Medication for the treatment of Hypothyroidism/Hashimoto’s Thyroiditis

Having felt tired and lacking zing for most of my life, seeing dozens of practitioners looking for answers and being told by my GP I should wait a little longer! to see what my thyroid antibodies were brewing, I was finally trialled on a low dose of thyroid medication – thyroxine (T4) to be exact. You may know what is coming but bear with me while I tell you about treatment options – sadly I wasn’t given this information.

Many thyroid patients who require thyroid hormone replacement to treat their hypothyroidism are never told that there is more than one medication. Here is a brief overview of the options available:-

Levothyroxine, a synthetic form of the T4 hormone, is the drug of choice for the mainstream and conventional medical world – commonly known here in Australia as Thyroxine. Generally a GP will prescribe only this drug for their hypothyroid patients.

However, as discussed previously, T4 is considered a storage hormone and must be converted in the body to the active T3. Therefore if your body cannot make this conversion, as mine couldn’t, when I started taking thyroxine I felt worse than when I was taking nothing! My body was converting the extra T4 into RT3 and I was like a bear heading into hibernation, every bodily function was slowing even further.

What next! After a great deal of research I found a doctor who knew a little about Natural Desiccated Thyroid, also known as NDT. NDT is a prescription drug derived from the dried thyroid glands of pigs. NDT is natural and gives you what your own thyroid would be giving you: T4, T3, T2, T1 and calcitonin. Most endocrinologists and many mainstream physicians do not support or prescribe the use of natural desiccated thyroid drugs.

For many, NDT is the answer and they live well on it. However, once again, I did not thrive on NDT – due to the fact that it still contains T4 and my body continued to convert this to RT3. My reverse T3 level continued to rise and I continued to feel unwell.

Life had become all about research, knowing there must be an answer out there!

Thankfully I found, for me, there was – in the form of Liothyronine. Liothyronine is a synthetic form of the active T3 hormone. Here in Australia it is called Tertroxin and generally not prescribed by mainstream GPs but nutritional doctors do – thank goodness! T3 takes more care to use as it has a short half-life, meaning its affects run out after 4-5 hours. I have alarms set on my phone to sound every 4 hours of daylight! but it is worth it. My body gets the active T3 I need to feel well for the first time in my life!

Hypothyroidism, and its associated health issues, is a complex disorder that requires understanding and help from people who really know – these may be fully qualified practitioners or people who have lived with it and found answers.

If you feel unwell and know something is wrong but can seem to find help, please contact us. We can point you in the right direction, provide contact details for practitioners who understand and don’t just tell you to ‘eat less exercise more’ or ‘it’s all in your head’. There is a wonderful, healthfull life to be lived out there for us all!

Hashimoto’s Disease

I want to dedicate this blog post for all of you lovely ladies out there who suffer from Hashimoto’s; an autoimmune disease in which the body’s immune system cells attack the thyroid, leading to an underactive thyroid. Hashimoto’s is a relatively unknown but very common condition, and as sufferers know, it can be extremely hard to find answers about it. Hashimoto’s is very complex and can cause a myriad of problems such as

  • Weight gain (particularly around the abdomen)
  • Low body temperature
  • Decreased metabolism
  • Increased appetite (mainly for sugar)
  • Depression
  • Severe fatigue
  • Eyebrow thinning
  • Menstrual irregularities and infertility
  • High cholesterol and high blood glucose

Basically, the thyroid gland interacts with nearly every system within the body, and when it is under attack, all of these systems are affected in one way or another.

When looking for answers, most doctors will put you on thyroxine and tell you to stop reading so much guff on the internet. They will most likely tell you to lose weight by eating less and moving more, lower your cholesterol by limiting saturated fats and eating more ‘heart healthy’ polyunsaturated fats and prescribe the oral contraceptive pill to help menstrual irregularities.

As you probably already know, I suffer from Hashi’s, and after years of trying many therapies, conventional and alternative (thyroxine, acupuncture, desiccated thyroid extract etc etc etc), I found the only way I could feel completely better was through T3 only supplementation.

However, after having a complete diet overhaul (low-fat to high-fat, high carb to low carb), I found that this way of eating went hand in hand with my medical supplementation. So, in my quest to help you help yourself, I have put together this ‘how to’ post to eat your way to Hashimoto health!

How to eat for Hashi’s

If you suffer from Hashimoto’s, it is likely you have tried every method under the sun to lose that stubborn abdominal fat; 6 meals a day, no meals a day, intermittent fasting, meal replacements or any other crap you can pick up at Chemist Warehouse that promises you can lose 7 kilos in 2 days!

