While western medicine has a time and a place, and to be sure I'm grateful to be an M.D. who can prescribe pharmaceuticals when needed, too often it is assumed that they are the only solution. When it comes to Hashimoto's and hypothyroidism, the right dose of the right medication can make a world of difference in how a woman feels! But the thing with these medications is that while they provide a missing element – thyroid hormones – they don't actually do anything to nourish, heal, or boost the thyroid's health. That's where thyroid supplements come in.
The thyroid gland requires specific vitamins and minerals to function at its best. What's more, the right supplements can make a world of difference in the health of your thyroid tissue.
The Right Thyroid Supplements Can Make a Huge Difference
It is possible for many people to improve thyroid hormone levels and lower thyroid antibodies without medication – or to augment levels even if you are on medication. I personally have seen patients’ antibodies go from well over a 1000 down to as low as the 40s – close to normal – and the need for medication doses be significantly reduced. However, there’s definitely a time and place for thyroid medication, which I also sometimes prescribe in my medical practice. Research suggests that certain supplements – nutrients and herbs – can reduce thyroid antibodies, improve free T3 and free T4 levels (thyroid hormone) levels, and stabilize TSH – all markers that thyroid health is improving. If these labs look like a foreign language to you, click here.
Whether you have Hashimoto's, non-autoimmune hypothyroidism or are on the cusp of possibly needing medication but not absolutely requiring and want to help your thyroid before you cross that line, that's where a few well-selected herbs and nutritional supplements can make a major contribution, and it's precisely why I use them in my medical practice. The ‘new medicine for women’ is integrative – bringing together the best of conventional and traditional approaches And that's what I bring to you in this article.
The Thyroid Supplement “Starter Plan”
These 6 supplements can help to improve the health and functioning of your thyroid. These can be taken alone or in combination with each other. They can also be used in conjunction with thyroid medication for hypothyroidism or Hashimoto’s, but it’s important to work closely with your medical provider because if your thyroid health starts to improve, you could actually end up needing less medication – a good thing – but you want to check so you’re not overmedicating
My usual ‘starter’ go-to combination consists of selenium, myoinositol, and ashwagandha (which is generally very well tolerated even by those who avoid nightshades). In my practice, I always check a vitamin D level in my patients, and if that is not optimal (a blood level of between 50 – 80) I add vitamin D to the ‘starter plan.'
I generally recommend trying this starter plan for at least 3 months, or as long as six months, and then staying on your supplements until thyroid health is solidly improved. You can, at any time, add in the other supplements below to get an even bigger impact, but often, simpler works just fine.
Top 6 Supplements for Thyroid Health
In some cases, especially in pregnant women and new moms, or anyone with major lab abnormalities or significant thyroid symptoms, thyroid hormones medication is still necessary – and that’s not a failure. Meanwhile, all women with thyroid problems (whether they take thyroid medication or not) can work to heal Root Causes – and support your thyroid wellness, with natural strategies and supplements.
In the descriptions below I mention whether each supplement is safe while pregnant and breastfeeding.
Vitamin D3
Studies show that vitamin D levels tend to be lower in people with hypothyroidism. Because the body needs vitamin D to produce and use thyroid hormones, and because vitamin D is an important immune modulator that’s involved in hundreds of health-sustaining functions in the body – including bone health, modd, blood sugar regulation, and energy – it’s important to have optimal blood levels of between 50-80 ng/mL. In some cases, vitamin D is the missing link when a woman is already on supplemental thyroid hormones, but her dose needs to keep changing or she’s not seeing results. Before starting vitamin D as a thyroid supplement it’s optimal to have your levels tested, but if for some reason you’re unable to, a standard dose of 2000 units/day is appropriate for most adults.
Dose: Vitamin D3 2,000–4,000 IU/day, depending on your serum levels; ideally, recheck blood levels six weeks after starting supplementation to determine whether you are on your personally optimal dose. Safe during pregnancy and breastfeeding.
Selenium
The body turns the mineral selenium into the powerful antioxidant glutathione, which protects the thyroid from inflammation and oxidative stress. Several studies have shown that supplementing with selenium can reduce TPO antibodies.
Selenium is also critical in the conversion of T4 (the inactive form of thyroid hormone) to T3 (the active form) and it has been shown to decrease the risk of developing postpartum thyroiditis in women who are positive for TPO antibodies before or during pregnancy. It can be started during pregnancy and continued into the postpartum period to reduce risk.
