Iodine and Hashimoto’s Thyroiditis, Part I

Mario Renato Iwakura is a Brazilian engineer and Hashimoto’s thyroiditis patient who is intimately familiar with the hypothyroidism literature. Mario has graciously agreed to do a guest series on the place of iodine and selenium supplementation in treatment of hypothyroid disorders. I’m very excited to have Mario’s thoughts, as he’s extremely smart and passionately engaged with the science. — Paul

Most doctors believe that iodine supplementation will aggravate autoimmune (Hashimoto’s) thyroiditis. This view is supported by observations that the incidence of Hashimoto’s hypothyroidism tends to increase in populations that increase their iodine intake. (The incidence of hyperthyroidism, on the other hand, increases as iodine intake decreases.). However not all epidemiological studies support this association [1][2][3][4].

Dr. Datis Kharrazian (“Dr. K”), whose 2010 book “Why Do I Still Have Thyroid Symptoms?”[5] is popular among Hashimoto’s patients, vehemently opposes the use of iodine in Hashimoto’s [5][6][7]. Chris Kresser of The Healthy Skeptic [8] has argued this point of view in his post “Iodine for hypothyroidism: like gasoline on a fire?”. And there’s little doubt that some patients have experienced bad consequences from high-dose iodine.

On the other side, doctors such as Dr. Guy E. Abraham [9], Dr. David Brownstein [10], Jorge D. Flechas [11] and Dr. David Derry [12] have claimed success prescribing high doses of iodine for Hashimoto’s and for breast and thyroid cancers.

Can these experiences by reconciled? What we will try to do is demonstrate that iodine acts synergistically with selenium, and that it is imbalances between the two that damage the thyroid.

First, Some Background

Thyroid peroxidase or thyroperoxidase (TPO) is an enzyme expressed mainly in the thyroid that liberates iodine for addition onto tyrosine residues on thyroglobulin (TG) for the production of the thyroid hormones thyroxine (T4) or triiodothyronine (T3).

The human body normally has low levels of auto-antibodies against both TG and TPO, which serve some physiological function. Autoimmune thyroiditis features high levels of these auto-antibodies, leading to immune attacks on the thyroid.

High levels of  thyroid auto-antibodies are positively associated with hypothyroidism symptoms [13][14]. TPO antibodies and TSH levels are strongly associated with progression of subclinical hypothyroidism to overt hypothyroidism [3], as can be see in Table 3 below:

Selenium Can Cure An Iodine Excess

Dr. K said in his book and site that “iodine stimulates the production and activity of the thyroid peroxidase (TPO) enzyme” [5][7]. Since TPO is a target of autoimmune attack in Hashimoto’s patients, this might worsen the disease [5][6][7]. In his book he also states that excessive iodine will shut down TPO activity [5], but he neither cites a reference nor states what level of iodine intake will cause this to happen.

In fact, excess iodine combined with selenium insufficiency will reduce (not increase, not shut down) TPO activity [15]. Let’s look at a study that had seven groups: normal iodine and lab-chow selenium only (NI), excess iodine and lab-chow selenium only (EI), and five groups with excess iodine and steadily increasing levels of selenium added to water (IS1 to IS5). TPO activity was reduced by excess iodine (EI), but returned to control levels (NI) with moderate selenium (IS1 and IS2). With excess iodine and excessive selenium (IS3 to IS5), TPO activity was also decreased, as we can see from table 2 below.

Some other studies have also demonstrated this reduced TPO activity at high iodine intakes [23][24].

This study [15] also showed a picture (fig. 1) of thyroid follicles from rats receiving normal iodine diet (NI), excessive iodine (EI) and excessive iodine plus 0.2 mg/L selenium (IS2). Thyroid follicles from the excessive iodine group (EI) are enlarged, a characteristic of goiter. But, there is virtually no difference between the first and last picture! If selenium and iodine are increased together, no goiter occurred.

Note that the IS2 level of selenium, which protects against iodine toxicity, corresponds in a person who drinks 1-2 liters per day to a selenium dose of 200 to 400 mcg per day – which happens to be the Perfect Health Diet “plateau range” for selenium.

Selenium Can Cure Autoimmunity

Another paper, also from China, looked at the effects of selenium in an animal model of iodine induced autoimmune thyroiditis [16].

There were three groups of mice, a healthy control group, and groups with iodine induced autoimmune thyroiditis without (AIT) and with (AIT+Se) selenium. The AIT+Se group was given high iodine (AIT only) for 8 weeks to induce the disease, and then, for 8 weeks more, they were given iodine plus selenium. After 8 weeks of selenium supplementation their thyroid follicles were almost fully recovered, as we can see below, even though high-dose iodine had continued:

The AIT group has enlarged cells characteristic of goiter and dead tissue; the AIT-Se group thyroid section resembles a normal thyroid. Thyroid weight doubled in the AIT group, proof of goiter, but returned to normal after selenium supplementation.

Before selenium was given to the AIT+Se group, serum TgAb antibodies were elevated, but they returned to normal after selenium supplementation:

An interesting aspect of this study was the changing population of immune cells. A specialized subpopulation of T cells, negative regulatory T cells or Tregs, helps establish and maintain self-tolerance by suppressing response to self-antigens and suppressing excessive immune responses deleterious to the host. Deficits in Treg cell numbers or function lead to autoimmune diseases [17].

In this study, CD4+CD25+Foxp3+ Treg Cells were reduced by high iodine, but returned much of the way toward normal after 8 weeks of selenium even though high iodine intake continued. The implication is that selenium-iodine balance may be needed to maintain proper Treg cell populations, and that selenium supplementation may restore normal regulation of autoimmunity.

The researchers concluded:

“In the present study, we observed that Se supplementation increased the frequency  of CD4+CD25+Foxp3+ T cells and enhanced expression of Foxp3 in vivo. These changes were accompanied by suppressed TgAb titers and reduced thyroiditis. Thus the benefit of Se treatment may be due to the increase of CD4+CD25+ regulatory T cells.”

Under What Circumstances Does Excess Iodine Induce Autoimmunity?

In the previous study high doses of iodine were used to induce autoimmune thyroiditis. Let’s look more closely into the circumstances in which that happens.

It’s often said that excessive iodine in Hashimoto’s triggers an immune response characterized by proliferation of T lymphocytes, a disrupted Th1/Th2 axis, and altered CD4/CD8 levels. Pathogenesis of autoimmune disease is believed to begin with the activation of T cell autoaggression (turning them into “allergized T cells”).

Our next study, also from China, showed that excess iodine can indeed cause such an autoimmune pathology, but only if there is a deficiency in selenium [18].

Mice in 5 groups were orally administrated different combinations of iodine and selenium for 30 days. Four groups had no selenium but varying amounts of iodine in their water:  0 μg/L (group I), 1500 μg/L (group II), 3000 μg/L (group III), and 6000 μg/L (group IV). The fifth group had 6000 μg/L iodine plus 0.3 mg/L selenium (group V).

In Group IV, high-dose iodine at 6000 μg/L caused a proliferation of lymphocytes. But this was completely abolished by the addition of selenium to water in Group V:

Normally there are relatively stable population of T cells and their subgroups in tissue till immune function is in disorder. As we can see from Fig. 1, increasing iodine increased T lymphocytic reproductive activity, and was clearly high in group IV. But group V, which also received selenium, had the same values as the control group (I).

Subjects with Hashimoto’s also have a lower ratio of CD4+ to CD8+ lymphocytes than controls [19][20]. From fig. 2, we can see that iodine supplementation in groups II and III actually increased the CD4+ to CD8+ ratio, until the onset of autoimmune symptoms at very high doses in Group IV when the ratio decreased. However, group V, which had the highest iodine intake but with selenium as well, had the highest CD4+ to CD8+ ratio of all groups.  This suggests that high-dose iodine and selenium together may actually diminish the autoimmune syndrome compared to the low levels in the controls.

Another marker of autoimmune thyroiditis is the relative strength of the Th1 and Th2 responses, as indicated by the markers interferon-gamma and interleukin-4 (Th2). Th1(IFN-γ)/Th2(IL-4) ratios are increased in Hashimoto patients [21][22], and related with severity of Hashimoto’s disease [22].

As we can see from Fig. 3, the group with the highest iodine intake but no selenium (IV) was the only group that had clearly higher Th1/Th2 ratio. High iodine plus selenium in group V had similar Th1/Th2 ratios than control group (I).

The researchers concluded:

“The results revealed that there was no significant difference in the immunotoxicity between interventional group (group V) and control group (group I), indicating that adequate selenium has a favorable interventional effect on excessive iodine intake.”


Excess iodine intake can cause an autoimmune thyroiditis that bears all the characteristics of Hashimoto’s. However, in animal studies this occurs only if selenium is deficient or in excess. Similarly, in animal studies very high iodine intake can exacerbate a pre-existing autoimmune thyroiditis, but only if selenium is deficient or in excess.

With optimal selenium status, thyroid follicles are healthy, goiter is eliminated, and autoimmune markers like Th1/Th2 ratio and CD4+/CD8+ ratio are normalized over a wide range of iodine intake. It seems that optimizing selenium intake provides powerful protection against autoimmune thyroid disease, and provides tolerance of a wide range of iodine intakes.

In the next post in this series (Iodine and Hashimoto’s Thyroiditis, Part 2, May 26, 2011), we’ll transition from animals to humans. Does epidemiological evidence suggest that these animal findings are transferable to humans?


[1] F. Aghini-Lombardi et al. The spectrum of thyroid disorders in an iodine-deficient community: the Pescopagano Survey. J. Clin. Endocrinol. Metab. 84, 561–566 (1999).

[2] Marino MA et al. Urinary iodine in patients with auto-immune thyroid disorders in Santo André, SP, is comparable to normal controls and has been steady for the last 10 years. Arq Bras Endocrinol Metabol. 2009 Feb;53(1):55-63.

[3] Strieder TG et al. Prediction of progression to overt hypothyroidism or hyperthyroidism in female relatives of patients with autoimmune thyroid disease using the Thyroid Events Amsterdam (THEA) score. Arch Intern Med. 2008 Aug 11;168(15):1657-63.

[4] Stuckey BG et al. Low urinary iodine postpartum is associated with hypothyroid postpartum thyroid dysfunction and predicts long-term hypothyroidism. Clin Endocrinol (Oxf). 2011 May;74(5):631-5. doi: 10.1111/j.1365-2265.2011.03978.x.

[5] Dr. Datis  Kharrazian. Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal: A Revolutionary Breakthrough In Understanding Hashimoto’s Disease and Hypothyroidism.

[6] Dr. Datis  Kharrazian. Iodine and Autoimmune Thyroid — References.

[7] Dr. Datis  Kharrazian. Iodine and Hashimoto’s.

[8] Chris Kresser. Iodine for hypothyroidism: like gasoline on a fire?.

[9] Dr. Guy E. Abraham.

[10] Dr. Brownstein. Iodine, Why You Need It.

[11] Dr. Jorge D. Flechas.

[12] Dr. David Derry. Breast Cancer and Iodine : How to Prevent and How to Survive Breast Cancer.

[13] Ott J et al. Hashimoto’s thyroiditis affects symptom load and quality of life unrelated to hypothyroidism: a prospective case-control study in women undergoing thyroidectomy for benign goiter. Thyroid. 2011 Feb;21(2):161-7. Epub 2010 Dec 27.

[14] Díez JJ, Iglesias P. Relationship between thyrotropin and body mass index in euthyroid subjects. Exp Clin Endocrinol Diabetes. 2011 Mar;119(3):144-50. Epub 2010 Nov 17.

[15] Xu J et al. Supplemental Selenium Alleviates the Toxic Effects of Excessive Iodine on Thyroid. Biol Trace Elem Res. 2010 Jun 2.

[16] Xue H et al. Selenium upregulates CD4(+)CD25(+) regulatory T cells in iodine-induced autoimmune thyroiditis model of NOD.H-2(h4) mice. Endocr J. 2010 Jul 30;57(7):595-601. Epub 2010 Apr 27.

[17] Sakaguchi S et al. Foxp3+CD25+CD4+ natural regulatory T cells in dominant self-tolerance and autoimmune disease. Immunol Rev. 2006 Aug;212:8-27.

[18] Chen X et al. Effect of excessive iodine on immune function of lymphocytes and intervention with selenium. J Huazhong Univ Sci Technolog Med Sci. 2007 Aug;27(4):422-5.

[19] Gopalakrishnan S et al. The role of T-lymphocyte subsets and interleukin-5 blood levels among Indian subjects with autoimmune thyroid disease. Hormones (Athens). 2010 Jan-Mar;9(1):76-81.

[20] Zeppa P et al. Flow cytometry phenotypization of thyroidal lymphoid infiltrate and functional status in Hashimoto’s thyroiditis. Anal Quant Cytol Histol. 2006 Jun;28(3):148-56.

[21] Colin IM et al. Functional lymphocyte subset assessment of the Th1/Th2 profile in patients with autoimmune thyroiditis by flowcytometric analysis of peripheral lymphocytes. J Biol Regul Homeost Agents. 2004 Jan-Mar;18(1):72-6.

[22] Nanba T et al. Increases of the Th1/Th2 cell ratio in severe Hashimoto’s disease and in the proportion of Th17 cells in intractable Graves’ disease. Thyroid. 2009 May;19(5):495-501.

[23] Müller K et al. Effect of iodine on early stage thyroid autonomy. Genomics. 2011 Feb;97(2):94-100.

[24] Man N et al. Long-term effects of high iodine intake: inhibition of thyroid iodine uptake and organification in Wistar rats. Zhonghua Yi Xue Za Zhi. 2006 Dec 26;86(48):3420-4.

Leave a comment ?


  1. Hi Laura, you’re a candidate for a female hormone panel to test sex hormone levels by saliva.

    Also, what are you thyroid numbers, TSH, FT4 and FT3 on your current thyroid med dose?

  2. Hi – I have been searching the internet for answers and I found this article and the comments that follow. I noticed nobody has written since August so I hope this gets through to someone. I was slightly hypothyroid a few years ago with symptoms, (mostly cold intolerance and inability to lose weight) so my nurse practitioner asked me to use Iodoral iodine 12.5mg one tablet a day, I felt much better, but felt even better on 2 tablets a day. (she checked my iodine levels and they were low) She also asked me to eat sea salt and even put it in water and drink it, which I did for awhile, but it made me so tired I couldn’t stand it. Now I use the sea salt to cook with. Last winter, about February or so, I started sweating. I hadn’t broken a sweat, even with exercise for years. It wasn’t like a hot flash I was just hot all of the time. When I had my routine blood drawn in May, my TSH was extremely low. My Dr. said he wanted rechecked in a couple of months. (I don’t see the nurse practitioner anymore) When it was rechecked in Sept or so, it was even lower, so he checked the free T3 and T4. Sorry I don’t remember the numbers, but they were normal. I have been taking the same dose of iodine this whole time. (about 3 1/2 years) He ordered an ultrasound of my thyroid to see if I had any nodules, I have several, one of them is about 2cm in size. He then ordered a thyroid uptake scan to see if the nodules were causing the problem. (I first had to be off of the iodine for a month, I feel horrible off of the iodine) They did not need to do the scan because the uptake of radioactive iodine was practically nonexistent. (uptake at 3 hrs 2.6% and 24 hrs 8.9%) The Dr. told me my nodules were not doing anything. My free T3 and T4, which he rechecked after this test are still normal. He has no explanation for the numbers and I forgot to mention some other symptoms I am having are heart racing (sometimes) nervousness, anxiety and, of course I am hot all of the time. He wants me to stay off of the iodine for three months and see an endo after he rechecks my numbers. I am not sure what this means. Does anyone have ideas? Sorry, I know the thyroid is complicated and this is not a lot of info.



  3. Hi Kelly,

    It does sound like a mild hyperthyroidism. One thing I would say is make sure you supplement selenium, at least 200 mcg per day. Your level of iodine intake can be toxic to the thyroid if you don’t have adequate selenium. Other micronutrients that might be involved include magnesium, iron, and copper.

    Best, Paul

    • Hi Paul,

      Is there a way to know for sure if someone is absorbing these nutrients? My wife takes all sorts of whole food vitamins, progesterone, etc and never feels anything *good or bad. I suspect shes not absorbing anything. I also suspect possible Hashi’s or hypothyroid. I need to find a dr that takes that test.

      I put her on Iodine/Iodine from Feels nothing about months lol

      She has no energy and is trying to drop a little weight, that no excercise seems to do.


  4. Paul,

    Thank you for answering! Is the hyperthyroidism possibly caused by the iodine I have taken for so long? Is is because I didn’t take selenium with it? I feel so much better taking iodine I don’t want to wait until I see an endocrinologist in January to start taking it again. Would it make the hyperthyroidism worse if I took it again? What is a good source of these other minerals you mention? I don’t know if this has anything to do with it or not, but I have been sick with different illnesses (colds, sore throat, cough etc) the entire time I have been off of the iodine. The Dr. would not agree that it has anything to do with it, but I have not been sick for ages much less for this long. So, not sure what to do…I know you probably can’t tell me what to do about the iodine, but maybe you might be able to give me an idea of what could happen?

    Thanks again,


  5. Hi Paul,

    I’ve been visiting your website for a while now and think it’s excellent.

    I was interested to read about your wife’s reaction to copper. I react extremely badly to copper supplements or even copper rich foods such as shellfish. I’ve tried to supplement in the past but this made me feel extremely bad. On the other hand, if I take a small amount of copper I seem to tan better which could imply I’m lacking it.

    Is this negative reaction to copper supementation always due to an underlying copper deficiency causing the thyroid to speed up after receiving copper? A lot of doctors caution against supplementing copper due to hidden copper overload.

    Your thoughts would be greatly appreciated,



  6. Hashmotos, Selenium and Iodine, Part Two | Next Level Nutrition - pingback on December 29, 2011 at 5:05 pm
  7. I asked this question on PaleoHacks about selenium supplementation back in October.

    The answer from user “Phoenix” with the JNCI link led me to purchase the yeast bound selenium from Source Naturals.

    Thanks for this series Paul.


  8. Hi Jack,

    The paper cited by Phoenix was also given here by Jaquen (, and was the basis for our suggestions on the recommended supplements page.

    Best, Paul

  9. Goitrogens... | Mark's Daily Apple Health and Fitness Forum page - pingback on January 8, 2012 at 1:53 pm
  10. Paul,

    I am interested in your response to the copper question posed above by EdClements, as I too have noticed uncomfortable reactions to copper-rich foods.

    And I would expand the question: is there a reliable test for copper status? Given the consistently bad reactions (plus all of the doctors out there who argue that copper overload is far more common than copper deficiency), it is difficult simply to push forward with the copper-rich foods hoping that there is light at the end of the tunnel. Knowing for certain that I was low would make a big difference.

    Thank you!

  11. Hi Ed,

    I’m sorry I seem to have overlooked your comment.

    It’s hard to diagnose what is going on from afar. I have heard people with copper deficiencies say they get negative symptoms when they initiate supplementation. However, you can also get negative symptoms from an excess.

    I think it’s worth asking a doctor for help diagnosing what’s going on. You say you tan more easily when taking copper. Since jaundice is a possible symptom of copper excess, you should be sure that this is actual tanning and not a buildup of bilirubin. An earlier sign of liver toxicity due to excess copper is an elevated ALT level.

    Other possible diagnostic tests: Total blood copper and ceruloplasmin levels are direct tests for copper levels. Ceruloplasmin is made of copper and can be low in copper deficiency, but also in Wilson’s disease ( which is a genetic disorder afflicting about 0.01% of the population.

    Copper and iron share a lot of chemical traits and it’s worth also testing iron status I think, eg through ferritin level. Iron diseases can interact with copper status, eg,

    Assuming there is nothing pathological going on and you don’t have a clear copper deficiency or excess based on blood copper and ceruloplasmin, then I would experiment with different supplementation approaches.

    First, look at zinc status. You could try supplementing zinc alone or taking copper with zinc. The two need to be in balance so the combination is less likely to cause harm than taking either alone. Be sure to take selenium and magnesium also. Give blood regularly to keep iron down.

    Best, Paul

    Hi MM,

    I believe the blood copper and ceruloplasmin tests are fairly reliable. Interpreting them requires some consideration, because there are multiple possible causes for high or low levels. Here’s some background:

  12. I am Pharmacist trying to learn about the truth to optimal health, what we don’t learn in school. Love your book and blogs as well as the circle of health professionals that are on same track (Dr. Mercola, Mark’s Daily, Dr. Brownstein etc).
    Question: There are whole food ways to getting some recommended supplements, specifically with selenium and brazil nuts. I like the idea of taking an actual supplement to know your getting an accurate consistant quantity. However, I just discovered the super food chlorella has 570 mcg of selenium per 3 gm (The recommended gm amount per day for broken cell organic chlorella from Now foods and other manufactures).
    So if the tollerable upper limit is 400-600 mcg Selenium per day from food and supplement form. With 50 mcg per multi mineral, 20-35 mcg per 3.5 oz of beef (and other daily food sources) and possible 570 mcg from chlorella is it still practical to supplement 200 mcg? I have some confusion on the various forms and absorption of Selenium (life extensions varieties) and am wondering if the organic plant based form in chlorella is well absorbed. Also, is there a potential need to add to your recommended supplement best time to take and in what combinations? If some minerals compliment each other taken together vs. block (vitamin C and selenium) uptake.

  13. Hi Danny,

    I didn’t realize chlorella has so much selenium. No, it wouldn’t be safe to supplement if you are taking chlorella; even 1 g/day chlorella could put you at risk for selenium excess.

    Chlorella may have other health risks, interesting post today at Robb Wolf’s blog:

    I don’t like to be over-prescriptive about times and methods. I think that’s a second-order effect and less important than amounts.

    Best, Paul

  14. I’ve been exploring for a little for any high-quality articles or weblog posts in this kind of house . Exploring in Yahoo I finally stumbled upon this web site. Studying this information So i’m satisfied to show that I’ve an incredibly just right uncanny feeling I came upon exactly what I needed. I most indubitably will make certain to don?t omit this web site and give it a look regularly.

  15. Back in 2001, I was supplementing zinc and copper. I looked up the list of copper deficiency, and did not have any. I thought, “I’m supplementing zinc, I should not have any symptoms of zinc deficiency.” But I DID!

    Every recommendation to take zinc ALWAYS says to make sure to take copper also, “to keep them in balance.” Well, I have found I have to take zinc but NOT copper to keep them in balance. (Apparently, my body metabolizes copper at a slower than avg rate, but metabolizes zinc at a normal rate, or slightly higher. No, I don’t eat oysters or liver.)

    Biochemical individuality FTW.

  16. Hi Paul and others with relevant knowledge (or ideas…),

    I’ve posted on some other pages in other topics about my recent dizziness. It’s been going on for at least two months I think. I realized yesterday though that I have been mislabeling the symptom– it’s not actually dizziness, but more of a balance thing. It’s very difficult to explain, but as far as I can tell, I only feel it when I’m standing and not leaning on something (possibly also when I’m sitting, if I’m not leaning against a chair back, etc.) so I don’t notice anything when I’m driving at all. Basically my body seems to sway a little (but it’s not normal, I have never felt this in my life).

    Anyway, I’ve been trying to think of every possible thing it could be… it could be ears, could be nerve issue, I also read of possible vitamin B12 deficiency, so I bought a Super B complex and started taking that. Last night while I was trying to test in which scenarios I feel the imbalance thing, my husband thought of a possible thyroid issue. Neither of us know much about it, but he remembered his step-mom having balance issues when she had thyroid issues in the past. So, I was wondering if that’s possible…

    Other symptoms I have are weight loss. I now weigh 120 lbs. (was around 130 to 133 in Oct 2011) Since I’m 5’6″ and type 1 diabetic, I was not trying to lose weight at all. So, my BMI is now at 19.4 I believe. The past couple days I’ve been trying to eat more because I don’t want to lose more weight (I can see my ribs and my chest bone and I can see individual muscles in my arm which I don’t like because I feel like I’m wasting away). Despite this, I feel very good, my energy is great and I dont feel ill otherwise. My blood sugars have been great and I’ve been taking less insulin the past two months. When I mentioned weight loss to my doctor, he thought all was fine and didnt really listen to me. I thought about parasites (I used to travel a lot, often to poor areas) and have never taken any parasite medications after trips. But my doctor doesnt think there’s anything there either since a recent stool test showed negative for ova and parasites, neg for giardia, neg for c. dificile. But I know those are not always accurate (and, it wasnt the metametrix test that you recommend). So, I’m trying to figure it out.

    My multi does have selenium, but only 20mcg, so I did get a bottle of Now Selenium, 200 mcg, but havent taken it yet. Could I possibly be hyperthyroid? This would be funny (well not really…) because a few months back we discovered at the vet that our cat is hyperthyroid (she has been steadily losing weight) so we switched to a new catfood that has extremely low iodine.

    I had bloodwork done a few weeks ago. We did not do T3 or T4 or rT3, we only did TSH. So, here are my TSH levels from this and tests done previous years:

    Jan 2012- 1.240 (normals 0.450- 4.500)
    Aug 2009- 0.818 (normals 0.450- 4.500)
    Jan 2007- 0.69 (normals 0.35- 5.50)

    Aside from seeing that they’re indicated as normal, I don’t know what they might indicate. From these posts though, it sounds like I would need to get T3 and T4 checked.

