For those people who have normal T4 levels, but low or depressed T3 levels, a thyroid hormone conversion problem needs to be suspected.  The thyroid gland mostly produces thyroxine, which is also known as T4.  The thyroid gland also produces a small amount of triiodothyronine, which is T3.  Most of the T3 is produced by the conversion of T4 to T3.  But there are numerous factors which can affect the conversion of T4 to T3, which I’ll be discussing in this post.

Before I discuss some of the factors which can affect the conversion of T4 to T3, I’d like to briefly talk about this process.  The enzyme 5′ -deiodinase is responsible for this conversion process.  There are three forms of this enzyme, which include deodinase type I, deodinase type II, and deodinase type III.  The type 1 and type II deiodinases are primarily responsible for the conversion of T4 to T3, whereas the type III deiodinase is mainly involved in the inactivation of T4 and T3 (1) (2).  Most of this conversion takes place in the liver, although some of the conversion also takes place in the gastrointestinal tract.  As a result, if someone has liver problems and/or gut dysbiosis then this can potentially affect the conversion of T4 to T3.  A certain percentage of T4 is also converted into reverse T3, which I have spoken about in a different post entitled “Reverse T3: What You Need To Know About It“.

So why is it a concern if someone has problems converting T4 into T3?  Well, T3 is the active form of thyroid hormone.  Unfortunately not all endocrinologists test for T3, but when they do they will either test for total T3, where most of T3 is bound to a protein, or free T3, which isn’t bound to a protein.  Free T3 is what actually binds to the thyroid receptor.  If someone has normal T4 levels but low T3 levels then this is considered to be a hypothyroid condition.  Many medical doctors will only test the TSH and T4 levels, and the reason for this is because if the T3 is low then the TSH will typically be elevated, although this isn’t always the case.  I always recommend testing both the free T3 and free T4, along with the TSH.  If doing an initial thyroid panel it’s also a good idea to test the reverse T3, along with the thyroid antibodies.

Why Do Most Medical Doctors Give Synthetic T4?

When someone presents with hypothyroidism, most medical doctors will recommend a form of levothyroxine, which is synthetic T4.  A common brand is Synthroid, although there are other forms as well.  But if T3 is what actually binds to the receptor, wouldn’t it make sense to give the person T3 instead?  Well, some medical doctors will recommend synthetic T3 in the form of Cytomel.  However, many doctors are understandably cautious about doing this, as too high of a dosage can put the person into a hyperthyroid state.  Synthetic T4 will convert into T3, but of course if someone has a conversion problem then this won’t be the case.  Plus, even if someone doesn’t have a conversion problem they might do better taking a natural form of thyroid hormone such as Armour or Nature-Throid, which consists of both T4 and T3, along with T1, T2, and calcitonin.

Now that you have a better understanding of the importance of T3, I’d like to discuss the five factors which can have a negative effect on the conversion of T4 to T3.

Factor #1: Problems with the liver.  Since most of the conversion of T4 to T3 takes place in the liver, it would make sense that some health conditions affecting the liver can decrease the conversion of T4 to T3.  However, this isn’t always the case, as one study which investigated the relationships between thyroid function in obese adolescents with non-alcoholic fatty liver showed that they had a  higher conversion of T4 to T3 due to increased deiodinase activity as a compensatory mechanism for fat accumulation (3).  With that being said, if someone has problems converting T4 to T3 it usually is a good idea to give some liver support, such as milk thistle and N-acetylcysteine.

Factor # 2: Gut dysbiosis. As I mentioned earlier, the good bacteria in the gut helps to convert T4 into T3 through the help of an enzyme called intestinal sulfatase.  There isn’t much evidence in the literature showing that gut dysbiosis negatively affects the conversion of T4 to T3, but obviously if someone has dysbiosis then this should be addressed even if they aren’t having a conversion issue.  I did come across one study which showed that Crohn’s disease can affect the conversion of T4 to T3 (4).

Factor # 3: Selenium deficiency.  The iodothyronine deiodinases all contain selenium in the form of selenocysteine, and they play crucial roles in determining the circulating and intracellular levels of T3 (5).  Numerous studies show that a selenium deficiency can affect the conversion of T4 to T3 (6) (7) (8).  However, this might only be the case with a severe selenium deficiency, as one study showed that only when selenium levels were decreased by more than 80% was deiodinase activity markedly decreased (5).

Factor # 4: Stress.  Elevated cortisol levels can affect the conversion of T4 to T3.  Studies show that stress can inhibit both type I iodothyronine 5′-deiodinase activity (9), as well as type II 5′-deiodinase activity (10) (11).  This is yet another reason why it’s important to improve your stress handling skills.

Factor # 5: Certain medications.  Amiodarone is an anti-arrhythmic compound, and due to the structural similarity between this and thyroid hormone it apparently inhibits the activity of 5′-deiodinase (12).  Beta blockers are commonly taken in hyperthyroid conditions, and certain ones such as propranolol, alprenolol, atenolol, and metroprolol can affect the conversion of T4 to T3 (13).

Factor # 6: Pro-inflammatory cytokines.  There is also evidence that certain pro-inflammatory cytokines such as tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6) can inhibit type 2 5′-deiodinase (5’D-I) enzyme activity (14) (15) (16).  These cytokines are commonly present in autoimmune conditions, including Hashimoto’s Thyroiditis and Graves’ Disease.

In summary, normal T4 levels along with low T3 levels frequently indicate a conversion problem.  This involves the enzyme 5′-deiodinase, and is one reason why when obtaining a thyroid panel you want to not only look at the TSH and free T4 levels, but also the free T3.  And it usually is a good idea to look at the reverse T3 as well.  Six common factors which affect the conversion of T4 to T3 include problems with the liver, gut dysbiosis, a selenium deficiency, high cortisol levels, certain medications, and pro-inflammatory cytokines.

When someone with hyperthyroidism or Graves’ Disease is following a natural treatment protocol, the goal should be to address the underlying cause of the condition.  However, while this is being accomplished it is important to manage the hyperthyroid symptoms.  While many people choose to do this with antithyroid medication such as Methimazole or PTU, or beta blockers such as Propanolol, others choose to manage their symptoms naturally.  In this post I’ll discuss some of the most common herbs used to manage the hyperthyroid symptoms.

Bugleweed. This herb has antithyroid activity, as it reduces the thyroid hormone levels, which in turn causes a decrease in the cardiac symptoms associated with hyperthyroid conditions.  Lycopus virginicus and Lycopus europaeus are the two main species.  Most of the research studies involving bugleweed which I have come across have involved lycopus europaeus (1) (2) (3).  These studies show that bugleweed is effective in mild forms of hyperthyroidism, although in my clinical experience I’ve had patients with moderate to severe forms respond to a 1:2 extract ratio.  On the other hand, for some people this isn’t potent enough, and in these cases taking antithyroid medication may be necessary to lower the thyroid hormone levels while addressing the cause of the problem.

Dosage: According to master herbalist Kerry bone, 2 to 6 mL of a 1:2 liquid extract should be used, although I have used higher doses than this on some patients.  6 to 18 mL/day of a 1:5 tincture is recommended by Kerry Bone.

Pregnancy and Lactation: According to Kerry Bone, bugleweed is associated with a substantial risk of causing harmful effects on the fetus or neonate, and he suggests that it shouldn’t be taken during pregnancy.  He also says this herb is contraindicated during breastfeeding due to the possibility of both prolactin reduction in the mother and antithyroid constituents passing into the breast milk.

Motherwort. This herb can greatly help with the cardiac symptoms of hyperthyroid conditions.  It can help to reduce the heart palpitations, decrease the heart rate, and also has antiarrhythmic activity.  While bugleweed is specifically used for hyperthyroid conditions, motherwort can be beneficial for other conditions, such as digestive disorders, bronchial asthma, amenorrhea, and even externally in wounds and skin inflammation (4).  So in addition to its effects on the heart and circulatory system, pharmacological studies have confirmed its antibacterial, antioxidant, anti-inflammatory, and analgesic activity (4) (5).  The results of one study showed that motherwort can weaken the generation of free radicals in mitochondria (5), which is one of the ways that it offers cardioprotection.  Another small study looked at the effect of motherwort in patients with arterial hypertension accompanied by anxiety and sleep disorders, and concluded that this herb may help with arterial hypertension and concurrent psycho-neurological disorders, with minimal side effects (6).

Dosage: According to Kerry Bone, 2 to 4 mL of a 1:2 liquid extract should be used, although I have used higher doses of this in some patients.  If using a 1:5 tincture then 6 to 12 mL should be used by most people.

Pregnancy and Lactation. There has been no increase in frequency of malformation or other harmful effects on the fetus from limited use in women.  However according to Kerry Bone there is evidence of increased fetal damage in animal studies, and as a result I don’t recommend motherwort during pregnancy.  Kerry Bone does mention that it is compatible with breastfeeding, and I have had some breastfeeding women take motherwort.

Lemon Balm. In past articles and blog posts I have briefly mentioned the benefits of lemon balm for people with hyperthyroidism and Graves’ disease.  However, I’m admittedly biased towards bugleweed and motherwort since I took those two herbs when I was diagnosed with Graves’ Disease, although I didn’t take lemon balm.  However, lemon balm can benefit many people with hyperthyroid conditions.  It has antithyroid activity, as it may block the binding of TSH to its receptor by acting both on the hormone and receptor itself, and might also inhibit the TSH receptor antibodies binding to the TSH receptors (7).  Lemon balm also has been used as a mild sedative, spasmolytic, and antibacterial agent, and might even have antitumoral activities (8).  I also came across a few studies which showed that lemon balm has inhibitory activity on the herpes simplex virus (9) (10).  Another study showed that lemon balm can decrease elevated liver enzymes due to its strong antioxidant properties and phenolic compounds (11).  Another study conducted on mice showed that lemon balm has anti-diabetic effects, which is probably due to enhanced glucose uptake and metabolism in the liver and adipose tissue, and the inhibition of gluconeogenesis in the liver (12).

