Thyroid

January 18, 2021

This is a long one, but I’ve struggled to find other posts by vegans with Hashimoto’s so I’m being thorough.  I’ll try to keep this up to date with my own experiences.


I started a job in 2017 that allowed me to have a primary care provider, a first in my 15 plus years as an adult.  In my lab work at my first visit, my TSH (thyroid stimulating hormone) was slightly elevated at 4.82. Recommended ranges vary but average around 0.4-4.5.  My provider asked if we could run my T4 (inactive thyroid hormone) which was normal at 0.82, so we both shrugged it off as not worrying, but something to watch.  The next year was curious because I had gone dairy and gluten free for a month during a trial of a gastrointestinal healing program.  My TSH that visit was a lovely 3.97, well within normal lab ranges.  Then when we checked in 2019, I had jumped all the way up to 5.3!  I was well into my Master’s program by now and decided I wanted to try to fix it with supplements.  I started taking selenium, common thyroid cofactors like B12, vitamin C, and zinc, and lots and lots of tyrosine and iodine.  I went back 6 months later ready to show how I’d improved using my new found knowledge and instead my TSH was up to 5.64.  I panicked.  I was starting to show some hair loss and that winter I had felt more cold, like a bone deep chill that felt worse than normal.

Lets pause and talk symptoms for a moment.  Your thyroid does an innumerable number of things within the body.  For real.  This little gland and its hormones (T3 being the active form) affect everything from weight to stress to temperature to hunger and insulin effectiveness to actual digestion to thinking processes and mood and far, far more.  Now I’m not sure if you’re seeing the issue, but when a patient has symptoms that are tiny bits of a few of these issues totally scattered around the list, how in the world are they going to notice them and how are you supposed to connect them?  This is especially true for low level or sub-clinical thyroid disorders, hyper (high) or hypo (low).  I had brushed aside a slightly high level because I didn’t think I had any symptoms of hypothyroidism.  Everyone is tired after lunch.  No one gets enough sleep or comes to work energetic.   It’s winter, of course I’m cold.  I’ve always just been larger framed, when I was dancing in high school I was a healthier weight, it’s just because I’m too lazy to make myself exercise regularly.  I’m in school, doing my Master’s, my brain is literally fried, no duh I can’t think of the word I’m looking for.

I didn’t know until it got better.  My symptoms were so minor and so universal, I couldn’t imagine that it wasn’t how I was supposed to feel.  That was normal, right?  I didn’t take it seriously until I was really sure I wasn’t just imagining my hair clumps in the shower getting bigger and the little patch of skin that was getting more visible on my hairline.  That, plus my TSH getting higher when I’d been supplementing for exactly the opposite effect.  I was ready to admit something was wrong and I asked her to run an anti-TPO blood test.  Thyroid peroxidase antibodies are the most common indicator of autoimmune disease in the thyroid.  I was positive, 160.9 when the reference range is below 9, my body was literally attacking my own thyroid gland.  

I thought I’d been panicking before.  Now I was completely shocked.  I had just graduated, three months earlier, from a program that taught nourishing the body via food and careful support to have a long and healthful life.  I was now pretty much guaranteed that I would be taking prescription medication and watching my lab results get worse and worse as my thyroid was destroyed with an ever-increasing prescription strength to make up for it. 

Obviously, I’d already been hitting denial, but now I cycled through anger, disbelief, and depression, just to name a few.  I was a wreck, ‘that’s not what I’m supposed to have’ and ‘I’m expected to be a near perfect healthy to help guide others to their best health’.  Our best guess is pretty farfetched, but I did have Epstein-Barr (mononucleosis) in high school and there is some linkage to Hashimoto’s, perhaps that was my seed?  Followed up by a decade of vegetarian junk food and inconsistent (read: absent) self-care, working night shifts for a couple years, city life with city pollution, a lot of animal exposure, who knows really.