Well, to put it simply, I have found the best way to eat for Hashi’s is to stick to 3 larger meals a day; the good ol’ fashioned breakfast, lunch and dinner! No more eating 6 small meals a day to help ‘fuel your metabolism’. Did you know that the ‘6 meals per day’ phenomenon only came out in the 1990’s in response to the blood sugar rollercoaster created by having wholegrains and sugar with each meal!

If you suffer from Hashi’s, you will most likely suffer from digestive issues caused by low stomach acid, so only eating 3 meals per day gives your digestive system time to rest between meals. Supplementation with a probiotic in the morning (to rebuild beneficial gut bacteria) and HCL, betaine and pepsin capsules with each meal may be required if symptoms are very bad.

To start the day, breakfast should ideally be within 30 minutes of waking and include 30-40g of protein (that’s protein not meat – keep in mind 100g of meat contains approximately 30g of protein). However if you exercise before breakfast or this is simply not do-able, it is important breakfast is before 10am. Lunch should be within 5 hours of breakfast and dinner eaten before 7pm (I have been known to eat my dinner at 4pm)!

If you do require something between meals, I would recommend a high-fat, high-protein snack (ie a good hunk of full-fat cheese, chunks of meat with homemade mayo, tablespoons of coconut oil and my favourite, a slice of butter sprinkled with cinnamon – sounds mental but don’t knock it til you’ve tried it)!

However, the trick is to make your 3 main meals so densely nutritious and satisfying that you don’t require anything in between; a decent serving of fatty meat (I normally get through around 150g), lots of saturated fats (helloooo coconut oil) and a serving of veggies (I love a whole capsicum or cucumber).

Following a meal like this I love a herbal tea with Lindt 90% cacao chocolate, and then I am good to go for another 4-5 hours!


What to eat for Hashi’s

Following on from my blog post ‘How to Eat for Hashi’s’, where I briefly covered meal timing, I have created ‘What to Eat for Hashi’s’ to outline the foods that should form a staple part of your diet and foods that should be avoided for optimal thyroid health.

Whilst there are some special considerations for Hashi’s, most of the foods I will tell you to avoid should really be avoided by everyone and not just those with thyroid issues!

If you have ever done any research on diet and thyroid health, you have probably read that you need to be using iodised salt, eating brazil nuts for their selenium and replacing all saturated fats with ‘heart healthy’ omega 3 and 6 fats. Well I am going to go completely against the grain and tell you to throw out your iodised salt shaker, put down that packet of brazil nuts and use that bottle of canola oil for your car as you will never need these ingredients again… EVER! Especially the canola – don’t you dare touch it ever again.

If you want to help your Hashi’s, replacing these foods with the foods I have listed below and further avoiding the ones I have listed below is a fabulous start!

Foods to eat in abundance

  • Coconut Oil: Anti-inflammatory, increases body temperature and thermogenesis, supports healthy thyroid function.
  • Egg Yolk: I am lucky enough not to be allergic to eggs so I think they are a tremendously nutrient rich food, however, eggs are typically avoided on an autoimmune diet. Yet many do not know it is the whites that contain the allergens which cause egg allergies, not the yolks. Caution is still advised when eating the yolk, however I believe they are a great dietary addition as they contain all of the nutrients required to raise an animal; if that’s not cool I don’t know what is. Oh and they help leaky gut (bonus)!
  • Organ Meats (Especially Liver): Organ meats are the most concentrated and bioavailable sources of vitamins, minerals, essential amino acids and essential fatty acids. Liver is just about the most nutrient dense food out there; it delivers a heap of B12 and vitamin D3 (people with Hashi’s are often deficient in both of these).
  • Bone Broth: The high levels of glycine and proline contained in bone broth aid in the healing of leaky gut and combat stress and whole body inflammation.
  • Saturated Fats: Help combat sweet cravings, assist in weight loss, help keep hormones healthy and functioning, reduces cholesterol.
  • Grass Fed Red Meats: The most bioavailable source of iron (people who suffer from Hashi’s are often deficient), a rich source of Conjugated Linoleic Acid which assists in satiety and weight loss, a good source of Omega 3’s (help fight inflammation – just make sure the meat is grass fed as grain fed red meats contain an undesirable Omega 6 to Omega 3 ratio.
  • Sauerkraut: Eating fermented food improves the balance of good bacteria in our gut which helps to promote digestive enzymes. This is important for anyone suffering from an autoimmune disease as it can help in the absorption of the nutrients in our food.
  • Celtic Sea Salt: Supports adrenal function which can be affected by a poor thyroid.
  • Turmeric: Helps to combat the chronic inflammation caused by autoimmunity.
  • Grass Fed Gelatin: Rich in the amino acid glycine which helps detoxify the body, improve digestion, heal leaky gut and promote hormonal balance.