Dosage:  Kerry Bone hasn’t listed doses for lemon balm, and so if I recommend this herb I usually will start someone on the recommended dosage provided by the manufacturer.

Pregnancy and Lactation: Even though lemon balm has some antithyroid activity, some consider lemon balm to be safe during pregnancy, while others recommend to avoid it.  It does seem to be compatible with breastfeeding, although it might produce a mild sedative effect in the baby.

Hawthorn. Although I usually recommend motherwort to help manage the cardiac symptoms associated with hyperthyroidism (elevated pulse rate and palpitations), I also will recommend hawthorn at times.  This can also be helpful in those people with cardiac arrhythmias.  Hawthorn also has anti-inflammatory, gastroprotective, free radical-scavenging, and antimicrobial activity (13).  With regards to its antimicrobial activity, hawthorn seems to be most effective against gram-positive bacteria, with no effect on Candida albicans.

Dosage: According to Kerry Bone 3 to 7 mL of a 1:2 liquid extract should be used.  If someone is taking a 1:5 ratio then 9 to 20 mL should be used.

Pregnancy and Lactation: According to Kerry Bone, hawthorn has shown no increase in the frequency of malformation or other harmful effects on the fetus from limited use in women.  Just as is the case with motherwort, I typically don’t recommend hawthorn during pregnancy.  According to Kerry Bone, hawthorn is compatible with breastfeeding.

Reminder: The Quality Of The Herb Does Make A Difference

When someone is taking one or more of these herbs and they aren’t helping to manage the symptoms, one needs to consider a few factors.  First of all, the potency of the herb is important.  For example, some people will prepare herbal teas using one or more of these herbs, which can offer some benefit, but many times won’t be potent enough to manage the hyperthyroid symptoms.  If you purchase a liquid herb then the extract ratio is important.  For example, a 1:2 ratio is more potent than a 1:5 ratio.  There aren’t a lot of companies which sell bugleweed, but most that do offer it as a 1:5 ratio.  If you are taking bugleweed as a 1:5 ratio and it’s not helping then you might need to increase the dosage, or switch to a 1:2 extract.

Speaking of dosage, I always get emails from non patients asking what specific dosage of bugleweed or motherwort they should take.  Obviously this depends on the person, as if someone has thyroid hormone levels well outside of the reference range, along with a very high pulse rate, and they’re not taking antithyroid medication, then they most likely will require higher doses of these herbs.  On the other hand, if someone has slightly elevated thyroid hormone levels and a pulse rate which isn’t too high then they most likely will require a lower dosage.

Finally, the quality of the herb does make a difference.  So for example, if you go online and purchase some motherwort to help with the elevated heart rate and palpitations, and it doesn’t seem to be helping, while there’s a chance the dosage isn’t high enough, there’s also the chance that the quality of the herb is poor.  So before coming to the conclusion that motherwort isn’t effective you might want to try a different brand.  If you have been following me for awhile you know that I recommend working with a natural healthcare professional who has experience working with hyperthyroidism and Graves’ disease, as they will have experience dealing with the proper dosing, and they should be able to recommend some good quality brands.

Where Does L-Carnitine Fit In?

L-Carnitine isn’t an herb, but I figured I’d briefly mention it here since it can help to lower thyroid hormone levels when taken in higher doses.  This also isn’t something I personally took when I was diagnosed with Graves’ Disease, but over the years many of my patients have taken this.  For more information on L-carnitine I’d recommend reading my article entitled “How Does L-carnitine Help With Hyperthyroidism and Graves’ Disease?”

In summary, while the goal of a natural treatment protocol should be to restore the health of the person with hyperthyroidism and Graves’ Disease, managing the cardiac symptoms is important.  In many people this can be accomplished with herbs, and four herbs which can play a role in managing the hyperthyroid symptoms include bugleweed, motherwort, lemon balm, and hawthorn.  Both bugleweed and lemon balm have antithyroid activity, while motherwort and hawthorn help with the cardiac symptoms.  Motherwort, lemon balm, and hawthorn also have other benefits as well.  And L-carnitine taken in higher doses also can lower thyroid hormone levels.

In my articles and blog posts I frequently talk about detoxification. It’s quite common for my patients to have followed one or more liver detoxification programs prior to speaking with me for the first time. In fact, I’m sure many people reading this have gone through at least one liver detoxification program over the last few years. And some people have gone through multiple liver detoxifications over the last year alone. However, most people who follow a liver detoxification don’t have a good understanding of the detoxification pathways. As a result, in this post I would like to share some of the basics so that you better understand the different phases of detoxification.

There are two primary phases of detoxification. In the phase one detoxification system, which is known as “biotransformation”, certain toxins are converted into intermediate metabolites which can actually be more harmful than the original compound. In the phase two detoxification system, also known as the conjugation process, these intermediate metabolites are combined with certain molecules and become less toxic and water soluble. And then of course these metabolites are excreted, which is considered as being phase three detoxification. I mentioned how in phase one these toxins can be more harmful, as these intermediate metabolites can cause damage to the proteins, DNA, and RNA if they don’t go through phase two detoxification. As a result, this can be problematic if someone has compromised phase two activity.

What Role Do Cytochromes Play In Detoxification?

Cytochrome P450 enzymes are produced by the liver, and are also found in the kidney, small intestine, lung, adrenals, and most other tissues. They are utilized in phase one. There are 58 different cytochromes, and different cytochromes will play different roles in the metabolism of toxins, which include medications. The cytochrome P450 can be inhibited or induced by certain drugs, as well as by certain nutrients (1). An inducing agent can increase the rate of another drug’s metabolism, whereas an inhibiting agent can inhibit the drug’s metabolism.

These cytochrome P450 enzymes not only play a role in detoxification, as they are also essential in the metabolism of certain nutrients. For example, the cytochrome P450 enzymes are necessary for the metabolism of vitamin D (2), as well as vitamin E (3). These cytochromes are also necessary for the metabolism of hormones such as estrogen, as the first step in the metabolism of estrogens is the hydroxylation catalyzed by cytochrome P450 (4).

Genetic Polymorphisms Can Affect Detoxification

Polymorphisms are common genetic defects, and these can occur in the Cytochrome P450 (CYP) family, which in turn can affect the detoxification process. This is especially true with regards to the phase one metabolism of drugs, since almost 80% of drugs are metabolized by these enzymes (5). For example, if someone has a polymorphism of CYP2D6 then the individual would be considered to be a “poor metabolizer” (5). And polymorphisms of other CYP genes are also common, such as CYP1A1, 2A6, A13, 2C8, 3A4, and 3A5.

But what’s the significance of these genetic polymorphisms? Simply put, having certain polymorphisms of the CYP enzymes can reduce the person’s ability to detoxify. And some of these polymorphisms have been linked to chronic health conditions. For example, many people with hyperthyroidism and Graves’ Disease will commonly be advised by their endocrinologist to take Propranolol, which is a beta blocker. The cytochrome CYP2D6 is primarily responsible for the metabolism of Propranol (6), along with some other beta blockers, such as metoprolol (7). As a result, if someone were to have a genetic polymorphism of this cytochrome then this can affect the clearance of Propranol. Why is this important? Well, someone who has a polymorphism of CYP2D6 might require a different dosage of these beta blockers when compared to someone who doesn’t have such a polymorphism. Of course most people aren’t tested for these polymorphisms, and so the medical doctor will just recommend what he or she thinks is the appropriate dosage. In the future more and more people are going to be tested for these genetic polymorphisms, which in turn will impact the drug recommendations given by medical doctors.

But even though the focus of this post is on the detoxification pathways, these polymorphisms can cause other health issues. As I mentioned earlier, people who have a polymorphism of CYP2D6 are considered to be “poor metabolizers”. Well, a few studies have linked this polymorphism with Parkinson’s disease (8) (9). This doesn’t mean that everyone with this specific polymorphism will develop Parkinson’s, although it very well might make that person more susceptible to developing this condition. There is also evidence that some of these polymorphisms can increase one’s susceptibility to cancer (10).

Although I’ve been focusing on CYP2D6, there are many other types of polymorphisms of the cytochromes one can have, as I briefly listed some of them earlier. In addition to having polymorphisms of the cytochromes, there are other polymorphisms which can affect detoxification. For example, polymorphisms of glutathione S-transferase M1 (GSTM1) can have a negative effect on detoxification. N-Acetyltransferases (NAT) are key enzymes in the conjugation of certain drugs and other xenobiotics with an arylamine structure (11), and these polymorphisms can also affect detoxification.

How Can Nutrient Deficiencies Affect Detoxification?

Having certain nutrient deficiencies can have a negative effect on detoxification. And the reason for this is because nutrients are necessary for the proper functioning of the detoxification pathways. Some of the more important nutrients required for phase one detoxification include vitamins B2, B3, B6, B12, and folate. Many reading this are familiar with glutathione, which is an important antioxidant that also plays an important role in both phase one and phase two detoxification. The amino acids glycine, taurine, glutamine, cysteine, and methionine are all important for phase two detoxification.

However, when looking back at phase one detoxification, remember that intermediary metabolites are produced, and these can lead to the formation of free radicals. As a result, it is important to have sufficient antioxidants to help neutralize these free radical reactions. This not only includes glutathione, but others such as selenium and vitamin C.

The Complexity of The Phase Two Detoxification System

As I briefly mentioned earlier, phase two involves the conjugation of the intermediate metabolite with another molecule to make it less toxic and water soluble. While this might sound easy enough, it actually can be quite complex, as there are numerous pathways required in this phase. This includes acetylation, acylation, sulfur conjugation, methylation, and glucuronic acid conjugation. I’m not going to discuss these here, but just remember that having problems with any one of these pathways can affect phase two detoxification.

But what would cause these systems to malfunction? Well, there can be numerous factors which cause this. Having a genetic defect such as an MTHFR polymorphism can cause problems. Or having a certain nutrient deficiency can also lead to big issues. For example, if someone has a vitamin B5 (pantothenic acid) deficiency then this can affect acetylation. If they have a deficiency in glycine or taurine then this can affect acylation. If they have a deficiency of vitamin A or niacin then this can affect sulfation, etc. So for example, glutathione synthesis is magnesium-dependent. There are other important nutrients and amino acids required, but if someone has a severe magnesium deficiency, yet they take something such as N-acetyl cysteine to help increase glutathione levels, they won’t be able to accomplish this if the magnesium deficiency isn’t addressed.

Thyroid Health and Detoxification

Thyroid hormones play an important role in detoxification. Either a hypothyroid or hyperthyroid state can have a negative effect on the cytochrome P450 enzymes, which you now know play an important role in phase one detoxification. For example, one study in mice showed that hypothyroidism can affect the metabolism of xenobiotics by suppressing the CYP3A enzyme, while inducing the CYP2B enzyme (12). Numerous studies also show that a thyroid imbalance can affect the cytochrome enzymes (13) (14) (15).

So what does this mean? Well, it means that having hypothyroidism or hyperthyroidism can have a negative effect on detoxification. And so while it’s beneficial for people with these conditions to do things to detoxify their body, if they have a thyroid hormone imbalance then this can reduce the ability of body to metabolize toxins. And so it is important to correct any thyroid hormone imbalance in order to achieve optimal detoxification.

So hopefully you have a better understanding of the importance of the detoxification pathways. When someone undergoes a liver detoxification, the foods and supplements they are taking should support these pathways. If someone is deficient in one of these nutrients then this will have a negative effect on detoxification. However, having certain genetic polymorphisms can also have a negative effect on the detoxification pathways. In addition, having healthy thyroid hormone levels are also important for proper functioning of the detoxification pathways.

It’s common for people who have thyroid and autoimmune thyroid conditions to have blood sugar imbalances.  Eating a large amount of carbohydrates and refined sugars is the primary factor responsible for this.  However, many people wonder about natural sugars and sweeteners, and so I decided to put together a post which discusses this, including which ones are okay to consume, which ones should be avoided, and which ones are controversial.

One thing to keep in mind as you read this information is that while some natural sweeteners are better than others, regardless of the type of sugar or sweetener, you do want to minimize your overall consumption of these.  Although there are some health benefits of certain sweeteners such as honey and maple syrup, eating large amounts can have a negative effect on one’s health.  This is true not only with the sweeteners I mention here, but even with whole foods which contain larger amounts of sugar, such as fruits.  For most people, eating a few servings of fruit per day is fine, but eating large amounts of fruit on a daily basis can cause health issues in some people.  This is especially true with those who have blood sugar imbalances and/or a yeast or bacterial overgrowth.

I’m not going to talk in detail about fructose in this post, but I wanted to briefly mention it, as when it comes to the different types of “natural” sweeteners, the high levels of fructose in some of these can be an issue.  Of course fruit has fructose, but eating a small amount of fructose won’t cause problems for most people.  On the other hand, consuming large amounts of fructose on a regular basis can impair insulin sensitivity and cause metabolic dyslipidemia (1) (2) (3).  While many people realize that high fructose corn syrup can be detrimental to their health, they might not realize that certain natural sweeteners such as agave syrup also has large amounts of fructose.  Once again, this doesn’t mean you need to completely avoid consuming fructose, but you do want to minimize your consumption of it.

With that being said, let’s go ahead and discuss some of the different forms of natural sugars and sweeteners:

Honey. There are many different health benefits of honey.   Honey consists of mainly fructose and glucose, along with 25 different oligosaccharides, and it has a glycemic index anywhere from 32 to 85 (4).   It also contains small amounts of proteins, enzymes, amino acids, minerals, trace elements, vitamins, aroma compounds and polyphenols (4).  Many studies have shown that honey is more tolerable than most common sugars or sweeteners in healthy subjects, as well as in patients with impaired glucose tolerance or diabetes mellitus (5).  Another study showed that honey caused greater elevation of insulin than sucrose, although it reduces blood lipids, homocysteine, and CRP in normal and hyperlipidemic subjects, and when compared with dextrose and sucrose caused lower elevation of the plasma glucose level in diabetics (6).  However, another study showed that while consuming honey can provide beneficial effects on body weight and blood lipids of diabetic patients, it also raises hemoglobin A1C (7).  Even though honey is high in fructose, most people with thyroid and autoimmune thyroid conditions can have a small amount of raw honey every now and then.

Maple syrup. Maple syrup, along with honey and brown sugar has shown intermediate antioxidant capacity (8).  It has many different phytochemicals, which might lead to numerous health benefits (9).  One study compared the enhancement of plasma glucose levels in type 2 diabetes by oral administration of sucrose or maple syrup, and concluded that maple syrup may have a lower glycemic index than sucrose, which may help in the prevention of type 2 diabetes (10).  Just as is the case with raw honey, many people with thyroid and autoimmune thyroid conditions do fine consuming small amounts of maple syrup every now and then.

Molasses. Molasses can also be used as a natural sweetener, as it the main byproduct of sugar production, and it is high in antioxidants (11).  In fact, one study looked at the total antioxidant content of some of the different alternatives to refined sugar, including raw cane sugar, maple syrup, agave, honey, etc., and found that dark and blackstrap molasses had the highest total antioxidant content (12).  Blackstrap molasses is also a good source of calcium (13).  Small amounts of molasses is fine for many people with thyroid and autoimmune thyroid conditions.

Agave syrup. A lot of people consider agave to be a healthier type of sweetener.  The good news is that agave syrup has a low glycemic index and might contain beneficial antioxidant nutrients, trace elements, or phytochemicals (14).  The bad news is that it is very high in fructose, and depending on the source and how it’s processed, it might actually have higher levels of fructose than high fructose corn syrup.  Consuming agave syrup can potentially lead to elevated serum triglycerides and VLDL (14).  Dr. Joseph Mercola has put together a very interesting and eye-opening article on agave syrup, and explains why you should avoid it.

Stevia. Stevia is a small perennial shrub that has been used for centuries as a bio-sweetener and for other medicinal uses such as to lower blood sugar (15).  It has no calories and is over 100-300 times sweeter than table sugar (15).  Steviol glycosides are the secondary metabolites responsible for the sweetness of stevia (16). One study on diabetic rats showed that stevia consumption not only resulted in a reduction of blood glucose, but also might ameliorate liver and kidney damage (17).  Based on another study on male rats which decreased their fertility, there is a small concern that stevia can have a negative effect on fertility (18).  However, this is yet another controversial subject, and there is no evidence that taking stevia can decrease fertility in humans.  With that being said, if someone is trying to conceive and/or is having a difficult time conceiving then it probably would be a good idea to play it safe and avoid stevia.  In addition, a recent study showed that the stevia glycosides can inhibit the growth of lactobacillus reuteri (19).  This has caused some healthcare professionals to claim that stevia is harmful to the gut flora, although more studies are definitely needed in this area before we can come to such a conclusion.  I’ve had patients with thyroid and autoimmune thyroid conditions consume small amounts of stevia while following a natural treatment protocol without it having a negative effect on their recovery.

Coconut sugar. I have had many patients ask about coconut sugar, also known as coconut palm sugar.  This is lower in fructose than some of the other sugars and sweeteners I’ve listed here.  However, the fructose content is somewhat controversial, as some sources claim that it has less than 10% fructose, while other sources claim it’s closer to 40%.  Coconut sugar does seem to be a good source of certain minerals and inulin.  While inulin can be beneficial to the gut flora, as it can help to stimulate the growth of the Bifidobacteria species (20) (21), some claim that it might cause problems with gut healing.  With that being said, I came across a study which showed that inulin-enriched pasta actually preserves intestinal mucosa barrier functioning and might be used in the prevention of gastrointestinal diseases and metabolic disorders (22).

Luo han. This comes from a Chinese plant, and is minimally processed.  One study conducted on rabbits showed that it not only improves the lipid profile by lowering total cholesterol and triglyceride levels while increasing HDL-C, but it also lowers plasma glucose levels (23).  Another study showed that Luo han can provide a positive health impact on stimulating insulin secretion (24).  Another study showed that Luo han might be beneficial as an antibacterial agent (25).  Small amounts of Luo han are probably fine to consume.

Xylitol and other sugar alcohols. Xylitol is a naturally occurring alcohol found in plants, and is a common sugar substitute.  Xylitol does seem to have some health benefits, as there is evidence it can help with otitis media (26), and also might help to prevent dental cavities by inhibiting the growth of several strains of mutans streptococci (27) (28).  Erythritol is another type of alcohol and also was found to prevent dental caries.