My saving grace was being introduced to Dr Izabella Wentz’s books.  I chewed right through her first one, Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause.  I strongly recommend grabbing that book but you can also find a lot of resources on her website www.thyroidpharmacist.com.  I changed my supplements and eating the next day.  NO gluten and NO dairy at all, hands down.  I also immediately stopped taking the supplements with tyrosine and iodine and started levothyroxine or Synthroid, a lab made version of T4 which I had previously been strongly against relying on.  Tyrosine increases thyroid activity and iodine increases TPO activity specifically, both of which she aims to decrease.  The hope is to use the prescription thyroid hormone replacement to lessen the strain on the thyroid gland and by lowering the thyroid activity, less TPO will be made and therefore fewer of the anti-TPO antibodies will be active, reducing the autoimmune response.  I’m oversimplifying like crazy, but I just want to get the basic concept across.  Beyond that, I’ve always known that I don’t handle dairy well, snotty noses and sore throats make that clear, along with the bloating.  When working with any autoimmune disorder, decreasing inflammation is helpful and dairy is definitely inflammatory for me.  Gluten was a rougher choice.  When I did that gastrointestinal trial a couple years before, I had noticed a reduction in bloating and acid reflux (generally mild and infrequent) but they returned partially when I went back on gluten, this was before I caved in and had dairy.  This is an example of reintroduction after a food elimination diet, it can be helpful for identifying food reactions.  With my previous reaction in mind, Dr Wentz also made a strong case for most Hashimoto’s patients feeling better off gluten and some even cleared their autoimmune response with impressive lab results.

So how am I doing and what am I doing?  As I write this, I’m about 6 months into my adapted Root Cause protocol, dairy and gluten free with supportive supplementation.  My largest break from Dr Wentz’s protocol is soy.  She does recommend removing it from your diet, but I use it daily, largely because of its high protein content and ease of use, tofu and soy milk are my best friends, soy yogurt being a favorite as well.  As an infant I was raised on homemade soy milk because I did so poorly on dairy milk and formula.  I am careful to select organic and non-GMO soy whenever possible, my tofu and tempeh, soy milk, edamame and so forth.  I hope that my thyroid health will continue to improve, and I will not need to eliminate soy. 

TSH lab levels 2017-2020 (shaded purple is normal range though I feel better closer to 1-1.5)
Anti-TPO lab levels 2020

Definitely getting better, right?  There are two different labs involved, I assume some of the bouncing is because of that difference.  In between check ups with my primary care provider, I’ve used Ulta Lab, recommended by Dr Wentz.  I can order my own labs and pay less out of pocket that way, others may be better off going through their primary care provider for all their testing.

A point to make, my primary care provider and I went back and forth a few times on my levothyroxine dosage.  We started at 50 mcg, 6 weeks, recheck TSH, not low enough, went to 75 mcg, 4 weeks, rechecked TSH, this time she was happy with it but I was not.  Be an advocate for yourself!  The first week of taking the 75 mcg, I felt better.  That was the first moment that I realized I didn’t have to have this general drag, that I was supposed to actually feel more energetic and clearer minded.    Unfortunately that feeling didn’t last beyond the first week so I wondered if perhaps a slightly higher dose would make that more permanent.  My primary care provider respected my request and increased me to 88 mcg with a bit of hesitation on her part and firm instructions to let her know immediately if I started to experience any hyperthyroid-like symptoms.  The clarity and consistent energy came back, I still occasionally get snoozy in the afternoon, but during school I was napping daily for a couple hours after working mornings (granted late nights don’t help).  

A Warning: my hair loss actually got worse when I went off my initial attempt at thyroid supplements and didn’t yet have a high enough dosage of levothyroxine.  It took 3 months or so before I was sure it had slowed back to normal shedding and I started seeing baby hairs growing back in that patch on my hairline.  As of two weeks ago, it’s starting to fill in rather than look like it’s struggling to grow.  My ponytail is still about as thick as a pigtail used to be, but it’ll take a while for the new hairs to get long again.


