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What to do after diagnosis

What do do after diagnosis?

There are many driving factors in autoimmune thyroid disease, starting with genetics, biochemistry, and environmental toxins. Learn how to spot your root causes and what you can do to turn them off.

Find your root causes

The first step to finding your root cause is an elimination diet. A common elimination diet for Hashimoto's Disease is AIP. 

Here are a few good resources for AIP to get you started: 

The Paleo Mom

Dr. Kharrazian

Mickey Trescott

Some good AIP books:

He Won't Know it's Paleo, by Breanna D. Emmitt

The Healing Kitchen by Dr. Sarah Ballantyne and Alaena Haber

The Autoimmune Paleo Cookbook by Mickey Trescott

For more on root causes, the 411 highly recommends, Hashimoto's Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause by Dr. Izabella Wentz and we also recommend you follow her blog.


Other common root causes

You can and most likely have more than one root cause

Start with your DNA, with the MTHFR gene that many of us share and other genes that can lead to autoimmune disease.  Then look to your biochemistry. What's going on inside? Have you been exposed to Lyme, EBV, mercury poisoning, mold, vaccinations, household toxins? Then look to other triggers such as childbirth, car accidents, sexual abuse, loss of loved one...

Treating your root causes

Some traumatic events you can't erase, but you can help cope through exercise, therapy, yoga, and meditation. 

Finding a good functional doctor is key to addressing other root causes, such as mold illness, mercury poisoning, EBV, and Lyme. 

Removing toxic household cleaners and perfumes is an easy step. Go for more natural, environmentally friendly products, and your body will thank you. Filter out chlorine in your water, and switch to an all natural toothpaste without fluoride such as Jason Toothpaste. 

Lyme Disease is too comprehensive for one web page. Please go HERE if you think Lyme may be your root cause for a blog post written by H411 staff and Lyme patient, Jodi WM. 


Deer Tick image Wikipedia

Optimizing thyroid levels

Many doctors only care about getting your thyroid levels in range and not optimal. If you are on a T4 only hormone like Synthroid (we recommend Tirosint, the cleanest of the T4 hormones) you may feel best with a TSH around one and frees in the upper ranges. If you are on a compounded T4/T3 hormone or a porcine (pig derived) hormone like NDT, you may feel best with a TSH way below range. In fact, if you are on NDT, your TSH will be suppressed and dosage should be by FT3, FT4, and RT3. If you try NDT and feel awful, keep in mind that you may have low iron/ferritin and/or weak adrenals. We don't advise starting on any hormone with T3 until after you test and treat your iron and adrenals, or you may end up having a negative reaction to the hormone such as tired, shaky, emotional, and too sick to function.


Please note, though there is an ongoing debate on this issue, some 411 members have reported a rise in antibodies when switching to NDT. Though it's a wonderful thyroid hormone for those who tolerate it well, it may not be suitable for everyone.

If you don't tolerate NDT but your doctor wants to add a small amount of T3 hormone to your synthetic routine, be advised that the makers of Cytomel cannot guarantee a gluten-free product. You may feel best with a compounded T3 hormone. Some 411 members also report adverse reaction to time-release fillers, and they do best by breaking up their T3 dosage between morning and afternoon.


The 411 on iron

If you have tried and failed on NDT, consider that your iron may not be optimal. Below are good ranges and also reasons why iron may not be optimal. For low iron, consider parasites and ovarian cysts. For high iron, consider inflammation. 


Cortisol testing and why doctors get it wrong


Weak adrenals is another reason thyroid patients fail on NDT. Too many doctors test cortisol using a one time blood test, and not the more reliable 24 hour saliva or DUTCH urine tests. Cortisol, made by the adrenal glands, will fluctuate throughout the day. It can be low in the morning (wake up tired and groggy) and high in the evening (can't fall asleep at night or wake up during the night). If you measure it once, you will not get an accurate reading of what your adrenals are doing. 

Your doctor can order the 24 hour saliva test, an at-home test which will measure cortisol four times throughout the day. 

Symptoms of adrenal dysregulation include tired, wired, jittery, quick to anger or frighten, sensitivity to light, sound, heat, rapid heartrate, increased belly fat and back of the neck fat (hump)...

And excellent book on adrenals is Adrenal Fatigue: The 21st Century Stress Syndrome by Dr. James Wilson.

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