017 and the 218 from 06/2017. We are at a loss. I am 53 and was diagnosed with Hashimoto’s at age 38. I am 5’9″ and 158 so my weight isn’t a huge issue other than I was always very thin before all this started; I am more concerned with my health. Do you have any suggestions? What additional tests would be helpful? Testosterone? I would hate to change my diet significantly. Are there supplements such as Zinc and Selenium (which I haven’t tried yet), that you believe would be helpful? Thank you, Christine

  56. Dr. Childs,

    Three years ago, my TSH was 24 and my peroxidase levels were 3863 U/ml (extremely high). Per my doctor, I started a gluten, dairy, soy free diet. I was very strict about it for a year, but then as time went on became lax on the dietary restrictions. For 2 1/2 years my TSH has been around 2.5. and my weight is about 114, but my peroxidase levels have only come down to 2191 U/ml. I had just visited an opthomologist and he told me I have Thyroid Eye Disease. He said not much can be done to bring down these levels and we must just wait. It’s been 3 years and my level has gone from 3863 to 2191 and he wants it less than 30. How can I accomplish this? I told him about the gluten, dairy, soy free diet and he felt they were unrelated. I felt better eating that way, but what possibly can I do to bring down this inflammation almost 2100 points?

  57. Hi, Just wanted to say that I have been doing the AIP protocol diet since January 4, 2018. Today is February 26, 2018. I just had my blood work done Thursday got my results back today…..in less than 2 months my TPO antibodies went from 68.8 down to 54. Granted they are still high but almost 15 points in less than 2 months…I think thats awesome! 🙂

  58. I’ve been on LDN for the past 5 months. My TPO has gone up since I’ve been on it. I’ve heard that LDN might not make a difference for some people. I’d prefer to be off it, if it is not benefiting me. Do you think that after 5 months I should be seeing results of a lower TPO?

  59. Hi, I just had my TPO levels retested after a month of clean eating (No dairy, sugar, gluten) for the past month, as well as taking supplements that supports the thyroid. It went from 660 to 240. But my doctor seemed unimpressed? I think that’s a huge improvement! Do you have any insight about this? Thanks!

    • Hi Wendy,

      That’s great! Congrats 🙂 As long as you are feeling better and your labs are improving then you are heading in the right direction. Doctors don’t tend to be impressed unless they can take credit for the result!

  60. My testosterone total was 432 I’m 36. It’s often lower too. Below range. My TPO was 52 and thyroglobulin antibodies were 5.8 in a range of 0.0-0.9. My my 4 part salivary cortisole test was normal but lower. Would TRT help and DHEA?

  61. HI, doctor, I was wondering if anti-TPO would end up destroying the whole thyroid gland and Hashimoto is a progressive chronic disease? And also do you need to skip Synthroid the day of lab tests to get more accurate results or its fine to take the medicine and do the blood work after. Thank you my endo does not seem of big help when it comes to answering my questions.

  62. Hi Doc, I’m female, I worry taking testosterone is just going to make my weight problem worse. Im also Type 1 Diabetic since I was a kid (49 now). Sounds awesome but……

  63. Dr. Childs –

    Thank you for this great information! I am starting my gluten, soy, and dairy free today. We miscarried in November 2017 and the only abnormal lab from all of the testing was TPO of 227uIU/mL at the end of December 2017. That number has increased to >1300uIU/mL at the beginning of April 2018. (I’m on levothyroxine and TSH looks good between 1 & 2).

    I started taking Selenium at the end of January after reading that it could lower TPO antibodies but when I told a doc at an appt in Feb that I was taking that along with prenatals as we were hoping to conceive again, she said not to take it as it might cause birth defects.

    I was wondering if you could speak to the safety taking the supplements you mentioned in this article while trying to conceive/during pregnancy. (Testosterone, DHEA, Zinc, Selenium, and LDN). Thanks so much!

    Janie

  64. I’m 56. When I was first diagnosed 10 years ago my TSH was 248, TPO was 600, and my Antithyroglobulin was 22,247…that’s not a typo. Results were verified by repeat testing. Free T3 was 0.3L, Vitamin D 21.2L. I started on 60mg of Armour Thyroid and I’m now at 180mg 10 years later. TSH is now low but TPO is 114 and Thyroglobulin is 883.6. and Free T4 is 0.46. I’ve gone HFLC a couple of times and it helped, but I feel like I’m slowly getting worse. My brain fog is progressing for the worse and I’m beginning to feel hopeless. I’m scheduled to see someone that looks further than just throwing Armour at me and hoping she can help. I’d welcome any feedback.