Supplements

I’m going to run you through my supplements, don’t freak out but it is a decently long list, many recommended by Dr Wentz and from my own education.

Levothyroxine 88mcg (I take this right before I brush my teeth in the morning)

Before or during Breakfast

Amino Replete (Pure Encapsulations – this is a free form amino acid formula, personal choice based on other testing)

After eating Breakfast

Betaine HCl (Betain HCl 648 mg and Fungal Pepsin 150 mg – vegan formula by NOW)

Selenomethionine 200 mcg (Thorne)

Methyl Assist (B6 16 mg, Folate 2.7 mg, and B12 1 mg – Pure Encapsulations)

Biotin 8 mg (Pure Encapsulations)

DIM Detox (Pure Encapsulations – this is support for a personal genetic SNIP)

Biocidin (Bio-Botanical Research Inc – this is an herbal immune support blend)

After eating Lunch

Betaine HCl (NOW)

Vitamin D3 2,500 IU (I’ve used a couple different ones, right now it’s Pure Encapsulations vegan drops and the amount has shuffled around from 2,500-5,000 IU.  This one is still a work in progress.)

Omega-3s (DHA 360 mg and EPA 180 mg – vegan formula by Source Naturals)

NAC 1,800 mg (Pure Encapsulations)

PureProbiotic 5 billion CFU (Pure Encapsulations – this is generally considered a low dose, but I take it more for support than for changing my microbiome)

I switch between iron and zinc each day so they are taken every OTHER day.

OptiFern-C (iron 28 mg plus cofactors – Pure Encapsulations)

Zinc Picolinate 15 mg (Thorne)

At Bedtime

Magnesium CitraMate (magnesium citrate 55 mg and magnesium malate 80 mg – Thorne)


Food

I do follow a gluten-free and dairy-free diet, once in a blue moon I’ll eat something with egg in it, but that’s been maybe twice in the last 6 months (drat mini chewy Sweetarts for being so irresistible) and egg is a food that Dr Wentz touches on as a possible avoidance, very minor compared to dairy or gluten.  A normal breakfast is homemade granola, soy yogurt, a bunch of fruit, and some hemp hearts, occasionally I’ll make a batch of waffles or a tofu and veggie scramble.  In summer I’ll blend a quick smoothie, greens, fruit, and various protein and supplement mixes.  Please note, if you choose to lower your consumption of iodine, check the labels on protein powders, it is often added.  Lunch is random, lentil sheppard’s pie, a salad with beans and seeds, mac and cheese with veggies and a legume based pasta.  Vegan food bloggers are my inspiration for a lot of my new meals.  I don’t always eat a dinner, I lean towards a 16/8 restricted eating window or an intermittent fasting cycle.  I’ve found I sleep far better if I don’t eat after 6 or even 5.  If I do have dinner, it’s generally similar to lunch, or something more snackish, like rice cakes and nut butter or even a handful of nuts and some fruit or veggies.  If dinner is big, I’ll take another Betaine to help make the most of the protein I’ve eaten.  

It doesn’t always sound like much food, but I’ve learned to make sure I have large enough servings.  When I first tried intermittent fasting, I didn’t get enough calories into my days!  I personally lean away from snacking, this helps me stick to a 8 hour window and theoretically improves both digestion and metabolism.  Of course, interspersed with the whole foods and nutrient rich meals are still going to be potato chips, quesadillas with vegan cheese, chocolate cocomels (coconut caramels), the occasional cashew milk ice cream, Nairns oat graham crackers with melted Dandies marshmallows…I’m definitely not ‘perfect’ but I also know that the more whole, unprocessed, nutrient rich foods I eat, the more improvement I should see with my autoimmune flare ups and the healthier my thyroid will stay.  That thought in the back of my head tends to temper my less healthy food cravings to manageable levels.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

Create your website with WordPress.com
Get started
%d bloggers like this: