MWe highly recommend that all our members purchase Dr Barry Peatfield’s book Your Thyroid And How To Keep It Healthy –
http://www.amazon.co.uk/s/ref=nb_sb_ss_c_0_11?url=search-alias=stripbooks&field-keywords=barry peatfield&sprefix=Barry+Peatf,aps,144

This is a valuable reference book for all matters thyroid and adrenal. It is easy to read and worth its weight in gold. Dr Peatfield explains in plain English everything you need to know.

The following is a suggested starting point if you have Hypothyroidism:

For thyroid hormone (your own or supplemented, synthetic or natural) to work optimally, you need to first ensure that your body is able to utilize thyroid hormone; low levels of minerals or vitamins can prevent the body from utilizing the thyroid hormone. Therefore, it is necessary to have the following parameters checked: Ferritin (preferably together with serum iron and transferrin saturation%), Folate, B12, D3 – and in an ideal world also Magnesium, Zinc and Copper.

The GP or endocrinologist should order all those tests on NHS, but it is often refused. Therefore – the cheapest way to achieve a comprehensive thyroid/antibody/mineral & vitamin check is to order a private test with private laboratories like Blue Horizon or Medichecks. You can do this from the comfort of your home with a “finger prick home testing kit”. Results will be emailed directly to you, not your doctor.
https://bluehorizonmedicals.co.uk/thyroid-check-plus-eleven.html

https://www.medichecks.com/thyroid-function-tests/thyroid-check-ultravit

Ferritin (stored iron): minimum level needed for good conversion is 70
– optimal level is 100 -130 ng/mL  for women, 130 -150 ng/mL for men

Ferritin is one of the most important minerals to check. At a level below 70 the body will be unable to sufficiently convert the inactive T4 into the active thyroid hormone T3 that is needed in every cell of the body.

Taking thyroid hormone despite low ferritin levels will lead to the T4 not getting properly converted and sufficient thyroid hormone not getting utilized in the body. Low levels of ferritin requires swift action – for levels below 20 it would make sense to ask your doctor for an iron infusion, which would bring the ferritin up into optimal figures within 24 hours….

Failing to achieve an iron infusion with extremely low levels, the patient needs to supplement iron orally and take it together with 1000 mg of Vit C to prevent constipation. Iron needs to be taken as far away from thyroid hormone as possible – at least 4 hours either side, preferably at opposite ends to the day. Iron is best absorbed when taken on an empty stomach, but that can lead to nausea, so is not always practical. Commonly 200 mg Ferrous Fumarate, Ferrous Sulphate or Ferrous Glutamate need to be taken – probably 3 times daily if results were extremely low.

Several of our members recommend Solgar’s ‘Gentle Iron, which is Ferrous Bisglycinate. Biocare’s ‘Nutrisorb iron’ is another one that is recommended. Whichever kind of iron you choose, take it together with 1000 mg Vit C.

Although the majority of doctors, medical websites and even lab facilities will state you should be off iron for a good 12-24 hours before testing, the American Hemochromatosis Society says to refrain from iron pills for a week prior to the tests. i.e. you want to see what your body is hanging onto and treat that. Five days is probably enough.

Please note:
Higher than optimal levels of ferritin indicate inflammation in the body.
Very high levels of ferritin (above a level of 1000) can signal hemochromatosis.

Folate: an optimal level would be near the very top of its ref range –

Low levels of folate usually reflect a diet deficient in fresh leafy green vegetable. To raise low levels, it is important to incorporate lots of fresh green veggies into your diet. Taking a high-quality Vitamin B complex will help to elevate Folate. Vit B complex is one of the essential supplements that every hypothyroid person should take.

Vit B12 – optimal levels in an ordinary (non-active test) should be around 900 -1000 ng/mL  (please note, that is above most ref ranges). When lower, it is recommended to supplement with a Methylcobalamin sublingually (like Solgar’s Methylcobalamin B12, 1000 iu)

Please note that levels in an active B12 assay should be near the top of its ref range.

Vit D3 – an optimal level for D3 is around 100 ng/ml… But even an optimal level of D3 needs to be maintained (especially during the winter months) by taking at least 1000 iu or more of a D3 supplement. D3 has a half-life of 60 days in the body – so without supplementation or sufficient natural exposure of the skin to the sun, after 60 days the D3 level in our bodies will have halved.

Zinc & Copper – both need to be in the middle of their respective ref ranges.