  65. Hi Dr. Childs,

    Thank you for this highly informative post. I had a partial thyroidectomy 1.5 years ago for a toxic adenoma. My levels had been fine, until recently where the most recent blood test results showed elevated thyroid antibodies but the TSH, T4, and T3 levels are fine at the moment. My family doctor is not concerned, however, I do have food intolerances and IBS, and I rather act early than have to deal with Hashimotos later. Which diet would you recommend to follow?

  66. Dear Doc, I have been diagnosed with Hashimoto’s recently but I have no symptoms, my TPO is high but my TSH is rather normal… as I have no symptoms at all ..:) I’m not sure how to go about it…any suggestions? Thank you for your article.

  67. Hello,

    I was diagnosed with Hashimoto’s 18 months ago with TPO antibodies >1000IU/ml, TGAb antibodies 48IU/ml and TSH initially at 3.6mIU/L. I have not been taking any pharmaceutical medications for my thyroid (the endocrinologist I saw took a wait-and-see approach based on my TSH levels). After 18 months of lifestyle and dietary changes and a range of supplements and vitamins from my naturopath (supported by my excellent doctor) my TSH levels reduced to 2.4-2.5 quite quickly but my TPO antibodies have stabilised at about 740- 760, and TGAb stabilised at about 10-14 from last two test results. I was initially tested for MTHFR mutation (which I have), homocysteine levels (reduced from 14.3 to 8.6umol/L), iron (was very low but now fine), a suite of gut parasites (but not H. Pylori – 2 parasites were found and successfully treated), heavy metals (high load of mercury, arsenic and lead) and Zonulin (OK at the time) but was more recently confirmed to have gut permeability issues after the mannitol/lactulose test. My naturopath has started me on 6 months of a comprehensive gut repair supplement and my doctor has suggested I basically go paleo again for that period. My naturopath doesn’t want to start my heavy metal detox until my gut is repaired and my homocysteine levels are down to about 5. I have been on a gluten free and sugar free diet since initial diagnosis and a 4 month period of paleo early on (perhaps resulting in the good zonulin test result) and in the last 4 months have cut alcohol, caffeine, dairy, chicken, fish and nuts on the suspicion of having ciguatera poisoning – I was eating a lot of locally caught tropical reef fish and developed debilitating acute and chronic symptoms which rapidly abated following the dietary exclusions – though I accept most of those symptoms are also consistent with Hashimoto’s. I have 3 months of the ciguatera exclusion diet to go. Sorry for the lengthy backstory, but I keep hearing that the AIP diet is the go-to for reducing TPO antibodies, but I honestly feel like my diet is heavily restricted already (I don’t eat out anymore – it’s too hard but very anti-social). Do you think I am doing enough and should just hold off starting an AIP diet until I see my test results at the end of my naturopath’s 6 months of gut repair program and then following the heavy metal detox? I will follow an AIP diet if a have to, but it looks depressing and stressful to me and hopefully is a last resort. By the way, my only Hashimoto symptoms currently are occasional mild joint aches and muscle spasms, mild fatigue rarely at the end of the workday, occasional mild head sensations (not aches), occasional tinnitus. I also have occasional insomnia and irritability but that is very cyclical and could be explained by perimenopause (I am 45 and read your bit on testosterone with interest – something to discuss with my doctor). Your thoughts?

  68. Dr.Childs
    I have hashimotos and am having a very difficult time finding a doctor in Dallas that will help, it’s mainly just throwing me a pill. Do you have a doctor you could recommend?
    Please can you help?

  69. Hello,
    I was having great success with lowering my TPO antibodies when diagnosed 2 years ago they were at 200, I managed to lower them to 50 and up until recently, they have started to gradually increase and now are 150.
    I am taking LDN, follow the AIP, take zinc and selenium, so I am stumped as to why they are rising. Surprisingly though I feel much better now than when they were at 50 so I am not sure what is going on. I am just concerned that they will continue to rise and since I have been doing everything under the sun and not sure what else can be done. I am taking Naturethroid and recently had to have the medication compounded and noticed since changing to the compounded formula they have started to rise. I am wondering if there could be a connection?
    Any suggestions would be highly appreciated.

    • Hi Stella,

      If other changes have been ruled out (recent stress, other illnesses, etc.) then that may be the potential cause or a contributing factor.

  70. I read that you should not take iodine if you have Hashimoto’s… but your T3 Booster(which I purchased)!has 75 mg…. can I take these or no? Have not yet and have not shown to my Dr.
    Thank you!!

    Sara Blazo

    • Hi Sara,

      Many people believe this but they don’t realize that iodine is essential for proper thyroid function and it must be taken in some way. You MUST consume iodine in food or take supplements whether you have Hashimoto’s or not because if you don’t then you will worsen your thyroid function. Some people believe that taking isolated iodine can worsen Hashimoto’s, but this almost never occurs if you take it with Selenium/Zinc both of which are in the supplement you are referencing. It’s a common misconception, but it is mostly just an unfounded fear. Many patients that take iodine (even those with Hashimoto’s) actually feel better. Hope this helps!

  71. Hi Dr Childs

    Please advise – my antibodies are decreasing using better diet and life style and my T4 T3 and TSH are now all in the normal range but I still have 361 TPOs please advise how long these peroxidade antibodies live in the system before they die.

    Many thanks Ree

    • Hi Ree,

      They are produced by your immune system so they will stay in your body as long as you are producing them.

  72. Very informative. I’ve been following you for a few months now. On the website and youtube since I was first diagnosed with hypothyroidism and recently,confirmed hashimoto’s. Please continue sharing your knowledge on these conditions, very helpful 🙂

  73. Dr. Childs,

    I have been suffering for month’s, my TSH started at 139. My PCP placed me on synthroid 50mcg since February of this year. My TSH levels have come down drastically, but I am currntly taking 75 mcg and my ANTIBODY levels just came back at 462, is the number. I feel horrible I have lost almost 40 lbs in the last 6 months. I feel the Synthroid is only making my symptoms worse. EXTREMELY Tired, but panicky, shaky, racing thoughts, forgetfulness, confusion, brain fog, VERY HIGH ANXIETY and sleepless nights. I am now seeing an Endocrinologist, but I was VERY limited, with the few of these specialists that accept my insurance. My Dr. thinks it may be a COMBO of Hashimoto’s & Graves Disease possibly, but no definitive answer, only says its Hashimoto’s. I am down to 123 lbs, I was 160lbs before I started feeling “OFF” and losing weight very drastically, and cannot afford to lose anymore weight nor feel horrible everyday. Do you have ANY advice??? I am starting to feel hopeless on getting answers or why I cannot even maintain my weight, when in fact, I am eating. I am encouraged by the information within this article regarding the best diets to follow.

  74. I’m really in need of some help. Since having my daughter more than a year ago I’ve had so many issues with my thyroid. At first my thyroid was in overdrive (so much so that I lost a very large amount of weight in two weeks and had to take medicine to slow my heart rate) shortly after my thyroid stopped working. I’ve since gained a lot of weight and my body hurts everywhere but mostly in my back. I can barely walk and I live on the 3rd floor of an apartment complex without an elevator.
    I’m 24 with a 1 year old and I can’t work, take care of my daughter much less myself because of the exshaustion and pain.
    It seems like my doctors have given up on helping me and I’m so incredibly frustrated. My last test results were as follows.
    Thyroid Peroxidase Ab 5062.9 U/mL
    Thyroglobulin 21 ng/mL
    Anti-thyroglobulin 123 U/mL
    TSH 0.220 mclU/mL

    The only thing my doctor is having me do is take levothyroxine 75mg every day.
    And blood tests every now and again.

    I’m tying to go gluten free after reading this but since I can’t eat meat (it hurts my stomach and I end up throwing up) the other diets seem very restrictive and not something I can maintain.

  75. With the meds they gave me for my Hashimoto’s it appears to be contained. Then last week they ran another test on my thyroid antibody and was shocked. Any thing under 30 is normal mine was 186. People the doc told me I was ok because of my range. Don’t feel fine or good for that matter. Looking for advice cause after all these years my trust in docs is fading…186 wow…no wonder I do not feel well.

    • Hi Jamie,

      Most physicians do not focus on treating antibodies but instead they focus on managing the thyroid with medication. You might be able to impact your antibodies by taking the steps listed in this post, though!

  76. Dr Childs,

    In March 2018 my TPO was 526, TSH 2.5. I had a toxic reaction to Levothyroxine and almost died. Since March I have totally changed my diet and have been treating the digestive and adrenal naturally with all the diet and supplements you recommend minus the DHEA. My endocrinologist basically recommended everything you did. In June 2018 the TPO was 418 and TSH 3.1 but I had started to feel better minus my hair is still over shedding and created a part where I never had one before. Today I received Aug TPO and its back up to 518 and TSH is 2.5. Clearly, I am not getting better. Do I need to do another elimination diet? Start taking DHEA?
    Thank you! K

  77. Hello, I have a question my thyroid levels came back all normal except the thyroglobulin which was elevated. Does this mean I automatically have an autoimmune disease such as Hashimoto’s? I also have IBS so I am wondering if it could be this as well. I was told I had an autoimmune disease due to the elevated thyroglobulin and was wondering what I could do to decrease it. My TPO was negative for antibodies but thyroglobulin tested positive for antibodies. What does it mean and how can I treat it to reduce inflammation with meds, or supplements and diet restrictions? Thank You.

    • Hi Amanda,

      No, the presence of antibodies does not necessarily mean you have Hashimoto’s but there is a very high chance that that is the case. The information in this post should help you to treat the raised antibodies in a natural way.

  78. Hello, I have a six year old diagnosed with Hashimotos and two other autoimmune problems TPO are 222 and Thyroglobulin Antibody are 1122.5HIGH. taking Synthroid 25
    I’m told not to change the diet because still growing. I would like to know if any of this diets would be ok to use on a six year old? Thank you

    • Hi Dee,

      A healthy diet shouldn’t be a problem for a young child as long as you are getting a sufficient amount of protein, fat, carbohydrates, and calories in their body so they can grow normally. There are plenty of other kids who grow up on things like McDonald’s and other unhealthy foods and these diets are far superior when compared to that type of standard American diet.

  79. Hi Dr Childs,

    The biochemistry of my niece recently came out ANTI TPO Chemiluminescence as >1300. She is 18 yrs old. We are from India. How should we take this forward. awaiting your suggestions.
    Thanks in advance.

  80. Dr. Child’s,
    I am a pharmacist in a rural area of Texas and I have a large practice of HRT both women and men for the last twelve years. I began this part of my practice for similar reasons as you stated keep you doing your blog and this aspect of your practice. I just discovered your blog about two weeks ago and have been reading ferociously trying to educate myself as to why my patients have not lost weight after we have balanced their sex hormones. I look at T4, T3, and when I suspected reverse T3 and I recommend treatment when necessary.
    I work with three to four physicians in managing these patients, but after reading your blog feel that I have failed to treat them completely. My current question is “at what dosage of naltrexone should I begin treating a menopausal patient ?”
    Should I double the dose if the patient has bad fibromyalgia?
    If you would prefer to discuss these questions privately, use my email or we could arrange phone conversation if you prefer.
    I would appreciate the guidance so I can continue your ministry/mission here in rural area.
    Dennis, DPh.

    • Hi Dennis,

      As a general rule, I usually start at the lowest dose and then increase based off of the need. A lot of the changes in dosage that I make are based on the patient and clinical intuition so I can’t really give you any hard and fast rules on this one.

  81. I have a question about what vegetarians can eat because I am at an absolute loss. In 2017 I was diagnosed with Hashimotos and put on 25 micrograms of Synthroid. That doctor told me I could eat anything. I switched doctors because she gave the impression she didn’t want to really do anything unless surgery was necessary. At the first visit with the new doctor he took me off of Synthroid because he said only people who are pregnant should be on a dose that low. He also said I have a goiter and two nodules. I am 41 and have been a vegetarian since I was 7. I will soon be looking for a new doctor because I don’t think an appointment should be a grand total of 3 minutes and he bluntly told me that my questions about what causes my conditions are not relevant and if there is something relevant he will tell me. His 3 minute appointment had led me to do a considerable amount of research. I am confused because he gave me a sheet that says to avoid food with iodine but some websites have said thyroids need iodine. Your website says to avoid the same foods that are on his sheet. I am 41 years old and have been a vegetarian since I was 7. For decades I have lived off of beans, cheese, pastas and eggplant dishes. Just last week I had a gorgonzola salad in a bread bowl topped with tomatoes, red peppers and tons of cheese. The next day I had a pasta dish that contained tofu, cheese, potatoes and broccoli. For dinner than same day I had a three bean chili with cheese. I am now at a loss for what to eat. What can vegetarians eat if they avoid all of the foods on your list? Eating plain salad is boring and not healthy. Any advice you can provide would be greatly appreciated. I don’t want to deprive my body of needed nutrients that come from cheese and beans so I am wondering how vegetarians can get the proper amount of calcium and protein.

  82. Hello, I came across this article while trying to make sense of my 14 yr old boy’s blood test. His Tpo is 2412( not a typo) he has a nice size nodule on his parathyroid and his tag is back up to 7.2
    I am at a loss as to how to help! We are seeing an endocrinologist, and we have a repeat sonogram today to see if it’s grown or not. With him being so young, would the supplements be ok for him to take to lower levels?

  83. Hello,

    I have a friend w/hypothyroidism. His iodine and selenium blood /urine test values are extremely high. He does not take these in additional supplements, so the high values are confusing. Any ideas?
    Thanking you in advance.
    Joene

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