However, some people experience gastrointestinal discomfort and sometimes even diarrhea when consuming sugar alcohols such as xylitol.  A few studies have shown accelerated intestinal transit after xylitol ingestion (29) (30).  Since sugar alcohols are fermented by gut bacteria,  someone with a condition such as small intestinal bacterial overgrowth (SIBO) will want to avoid all sugar alcohols.  There is some concern that some sugar alcohols might cause an increase in intestinal permeability (a leaky gut), although I wasn’t able to find any studies showing this to be the case.  For those who have dogs you will want to make sure that they don’t ingest any foods which contain xylitol, as there is evidence that acute liver failure can occur when they consume xylitol (31).

Which Natural Sugars/Sweeteners Can You Safely Consume?

Now that I have discussed some of the more common natural sweeteners, I’d like to summarize which natural sugars/sweeteners most people with thyroid and autoimmune thyroid conditions can safely consume, and which ones should be avoided.  As I mentioned in this post, sweeteners such as honey, maple syrup, and molasses seem to be fine in very small amounts.  There is some controversy over stevia, although I personally think that it’s fine for most people to have small amounts of this as well.  However, if someone has problems conceiving then it might be best to avoid stevia.  I recommended to avoid sweeteners high in fructose such as agave since it has high levels of fructose.  Luo han seems to be a safe option.  Although coconut sugar is a better option when compared to certain sweeteners such as agave, it probably is best to first choose honey, maple syrup, or molasses.  Small amounts of sugar alcohols are fine for some people, but they can be problematic for someone with SIBO, and there is some concern that they can cause a leaky gut, although more research needs to be done in this area.

Keep in mind that there are some people who have problems tolerating honey and maple syrup, and if this is the case then of course it’s best to avoid these.  With regards to stevia, if you do take this I would recommend pure organic stevia, and avoid processed types.  But every now and then there will be someone who doesn’t seem to do well even with organic stevia, and thus should avoid it.

In summary, many people with thyroid and autoimmune thyroid conditions have questions about which natural sugars and sweeteners they can safely consume.  Many people with these conditions are able to consume small amounts of honey, maple syrup, and molasses.  In my opinion stevia is also okay to consume by most people, as long as it’s not processed.  Luo han is probably safe to consume in small amounts.  There is controversy over coconut sugar and the sugar alcohols.  And sweeteners high in fructose such as agave should be avoided.

In the last blog post I spoke about 5 power foods for hyperthyroidism and Graves’ Disease, and so it’s only fair that I put together a blog post where I discuss 5 power foods for hypothyroidism and Hashimoto’s Thyroiditis.  Remember that this list isn’t all-inclusive, as there are other foods which are nutrient dense that can benefit people with hypothyroid conditions.  Also, keep in mind that while I intentionally left off cruciferous vegetables because of the stigma they receive by many people with hypothyroidism due to their goitrogenic properties, many people with hypothyroid conditions can eat normal amounts of cruciferous vegetables.

Keep in mind that not everyone with hypothyroidism and Hashimoto’s Thyroiditis will be able to eat all of these “power foods”.  For example, the first power food I listed is coconut oil, and while most people do fine when eating this, if someone has a condition such as small intestinal bacterial overgrowth then they might not be able to consume coconut oil, along with other coconut products.  Obviously everyone is different, and while most people with hypothyroid conditions can eat the foods I’ve listed, there are always exceptions.  So with that being said, let’s go ahead and talk about these power foods.

Power Food #1: Coconut Oil. Because coconut oil is a saturated fat, many people still try to avoid this oil out of fear that saturated fats can cause heart disease.  Of course this isn’t proven in the latest research, and the evidence actually shows that coconut oil can lower lipid levels in serum and tissues and LDL oxidation by physiological oxidants (1).  Another study demonstrated that coconut oil has anti-inflammatory, analgesic, and antipyretic (can reduce fever) properties (2).  The anti-inflammatory properties can be especially beneficial for those with autoimmune thyroid conditions.  Coconut oil is also one of the fats you can safely cook with.

Lauric acid is the main ingredient of coconut oil that offers some wonderful benefits.  In addition to the benefits I already listed above, coconut oil also has antimicrobial properties due to lauric acid, which converts into monolaurin (3) (4) (5).  Lauric acid also has insulinotropic properties (6), which means it helps stimulate the production of insulin.  Another study showed that lauric acid present in coconut oil might protect against diabetes-induced dyslipidemia (7).

There are some sources which demonstrate that coconut oil can speed up the metabolism, and thus benefit people with hypothyroidism.  In fact, a few sources claim that coconut oil can cure hypothyroidism.  Although coconut oil might have a positive benefit on the metabolism, keep in mind that most cases of hypothyroidism have an autoimmune component, and just taking coconut oil isn’t going to address this.  But with that being said, due to some of the other health benefits I mentioned earlier, coconut oil should be consumed by most people with thyroid and autoimmune thyroid conditions.  I recommend for most people with thyroid and autoimmune thyroid conditions to consume at least one tablespoon of coconut oil per day.

Power Food #2: Avocados. Avocados are one of most nutrient dense foods, and so eating an avocado per day can help to provide many nutrients, and comes with other health benefits as well.  Current research has shown that avocado seeds may improve hypercholesterolemia, and can be useful in the treatment of hypertension, inflammatory conditions and diabetes (8). Seeds have also been found to possess insecticidal, fungicidal, and anti-microbial activities (8).  Avocado oil consists of 71% monounsaturated fatty acids (MUFA), 13% polyunsaturated fatty acids (PUFA), and 16% saturated fatty acids (SFA), which helps to promote healthy blood lipid profiles and enhance the bioavailability of fat soluble vitamins and phytochemicals from the avocado or other fruits and vegetables, naturally low in fat, which are consumed with avocados (9).  A recent study showed that avocado consumption is associated with improved overall diet quality, nutrient intake, and reduced risk of metabolic syndrome (10).  If you are unable to purchase organic avocados, the good news is that avocados are currently on the “Clean Fifteen” list of the Environmental Working Group, which means that non-organic avocados are lower in pesticides when compared to other fruits and vegetables.

Power Food #3: Bone Broth. Bone broth involves boiling the bones of animals, and it is very nutrient dense.  In addition, bone broth includes amino acids which can help to reduce inflammation and heal the gut.  This can be essential for someone who has Hashimoto’s Thyroiditis, as many people with this condition have a leaky gut.  And some researchers feel that everyone with any type of autoimmune condition has a leaky gut.  I’m not sure if this is true, but regardless of whether or not someone has a leaky gut, drinking bone broth can be beneficial.  And if someone does in fact have a leaky gut, then drinking a few cups of bone broth can help with the healing process, assuming the trigger which caused the leaky gut in the first place has been removed.

How much bone broth should someone drink on a daily basis?  If someone has received a positive test for a leaky gut then drinking at least 2 or 3 cups of bone broth daily would be a good idea.  If someone has an autoimmune condition and doesn’t know if they have a leaky gut, I would recommend drinking at least one or two cups per day, although more than this would be fine.  Of course the quality of the bone broth is important.  For example, if you are drinking beef bone broth then I would make sure the bones are from cows which were 100% grass fed.

Power Food #4: Asparagus: Asparagus possesses a variety of biological properties, as they are rich in antioxidants, plus they are anti-inflammatory, antihepatotoxic, antibacterial,  and antioxytocic (11).  Asparagus can also protect the liver cells against toxins and might even help to alleviate alcoholic hangovers (12).  This plant also contains vitamins A, B1, B2, C, E, magnesium, phosphorus, calcium, iron, and folic acid (11). Other primary chemical constituents of Asparagus are essential oils, asparagine, arginine, tyrosine, flavonoids (kaempferol, quercetin, and rutin), resin, and tannin (11).  Just as is the case with avocados, asparagus is also currently on the “Clean Fifteen” list from the Environmental Working Group.

Power Food #5: Garlic. Garlic has many different health benefits, and while some people are unable to tolerate garlic, for those who are able to eat garlic I recommend doing so on a frequent basis.  With regards to autoimmune conditions such as Hashimoto’s Thyroiditis (as well as Graves’ Disease), garlic can help to decrease proinflammatory cytokines and suppress nuclear factor kappa B (13) (14), which are both factors in autoimmune conditions.  In addition, many people are aware of the antimicrobial properties of garlic, as garlic can help to eradicate bacteria such as H. Pylori, and in some cases can even be effective against strains which are antibiotic resistant (15).  Garlic also has antifungal and antiparasitic activities (16) (17), and of course pathogens can play a role in thyroid autoimmunity.

How much garlic should you eat on a daily basis?  Well, it really does depend on the person, as if someone has a known infection then they should be eating more garlic than someone without an infection, and probably should also consider taking a garlic supplement on a daily basis.  Eating one or two cloves of garlic when having an infection would also be wise, and eating a clove of garlic per day would benefit those without an infection, as garlic can help to prevent infections as well.

So if you have a hypothyroid condition then I would consider incorporating most, if not all of these power foods.  Avocados and coconut oil are healthy types of fats, and both have anti-inflammatory properties.  Bone broth can benefit those who have a leaky gut, which is a component in many people with Hashimoto’s Thyroiditis.  And some sources claim that everyone with an autoimmune condition has a leaky gut, which would make bone broth even more important.  Asparagus has numerous properties which can be beneficial, and garlic is one of the most beneficial foods.

One of the most common questions I get asked from people with thyroid and autoimmune thyroid conditions is “what foods should I eat?”  A general answer I commonly give is to eat whole foods, minimize the refined foods and sugars, and to avoid common allergens such as gluten, dairy, corn, etc.  When it comes to choosing specific foods for thyroid and autoimmune thyroid conditions, one of the challenges is that some healthy foods can cause problems.  For example, if someone tries to avoid all foods with antinutrients such as lectins, phytic acid, saponins, and oxalates, this will greatly minimize the amount of foods they can eat.  On top of this you might decide to avoid eating eggs and the nightshades.  After doing this you will be left with a very small category of foods.

So when putting together this list, I realize that there are some foods which fall within the categories I listed above.  And I’m not suggesting that everyone should eat these foods.  For example, one of the power foods I listed below is eggs.  Eggs have a lot of good nutrients and are a pretty good source of protein.  The problem is that it’s not uncommon for people to be sensitive to eggs.  Of course it’s possible to have an allergy or sensitivity to any food, although some food allergies and sensitivities are more common than others.  The point I’m trying to make is that the “power foods” I listed below represent an excellent source of nutrients and can benefit many people with hyperthyroidism and Graves’ Disease.  However, this doesn’t mean that everyone with these conditions can eat these foods.  And of course there are other nutrient dense foods which I didn’t include on this list.  While this blog post focuses on power foods for hyperthyroidism and Graves’ Disease, for those with hypothyroidism and Hashimoto’s Thyroiditis, in the next blog post I’ll discuss some of the power foods for hypothyroid conditions.

With that being said, let’s go ahead and list five power foods that can benefit those people with hyperthyroid conditions:

Power Food #1: Kale. Kale has some wonderful health benefits.  First of all, it is very nutrient dense.  Second, it has antiproliferative effects (1), and so it can help with the prevention of cancer.  There is also evidence that it can favorably influence serum lipid profiles and thus reduce the risk of coronary heart disease (2).  As for whether you should eat kale raw, or if you should cook it, one study showed that the cooking process of kale resulted in lowering of the activity of its antioxidants (3).  However, you still will get many of the benefits of kale if you lightly steam it.  As for how kale can specifically benefit people with hyperthyroidism, kale is considered to be goitrogenic, which means that when consumed in larger amounts it can potentially inhibit thyroid function.  Cooking might reduce the goitrogenic activity, and if you have hyperthyroidism or Graves’ Disease feel free to eat a few servings of raw kale per day.  Bone density is an issue with hyperthyroidism, and kale is one of the best sources of calcium, and unlike spinach it exhibits excellent absorbability for its calcium (4).

Power Food #2: Organ Meats. Although I still can’t get over the “mental barrier” which has prevented me from eating organ meats, this category of food is very nutrient dense.  And while eating nutrient dense foods is important for everyone, one can argue that it is even more important for someone who is dealing with hyperthyroidism.  One of the biggest problems many people with hyperthyroid conditions have is losing a large amount of weight.  This of course is due to the increased metabolic rate caused by the elevated thyroid hormone levels.  And while it is important to normalize the thyroid hormone levels, while one is trying to accomplish this it is important to eat nutrient dense foods.

In addition, Coenzyme Q10 (CoQ10) is high in organs with high rates of metabolism such as the heart, kidney, and liver (5).  And numerous studies show that CoQ10 is low in people with hyperthyroid conditions (6) (7).  Although one can of course supplement with CoQ10, since organ meats have high amounts of this then this presents another option.

Power Food #3: Eggs. As I mentioned earlier, eggs are a common allergen.  As a result, not everyone is able to eat eggs.  However, even if someone doesn’t have an egg allergy, the egg whites have certain compounds which can cause problems in those people with autoimmune thyroid conditions, as well as those with other types of autoimmune conditions.  On the other hand, although I do have most of my patients initially avoid eggs, I’m not opposed to some people reintroducing eggs.  And this is especially true with those people who have hyperthyroid conditions, as many people with hyperthyroidism have a voracious appetite and are struggling to gain weight.  I know this described myself when I was diagnosed with Graves’ Disease.  Eggs are another nutrient dense food, and if someone doesn’t have an egg allergy it might be fine for them to eat egg yolks without much of a problem.

Some people are concerned that eating eggs will increase their cholesterol levels, even though research clearly shows that this isn’t the case (8) (9) (10).  In fact, one study showed that people who reported eating four or more eggs per week actually had a lower serum cholesterol concentration when compared with those who ate one egg or less per week (8).  In those with metabolic syndrome, eating eggs (including the yolks) improves lipoprotein profiles and insulin sensitivity (11).  Ideally you want to eat organic, pasture-raised eggs.

Power Food #4: Almonds. Almonds are rich in monounsaturated fat, fiber, α-tocopherol, minerals such as magnesium and copper, and phytonutrients (12).  Other cardioprotective nutrients unique to almonds include arginine, manganese, calcium, and potassium (13).  One study showed that incorporation of almonds into a healthy diet could ameliorate inflammation and oxidative stress in patients with type 2 diabetes mellitus (14).  There is also evidence that almond and almond skin ingestion may lead to an improvement in the intestinal microbiota profile and a modification of the intestinal bacterial activities (15).  One potential problem with almonds, as well as other nuts and seeds, is that it has antinutrients such as lectins and phytic acid.  As a result, you don’t want to eat large amounts of almonds, and if someone has a leaky gut then it probably would be best to avoid eating almonds while repairing the gut.  Because some researchers speculate that everyone with an autoimmune condition has a leaky gut, almonds are excluded from most autoimmune paleo diets, which means that those people with Graves’ Disease who are following this diet would want to avoid eating almonds.

Power Food #5: Berries. Consuming different types of berries can be beneficial to one’s health.  This includes blueberries, raspberries, blackberries, strawberries, and cranberries.  All berries have different phytonutrients, and the phenolic compounds are responsible for their antioxidant properties (16) (17).  In addition, numerous studies have shown berries of different kinds to have anti-inflammatory properties, and can potentially modulate inflammatory cytokines which are found in different types of autoimmune conditions (18) (19) (20) (21) (22).  Berries are typically high in oxalates, and so you want to be cautious about eating too many of these.  Growing up I never was much of a berry eater, as I frequently ate a lot of apples, grapes, and bananas.  But I currently have a smoothie on a daily basis, and I’ll always include some organic berries, as I usually rotate between blueberries, blackberries, raspberries, and strawberries.

So these are some of the “power foods” which can benefit people with hyperthyroidism and Graves’ Disease.  Of course there are other foods I didn’t include on this list which are also nutrient dense.  For example, while kale is without question a “power food”, so are other cruciferous vegetables such as broccoli and cabbage.  And although organ meats are very nutrient dense, other types of meat are nutrient dense.  For those people with hypothyroidism and Hashimoto’s Thyroiditis, in the next blog post I’ll discuss power foods which can be beneficial for people with these conditions.

Many people with hypothyroidism and Hashimoto’s Thyroiditis take thyroid hormone medication, and every now and then I’ll get asked if there is a natural substitute for thyroid hormone.  I deal with both hyperthyroid and hypothyroid conditions, and with hyperthyroid conditions there are some pretty good natural alternatives for the medication.  For example, bugleweed is an herb which has antithyroid activity, and many people choose to take this instead of antithyroid medication.  And motherwort can be used instead of beta blockers in some people with hyperthyroidism.  But are there nutritional supplements or herbs which can effectively manage the hypothyroid symptoms while someone is trying to restore their health back to normal?

Most people with hypothyroid conditions are aware that there are natural alternatives to synthetic thyroid hormone, such as Armour and Nature-Throid.  But while many people do better on natural thyroid hormone, this is still a form of hormone replacement therapy.  In other words, natural thyroid hormone isn’t doing anything for the actual cause of the condition.  Then again, neither is the bugleweed or motherwort many people with hyperthyroid conditions take, as I recommend these to manage the hyperthyroid symptoms while trying to address the cause of the condition.  Even so, some people prefer to take supplements and herbs, and would like to avoid taking hormones whenever possible.

Are There Supplements And Herbs To Take Instead of Thyroid Hormone Medication?

If someone has depressed thyroid hormone levels then unfortunately there are no nutritional supplements or herbs which will replace thyroid hormone.  And this is the case with any hormone deficiency.  However, there are nutrients and herbs which can help to increase the output of thyroid hormone, and in some cases these can be taken while the cause of the condition is being addressed.  So what I’d like to do is talk about some of these nutrients and herbs which might be beneficial in some cases of hypothyroidism.

Iodine. Yes, I’m starting with the controversial iodine.  I’m definitely not suggesting that iodine can be taken instead of thyroid hormone medication, and  I realize that many people with Hashimoto’s Thyroiditis don’t do well when taking iodine.  However, iodine is necessary for the formation of thyroid hormone, as thyroxine (T4) consists of four iodine atoms, while triiodothyronine (T3) consists of three iodine atoms.  Although an iodine deficiency can cause hypothyroidism, most cases of hypothyroidism are caused by Hashimoto’s Thyroiditis.  With that being said, if someone has a non-autoimmune hypothyroid condition and tests positive for a moderate to severe iodine deficiency, then it probably would be a good idea to correct this deficiency.  If someone with Hashimoto’s tests positive for an iodine deficiency then eventually this should be corrected, although other factors may need to be addressed first in order to make sure the person doesn’t have a negative reaction to iodine.

Tyrosine. This is an amino acid, and like iodine, this is also necessary for the formation of thyroid hormone.  As a result, many thyroid support formulas will include tyrosine.  However, very rarely is a tyrosine deficiency the primary cause of hypothyroidism.  And so while supplementing with tyrosine usually won’t cause any problems, it also is unlikely to make much of a difference with regards to thyroid hormone output.

Selenium. This mineral is important for the conversion of T4 to T3.  As a result, if someone has normal levels of T4 but low levels of T3, they very well might have a selenium deficiency.  However, there are other factors which can also interfere with the conversion of T4 to T3, such as high cortisol levels.  Some studies have shown that selenium can help to reduce thyroid antibodies, and while this isn’t always the case, when it does help to lower these antibodies this will minimize the amount of thyroid gland damage, which in turn can help with the output of thyroid hormone.

Iron. Iron is another mineral which is essential for normal thyroid hormone metabolism, and a deficiency of this mineral impairs thyroid hormone synthesis by reducing the activity of heme-dependent thyroid peroxidase (1).  Iron deficiency anemia is very common, and while this might not be the cause of most cases of hypothyroidism, if someone has an iron deficiency I think it’s safe to say that it’s not helping with the thyroid condition.  And so I recommend for most of my patients to not only get a complete blood count, but also an iron panel which includes serum iron, ferritin, iron saturation, and TIBC.

Zinc. Studies show a significant correlation between serum zinc levels and thyroid volume, along with thyroid antibodies and free T3 levels (2) (3).  Once again, taking zinc alone probably won’t make much of a difference in someone with hypothyroidism, although if someone is deficient in zinc it could be a contributing factor.

Ashwagandha. There are a few studies which show that ashwagandha can stimulate thyroid hormone production (4) (5).  In fact, one of these was a case study which showed that taking ashwagandha caused thyrotoxicosis in a 32-year old woman.  However, I’ve given ashwagandha to numerous patients with hyperthyroid conditions without a problem, as it doesn’t seem to directly affect the thyroid gland, but instead affects the hypothalamic-pituitary-thyroid (HPT) axis.  It also affects the hypothalamic-pituitary-adrenal (HPA) axis, which can in turn modulate cortisol levels.  Ashwagandha is commonly given to lower elevated levels of cortisol, but in most cases it can also be safely taken with those who have depressed cortisol levels.  Anyway, some people with low or depressed thyroid hormone levels might benefit from taking ashwagandha.

Coleus. Coleus (Coleus forskohlii) is a member of the Lamiaceae or Mint family.  While it can help with numerous conditions such as cardiovascular disorders, abdominal pain, and constipation, it also is commonly used for hypothyroidism, as it can potentially stimulate thyroid hormone production.

Thytrophin PMG. Some think of this as a glandular, although it’s actually referred to as a protomorphogen.  I have been using this in my practice for many years.  This product doesn’t contain any thyroid hormone.  In fact, many people with Graves’ Disease are able to take this, as its main purpose is to help neutralize the effects of the thyroid antibodies.  Thytrophin PMG isn’t meant to be a replacement for thyroid hormone medication, although every now and then I’ll receive an email from someone who is taking this instead of synthetic or natural thyroid hormone.

Thyroid glandulars. There are numerous types of thyroid glandulars, some of which don’t have thyroid hormone, and other products which do include thyroid hormone.  Obviously if someone is looking to completely avoid taking any type of thyroid hormone then they probably will also want to avoid taking thyroid glandulars which have thyroid hormone.  On the other hand, since these usually have a smaller amount of thyroid hormone, along with some of the nutrients and herbs I listed above, many are willing to take a thyroid glandular instead of levothyroxine, Armour, or Nature-Throid.

So these are some of the supplements and herbs which might benefit people who are looking to avoid taking thyroid hormone medication.  Unfortunately there is no natural substitute that can be taken in place of thyroid hormone, and having sufficient levels of thyroid hormone is very important.  While some people might do fine taking some of the nutrients and/or herbs I discussed in place of thyroid hormone, most people with overt hypothyroidism will need to be on some type of thyroid hormone medication, although they might be fine taking a thyroid glandular which has a small amount of thyroid hormone, along with other nutrients and herbs to support the thyroid gland.

I think it’s safe to say that we’re in a “smoothie era”, as millions of people consume smoothies on a daily basis.  There are a number of positive benefits of consuming green smoothies.  I personally have a green smoothie every morning for breakfast, and many of my patients do the same.  But while there are some great health benefits of drinking green smoothies on a daily basis, there are also some potential downsides of drinking these.

Before I discuss some of the potential “risks” of drinking green smoothies on a daily basis, I’d like to briefly mention a few of the primary benefits of green smoothies:

Benefit #1: Green smoothies can make it easier to start the day with a few servings of vegetables.  I look at the food diaries of patients all of the time, and to no surprise, most people don’t eat enough vegetables on a daily basis.  And most people who eat a few servings of vegetables per day don’t eat any during breakfast, but instead eat them during lunch and/or dinner.  Obviously this doesn’t apply to everyone, but it does apply to most people. It definitely applied to me growing up, as for the first few decades of my life I usually had a bowl of sugary cereal with cow’s milk for breakfast.

Benefit #2: Smoothies offer “instant hydration”, as they allow you to start the day off with a couple of cups of water.   To be fair, many people don’t add water to their smoothies, but instead add something else such as cow’s milk, almond milk, coconut milk, etc.  But many people don’t drink enough water, and so I would encourage you to at least add one cup of water to your smoothie.  For example, if you currently add two cups of coconut milk to your smoothies, try adding only one cup of coconut milk and one cup of purified water.  On most days I personally add 1/4 cup of organic almond milk to my smoothies, and 1 3/4 cups of purified water.

Benefit #3: You of course can include other healthy ingredients to your smoothies.  In addition to green leafy vegetables you can add carrots, avocados, and berries.  Many people can also add raw egg yolks and/or coconut oil to their smoothies.  Some people add a type of protein powder to their smoothie, which usually is fine, but just remember that these powders shouldn’t take the place of whole healthy foods.  I know some people have smoothies which consist of almond or coconut milk, strawberries and bananas, some type of protein powder, and nothing else.  While this is healthier than the bowl of sugary cereal I mentioned earlier, you should also add some vegetables and a healthy type of fat such as an avocado or coconut oil.  I can understand not wanting to add a raw egg yolk, although when combined with the other ingredients I mentioned, most people won’t even taste the raw eggs.  But besides the fact that some people find adding a raw egg to be disgusting, if someone is following a strict autoimmune paleo diet then they probably won’t be adding eggs to their smoothies.

So these are some of the health benefits of drinking smoothies.  But there are also some potential risks of drinking smoothies:

Risk #1: Green smoothies are typically goitrogenic. This of course depends on which green vegetables are added to the smoothie, but two of the most common green leafy vegetables added to smoothies are kale and spinach.  And while both of these have healthy nutrients, eating large amounts of raw kale and spinach can potentially inhibit thyroid activity.  Although there might be some risks with those people who have a hypothyroid condition with regards to eating large amounts of raw goitrogenic vegetables, adding 1/2 cup to one cup of these vegetables to a daily smoothie usually won’t cause a problem with most people, even those with hypothyroidism and Hashimoto’s Thyroiditis.  On the other hand, adding a few cups of raw goitrogenic vegetables to your smoothies and having one or two of these on a daily basis might cause problems in some people with hypothyroid conditions.  I spoke about goitrogens in greater detail in an article I wrote entitled “An Update On Goitrogenic Foods and Their Impact on Thyroid Health“.

Risk #2: Green smoothies can be high in oxalates. Oxalates are substances which bind to calcium, and this interferes with its absorption.  Eating foods high in oxalates can therefore lead to a decrease in bone density.  Another risk is that large amounts of oxalates can cause kidney stone formation.  I actually spoke about this in a post entitled “Should Spinach Be Avoided In Those With Thyroid Conditions?“, as I discussed the risk of loading smoothies with foods high in oxalates, such as spinach and swiss chard.  But it’s not just green leafy vegetables which are high in oxalates, as blackberries, blueberries, and raspberries are also high in oxalates, and of course many people add berries to their smoothies.  Once again, I’m not suggesting that people shouldn’t add berries to their smoothies, or other foods high in oxalates.  But it might be a good idea to minimize the amount of these foods you add to your smoothies.

Risk #3: Smoothies prepared the wrong way can spike up your blood sugar levels. Although I do think it’s fine to add some fruit to your smoothies, some people add too much fruit.  Bananas are one of the most commonly added fruits to smoothies, and while many people do fine adding a small banana to their smoothie, some people will add a few bananas, along with a few servings of other fruits to their smoothies.  This can especially be problematic for someone who has blood sugar imbalances, or an underlying yeast infection.  It’s not uncommon for people to prefer fruit over vegetables, and this definitely describes me.  When I first began making smoothies I probably added too much fruit, but I currently add 1/4 cup of organic berries to my smoothies and in my opinion it tastes fine.  Adding a healthy source of protein or fat will minimize the impact that the fructose will have on your blood sugar levels.  I would recommend adding an avocado, one tablespoon of coconut oil, and/or one or two raw egg yolks.

Risk #4: Some people include unhealthy ingredients in their smoothies. Although I’m fine with most people adding some type of “healthier” protein powder to their smoothie, doing so isn’t required.  And even if you do add a small amount of protein powder, you want your smoothie to consist primarily of whole foods.  Add a small amount of fruit, a few servings of vegetables, a healthy type of fat, etc.  But if you do add a protein powder you want to make sure it’s of good quality, and you also want to carefully read the ingredients and make sure it doesn’t include any artificial colorings or flavorings, as well as other unhealthy ingredients.

So What’s The Final Verdict?

I think most people with thyroid and autoimmune thyroid conditions can have green smoothies without a problem.  Just like anything else, the key is having a “balanced” smoothie.  Some people add too much fruit, while others add excessive amounts of green leafy vegetables.  But most people will do fine adding a small amount of fruit, while adding a few servings of vegetables, making sure to add a variety of different vegetables (i.e. 1/2 cup of arugula, 1/2 cup carrots, 1/2 cup broccoli, etc.).