Magnesium – needs to be mid-range or high in the range. Having said that, blood tests for magnesium are not very reliable, because only 1% of the body’s magnesium is stored in the blood. All hypothyroid people need to supplement magnesium as part of a daily balanced multi mineral complex, which should ideally also contain 200 iu of Selenium (else that needs to be supplemented separately), which is also needed for the utilization of thyroid hormone. Sometimes additional magnesium is needed – (please see below)

Next let us talk about the adrenal function. One of the most common reasons why thyroid hormone does not work is because the adrenals are exhausted due to excessive stress. Thyroid and adrenals work hand in hand, and sufficient cortisol needs to be available to utilize thyroid hormone; when cortisol levels become low (or too high, which happens in the initial phases of excessive stress), thyroid hormone can no longer get utilized at the cellular level, where it needs to do its work. To see where you stand, it is helpful to check the adrenal function with a 24-salivary adrenal profile, which we can order ourselves – for instance with Genova Labs. http://www.tpauk.com/forum/resources/discounts-on-tests-and-supplements-scroll-for-more-companies.2412/

Most patients with low thyroid levels will also suffer from weak adrenal function. If the adrenal profile shows that extra adrenal support it needed, we usually recommend a specially formulated adrenal support supplement (glandular) like Adrenavive II. Those should ideally be taken for 10 days before thyroid hormone medication is commenced. Often that is not possible because the patient has already been taking thyroid hormone for some time. In such cases Dr Peatfield usually recommends for the thyroid hormone to be either halved or stopped (depending on current dosage) for 8 to 10 days whilst introducing the specific adrenal support. The golden rule is: treat the adrenals first, the thyroid second. This is because thyroid hormone on unsupported adrenals can overwhelm the system and lead to a crash.

Some free home tests will also be very useful for assessing the adrenal function:

http://www.tpauk.com/main/?post_type=article&p=3855&preview=true

The following is a list of supplements that every hypothyroid patient needs to take – preferably daily – to support the adrenal and thyroid function  (with the proviso that the supplement is tolerated. Some patients react adversely to some supplements and those obviously can’t take them). Please always opt for the best quality supplements throughout. It is very important that you only buy high quality natural products. Cheap syntheticsupplements just clog up your system with fillers and additives. Please stick to good reputable companies like Thorne, Viridian, Biocare, Lamberts, Solgar, Jarrows etc.

Many thyroid patients find that they have to take a large number of supplements for a very long time – some indefinitely.  But we are all different and have different requirements. So everyone needs to experiment and find out which supplements are only needed for some time and which are needed for a very long time. Initially, however, most of us will need most of them, at least initially.

An adrenal support glandular like NAX (Nutri Adrenal Extra, Adrenavive II or similar – when indicated…

Apart from adrenal glandulars (which need to be taken for as long as necessary) all the following supplements are needed to be taken as a matter of course:

Vit C – start with at least 1000 mg (‘time released’ helps if sensitive) and slowly raise dosage throughout the day to bowel tolerance. Vitamin C also helps with the absorption of other nutrients

Vit B complex – make sure each B vitamin is 50 mg in strength – [note: B12 is a separate vitamin to take when B12 levels are low]

D3 – at least 1000 iu daily all through the year. More if D3 levels are low

Mega Mineral Complex – make sure the complex includes ~200 iu Selenium- if not, you need to supplement Selenium separately

Co-Q10 – at least 100 mg or higher

Probiotics – the very best quality – i.e. Bio-Acidophilus forte from Biocare or Acidophilus Extra 10 from Lamberts; but also, swap every few months and use a probiotic that contains different strains. Alternatively, you could buy or make your own kefir, which is a lot cheaper.

Betaine-HCL – Most people with Hypothyroidism also suffer from low stomach acid – in particular when mineral and vitamin levels are low – and it is advisable that you test yourself for the possibility of suffering from low stomach acid:
Buy some Betaine HCL caps (Viridian or NOW) and take 1 caps in the middle of a high protein meal. Wait for a minute or two. If you feel a burn under your sternum, then you have enough stomach acid and you do not need supplementation. If you feel nothing (likely) then your stomach acid is too low and you should supplement 1 caps of HCL with every main meal. But NEVER without food. These caps contain hydrochloric acid and can do harm when taken on an empty stomach. You should also read in Dr Myhill’s article linked below about dosing Betaine HCL. If you do feel a burn when you take your first caps, please do not worry. No damage is done and the burn will subside quickly.
Please read the following link
http://www.drmyhill.co.uk/wiki/Hypochlorhydria_-_lack_of_stomach_acid_-_can_cause_lots_of_problems

Additionally, it may be necessary to supplement whatever you are low in:

B12 – Choose a Methylcobalamin B12 nuggets 1000 iu – 1 nugget under the tongue per day (i.e. Solgar and Jarrow’s)

Iron – You need to try out which iron suits you best. (see info above)

Magnesium – deficiency that shows in a blood test is rare, but hypothyroid patients are often in need of extra magnesium because of the many benefits it gives. You can also get great benefit from using Magnesium salts in your bathwater.

Please read:
http://www.greenmedinfo.com/blog/magnesium-deficiency-symptoms-and-diagnosis

Zinc or Copper – a copper deficiency is rare, and it is seldom necessary to supplement copper. When necessary, supplementation needs to be carefully monitored, as copper is a heavy metal. Zinc deficiency is more common, but easily fixed with a supplement. NOTE: To find out if you have low levels of zinc, put a zinc tablet in your mouth and crunch it up. If it tastes strongly of copper, your levels are good. If, however, it tastes of nothing but chalk, your zinc levels are very low and must be supplemented.

Diet

For most people suffering with symptoms of hypothyroidism, the cause for it is an autoimmune condition called “Hashimoto’s thyroiditis”. Everybody who suffers from Hashimoto’s will by the nature of the disease be intolerant to gluten – whether they are aware of the symptoms or not – and should cut it out from his or her diet. Symptoms are not limited to the digestive system. The human body has not evolved to digest gluten, which is an allergen that causes inflammation chiefly in the brain (where it causes “brain fog”) and the gut. At best it can be tolerated, but gluten never gets fully digested. Intolerance to gluten does not solely mean bowel trouble (although that is most often the case) but can also affect other organs. The gluten molecule is almost identical to the thyroid molecule and our confused immune system (the autoantibodies) will misidentify gluten for thyroid and will attack and cause warfare in the gut and throughout the body. That leads inevitably to inflammation and so-called “leaky gut”. Thyroid uptake into the cells cannot happen when there is inflammation. The direct result will be a worsening of Hypothyroidism.

Dairy is another culprit for keeping that inflammation in the gut alive and should be avoided. Modern day farming means that our milk is contaminated with antibiotics and hormones, as cattle are routinely injected with both to keep diseases at bay and to increase the milk yield. When we drink milk, or eat milk products we are inviting those antibiotics and hormones into our intestines, where they can play havoc with all the good bacteria in our gut and kill them off sufficiently for the bad bacteria and the yeast in the gut to take over. This out of balance gut flora will help the yeast to mushroom aid the permeation of the gut lining and create “leaky gut syndrome”. Not everybody with Hashimoto’s will suffer from intolerance to dairy, but it is very common and therefore prudent to clear the body of all traces of dairy for, say, 2 months, and then reintroduce some and see if there is a reaction.

An intolerance to lactose, which many hypothyroid people suffer from, is another problem. When lactose intolerant people continue to eat dairy – even when following a gluten free diet – their bodies will continue to make antibodies to gluten.

“Casein” creates a further problem. To quote from Dr Tom O’Bryan’s book “the Autoimmune Fix”:

“80% of the protein in cow’s milk and 20-45%of the protein in human milk come from Casein. Casein is a difficult protein to digest – it takes hours for casein to break down in our intestines. The immune system reacts to dairy in different ways, depending on which component of dairy our body sees as an irritant. For example-one of the components of poorly digested dairy are molecules called “casomorphines”. These peptides bind to opiate receptors in the brain and are associated with sudden infant death syndrome, the histamine release of food allergies, stimulation of high-fat food intake, and cognitive dysfunction from ADHD to autism. When your immune system decides that casomorphines are a problem, you will make antibodies called casomorphin antibodies. Casein is also added to some non-dairy alternatives like rice milk as a preservative. Exposure to high levels of casein can lead to an immune response of inflammation similar to the immune system reacting to gluten.”

*Please note that switching to lactose-free milk products is not tackling the problem; it is still milk with only the lactose taken out, but the hormone, antibiotic and casein problems remain.

Processed sugar does its bit to destroy the gut lining too. Sugar feeds the yeast, which will mushroom and develop tentacles that bore through the gut lining, making it porous (leaky gut syndrome).

It is easy to see why a gluten and dairy free diet will go a long way to healing the porous and inflamed gut. And by keeping refined sugars to a minimum in addition to a gluten and dairy free diet, we equally help reducing the chronic inflammation of the gut. If we can manage to stick to a gluten and dairy free diet, the gut will eventually heal and the thyroid autoantibodies (AAs) will drastically reduce or go into remission. It is worth noting though that AA’s are not eliminated for good. Any renewed challenge to the immune system (food allergens, chemicals, excessive stress, parabens, viruses, bacteria, yeasts etc etc) can bring AA’s back out in droves. Thyroid autoantibodies (TPO & TgAB) will only truly reduce in numbers (as opposed to going into remission) or vanish altogether once their work of destroying the entire thyroid function is done… and that can take many decades.
Because Hashimoto’s is an autoimmune condition, NOT a thyroid condition, with good management it is possible to stop frequent autoimmune attacks and to get the AAs largely into remission, and thereby prolonging the functional life of the thyroid gland. We can’t reverse the damage that has already occurred to the thyroid gland, but we can prevent it from getting worse for quite some time to come, simply by sticking to a gluten and dairy free diet and by limiting sugar.

With best wishes for good health,

Christina