Also in this article:

Hair loss in Hashimoto’s patients – What you need to know

Recent published study – Hashimoto’s reduces brain function


Top 10 reasons Hashimoto’s patients don’t get better

Hashimoto's disease chalkboard imageThere is not one easy fix to successfully managing Hashimoto’s hypothyroidism, an autoimmune thyroid disease. As many people have learned the hard way, using thyroid hormones to get TSH within lab ranges certainly doesn’t guarantee a fix for most people, although it can help.
For Hashimotos patients to truly manage their autoimmune Hashimoto’s hypothyroidism, it’s important to understand the factors that contribute to it.

10. Immune Reacting Fillers in Thyroid Hormone Replacement

Many thyroid supplements use corn starch or modified food starch that contains gluten. You need to make sure your thyroid hormones are gluten-free and free of corn starch if you react to corn. If your medication is in capsules make sure the capsules are gluten-free. Otherwise you could be taking hormones every day with dietary proteins that stimulate your autoimmunity.

9. Taking Immune Enhancing Supplements

Nutritional supplements can either help or flare up your autoimmunity based on an individual’s T-helper dominance (whether you have a TH-1 or TH-2 dominance). Supplements such as echinacea, green tea, acai, astragalus, licorice, and a variety others. can either help or aggravate autoimmunity depending on your dominance. If you are unaware of this you may be taking supplements that promote an autoimmune response. Please refer to Chapter Three of my thyroid book, Why Do I Still Have Thyroid Symptoms? for more information and lists of supplements and herbs to be aware of.

8. Fixating their focus on thyroid hormone replacement only

Many thyroid patients believe that if they could only figure out the perfect version of thyroid hormones (natural versus bio-identical or T3 versus T4) they can correct all of their symptoms. Unfortunately, Hashimoto’s hypothyroidism is a complex autoimmune disorder and thyroid hormone replacement is only one part of a large puzzle. However, if you need help learning more about thyroid hormone variations please refer to a previous newsletter article titled, Which thyroid hormone is right for you?

7. Increasing Stress

Emotional stress activates pathways involving the inflammatory immune messengers IL-6 and TH-17. This activity creates an autoimmune flare-up. Unhealthy relationships with your spouse, co-workers, or friends can promote autoimmune flare-ups, as can a bad work environment, or other significant and chronic lifestyle stressors. If you have Hashimoto’s you need to create a healthy emotional environment for yourself. Bad personal relationships or poor work environments can be detrimental to Hashimoto’s patients.

6. Not Strictly Gluten-Free

You are either 100 percent gluten-free or you’re not gluten-free. Choosing to eat gluten-free only when it is convenient is not a gluten-free diet. If you are not strict about your food being 100 percent gluten-free when you eat out and you continue to consume condiments that have gluten, regular beer, and foods fried in fryers that use the same oil for breaded foods, then you are still being exposed to gluten. Gluten is a major trigger for most Hashimoto’s patients and many cannot improve until they are 100 percent gluten-free.

5. Not avoiding gluten cross-reactive foods

Although a strict gluten-free diet is a great place to start, if you are still eating foods that cross-react with gluten you may not recover well. Cross-reactive foods have proteins similar in structure to gluten and can trigger the same immune response as if you were eating gluten. The most commonly ignored cross-reactive food is milk (casein), followed by rice, corn, sesame, and gluten-free oats. In fact, it is best to avoid all grains and adopt a diet such as a Paleo diet when you have Hashimoto’s.

4. Ignoring their brain health

The most common form of collateral damage in chronic Hashimoto’s patients is accelerated brain degeneration. Brain degeneration leads to identical symptoms of hypothyroidism, including fatigue and depression. I strongly suggest all thyroid patients become experts in identifying and supporting their brain health by referring to my second book, Why Isn’t My Brain Working?

3. Ignoring insulin sugar spikes

Surges of insulin that follow eating or drinking something sugary or starchy (sweet coffee drinks, desserts, bowls of pasta or rice, bread, etc.) trigger the inflammatory TH-17 activity, which promotes autoimmune flare-ups. Eating sweets throughout the day or overeating promotes insulin surges, which can be identified by symptoms of fatigue or sugar cravings immediately after eating. If you have those symptoms after eating it means you are not managing your insulin levels and your Hashimoto’s autoimmune response will be hard to tame.

2. Missing meals

When blood sugar gets too low it raises the inflammatory messenger IL-6 and promotes autoimmune flare-ups. Symptoms of low blood sugar are most noticeable between meals or if you skip meals and include shakiness, blurred vision, crankiness and irritability, and loss of function. If you feel a jump in your function and energy after eating it confirms your blood sugar was low—when your blood sugar is stable the only thing you should feel after eating is not hungry. Constantly skipping breakfast and missing meals will aggravate your autoimmune response and promote autoimmune flare-ups.

1. Passive attitude

The passive patient does not question or challenge her doctor. If you are a passive Hashimoto’s patient and you do not take your health into your own hands you may not fare as well as the person who educates herself. The conventional model is based only on lowering your TSH with whatever thyroid medication your insurance plan or doctor prefers. Once TSH is within lab ranges, this model has nothing more to offer except to check your TSH once a year. It takes time and effort, but the thyroid patient who wants to feel better needs to roll up her sleeves and master the various mechanisms of Hashimoto’s. The more you understand Hashimoto’s the more likely you are successfully manage your health.

Hair loss in Hashimoto’s patients –- What you need to know

thinning hair imageThyroid hormones are important for the health of hair follicles and many thyroid patients struggle with thinning hair and hair loss. Although many thyroid patients resolve their hair loss issues with thyroid hormone medication, many others don’t. It’s important to understand factors beyond thyroid medication that affect hair loss.

Inflammation can impair hair follicle cell function

First, the autoimmune response impairs how thyroid hormones act on cellular receptors, including the cells in hair follicles. When inflammation is high, inflammatory immune cells called cytokines can interfere with the action of thyroid hormones on these cellular receptors. This is one reason why, in addition to making sure your thyroid hormone levels are sufficient, it’s important you manage inflammation. Many times hair loss will not resolve until the patient learns how to manage their autoimmunity.

Elevated testosterone in women main cause of hair loss

However, the most common reason female Hashimoto’s patients suffer from hair loss is due to elevated testosterone. Symptoms of elevated testosterone include thinning hair, hair loss, an inability to lose weight, and in more extreme cases, excess facial hair. For most women, high insulin levels brought on by an unhealthy diet and lifestyle cause excess testosterone. This is because insulin stimulates an enzyme in the ovaries called 17,20 lyase, which promotes the synthesis of testosterone. This increased testosterone then leads to thinning hair and hair loss. Factors that promote insulin surges and hence elevated testosterone are a diet high in starches, refined carbohydrates, and sugars, and a sedentary lifestyle.

Poor blood flow to scalp causes hair loss

Another common cause of continued hair loss in Hashimoto’s patients is poor circulation. The hair follicles need a constant supply of nutrient-rich blood. If circulation to the scalp is compromised, hair loss is inevitable. Clinically, the signs that signify poor circulation include cold hands, cold feet, cold tip of your nose, and poor nail health (nails also require good circulation to be healthy). Thinning hair is not the only consequence—poor circulation can have devastating impacts on your brain health. I discuss this concept in detail and offer strategies in my new brain book, Why Isn’t My Brain Working?

Recent published study –- Hashimoto’s reduces brain function

brain scans 1A recently published case study showed that neurological symptoms can occur in Hashimoto’s patients. SPECT brain scan imaging showed reduced brain activity (hypoperfusion) both in patches and throughout the entire brain. The brain scan images completely changed after subjects were given corticosteroids to suppress the autoimmunity, showing improvements in many areas. However, patchy areas of impairment persisted despite autoimmune suppression.

brain scans 2This study illustrated two key concepts. First, Hashimoto’s impairs brain function and dampening autoimmunity can improve function. Second, areas of continued brain degeneration persist despite treatment that dampens autoimmunity.

I cannot stress enough how important it is to improve your brain health when you have Hashimoto’s. This is exactly why I wrote my second book on brain health—it is so critical for my Hashimoto’s readers. In in my practice I have found the most important second step Hashimoto’s patients must take after reducing their autoimmune expression is to optimize their brain function.

To read the study, click here.



