Only a holistically oriented therapy can help permanently

Hashimoto’s thyroiditis is still not curable, thus the causes of the disease can not be treated directly. In the targeted therapy, only the symptoms of the resulting hypothyroidism are treated, with synthetic thyroid hormones such as L-thyroxine.

According to most doctors, Hashimoto’s thyroiditis is good for this type of therapy and most sufferers have little or no discomfort.

But in reality it usually looks very different, and there are a lot of patients who suffer from a wide range of symptoms and limitations, even when their blood levels look pretty good at first glance.

But it is true that we humans are very different, and our well-being values ​​are different for everyone. Some require low thyroid levels to feel comfortable while the other requires thyroid levels at the upper limit of normal.

For this reason, it is almost impossible for a doctor to perfectly adjust a thyroid patients hormonally,  based only on the measured blood levels. Only the patient himself can assess his condition and should also in hormone settings rely on his own attitude, to find the comfort zone and thus the appropriate dosage.

But first: Root cause analysis!

If the patient finds a doctor who actually diagnoses Hashimoto’s thyroiditis, he will quickly realize that the doctor will only initiate a pure symptom control with thyroid hormones. For what reason the patient was afflicted with this disease and what causes would be considered, are probably addressed only in the rarest cases. There are now so many possible and known triggers that have to be processed in advance.

These include: micronutrient depletion, heavy metal contamination, fungal diseases, HPU / KPU, leaky gut, viral and bacterial infections and much more. Often, thyroid problems disappear when the triggers of the condition are treated appropriately in advance. For detailed information on the most common causes of Hashimoto’s thyroiditis, see: Main Causes of Hashimoto’s Thyroiditis

When should the treatment with thyroid hormones begin?

Beside the cause research, it is particularly important to start as early as possible with the therapy, in the form of a hormonal treatment in order to minimize the suffering of the patient as much as possible. This applies for a pronounced hypofunction of the thyroid gland, and also even in the case of a slight hypofunction. Early treatment can reduce the autoimmune process and prevent progression of the disease.

Due to the fact that the Hashimoto progresses in episodes, it is important at the beginning of the therapy to determine the thyroid hormones (fT3, fT4, TSH) in the blood at regular intervals, to get an idea of ​​the course of the disease.

How does hormone intake work?

Basically, you start a hormone intake with L-thyroxine very carefully and in small steps, because the body and all organs first must get used to the hormone intake from the outside. Normally, you start with a low dose around 25μg and then increase by 6.25μq every few weeks, or by 12μg if you can tolerate it well.

If increased too fast, the body reacts with overdose symptoms. Every 4-6 weeks the fT3, fT4 and TSH in the blood should be determined. Then the hormone dose should be adjusted accordingly. With me for example, it is like, that I constantly feel changes after a dosage change … over exactly 6 weeks. Then the dose is settled for me or the dose arrived, and only then a blood test makes sense again.

But this is very different for everyone. With Hashimoto a TSH of approximately 1.0 μlU / ml is pursued …. normally … But who is already normal :). I basically need a much lower TSH, to feel okay. The two free values ​​fT3 and fT4 should be in the middle or in the upper third.

This is true for most patients, but not for everyone. Some sufferers feel well even with rather low values. So you should always go by your own feelings and do not necessarily rely on what doctors and the values ​​say. The blood values ​​serve only as a rough direction indicator.

It is particularly helpful to keep and document the determined blood values ​​in order to keep an eye on the course of the values ​​as well as the well-being in the longer term.

Which thyroid medications are available?

There are currently several drugs on the market that can be considered for treatment of hypothyroidism. Usually pure T4 Monopräparate are used. Thyroxine (T4) is a storage hormone, which is released in combination with the metabolically active hormone triiodothyronine (T3), controlled by the thyroid gland.

T4 has a half-life period of at least 7 days and is therefore degraded very slowly in the body, which makes a “fast” setting with thyroid hormones difficult and requires patience. The T4 is converted in the organs to the metabolically active Triiodothyronine, which is responsible for the entire energy balance of humans.

But it is very common that this process does not run smoothly and thus a treatment with a pure T4 monotherapy does not succeed. In this case, depending on condition and blood values, additional T3 preparations or combination preparations should be taken.

For a detailed list of common, synthetic thyroid hormones, see: Which thyroid medications are available?

The T4 mono preparations usually use L-thyroxine from Henning, Euthyrox or Eferox, which is available in doses of 25 to 200 μg per tablet.

In the case of the T3 mono preparations, they are Thybon from Henning or triiodothyronine in dosages of 20 to max. 100μg per tablet.

The most common combination preparations are prothyride and novothyral. Wherein prothyride has a T4: T3 proportion of 10: 1 (100μg T4 + 10μg T3) and Novothyral in the ratio 5: 1 (100μg T4 + 20μg T3) is produced.

Why natural porcine hormones are better

In addition to the commercially available, synthetic thyroid hormones, there are fortunately also natural thyroid preparations such as Acella NP Thyroid, Armor Thyroid, Erfa Thyroid, Nature Throid, West Thyroid Pure or Receptura Thyroid hormone capsules. Although these drugs are not common in Germany, they can, if the usual drugs do not lead to success, cause a significant improvement in the course of the disease and therefore should definitely be considered if necessary.

In the US, natural thyroid hormones are absolute standard and for good reason. Natural hormones are bioidentical and are usually tolerated much better. In addition to the well-known T4 and T3, they also contain T2, T1 and calcitonin, which are also produced by a healthy thyroid gland. Because of this fact, it quickly becomes clear that, especially in patients without a thyroid gland or with a severely reduced thyroid, pure monotherapy with L-thyroxine can hardly be successful, as the other thyroid hormones are missing.

Important Dietary Supplements and Antioxidants

Due to poor food intake, which is unfortunately observed in Hashimoto’s patients, certain deficiency symptoms can occur, which can cause quite significant symptoms and problems. In addition to a well thought-out and balanced diet, the following supplements can help Hashimoto patients and should also be checked with the diagnosis of the disease, in the blood picture.

According to the latest scientific knowledge, various diseases such as Hashimoto, Graves’ disease, rheumatism etc. are caused or negatively influenced by, among other things, free radicals. Thus, you should pay attention to a deliberate intake of antioxidants. These are able to influence the course of the disease positively and to make the therapy more effective. These include in particular vitamin A, C, E, selenium and zinc.


Zinc is a particularly important trace element, needed for the formation of many hormones. It interferes with the sugar-, fat- and protein metabolism. It has been found that zinc can alleviate the autoimmune process in thyroiditis. In addition, it has an anti-inflammatory effect and increases mental performance.

The intestinal mucosa and the pancreas also need quite large amounts of zinc to do their job and to ensure the digestion and the detoxification process in the body. Zinc, as an orotate or picolinate, has high bioavailability and is particularly well absorbed by the body.


The trace element selenium is involved in the conversion of fT4 into the active fT3. It has been shown to lower the antibodies in autoimmune disease, thus reducing the inflammatory process and being the drug of choice in an acute Hashimoto phase.

For me, daily intake of 100μg sodium selenite allowed me to observe a two-thirds decrease in TAK and TPO antibodies. Even during heavy relapses, I was able to counteract effectively with 200μg daily and significantly reduce the duration of the relapses. Selenium is present in quite high concentrations in the thyroid tissue. It is a building block of the deiodases, that convert thyroxine to triiodothyronine. According to studies, the disease course could also be positively influenced in the case of Graves’ disease with the help of a high selenium concentration in the blood.

In case of a deficiency, hypothyroidism may develop or an existing hypofunction may worsen. Thus, a selenium deficiency should be avoided, especially in Hashimoto patients. In addition to thyroid hormones or as an alternative to thyroid hormone therapy, 50-300μg per day is recommended.

Vitamin D3

Most Hashimoto patients suffer from D3 deficiency. The problem is that vitamin D3 is produced almost exclusively by sunlight (UVB) through the skin, and in today’s generation too little time is spent in the sun or in the open daylight. For example, because D3 deficiency is associated with fatigue and decreased performance, symptoms overlap with classic Hashimoto symptoms.

A blood level above 40 ng / ml should be sought. Vigantoletten with 1000 iE are very good for the beginning, but also dosed very low. You should take at least 5 tablets daily or get a prescription for Dekristol  by the doctor. This contains more than 10 times the amount in just one tablet and is in the long term much cheaper.


Iron or ferritin is significantly involved in the production of thyroid hormones. At a ferritin level of less than 30 μg / L, the free thyroid levels (FT3 and FT4) may decrease and, incorrectly, the thyroid hormone dose is increased, instead of filling up the ferritin reservoir.

Thus, iron and ferritin should always be checked. Useful are preparations such as Ferroverde, which provides a pure vegetable iron from curry leaf extract. This iron variant is significantly better tolerated than the artificially produced variant, as it is the case in Ferro Sanol.


Magnesium is one of the most important intracellular elements and therefore also involved in the complex process of hormone production. In terms of thyroiditis, it helps, among other things, with strong muscle tension and sleep problems.

It also calms down very well. Magnesium orotate is absorbed particularly well by the body.

Vitamin B6 and B12 complex

Due to a poor absorption in the intestine in Hashimoto patients, most of the B vitamins levels are low and should be supplemented. If you suffer from paleness, tiredness, lack of concentration, inclination to fall, dizziness, etc., you should have checked the holo-TC in your blood and, if necessary, take a suitable preparation.

A good preparation also contains the vitamins B1, B2 and niacin, folic acid, biotin, pantothenic acid (B5), inositol and choline.

Vitamin C

Vitamin C also is a very powerful antioxidant, which has a very positive effect on the autoimmune process. Vitamin C occurs in almost all cells of the immune system that make up the immune system. It is also used in higher doses for CFS and Lyme disease.

Every time the body gets stressed, the need for vitamin C increases rapidly. It is important to note, that vitamin C contains not only pure ascorbic acid, but also bioflavonoids. Only in combination a good supply is possible.

Vitamin E

Vitamin E is the most important fat-soluble antioxidant. It protects fats from the attack of free radicals and thus prevents them from oxidation. Because of these antioxidant properties, the substitution of vitamin E in Hashimoto’s thyroiditis makes sense.

The Hashimoto usually comes with intestinal complaints, so that the nutrient uptake via the intestine usually no longer runs well. For this reason, Hashimoto patients should pay attention to their nutrient balance and add supplements to the basic nutrients of food.

Also a screening of the intestinal flora makes sense, to see if the intestine is out of balance. If this is the case, then usually the supplements do not serve the desired effect, and it should also be worked on bowel rehabilitation.

Image source:

  • hashimoto-therapy: © Ghazi-Michael Ayed