Food sources of selenium are a great option, though they don’t replace supplementation. Brazil nuts, mushrooms, lamb, turkey, chicken, eggs, cod, and halibut are all selenium-rich. A note of caution: selenium can worsen thyroid function if you’re also experiencing iodine deficiency. Make sure you know your iodine status before starting selenium.
Dose: 200 mcg/day (do not exceed that amount), which is safe during pregnancy and while breastfeeding
Inositol
Recent research has discovered that the combination of selenium (200 mcg/day) and myoinositol is even more powerful at reducing anti-thyroid autoantibodies – both anti-TPO and anti-Tg antibodies – and also helping to improve thyroid function and TSH levels – than selenium alone. In one major study, six months of treatment was needed to begin to see maximum benefits. In this study, participants also reported improvements in their quality of life—one thyroid supplement success! Another study of 168 individuals with Hashimoto’s, all with TSH between 3 and 6 µIU/ml, found that participants who received myoinositol and selenium together (over those who took only selenium) saw significant decreases in TSH, TPOAb and TgAb levels, as well as in enhanced thyroid hormones and personal wellbeing.
Dose: 600 mg/day; safe in pregnancy and breastfeeding. I recommend staying on the combination at least until thyroid autoantibodies are normalized; indefinitely if needed.
Ashwagandha
In animal studies, this Ayurvedic herb has been shown to increase circulating T4 levels with no influence on T3. Other studies have shown that both hormones (T3 and T4) increased under the same protocol. Research also suggests that ashwagandha may have benefits for the liver. And since that’s where T4 to T3 conversion largely happens, perhaps explains some of the benefits.
Dose: The lowest effective dose for acute usage of ashwagandha, and perhaps the most cost-effective dose, is 300-500 mg. The optimal dose is 6,000 mg a day usually divided into three doses (2,000 mg each). Ashwagandha is safe while breastfeeding, but not safe in pregnancy.
Zinc
Zinc is involved in the conversion of T4 to T3. It’s an important nutrient if you appear to have problems with thyroid-hormone conversion. In one study, participants who took zinc sulphate for 12 months had T3 levels come into the normal range. They also had decreases in reverse T3, and had better communication between the hypothalamus and the thyroid (the hypothalamus releases thyrotropin-releasing hormone which tells the thyroid to release TSH). Furthermore, research has connected zinc deficiency with decreased thyroid hormone levels and a lower resting metabolic rate.
Dose: 30 mg/day (take with meals to prevent nausea). Zinc is safe when pregnant and breastfeeding.
Guggul
Like ashwagandha, guggul is an Ayurvedic herb that has been shown to improve T3 and T4 levels. Animal research suggests that guggul improves iodine uptake and metabolic activity of the thyroid gland.
Dose: 750 mg/day. Safe while breastfeeding, but not in pregnancy. Discontinue when thyroid levels normalize.
Always Address the Root Causes
While these supplements can help, a truly holistic, integrative plan of healing the root causes of thyroid problems is always a wise plan. For more on the Root Causes of Hashimoto’s, and how to heal them, get my book The Adrenal Thyroid Revolution. It’s got the steps you’ll want to take to take back your health!
References
Maxwell C, Volpe SL. Effect of zinc supplementation on thyroid hormone function. A case study of two college females. Ann Nutr Metab 2007;51(2):188‑94.
Nishiyama S, et al. Zinc supplementation alters thyroid hormone metabolism in disabled patients with zinc deficiency. J Am Coll Nutr. 1994 Feb;13(1):62-7.
Nordio, M. et al. Treatment With Myo-Inositol and Selenium Ensures Euthyroidism in Patients With Autoimmune Thyroiditis. Int J Endocrinol 2017, 2549491. 2017
Nordio, M and P. Raffaella. Combined Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Subclinical Hypothyroidism Patients with Autoimmune Thyroiditis. Journal of Thyroid Research.Volume 2013 (2013), Article ID 424163, 5 pages
Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol. (1998)
Panda S, Kar A. Withania somnifera and Bauhinia purpurea in the regulation of circulating thyroid hormone concentrations in female mice. J Ethnopharmacol. (1999)
Tripathi YB, et al. Thyroid stimulatory action of (Z)-guggulsterone: mechanism of action. Planta Med. (1988)