  • shirley June 8, 2014 at 2:00 pm

    After 20 years of brain fog and fatigue to the point I could not work, I am now on a grain free diet. I have more energy and not as much brain fog but I still do not think or remember many simple things like simple words. What do you suggest to optimize the brain?

    • Thyroid Book June 10, 2014 at 5:53 am

      Have you seen his new brain book? He has lots to say about this. As with everything, it’s all about finding finding the root cause. It can be a neuro inflammation issue, a food that is cross reacting with gluten, a neurotransmitter issue, a hormone issue, etc. The brain book will give you more ideas:

  • INDIANA CERTA June 17, 2014 at 1:38 pm




    • Thyroid Book June 24, 2014 at 3:41 am
    • Ken June 30, 2014 at 6:58 pm

      You should see Dr Lemmer at Be Well clinic in McLean or Naturopath Kan at Nova Medical Group in Ashburn.

      Also you need to change diet ASAP


      • Sara May 31, 2020 at 8:32 pm

        Please guide what all millets are safe to eat in hoshimoto’s? Are sorghum and Ragi okay?

        • Susan June 28, 2020 at 12:14 am

          Hi Sara,

          Dr. Kharrazian recommends against consuming all grains due to the possibility of cross-reactivity with body tissue.

    • Thyroid Book July 15, 2014 at 7:17 am
  • Marge Cantu July 3, 2014 at 10:54 pm

    The “Why do I Still Have Thyroid Symptoms? and “Why isn’t my Brain Working?” books are life changing. I read both books and realized the seriousness of Hashimoto’s and what to do about it. Thank you Dr. Kharrazian for all your research & work!

    • Thyroid Book July 15, 2014 at 6:59 am

      Thank you! If you have the time, reviews on amazon always help spread the word!

  • patty July 10, 2014 at 2:59 am

    hola…tengo hashimoto y tengo la testosterona baja…(yo había leído que en el hipotiroidismo los niveles de testosterona bajaban).. reflejándose en problemas con la líbido, piel seca, debilidad muscular, etc etc…Por lo leído en el párrafo anterior…no siempre bajaría la testosterona?….y en mi caso, sería recomendable utilizar geles de tedtosterona ?….gracias por su valiosa respuesta…saludos.

    • Thyroid Book July 15, 2014 at 6:58 am

      El Dr. Kharrazian siempre aconseja para hacer frente a la causa del desequilibrio hormonal funcionalmente primero si es posible. De lo contrario, lo mejor es consultar con un profesional con experiencia de trabajo con las hormonas bioidénticas y poner a prueba con regularidad.

    • amelia rodriguez February 24, 2015 at 5:18 am

      ojala llegues a ver esta respuesta. Si tus hormonas estan desequilabradas, segun el doctor kharrazian, se debe ver si hay un problema mas central que pueda ser la tiroides.

      Por ende, yo no empezaria con el balanseo de las hormonas si no con la determinacion si hay defecto en la function de la tiroides. Si es asi, leeria su libro Why Do I Still Have Thyroid Symptoms en espanol para que hagas cambios de inmediato y trates tu tema de la salud de forma integral, inclusive tu salud intestinal.
      Buena suerte

      • Ana Gambetta July 5, 2020 at 9:33 pm

        ¿Yá hay versión en español? No la encuentro!

        • Susan (admin) July 7, 2020 at 1:03 am

          Hi Ana,

          Utilicé Google Translate para escribir esto, así que perdona cualquier error.
          Había una traducción al español pero era tan mala que tuvieron que comenzar de nuevo. Se está trabajando y, cuando se publique, el equipo del Dr. Kharrazian lo anunciará en el sitio web y en el boletín electrónico.

  • Marilyn July 13, 2014 at 7:14 pm

    Does Dr. Kharrazin have any doctors he trained in Canada?

    • Thyroid Book July 15, 2014 at 6:55 am

      Only US practitioners receive training at this time I believe.

  • Elizabeth Marriott July 14, 2014 at 4:30 pm

    Dr K – Do you know of any doctors in Scotland who work with these issues along your lines? Had a good one but he died and the NHS has turned its back on treating for symptoms when tests are ‘normal” Need help!