Some healthcare professionals are opposed to smoothies because they feel it’s better to eat your food rather than drink your food.  In other words, rather than consume some or all of these ingredients in the form of a smoothie, they would recommend to simply have one or two eggs for breakfast, a few servings of vegetables, a serving of berries, a healthy type of fat, some meat, etc.  I can’t argue with this, as I admit that it’s better to sit down and eat a meal rather than drink a smoothie.  However, we live in an “era of convenience”, and whereas most people aren’t going to take the time to individually prepare all of these foods, many people are willing to add them to a smoothie.  Of course it can also be time consuming to make a smoothie, as I know it takes me awhile to make my morning smoothie.  In any case, for those people who are preparing a healthy breakfast I’m not suggesting to replace it with a smoothie.  On the other hand, for those people who aren’t eating a healthy breakfast and/or aren’t consuming a sufficient amount of vegetables each day, then having a daily green smoothie might be a good idea.

Something else to keep in mind is that even if you have a morning smoothie, you obviously still want to eat vegetables throughout the day.  I recommend eating a combination of raw and cooked vegetables.  Some healthcare professionals don’t recommend any raw veggies, but I think having a few servings of these are fine, along with having a few servings of cooked vegetables.  But there are some people who will overdo it with the raw vegetables, as they might have a green smoothie for breakfast, a big salad for lunch, another smoothie as an afternoon snack, and another salad for dinner.  I’m not opposed to people having salads, but they also should try adding in a few servings of steamed veggies each day.

In summary, millions of people consume green smoothies on a daily basis, and there are both benefits and risks of drinking these.  Some of the primary benefits of green smoothies are that they allow you to add some extra vegetables, along with some purified water, and other healthy ingredients, such as healthy fats and protein.  However, green smoothies are usually goitrogenic, can be high in oxalates, and might spike up the blood sugar levels.  You of course want to make sure not to add unhealthy ingredients, which can easily be avoided by sticking with whole foods, and organic foods whenever possible.  Overall I think green smoothies are fine for most people with thyroid and autoimmune thyroid conditions to drink on a daily basis, but you want to make sure not to load it up with too much of a single ingredient, such as green leafy vegetables, fruit, protein powder, etc.

Most people don’t consider problems with oral health to be related to health conditions in other bodily areas.  However, having poor oral health can increase the risk of developing certain chronic conditions, and might also play a role in the development of autoimmune thyroid conditions such as Graves’ Disease and Hashimoto’s Thyroiditis.  Of course I’m not suggesting that most cases of thyroid autoimmunity are caused by poor oral health, but this is a factor that is overlooked by most people, yet should be considered.  Fortunately more and more healthcare professionals are realizing that mercury amalgams can cause problems, and some also are aware of the potential risk factors of root canals.

It should make sense when you think about the connection between oral health and the rest of the body.  This is especially true with mercury amalgams, as many people reading this are aware of the risks of these, and it’s not uncommon for me to speak with a patient who has gotten all of their silver fillings replaced.  However, many people don’t make a similar connection with root canals and other health conditions.  Part of this has to do with the approach of most dentists, as while many dental clinics are avoiding the use of mercury amalgams, most still perform root canals on a frequent basis.  In addition, while there are tests which measure the amount of mercury in the tissues, which in turn can be linked to mercury amalgams, there isn’t a reliable test to see if a root canal is causing any health issues.

Is Mercury The Cause Of Your Autoimmune Thyroid Condition?

Before talking about root canals, let’s go ahead and briefly talk about the impact of mercury.  First of all, there is no doubt that having mercury amalgams results in the release of mercury vapors during the act of chewing.  What’s controversial is the effect that the mercury vapors have on our health, and whether this can serve as a trigger for thyroid autoimmunity, as well as other health conditions.  While some studies show that there is no relationship between dental amalgams and Hashimoto’s Thyroiditis (1), other studies have shown that the removal of dental amalgam decreases TPO and thyroglobulin antibodies in patients with autoimmune thyroiditis (2).  I’ll expand on this shortly.  Both the FDA and Centers for Disease Control (CDC) consider mercury amalgams to be safe in most cases.  On the other hand, the World Health Organization (WHO) considers mercury to be one of the top ten chemicals of major public health concern, and mentions how exposure to mercury, even in small amounts, may cause serious health problems (3).

I briefly spoke about the possible relationship between mercury and thyroid health earlier, and would like to expand on this, as there are numerous studies which demonstrate a negative effect of mercury on thyroid health.  Keep in mind that not all of these studies involve inorganic mercury, which is the mercury found in dental amalgams.  Methylmercury is found in fish, and both inorganic mercury and methylmercury can negatively impact the thyroid gland.  One study looked at the role of environmental factors in autoimmune thyroiditis, and showed that replacement of dental amalgams in mercury-allergic subjects resulted in improvement of health in about 70% of patients, and in some cases lead to a normalization of anti-thyroid autoantibodies (4).  Another study looked at the relationship between mercury and thyroid autoantibodies, and showed that there is an association between mercury and thyroglobulin antibodies, but not thyroid peroxidase antibodies (5).  Thyroglobulin antibodies are found in those with Hashimoto’s Thyroiditis.  However, mercury also might play a role in the development of Graves’ Disease, as this autoimmune thyroid condition usually involves the presence of Th2 cytokines.  And I did come across a study which showed that mercury can potentially trigger or worsen Th2 cytokine production in humans (6).  Although these studies focus on the effects of mercury and the immune system, numerous studies have shown that mercury can also have a direct effect on the thyroid hormones (7) (8).

So does this mean that everyone who has mercury amalgams should get them removed?  This remains controversial, as while there is no question that mercury shouldn’t have been used as fillings in the first place by most dentists, sometimes getting them removed can do more harm than good.  In some cases removing these amalgams can exacerbate the autoimmune response of someone who has Graves’ Disease or Hashimoto’s Thyroiditis.  Anyone who is looking to get their mercury amalgams removed should hire a dentist who takes the proper precautions when removing them, such as a biological dentist.  You can find one of these dentists by visiting the website of the International Academy of Oral Medicine and Toxicology or International Academy of Biological Dentistry & Medicine.  Their respective websites are www.iaomt.org and www.iabdm.org.

What Is The Risk Of Having One Or More Root Canals?

While many people reading this are aware of the risks of mercury amalgams, many aren’t aware of the potential risks of root canals.  Although the American Dental Association claims that root canals are safe simply because there is no scientific evidence which show them to be harmful, there also aren’t any scientific studies which show that root canals are completely safe.  Just to let you know, the ADA still considers mercury amalgams to be safe.  Without question this is a controversial topic, as while there are many people who have had their health improve upon removing their root canals, until there are numerous scientific studies which show this then most dentists will continue to recommend this procedure to their patients.

Before talking about the potential risks of root canals it probably would be a good idea to briefly explain what a root canal entails.  First of all, a root canal is usually recommended when the nerve of the tooth becomes infected or the pulp becomes damaged.  I’m not going to get into the details of the procedure, as you can find this information online, but essentially they will drill a hole into the tooth and remove the dental pulp, the decayed nerve tissue, and they will try their best to sterilize the area in order to kill the bacteria.  Once this has been accomplished the tooth will be sealed, and often times a crown will be placed over the tooth.

I left out a number of details, but the main controversy is whether all of the bacteria can successfully be eradicated.  In other words, can the canals be permanently sterilized?  Many reading this are familiar with Dr. Weston Price, who was a dentist who looked at the relationship between dental health and nutrition, and how it impacted our overall health.  Dr. Price took one thousand extracted teeth and sterilized the canals with forty different chemicals in order to see if permanent sterilization could be achieved.  After 48 hours he broke the teeth apart and cultured them, and found that all but one of the teeth had bacteria.  Other biological dentists have confirmed Dr. Price’s findings.

Although there aren’t any research studies I’m aware of which show a correlation between root canals and specific health conditions, there have been numerous people with different health conditions whose health improved dramatically upon removing their root canals.  In fact, in the article I just mentioned, Dr. Price stated that “the bacteria in root canals favor destruction of the nervous system and many other systems, resulting in the creation of autoimmune reactions”.  While a root canal isn’t the trigger for most autoimmune thyroid conditions, if someone who is following a natural treatment protocol has one or more root canals and doesn’t see an improvement in their health, then they might want to consider having these removed.

Should You Have Your Root Canals Removed?

If you have mercury amalgams and root canals and were to visit a biological dentist, there is an excellent chance they would advise you to replace your silver fillings.  There is also a pretty good chance they would recommend to remove any root canals you have as well.  This admittedly is a tough decision to make in some cases.  A few years ago I had a cavity in the back of my mouth that was between my teeth.  While I felt some discomfort at times, none of the dentists were able to spot it on the on the dental x-rays.  And by the time one of the dentists discovered the cavity it was too late.  Because it was towards the back of my mouth I decided I didn’t want a root canal, and I decided to get an extraction.

However, the decision isn’t as easy if someone needs to get a root canal in the front of their mouth.  If one needs a root canal in one of their front teeth and they choose to get an extraction, it probably is a good idea to get this replaced.  Truth to be told, it might also be a good idea to get it replaced if it’s towards the back of the mouth, but it’s arguably even more important to get some type of replacement for an extracted tooth in the front of the mouth.  The two options usually given are bridges and dental implants.  And there are pros and cons with each of these.

A dental bridge involves a non-removable prosthesis which is attached to the surrounding teeth.  The problem with these is that the healthy teeth surrounding the replacement tooth will usually need to be filed.  With regards to dental implants, many people receive these and seem to do fine.  However, there are a few drawbacks.  First, they are very expensive, and if someone doesn’t have dental insurance then they will be spending thousands of dollars on this.  Second, it’s an extensive procedure that will take months to complete.  And finally, most dental implants are made out of titanium, and while many people do fine with these implants, some people will react to titanium.