    I have been eating enough carbs– I never have gone low carb. I try to have a good serving of carbs at each of three meals– either a bowl of rice or a potato or sweet potato. I also eat a banana most days and usually have to take at least 5 glucose tablets per day when blood sugars drop (5 tablets= 75 calories). So, my carbs shouldnt be too low.

    Other supplements I take:
    -500mg or 1000mg vit C/day
    -due to low vit D levels, got prescription for 50,000IU pill/week (for a couple weeks)
    -super B complex
    -just started the vit K2 (100mcg) 2 days ago
    -havent started the magnesium yet b/c I got one with calcium so I’m going to exchange it for no-calcium one instead (my multi has a little mag- only 50mg)
    -my multi has 2mg copper and 18 mg iron

    Sorry this is so long… I just feel a little desperate for some ideas.

    Thank you so much for any input.

  17. Hi KH,

    The loss of balance suggests a neuropathy to me. So I would look at neurological causes.

    The first place to look is glucose control – are you monitoring blood glucose, and do you ever become either hyperglycemic or hypoglycemic?

    Are you supplementing iodine? You need to be supplementing selenium if you are taking iodine.

    Vitamins D and K are important. Both are involved in myelination of nerves.

    Taking some calcium is fine but you should get as much magnesium as calcium. B complex is a good idea, so would be chromium.

    If you’re postmenopausal then don’t take a multi with iron.

    Both zinc and copper deficiencies can cause neuropathy. It doesn’t sound like you can be copper deficient and probably won’t be zinc deficient either. Watch out for copper toxicity if you eat liver.

    I would work on supplements and monitor glucose carefully for a bit. You may find that going low carb would help with glucose control.

    Best, Paul

  18. Hi Paul,

    Thank you so much for your quick reply! I will continue to focus on supplements. As far as blood glucose, I give myself an A+ for monitoring more than anyone I know! (I check at least 9 or 10 times a day, sometimes more just because that makes most sense to me!). I mentioned before but my A1c from these lab tests last month was 5.7, so my doctor was very happy since this is into non-diabetic range (maybe pre-diabetes) but for me it’s great!

    I’m all too familiar with hyperglycemia and hypoglcemia, but the balance issue is definitely not related to either one. And since I started most aspects of PHD in Oct 2011, my blood sugars have been incredibly stable (they still fluctuate, which is expected as this is the nature of the disease and a daily battle, but the fluctuations are not extreme).

    I have considered diabetic neuropathy, like you said, but I’m hoping and praying this is not the case. Of course I do have to consider it though… but the weight loss is why I thought maybe hyperthyroid or iodine/selenium imbalance. ?? The weight loss is uncharacteristic of my body for the past 11 years, so I think it’s showing me something.

    I’m not supplementing iodine, but this morning when I started wondering if I was simultaneously: selenium deficient and getting too much iodine from foods, I considered how my eating has changed. Recently, I have been eating 2 eggs most days (according to the nutrition panel on egg carton, that already is 80% RDA of Iodine!). Then a few tablespoons of salted butter/ day (I don’t know what kind of salt they use in the butter, but maybe it has moderate amount of Iodine) and I have been eating a piece of nori dried seaweed once or twice a week, plus salmon once or twice a week. Before PHD, I was eating almost no butter and an occasional egg (once a week or less). So, I was thinking maybe over the past couple months I have upped my iodine drastically without realizing it and at the same time I might be selenium deficient.

    I’m also supplementing glutathione. I dont know the best amount to take, but I got 50mg capsules.

    For the next week I plan to cut out a good deal of iodine (no seaweed, no fish, no egg yolks, only kosher salt not from the sea, etc.) and supplement with the 200mcg Selenium to see if there’s any noticeable change. If not, I’ll try to see a neurologist.

    Ok, thanks so much for all your work and input and for letting so many of us vent here and process externally! It’s really helpful!

    Very grateful,

  19. Hi KH,

    I wouldn’t cut out iodine containing foods, those are all very nourishing and I can’t imagine them being a problem. Best for the thyroid is to get both selenium and iodine, so actually I would recommend supplementing a bit of iodine along with the selenium.

    It’s good that your blood glucose is stable, that’s a relief.

    So I would focus on micronutrition. Also, exercises for balance, like standing on one leg, may help promote improved nerve function.

    Getting some coconut oil may help, since ketones are neuroprotective.

    Then mitochondrial nutrition might help.

    Best, Paul

  20. Hi KH,

    One more thing – via Chris Highcock comes this:

    Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis.

    “All studies with daily doses of 800 IU or more demonstrated beneficial effects on balance”

    It’s important to optimize vitamins D/A/K2.

    Best, Paul

  21. Thanks Paul! The studies look interesting. Hopefully my vitamin D levels will increase soon. I took the first 50,000IU capsule yesterday, along with K2 (100mcg) and my multivitamin, which has only 2500 IU of vitamin A, but I’m guessing I get enough to make up the difference from food (we eat lots of sweet potatoes, carrots and spinach).

    Interestingly, I don’t notice the balance issue when I walk briskly/ jog. I don’t quite understand how that could be. I don’t think I’m describing my symptom well at all… I don’t really know how to explain it. I don’t actually lose my balance walking and standing on one foot is no problem (we tested that last night just to see). It seems like it’s the perception in my brain, I notice it when I walk slowly/ saunter and when I’m moving my head around. Simple turns of my head, leaning forward, things like that feel like exaggerated movements. Maybe it’s actually not micronutrition, perhaps it is mechanical.

    I’m a little tentative about supplementing with iodine. If I continue including the iodine containing foods and supplement with only selenium, would that pose a problem? I was eating only brazil nuts everyday for the selenium, but after reading several comments about supplementing selenium instead of eating the brazil nuts, I decided to get the supplements instead.

    I’ll see how things go for a few days then think about making some doctor appointments.

    Thanks so much for your help!

    Hi KH,

    Be sure to eat egg yolks daily and liver weekly for vitamin A. The plant carotenoids aren’t necessarily sufficient.

    I think it’s desirable to get a little iodine along with the selenium, an excess of selenium relative to iodine can produce thyroid problems too. But it doesn’t need to be a lot. If you eat plenty of seaweed (not kelp) and shellfish/seafood, you should be OK. Otherwise take a kelp supplement.

    Keep me posted!

    Best, Paul

  22. KH, I had that same ‘out of balance feeling” you are describing. It is a very strange and troublesome feeling. I did have a few stumbles because of moving too fast as well so please be careful. Even jumping rope was a difficult experience. I don’t know what caused it but I definitely was supplementing with extra iodine. When I stopped, the feeling slowly subsided. I still have Hashimoto’s (TPO’s in the 1,600) and I am apparantley iodine deficient yet extremely reactive to it. It seems to me that the lowest TPO numbers come when I eat low iodine? Paul, am I wrong to think that whatever gets those TPO numbers down is the diet I should be eating? I am currently Paleo, gluten-free but so far my lowest TPO ever came with a raw vegan stint but I found that was hard to maintain and feel good on. Any thoughts on this.

    Hi Jean,

    TPO is a good marker for Hashimoto’s progression but it is not a good marker for your health. I wouldn’t sacrifice health with a vegan diet for the sake of slowing the advance of Hashimoto’s. However, it would be nice to find a diet that is good for both wellbeing and TPO.

    It does seem like you may benefit from being low in iodine until you find and resolve other issues that may be contributing to the Hashimoto’s. Usually it is a gut dysbiosis or infection of some kind.

    Best, Paul

  23. Thanks Paul. That was a quick response. 🙂 xo

  24. Hi All,
    I really appreciate all of the information here and both my mom (type 1 diabetic) and I are on this diet. I was hoping that one/some of you might be willing to give me some ideas on my current prediciment. I recenty got my labs back after many years of confusion over my abnormally low energy levels. The doctor I saw on Fri (not experienced with thyroid), prescriped Levothyroxin and would like to get me an MRI? Ya, I know that’s crazy. I have had the following labs done by my student health clinic, but do not have health insurance(am working on this currently, but as a student finances are very tight):
    T4: 5.2 mcg/dL (4.5-12.0)
    Total T3: 58 ng/dL (76-181)
    Free T3: 2.0 pg/mL (2.3-4.2)
    Total Cholesterol: 253 (high), although LDL: HDL ratio is good: 1.38
    Na+: 141 (135-145)
    K+: 4.5 (3.5-5.3)

    *I understand that thyroid hormone is responsible for modulating cholesterol for use in the body, so that is why this is high. I was really shocked to see such a high total after my first lab tests of TSH: 2.9 (5.5-7.8) and high cholesterol, as my diet is near impecible. FYI: this is what spurred me (not the doctor), to get the rest of my thyroid hormones tested and voila: subclinical hypothyroid (low free T3), even though my TSH was “normal”

    My sx:
    cold hands/feet bordering Raynaud’s, memory problems, really low energy, abnormal menses, sore neck for last few weeks, intermittent low mood, bradycardia, outer 1/3 of eyebrow hairloss, low blood sugars (partly due to low carb diet: been running random 72’s after meals and baseline around 80), normal weight, but with lots of exercise and good diet: excessive exercise (previous cardio addict) and low carbs (30% of Calories) may be a factor

    My questions:
    1. Does anyone know of an inexpensive way to test TPO?, as I suspect Hashi’s and would like to get a baseline. As I said, no health insurance
    2. Any links to look into the effects of cortisol on hypothyroid, cheap ways to test/recognize sx., and what to do to balance cortisol

    FYI: been following autoimmune diet for last week: ruled out all grains, legumes, (awhile ago), more recently: dairy, nightshades, decreasing Omega 6’s, and increasing Omega 3 ratio. Taking 4,000IU’s of Vit. D, selenium, probiotics, bone broth, malybdinum, low dose iodine, daily meditation, cod liver oil, and decreasing exercise intensity

    I am trying to get things done, largely on my own without the finances to cover a doctor, so the information provided here has been extremely helpful. Thanks again for ANY input and may you be well.

    Hi Bee,

    Just a quick response – being too low carb and/or protein could produce those symptoms. You might read the posts in our “Hypothyroidism” category, back to front. I would try adding carbs first and see if that relieves any symptoms. The other things you’re doing sound good.

    Best, Paul

  25. Hi Paul,

    First of all thank you so much for an amazing book! And thank you for taking the time to respond to these questions in the comments.

    I have a quick question if you have the time: I’m very confused on which form of iodine to take. Lugol’s and Iodoral contain potassium iodide (KI) as well as iodine (I2). There is some discussion in some places online (wikipedia’s Lugol article, for instance) that iodine (I2) is not good for internal ingestion. One site reasoned this by claiming that I2 was antibacterial and therefore could possibly harm the gut flora. I have spent some time trying to discover what the form of iodine as it occurs naturally in seaweed. I think this would be a good base for deciding whether to supplement with just KI or KI and I2 (I can’t just eat seaweed unfortunately – I am on the SCD diet).



  26. Also, a commenter above mentioned that potassium iodide is bad for the thyroid as it will ‘clog it’ since KI is not very soluble. As far as I can tell based off some basic googling (unfortunately chemistry was years ago), KI is a very soluble salt. So I believe this is an unfounded claim.


  27. Hi Alex,

    Potassium iodide is highly soluble and disintegrates into potassium and iodine in the blood. Both forms should be equivalent. Absorption should be good if it is taken with food. So I don’t see much difference between Lugol’s and Iodoral in terms of quality.

  28. Paul,

    You mean there would be no difference between Lugol’s (contains KI) and Iosol (contains ammonium iodide), right? The commentor above was claiming that KI was not soluble and would therefore ‘clog’ the thyroid (which I guess Byron Richards has claimed). To me that seems ridiculous.

    But my initial question (I commented twice – sorry about that) was the difference between taking a supplement that contains only KI and a supplement that has KI and I2. I am wondering if I2 is found at all in seaweed, and unfortunately I have been unsuccessful in my search. I am nervous about taking I2 because I2 has very strong anti-bacterial properties – thus I would be nervous about damaging the careful ecosystem of gut flora and other body bacteria. If I2 was found naturally in food, then I would assume my worries are unfounded, though I am under the impression that in nature mainly iodide compounds are found. Having said this though, some people report better success with a I2/KI supplement than just a KI supplement as far as I have read.

    Any thoughts on this?


  29. Hi Alex,

    OK, sorry to have missed the point. Yes, the free iodine can be cytotoxic, to human as well as bacteria, at high doses. The solution is to take the iodine with food and not in very high doses.

  30. i have just learned from a blood test that i have ‘224’ thyroid antibodies, or Hashimoto’s. i will be glad to learn more about this. i was taking iodine @ 15 mg/day for 4 months, and a much smaller dose for 6 mos. before then.

  31. Hi Grace,

    Diet, clearing infections, and good nourishment are important. Whether to include iodine among supplements is somewhat controversial, but our view includes toward cautious supplementation of at least 750 mcg to guarantee there is no deficiency, and possibly considerably more; Mario advocates higher doses, as you can see in his post. It is critical to optimize selenium intake if one is taking higher doses of iodine.

    Best, Paul

  32. Hi Paul,

    Thanks for the previous response, your advice is highly regarded & appreciated.

    Is your recommendation for detoxing bromide and copper: iodine, zinc, and sea salt? Also, I was eating kelp per your book’s recommendations in order to attain iodine, but read in this thread that it may contain bromide?? Not good news, any thoughts?

  33. Hi Bee,

    Yes, that’s basically it; vitamin C might help with detox too.

    Kelp does contain a lot of things, so purified iodine salts are better. Amazon doesn’t have them in low doses but iHerb does.

  34. Hi Mario and Paul

    It’s been over 6 months since my first post and I’m still trying to work out the Hashimoto’s puzzle.

    Following my original diagnosis I have cut out about 95% of my wheat/gluten intake and am in the process of adjusting my diet to be closer to the PHD with lots of coconut oil. I’ve also begun a small trial of Thiroyd-s from Thailand and started at 1 grain but have recently increased to 1.5 grains.

    My last tests showed my TSH has come down to 1.73 (from 2.3) and my FT3 levels are OK but my T4 and FT4 are now on the low side of the scale. On the positive side my TG antibodies have dropped down to 452 (from 639) and my TPO is under 50.

    Whilst I don’t want to become reliant on results I’m concerned about my low FT4 and T4. I am thinking of increasing my dosage to try and bring my T4 up to normal. I could supplement the dessicated thyroid with thyroxine and see if that has any effect and there is also the option to start supplementing iodine (am already taking selenium).

    As such I still do not have any typical symptoms except my skin and eyes are much drier. I also cannot seem to shift my blepharitis but think I need to tweak my diet more to fight it.

    I’m also still waiting to see what effect 3 months of treatment will have on my sperm morphology and motility.

    Any opinions would be greatly appreciated.



    • Hi David,

      Is Thyroid-s levothyroxine / T4?

      I would definitely start iodine. I think it’s risky to supplement selenium without iodine.

      Dry eyes probably means you’re too low carb. It could also be a deficiency of vitamin C.

      Try adding carbs and a low dose of iodine. In hypothyroidism, you have to go slowly, so don’t try too many things too quickly.

      Best, Paul

  35. Hi Paul

    Thiroyd-s is desiccated thyroid in 60mg doses. I think the T4/T3 mix is more like 5:1 ratio which could explain why my FT3 is ok.

    It’s possible the dry eye might also be auto immune caused but I do not think its down to carbs as I have a decent amount of them. It is interesting to note that the blepharitis started when I tried the paleo diet and cut out most carbs. I will increase vitamin c and see what happens.

    The next test is in 2 weeks so will stick with current regime then introduce iodine and see what happens.

    Thanks for your help!

  36. Maya Ramirez, M.D.

    Hi Paul! I was doing a google search on iodine and selenium and Iwakura’s excellent article came up. How cool. I know Khazarian is not in favor of iodine supplementation in Hashimoto’s thyroiditis, but in addition to thyroid health in these patients, I am concerned about their breast health. Breast cancer rates are higher than average in patients with Hashimoto’s. Iodine, when partnered with adequate amounts of selenium, reduces carcinogenic estrogen metabolites (eg. 4-OH estradiol), has a direct antioxidant benefit in the breast tissue, and through formation of iodolactones in the thyroid has an antiproliferative effect on the breast. These seem like compelling reasons for careful use of iodide AND iodine in autoimmune thyroid disease.

    • Hi Maya,

      Great point, and I fully agree. Iodine deficiency is associated with fibrocystic breast disease, and iodine and selenium are highly protective against all solid tumor cancers.

      Hashimoto’s is tricky because iodine can both help and hurt, but I think if you use it in the right way it is likely to be beneficial, at least at moderate doses such as 1 mg/day. At higher doses risks are greater but also benefits could be greater.

      • Hi Paul,
        In non-Hashimoto’s patients, are there also risks to taking iodine at higher doses.
        And how would you know if/when you are taking too much iodine.

        (i presume the actual dose of iodine that is too high would vary from person to person?).

        kind regards, Darrin

  37. Hi
    My thyroid gland is completely defunct.
    I take thyroxine & my doctor says my tests show I am taking enough & my levels are in the right range. I have developed bags under my eyes but what is the worst is that I ACHE almost everywhere = I NEED TO BE TOLD what to take to relieve these aches & pains !

    • Hi jennifer, to really know your tiroid status, your doctor need to evaluate not only TSH nd FreeT4, but Free T3, total T3 as well as reverse T3, and the ratio in beetween then. I would also include the measurement of blood selenium (or plasma, or whole blood, all are +- fine), CBC, ferritin, zinc. With these in hands, we can have a better idea on what can be done ( I asume that anti TPO and anti TG antibodies have already been done).

  38. Try a gluten free diet.Has to be 100% gluten free. It helped with my Hashimoto’s symptoms a great deal.

    • Thank you Kristi –
      I need a diet anyway

      • Jennifer,
        Thyroxine that u r on is extracted from animals and made synthetically. Synthetic hormones is made from nursing horse urine and has over 200 hormones in it and we only have 4 of those hormones as humans so u r putting all those other hormones in your body that we do not have as humans and this is very dangerous. Find a doctor that specializes in Bioidentical Hormone Therapy. The hormone therapy is a compound from plants and is identical to what our body makes. This is VERY important. Doctors have no training in hormones. It is like going to an eye doc for your obgyn check up. The aches and pains are from your tyroid being off. Cleaning up your diet and going gluten free is very important and detox the body and your home. Toxins in the body contributes to the imbalance so it is important to detox the body reg.. The garbage in our food and in our house is what is causing so many to have this problem with the hormone imbalance. You did not hear about this 40 or 50 years ago. Today,,,,look at all the sickness in the United States. It is all in the food. Our food will heal us or kill us.

  39. I am hypothyroid on Levo. My levels are normal..for years I had body aches all over.. found that My Vit D level was very low, after weeks of Vit D replacement , my body aches went away.. I had forgotten how it was to be ache free.. Its also important to take Calcium when on Vit. D..
    On lower eyelid swelling or eye bags plus years of dry painful eyes, I read that Cold pressed Castor Oil will help.. I applied and spread a dab on my inner lashes . it only took one night.. the swelling/eye bags were gone, and no more painful eyes..

    • anyone else know much about the external use of castor oil?
      uses/good/bad/pros/cons etc
      i just did a quick google & i see it’s around 95% Ricinoleic acid, which is an omega-9 polyunsaturated fat.

      • The known clairvoyant Edgar Cayce prescribed Castor Oil as treatment for several health ailments.. check on YouTube.. Edgar Cayce.

  40. Hi Paul, my name is Diane,I have had hashimotos for many years, I was diagnosed with it in 1993.I have alway’s wondered what supplements I can take. I was told by a friend recently about selenium but not for my thyroid but for people with dementia,it’s only because I wanted to now more about selenium that I have discovered that it could be good for me,also I have been advised to stay away from anything containing iodine,at the moment I take 175mg of Thyroxine a day,plus some other med’s.I have started the selenium 200mpg about 5 day’s ago, how long should it take to get into my system and I notice any changes.

    with reguards
    Diane. Macclesfield. United Kingdom.

    • Hi Diane,

      I would take some iodine with the selenium, you don’t want to be iodine deficient. Try 225 mcg/day and see if you tolerate that OK.

      You may not notice any immediate changes but hopefully you will be gradually decrease your thyroxine dose. Diet is more important than supplements. Don’t overdo the selenium, not on our supplement recommendations page we’ve adjusted our dose recommendations.

  41. Paul, I was recently diagnosed with Hoshimoto’s and hypothyroidism. I’m devastated. I picked up my Synthroid yesterday (0.25 mg) and haven’t decided when I’ll start. My TPO was 534, TSH 5.510. Should I start the Synthroid and start an Iodine/Selenium supplement treatment and maybe could work off the Synthroid? I’m devastated as I also have severe Osteoporosis. I am overwhelmed as to where to begin.

    • I would start the Synthroid but find the lowest dose that makes you feel OK. This may not be the same as the dose your doctor prescribed. You can cut up pills with a razor to try different doses.

      Then you want to work with nutrition, including iodine and selenium, to try to reduce the dose you require. Go slowly and patiently; it takes the thyroid gland a month to adapt to a new nutritional environment, and you want to test things one at a time, so it takes time to optimize everything.

      Be sure to eliminate wheat and other gluten-containing grains from your diet.

      Please keep us posted!

      Best, Paul

  42. PS: there is no telling how long I have had Hoshimoto’s. Weird thing is I have the Hyperthyroid symtoms of hyper. It’s an awful feeling!

    • Hi Brenda,

      It’s possible to have hyperthyroid nodules along with Hashimoto’s. If so you may be sensitive to iodine. Be very careful when testing it, and test with very low doses. (Eg 225 mcg tablet cut into quarters for 56 mcg.)

  43. PS: Weird thing is I have the Hyperthyroid symtoms of hyper. It’s an awful feeling!

  44. Brenda,
    You want to feel worse, tk the Synthroid! This is a man made sythetic drug that is extremely bad for your body and liver. Find a doc that specializes in Bioidentical Hormone Therapy. They r easy to find. NEVER tk sythetic ONLY natural. Docs do not have any training in the hormones. If u have Hoshimoto’s u need be extremely GLUTEN FREE or your throid meds will do no good. Hosh. causes your immune system to attack and destroy your thyroid being gluten free will stop that and then your thyroid can start working again but with help. My sister has this and we go to an amazing Bio Identical Hormone doc so I know what u r going throug and what u can do. U can not do it without going gluten free. It is impossible. Also u can have some hyperthyroid symtoms even if u r hypo.. Our doc Dr. Hall would not put my sis on anything until she got the gluten out of her body which took several months. She is doing so much better. She is now working on supplements to take.


  45. The iodine controversy continues for us Hashis people. I am hearing such conflicting stories I am stuck on the right next step to take. I have heard with hashis that we need to take it slow. but on the yahoo iodine board and cure zone I am reading a LOT of stories about iodine not suppressing Hashimotos antibodies until a higher dose is taken (like 50-100mg???!). I am currently taking 1mg and was told that is a drop in the bucket and won’t serve me. I am on Nature throid with continued adrenal symptoms (though not as bad) and my hair is still falling out. My nutrition is ridiculously good (veggies, quality pasture fed foods etc etc). Is there any literature or opinions you can send me to to make a more solid decision. I am still confused about selenium dose change as well? The 50mg loading iodine I took didn’t bother me at all in the matter of symptoms. Thank you!!!

    • Hi Carmen,

      1 mg iodine certainly does you a lot of good. It eliminates iodine deficiency, drives out other halides like bromine, and supports mucosal immunity.

      The higher doses are more speculative. Some people, including our Mario, have had good results at higher doses.

      Selenium — you need a good amount of selenium. Our foods (beef, lamb, shellfish, seafood, organ meats, bone broths, eggs) are selenium rich. So every day supplementation may be too much. Occasional supplementation is fine, and eating beef or lamb kidney is good.

      Thyroid and adrenal issues do take time to heal. I would focus on circadian rhythm strategies next.

  46. Carmen,
    There can be a couple of reasons your hair is falling out fast. When progesterone levels are too low, a woman begins to feel moody because her hormones are out of whack. It is at this point that she may notice she is shedding hair at a high rate.When the progesterone levels are too low and the estrogen (another hormone) levels are too high, this is called hyperestrogen or estrogen dominance. Women with this condition are apt to be depressed and fatigued. They may experience a low sexual drive and an inability to cope with stress. Unwanted facial hair may appear even though the hair on the woman’s head may be falling out.If a woman has high levels of testosterone (the male hormone), this may result in the loss or thinning of hair. Also did your doctor test your reverse T3? This is very important. With Hoshi it is extremely important to get your B12 completely check because usually when u have Hoshi u have low B12 and if this is the cause u have to do injections to get it bk up. When it gets to a certain point the only way to get it bk up is shots. You can do this at home, it is real easy. You have to have the right B12 for your Thyroid because it uses a specific type. My sister has been getting her doc to keep upping her Thyroid because see was still feeling really tired and it is finally high enough. She is doing stuff she has not done in a really long time.

  47. Thanks Trista…I AM estrogen dominant and low on progesterone and using DIM and Emerita. My B12 was literally at the top of the range (perfect) . My Rt3 was 18 (I realize it should be 20 or over) but it WAS 11 at one point so I am improving.
    I am trying to figure out what dose of iodine I should be taking….
    I am (unfortunately) OVEReducated on Hashimotos so the iodine is the thing I ned more educaition on in regards to the Hashimotos.

  48. Thank you Paul…I did circadian dosing with T3 but never with nature throid. Still trying to figure that process out. (dosing timing etc).
    Its all a lot to handle.

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