    • Thyroid Book July 15, 2014 at 6:54 am

      At this time only practitioners in the US receive training, however some work long distance. You can inquire through the Find a Practitioner page.

  • Angela July 17, 2014 at 6:00 am

    I was diagnosed with cholestatic liver disease/questionable autoimmune Hepatitis. I have this diagnosis because I have every symptom for autoimmune hepatitis but all my blood markers and two liver Bx came back normal. I was prescribed URSO which makes my liver enzymes normal but my symptoms are still there. I have been trying to change my diet but my symptoms keep coming back. Everytime they come back its worse everytime. Every DR I see says my labs are normal and dismiss me.They say I am a rare case. Does Hashimoto disease act similar to autoimmune liver disease as explained in this blog?

    • Thyroid Book July 27, 2014 at 6:22 pm

      The basic mechanisms behind autoimmune disease are similar regardless the tissue being attacked. You might want to check out his brain book for newer info on working with autoimmune reactions.

    • Mike May 15, 2020 at 6:24 pm

      What foods eliminate grains ? I’ve been hearing from many people online that a grain free diet and keto diet really helps

  • sue August 6, 2014 at 4:57 am

    Please, I need a recommendation for a dr trained under dr k. In Orange California. I have hashimotos and now gaining a lot of weight walking heating healthy food choices plus gluten an dairy free. I hope u can advise

  • Lynda Beaudoin August 14, 2014 at 10:53 am

    J’aimerais communiquer avec un praticien au Quebec ou au Canada. I would like to communicate with a Quebec or a Canadian practicionner. Please help Thank you

  • Jamyla November 4, 2014 at 9:59 am

    I am looking for a doctor in Lebanon or in a European country if possible.
    I have Hashimoto.

    Thank you

  • Cheryl Dieffenderfer November 18, 2014 at 7:10 pm

    Is there a doctor in the Atlanta, Ga area trained by Doctor K? Two of my children as well as me have Hashimoto’s and adding the thyroid is now failing for one of them. She is already gluten free but had rice and egg allergies as a baby although seems to tolerate them now. I am wondering how to find the cross reactive foods as well as help her as the first step her doctor wants to take is an iodine supplement which I understand can lead to more problems. Thank you

  • Amanda November 22, 2014 at 8:28 pm

    Your list of local practitioners is quite short. Is there a more extended list that can be accessed? I began the protocol with a practitioner that moved out of state. Without the practitioner, getting the recommended supplements from Apex Energetics has been quite challenging.

  • Elsie December 10, 2014 at 2:49 am

    I was diagnosed with underactive thyroid 5 years ago and have been taking medication daily since then (25 mcg). Is it possible for me to go off medication thru diet? Have recently started a gluten free diet as well as dairy free. And is it possible to be dairy free when eating kefir every day? Is kefir classed as dairy free? Please reply.

    • bob April 25, 2015 at 4:27 am

      Kefir is dairy. Don’t let people fool you by telling you that the sugars eat all the lactose. It is still dairy, the proteins still look like gluten proteins in your system. I do not suggest eating kefir. Sorry. Sadly, for us it’s best to eat fermented veggies. Yuck, imo.

      • Amber May 24, 2020 at 1:00 am

        Hi there! New here. I was diagnosed with Hashimoto’s in March of this year. Changed my diet completely + already feel a lot better however I still struggle with inflammation often.. I’m not on medication. I cut out gluten, dairy, soy, grains, wheat, corn, nightshades, crucifers, refined sugars, eggs. I follow the AIP diet. Anyways, can anyone help with maybe what helped you curve the inflammation? I just ordered essential oils to diffuse, roll on skin + inhale with custom blends specifically for my symptoms. Hope these hell. thank you! Any good specialist in PA?

  • Bonnie February 19, 2015 at 2:06 am

    Is there a doctor in the Phoenix, Arizona area that has been trained by Dr.Kharrazian to treat my Hashimot’s? I have been on a strict diet, grain and dairy free along with multiple food allergies for 18 months with no improvement of my symptoms. I can’t even tolerate Armor or Synthroid.