As a result, if someone currently has a root canal on a tooth that is towards the back of the mouth it might be best to get it extracted and not get a bridge or implant.  On the other hand, if someone has one or more root canals in the front or side teeth, then the decision to get the tooth removed can be more difficult.  Obviously the decision is ultimately up to the person, but regardless of where the root canal is, it probably would be a good idea to seek the opinion of a biological dentist to discuss the different options you have.  After all, while I have experience working with a biological dentist, and have read articles and watched videos conducted by biological dentists who spoke about root canals, I’m of course not a dentist.  And while this doesn’t prevent me from giving my opinion when someone asks about mercury amalgams or root canals, in many cases it is wise to speak with a biological dentist about this.

So hopefully you have a better understanding about the potential risks of dental amalgams and root canals.  A few different studies have shown that mercury can have a negative effect on thyroid health, as it can affect both the immune system, thus causing an increase in thyroid autoantibodies, and it can also have a direct effect on thyroid health.  As for root canals, although there aren’t any scientific studies which show that they are harmful, there also is no proof that they are safe.  And there have been many people with different health conditions who experienced a dramatic improvement in their health upon removing one or more root canals.  Does this mean that everyone with mercury amalgams and root canals should have them removed?  This remains controversial, and while there is no question that many people with thyroid and autoimmune thyroid conditions can benefit from getting these removed, it probably is best to consult with a biological dentist about this.

Many people who have an autoimmune condition follow an autoimmune paleo diet.  This is similar to a “standard” paleo diet, with a few additional restrictions.  While a standard paleo diet allows the consumption of eggs, nuts and seeds, along with the nightshade vegetables, an autoimmune paleo diet excludes these foods.  So essentially the person is allowed to eat meat, fish, vegetables, fruits, certain coconut products, and some spices.  But is this the ideal diet for everyone with Graves’ Disease and Hashimoto’s Thyroiditis?

Before answering this question I’d first like to talk in greater detail about the similarities and differences between a “standard” paleo diet and an autoimmune paleo diet.  Here are the main foods which are allowed on a standard paleo diet:

• Meat (beef, pork, chicken, lamb, etc.) and fish
• Eggs
• Fruits
• Vegetables (including the nightshades)
• Nuts and seeds

Foods which are excluded in a “standard” paleo diet include all grains, legumes, and dairy products.  And of course anything refined should also be avoided.  A standard paleo diet is restrictive with regards to what foods you can eat, although keep in mind that it is nutrient dense, and the goal isn’t to restrict calories.  As a result, while some people do struggle initially to follow a paleo diet, after awhile many of these people do perfectly fine and wish they had followed this sooner.  Many people do better upon avoiding the grains, legumes, and dairy products.  However, when someone also needs to avoid eating eggs, nuts and seeds, along with the nightshade vegetables, this makes it even more challenging.  And of course it’s even more challenging for a strict vegetarian or vegan to follow an autoimmune paleo diet, as they won’t be consuming any meat or fish.

Why Is An Autoimmune Paleo Diet So Restrictive?

Why are so many foods excluded from an autoimmune paleo diet?   Well, there are a few different reasons.  An autoimmune paleo diet excludes foods people with autoimmune conditions are commonly sensitive to such as gluten, dairy, eggs, and corn.  These foods can cause inflammation and/or exacerbate an existing inflammatory condition.  Gluten can directly cause an increase in intestinal permeability (a leaky gut), which is a factor in many, if not all autoimmune conditions.  Other foods such as all grains, legumes, and the nightshade vegetables are restricted because they contain antinutrients which not only affect the absorption of nutrients, but like gluten, can also have a negative effect on the gut.  So it’s not just gluten which potentially can cause a leaky gut, but other foods can potentially cause this as well.  Essentially those foods which are excluded from an autoimmune paleo diet are those foods which can cause gut inflammation and/or an increase in intestinal permeability.

I must admit that I do like the autoimmune paleo diet, and I commonly recommend this to my patients with Graves’ Disease and Hashimoto’s Thyroiditis.  However, there are a few “flaws” with this type of diet:

1) Some people do fine eating one or more of the restricted foods. A good example of this is eggs.  There are many people who are able to eat eggs without a problem, especially egg yolks.  And eggs are an excellent source of nutrients.  With regards to dairy, although I recommend for people to avoid dairy while trying to restore their health, some people with autoimmune thyroid conditions do okay when consuming dairy products.  This is especially true with raw dairy products.  I’ve also had some people with Graves’ Disease and Hashimoto’s Thyroiditis eat small amounts of gluten free grains and still receive good results.  I’ve also had a few patients eat soaked nuts while following the protocol and do well.  The problem is that it’s difficult to predict who will do fine eating some of the restricted foods, which is why many healthcare professionals recommend for all of their patients with autoimmune thyroid conditions to avoid all of these foods.

2) It is possible to be sensitive to the “allowed” foods. Someone can be strictly following an autoimmune paleo diet and then find out that they are sensitive to another food they are eating which is permitted.  For example, they might have a sensitivity to chicken or beef, or even a vegetable or fruit they are eating on a frequent basis.  And while sometimes a person will experience negative symptoms upon eating these foods, other times there won’t be any overt symptoms.  This admittedly can be frustrating, as a person might be following a strict autoimmune paleo diet and might be feeling better from a symptomatic perspective.  But upon doing some retesting they notice their numbers aren’t improving.  For example, someone’s thyroid panel might worsen even though they are feeling better, and  while this doesn’t mean this is due to a food allergen, it is possible.  Perhaps a better example is someone who initially tests positive for an increase in intestinal permeability, and upon getting this retested a few months later the results show that their leaky gut has gotten worse.  Once again, this might not necessarily be attributed to a food sensitivity, although it very well might be.

3) Some people find the diet to be too restrictive. I find this to especially be true with those patients who have Graves’ Disease, although sometimes this will also be the case with those who have Hashimoto’s Thyroiditis.  The problem with Graves’ Disease is that the increased metabolism usually leads to weight loss, which can be extreme in some cases.  While some people with an autoimmune hyperthyroid condition will lose a small amount of weight (i.e. 5 to 10 pounds), others will lose 20 pounds or greater.  As an example, when I was dealing with Graves’ Disease I lost over 40 pounds.  Many people find it difficult to gain weight when dealing with Graves’ Disease, and sometimes this is true with Hashimoto’s Thyroiditis patients as well.

Of course everyone is different, and many of my patients with Graves’ Disease do fine when following an autoimmune paleo diet.  On the other hand, others struggle with the restrictive diet.  Although I try to encourage my patients to stick with the diet, if someone is about to break the diet due to the fear of losing even more weight, I’d much rather them eat some “forbidden” yet healthy foods (i.e. eggs, nuts, seeds, tomatoes, etc.) than completely ruin their diet by eating junk food.  And so there are times when I’m fine with people reintroducing one or more of the excluded foods and see how they do.  When taking this approach I will always have them reintroduce one food at a time for three consecutive days.  For example, if someone wants to reintroduce nuts, I’d have them start with almonds, and preferably soak them overnight to help reduce the antinutrients.  Then I would have them eat some almonds for three consecutive days and to pay close attention to any symptoms they might experience.

Who Should Follow An Autoimmune Paleo Diet?

I currently recommend an autoimmune paleo diet to just about all of my patients with Graves’ Disease and Hashimoto’s Thyroiditis.  However, as I just mentioned, I will make modifications if necessary.  Plus, one needs to consider that autoimmune thyroid conditions are a little bit different than many other autoimmune conditions.  For example, there is the concern of goitrogenic foods, which in my opinion isn’t a huge concern in people with hypothyroid conditions.  But it’s still something to be aware of, and I have discussed this in other articles.  Eating foods rich in iodine such as seafood and sea vegetables is commonly recommended with other autoimmune conditions.  And while many people with autoimmune thyroid conditions do fine eating these foods, some people get worse when eating foods rich in iodine.  I’ll soon be releasing an article which talks about the impact of seafood and sea vegetables on thyroid health.

With regards to the restrictive diet, I’m open to patients reintroducing egg yolks after one month if they’re struggling on the diet.  And while I prefer for patients to avoid grains, if adding a few servings of gluten free grains each week will make someone more compliant with the other recommendations then I’m usually fine with them trying this.  The same thing applies with properly prepared nuts.  This doesn’t mean that everyone will do fine eating these foods, but if they are going to stray from the diet I’d rather them eat a small bowl of rice than a bowl of whole wheat pasta or a slice of pizza. Obviously there are certain foods I won’t allow under any circumstances, although just because I recommend avoiding a specific food doesn’t always mean the patient will follow my recommendations while trying to restore their health.  It’s not uncommon for me to receive an email from a patient who ate something they weren’t supposed to, and sometimes it can be challenging for them to  get back on track with the diet.  Just remember that while you want to continue eating well even after you have restored your health back to normal, you won’t necessarily have to follow a strict autoimmune paleo diet on a permanent basis.

In summary, an autoimmune paleo diet is recommended by many natural healthcare professionals to those people with Graves’ Disease and Hashimoto’s Thyroiditis, as well as those with other types of autoimmune conditions.  Although I commonly recommend this type of diet to my patients with autoimmune thyroid conditions, some people do fine eating some of the restricted foods, and it’s possible to be sensitive to foods which are permitted.  In addition, some people find this diet to be too restrictive and therefore have a difficult time sticking to it.  As a result, there are times when I will make modifications to this diet if necessary, although I do encourage people to try to stick as close to the diet as possible for optimal results.