  • Rebecca February 19, 2015 at 8:06 pm


    I am reaching out because I’m really overwhelmed and can’t find clear answers online.
    I recently found out through an ultrasound that the right side of my thyroid shows signs of disease but all of my blood tests (including antibodies) are normal. They said it could be the very beginning of Hashimoto’s.
    I have decided to try going gluten free, however I am terrified by everything I’m reading and I’m not sure just how careful I have to be. I also have OCD so that is making me completely paranoid about cross-contamination but I’m not sure to what level I need to be. For example, if I go to chipotle do I need to tell them to put on new gloves before they touch my to-go bowl? Should I avoid eating out at restaurants altogether? I am terrified of the idea that microscopic particles of gluten are damaging my thyroid and I don’t even know it because I don’t have overly obvious symptoms.
    Any help and advice would be greatly appreciated.



    • bob April 25, 2015 at 4:33 am

      You can’t be eating at chipotle’s. Beans are inflammatory, corn is a grain, and anything else they put on it you have no idea what is in it. They claim that all of chipotle’s products are of high quality, but that doesn’t mean that they are not inflammatory. You don’t want the cheese or the sour cream.. I wouldn’t suggest any of their sauces as often times junk is hidden in them and you have no label. By the time you’re at the cash register, if you’ve done your homework on inflammatory items to avoid you’ll have beef, assuming they haven’t put a sauce on it while they cooked it which is unlikely, and some lettuce. There are so many foods that cause inflammation it’s disgusting. Good luck with your research.

    • Fifi May 9, 2015 at 4:13 pm

      Hi Rebecca,
      Remove all grains from your diet, not only those that contain simple gluten (i.e. the wheat, rye, barley and some oats) because all grains actually contain gluten, even rice! They are all one botanical family and their proteins are very very similar. Once your immune system is reacting to one it is likely to react to them all. This also goes for the pseudo grains like buckwheat, quinoa and amaranth, for example, and definitely includes all forms of oats, even if there is a big ‘gluten free’ sign on them. In fact it is totally impossible for any grain to be free from glutens, so remove them all from your diet, and yes, be paranoid about contamination. Best thing is to cook for yourself. If you want to get tested look at what Cyrex Laboratories have to offer as they do excellent autoimmune testing. However, you must be eating the potential offending foods for a test to be valid, so if you are going to do testing do it straight away, if not, if you can’t afford the cost then take an executive decision and eliminate ALL the grains and pseudo grains. Get the book The Paleo Answer by Loren Cordain out of the library to grasp some of the details. It is not a brilliantly written book but there is lots of info in it, and it is relatively new.
      Good luck.

  • bob April 25, 2015 at 4:24 am

    I really hope that in your books you discuss more than simply avoiding gluten, there are a LOT of foods that cause inflammation beyond gluten… and things in the glutenous family can and often times are just as bad (such as sugar cane) and protein look alikes (such as lactose products). Basically i’ve determined that a diet for hoshimoto’s disease is limited to vegetables and meat. The end. Good luck following that. I sure as heck can’t, but maybe that’s my depression and complications with my local store selling nearly rotten meat… I had crohn’s disease first and I was able to determine that diet alone can ENTIRELY bring your auto immune disease into remission. I have not proven this for hoshimoto’s disease yet as I have been having a difficult time mentally with three diseases and a sleep disorder, but I wouldn’t doubt that the same is true of that. And it’s not simply “avoiding gluten”, unfortunately.

  • Donna June 9, 2015 at 5:37 am

    If your thyroid is removed because of hashimptto disease do you still have hashimptto disease?

  • Ellynn June 13, 2015 at 6:43 pm

    I have had Hashimotos for about 15 years or more and have trouble concentrating enough to really read Dr. K’s books although I have them. If I give up gluten and dairy, which I live on, it don’t know what to eat. Endocrinologists don’t seem to help me with symptoms, all of which I have. I’m just exhausted all the time, want to cry, although my tsh is normal, and I take my med. Is there someone in the Amherst/ Northampton Mass area I could see? Please help.

    • Jen January 5, 2016 at 4:00 pm

      Hi ellyn, did u ever find any help with yor hashis? I am not far from u in rugby

      • Rachel March 20, 2017 at 6:22 pm

        Hi Jenn,
        Were you able to find a knowledgable doctor in your area? We are in northern Berkshire county. Would be so haooy to find someone in our area.
        Thank you!

    • Susan (moderator) January 5, 2016 at 6:31 pm

      Hi Ellyn; Have you checked the practitioner finder here?: There may be one near you. And, some of them on that page are willing to practice remotely. You’d have to contact them to find out.

      As far as diet, there is a lot of guidance in the books and online, on how to go about shifting your diet to one that will support your health. If you feel you are not capable of making the shift on your own, there are even programs that assist you in making the shift over time so it’s easier to handle. They guide you through what to make, how to change your kitchen so it supports that shift, offer support, etc.

      Don’t give up, and do try to find a MD, ND, LAc, DC or other medical practitioner trained in Functional Medicine, which gets to the root causes of autoimmune symptoms. See that link above. Also, if you have no luck on the link, I’d suggest going on the Hashimoto’s 411 facebook group and asking for a local doctor referral from the members. Good luck to you, and don’t give up!

  • Marcia Jacobs August 15, 2015 at 4:21 pm

    Does anyone know of a good endocrinologist in the CA Bay Area?
    My doc seems only interested in testing TSH…😓

    Thank you!

    • Susan (moderator) December 29, 2015 at 11:21 pm

      Marcia – If you are looking for a practitioner in your area, check the practitioner finder on his page – it lists practitioners who have trained under him and teach for him as well. They are not endos. There may be one near you, and some of them on the list may be willing to practice remotely.

  • Shayla September 12, 2015 at 5:09 am


  • Gisela December 26, 2015 at 8:54 pm

    Do you have any doctors in san francisco area

    • Susan (moderator) December 29, 2015 at 11:20 pm

      Gisela – Dr. Kharrazian does not manage a group of doctors. However, if you are looking for a practitioner in your area, check the practitioner finder on his page – it lists practitioners who have trained under him and teach for him as well. There may be one near you, and some of them on the list may be willing to practice remotely.

  • Donna Allgaier-Lamberti January 27, 2016 at 3:08 pm

    I looked at the locator to see who is in Michigan. No one is listed. However, if I may I would like to add my functional medicine physician who practices in Grandville (suburb to Grand Rapids, MI.) I go to her and she is knowledgeable and fantastic. She took me off of gluten, sugar and dairy, diagnosed my Hasimotos’ and adrenal issues, prescribed my Nature-Throid and pertinent supplements. She really listens, gives me options and respects my decision. I can personally recommend her.

    Natural Health Improvement Center PC Master
    Dr. Ann M. Auburn, DO
    4466 Heritage Ct. SW Unit D, Grandville, MI 49418
    PHNE: 616-301-0808 FAX: 616-301-7887

    • Susan (moderator) January 29, 2016 at 12:45 am

      Donna; Thanks for the reference. The practitioners on the finder page are those who are most highly trained in the protocols that Dr. Kharrazian uses, and they also lecture for him. That is why the list is limited.
      If Dr. Auburn would like to be in the list on the second page (it’s linked at the very top, “Go to:“), she can contact Apex Energetics, as they are the ones who run that list. It’s a more general list for practitioners who treat thyroid, and are knowledgeable about Dr. K’s work.

    • Tammy March 20, 2016 at 5:50 pm

      HI Donna,
      Just wondering if making all those changes that Dr Auburn has recommended has helped you? I have been on armour and naturethroid for over 10 years. I still feel terrible on either one of them even though my blood tests are normal. My antibodies got really high last year and they increased my dose and my antibodies went down but I’m still so brain fogged and exhausted. I have seen her in the past but at that time unfortunately, I couldn’t afford to do everything she recommended. I was thinking about seeing her again but not sure if she would be open to changing my thyroid meds. Thanks for any I put you may have on her.

  • KarenSA March 9, 2016 at 7:15 pm

    Hi Dr K
    I have a bioresoance device that shows that my Thyroid is not driving my Hashi but my Pituitary and Hypothalmus is. The Thyroid actually looks pretty healthy according to the bioresoance device but it is still Hypothyroid due to the Pituitary. I dont know how to explain this better and I live in Switzerland and the Dr here are not very familiar with anything but prescribing meds or hormone for it. I never feel different on or off the thyroid. My Antibodies are both doing well one is in normal limits and the other just above at the last test and the TSH was just under 1. I feel OK I have been tired all my life and that has not changed. Is there a way to correct my pituitary so that it doesnt keep hurting my Thyroid or to make it stop affecting my thyroid. I just dont know how to explain this better sorry. Pituitary Hypothalamus Thyroid Axis

    • Susan (moderator) March 10, 2016 at 11:03 pm

      Karen; Sorry, but the pituitary isn’t something I have the background to comment on. As far as your fatigue, you might look into testing for anemia (not only blood serum, but ferritin and percent saturation), adrenal function (24 hour saliva cortisol test), other hormone imbalances, vitamin D and B12 deficiency, MTHFR. There could be any number of factors, from virus to others, but those above are very common with thyroid autoimmunity, and any of them can be a source of ongoing fatigue.

  • Ashley April 2, 2016 at 2:37 pm

    Can you recommend a doctor in Philadelphia? I am having no luck. Thanks so much.

  • Verona Rose February 18, 2017 at 1:09 pm


    Are there any doctors in London?

    • Susan (admin) March 10, 2017 at 10:52 pm

      Verona; We are not familiar with specific practitioners in London at this point. You might contact Thyroid UK to see if they know of anyone.

  • Jackie March 21, 2017 at 6:32 pm

    I have had Throyiditis hashimotos for over 20 years. I recently went on Naturthroid and feel better! But I am still experiencing sudden false up! We only have one endrcronologist in Findlay, Ohio and he is not really interested in helping me much over the 20 years! I need to find someone new!! Where do I go??

    • Susan (admin) March 26, 2017 at 6:15 pm

      Jackie; It’s good to hear you are feeling better on the Naturethroid. I’m not sure what you mean by “false up”. Was that a typo? Maybe you meant flares. We don’t have a referral for you in Findlay specifically. You could check Dr. Kharrazian’s practitioner locator page at – some of them are willing to practice remotely. There are a lot of patients who are treated successfully via Skype etc.
      Also, check here: – unlike the link above, I can’t tell you if any of those are trained in Dr. Kharrazian’s protocols, but it’s worth a try. You’d have to determine if they are right for you.

  • Amy April 8, 2017 at 11:16 pm

    Hi Everyone, wow what an amazing resource, thank you. I’ve been diagnosed with Hashimotos and waiting to get my food sensitivities checked. With everything I’ve read should I even bother doing the test or start cutting gluten and dairy out asap?? I’m doing the blood test, how accurate and detailed is this test? Thanks for any help.

    • Susan (admin) April 25, 2017 at 8:28 pm


      Many people feel that an elimination diet is the best way to determine food sensitivities. If you choose to go the lab test route, make sure to use Cyrex Labs – they test for more factors than other labs.

      If you are doing the lab test, consult with your practitioner about whether or not to eat gluten before the test, and for how long. It can affect the results.

  • Amy April 8, 2017 at 11:17 pm

    One more question, does synthroid have gluten or soy?

    • Susan (admin) April 25, 2017 at 8:25 pm


      As of spring 2016, Synthroid was reported as gluten free on Isabella Wentz’s website (, but I don’t know if it has changed since then.

      As of 4/25/17, on their website, the “Full Prescribing Information” link leads to a page ( listing these ingredients:
      Each SYNTHROID tablet contains the inactive ingredients acacia, confectioner’s sugar
      (contains corn starch), lactose monohydrate, magnesium stearate, povidone, and talc. Each tablet
      strength meets USP Dissolution Test 3. Table 6 provides a listing of the color additives by tablet
      strength: [see page for more].

      I have not heard it has any soy.

      While it may be gluten and soy free now, any medication can change, and it’s best to keep an eye on ingredients over time. Sadly, many of the pharma producers for thyroid meds don’t pay attention to gluten, soy, or corn.

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  • Liv October 7, 2017 at 3:33 am

    I was diagnosed with Hashimoto 5 years ago. I was given Tapazole for around a year or so. I also made some changes (food, eliminated toxins, etc). Even though my thyroid levels are within control I don’t feel good at all; I have anxiety, panic attacks, etc. Should I read Why do I still have thyroid symptoms (since I don’t take meds and I started as hyperthyroidism not hypothyroidism) or the book Why isn’t my brain working? If I could only buy one book, which one would you recommend?

    • Susan (admin) October 9, 2017 at 10:59 pm


      Good question. Personally, if I knew I had Hashi’s, my thyroid labs were evened out for now, and I had a good understanding of how Hashi’s works, yet I had the anxiety etc., I’d go to the brain book first. And pay serious attention to the dietary recommendations and blood sugar balancing. However, I’d get back to the thyroid book as soon as possible. Also, many libraries have copies of both (esp the thyroid book, as it’s been around longer), and one can borrow via interlibrary loan in some areas. Best of both worlds.

      I’d also recommend seeking a healthcare practitioner trained in Functional Medicine to help deepen my understanding of what lies beneath my symptoms. Here are some search options:

      Dr. Kharrazian’s referral page: (; though the list is housed on his thyroid site, those practitioners are highly trained in all his protocols.

      You might also try the practitioner locator on the IFM page ( or the IAFNR page (

  • Thyroid Advisor March 7, 2018 at 5:55 pm

    It’s very interesting and helpful that you included that study on how Hashimoto’s affects brain health. Brain fog is not an uncommon symptom with thyroid disorders. I’ve had many patients ask me about that. Having another study to reference them to, will be a great benefit.

  • DJ January 17, 2019 at 7:33 pm

    Any doctor recommendations in New York – been diagnose with Hashimoto for 15yrs. Struggle every day and no endo doc would believe that I’m a healthy eater and exercise to try and keep weight in check but I’m still 50lbs overweight and struggling. Would love to find a holistic doc. Thanks.

  • Andre May 15, 2020 at 6:32 pm

    Why do people say that once you are on thyroid meds, you will be on it for life? Doesn’t make sense if your diet and exercise makes it better

    • Susan June 28, 2020 at 12:19 am

      Some patients can come off or reduce meds with the right protocols, if enough of the thyroid gland is still intact and functions properly. However the autoimmune attack on the thyroid destroys tissue that does not re-grow. Once enough tissue is destroyed, supplementation is the only way to get enough thyroid hormone in the body for all your cells to have enough to function properly. For some folks, once you go on hormone replacement, the gland is already destroyed enough that it can’t make enough hormone on its own.

  • violet June 14, 2020 at 6:29 pm

    Why is it that I never seen Dr Kharrazian talk about the linkage between hashimoto and shortness of breath and insomia ? I used his suggested practitioner in my area (seattle) and many naturopathic doctors and still haven’t discovered my root cause. I have bought his book as well. Any suggestions if i am able to book an appointment with him ?

    • Susan June 28, 2020 at 12:31 am

      Hi Violet,

      I’ve heard him talk quite frequently about insomnia in relation to autoimmunity and its driving factors. It’s a big issue for a lot of folks, and can have a variety of causes such as blood sugar imbalances and hormone imbalances.

      I’ve heard him mention air hunger, but I’m not sure if that is the shortness of breath you refer to.

      Sadly, many patients have to cycle through quite a few practitioners before they can find one who works for them. A naturopath is not necessarily trained in the functional medicine protocols Dr. Kharrazian uses and teaches. He has a new practitioner list on his Kharrazian Institute website here:

      Due to the pandemic, he stopped seeing patients in person and is not taking any new applications in 2020. Once the clinic opens again, the list of apps that were already approved in late 2019 will take the clinic schedule out somewhere between 1 and 3 years. The best you can do is keep an eye on the application portal on his website here:

  • Ines July 2, 2020 at 11:30 am

    Pourriez-vous me recommander un médecin en Suisse svp?
    Merci d’avance pour votre réponse

  • Susan (admin) July 4, 2020 at 7:25 pm

    Hello Ines,

    Dr. Kharrazian doesn’t have specific referrals for outside the US, but you might find someone on the Kharrazian Institute practitioner list here:

    To be on the list, one must have successfully completed all the available Kharrazian Institute courses. NOTE: The list will be updated mid-July to reflect who completed the recent Hashimoto’s course.

  • Melynda W April 14, 2021 at 8:58 pm

    Seems organic wine is on the list still…what else to eat with that? Grains are everywhere!!

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