Hashi Food Pyramid

Sex Hormones

It is important to have your sex hormone levels tested too, as high or low levels/ imbalances can prevent optimum metabolic and endocrine health.

Estrogen dominance has been linked to an increased risk of hormonal cancers, adrenal fatigue and thyroid dysfunction – among other things. I have estrogen dominance and need to work carefully with my nutritional doctor in order to balance this with bio-identical progesterone and testosterone in order to feel well.

The sex hormones that should be tested are:

  • Estradiol,
  • Progesterone,
  • Free testosterone, and
  • DHEA.

Testing should be 7 days after ovulation, which is usually days 19-21 for most women.

What NOT to eat for Hashi’s

Keep in mind that these are listed in order of toxicity and the top 3 (sugar, gluten and seed oils) should be avoided by everyone, not just those with Hashi’s!

  • Sugar (particularly fructose): Seriously, what are the reasons for eating this? It disrupts hormones, leads to weight gain, is linked with many chronic diseases, makes boys grow boobs (I’m not even joking – high levels of fructose in the diet increase the hormone aromatase which decreases testosterone and increases estrogen)! If anyone tells you that sugar is natural and that we have to eat it, tell ‘em their dreaming!
  • Gluten: Basically, our bodies aren’t meant to deal with gluten. Even if you’re not gluten intolerant or Coeliac, I challenge you to give up gluten for 30 days and see how good you feel!
  • Industrial Seed Oils: Become rancid very easily causing inflammation within the body. Did you know that the added ‘healthy’ Vitamin E in that bottle of vegetable oil you have is just a preservative to stop the oil going rancid at room temperature?! Definitely avoid any oil or margarine that has the heart foundation tick or the slogan ‘Contains Vitamin E’; it’s a farce!
  • Soy Products: Contain phytoestrogens which disrupt hormonal balance and induce estrogen dominance (think cellulite, weight gain around the thighs, menstrual disturbances and even an increased risk of breast cancer)! Not to mention the fact that most soy products are genetically modified but I’ll save that argument for a later date!
  • Chickpeas and Legumes: Contain both phytates and lectins which make them very difficult to digest but also leach micronutrients from the gut so they can’t be properly absorbed by the body.
  • White Potatoes: Contains a high concentration of lectins which damage the gut, leach valuable micronutrients from the body and issue an autoimmune response (given the body does not have the tools to deal with them). This process worsens a pre-existing autoimmune condition.
  • Other Sweeteners (regardless of calorie content): Although a sweetener may contain negligible calories, the sweetness on our tongue still issues an insulin spike which negatively impacts blood glucose levels and leaves us with sweet, carby cravings!
  • High FODMAP foods: Although this may not effect everybody with Hashi’s, consuming high FODMAP foods (such as onion and garlic) can actually promote an autoimmune flare up (ie temporary worsening of symptoms).
  • Processed foods with ingredients you can’t pronounce: Chances are, if you don’t know what fructo-oligosaccharides are, your body and digestive system won’t know either, leading to ahem, flatulence and funny poos…
  • High Casein Products: Most people with Hashi’s have a casein intolerance and consuming high casein foods (think cottage cheese and ricotta) can lead to digestive problems and a very sore tum!

Toxic Food

So what do I eat..?
I follow a mostly paleo diet; lots of good (saturated) fats, organic grass fed meat/eggs and a heap of veggies, with the exception of some occasional local, organic cheese. I have tried the autoimmune paleo protocol (an extension of the normal paleo diet that also excludes nuts, nightshades and eggs) and found that nuts do not suit me but I’m fine with capsicum, tomato and chilli.

Given I also suffer from Addison’s disease, I tend to follow a low-carb, almost ketogenic, paleo diet to keep my hypoglycaemia under control.

As far as fruit goes, I do indulge in the occasional berry, but now that I have completely quit all sugar (and sweetness from other sources), fruit tastes far too sweet for me and I much prefer sweet veggies, like a ripe, juicy red capsicum or a high cacao percentage chocolate. Although this may seem quite extreme to the naked eye, this is the best I’ve felt my whole life.

As sufferers know, maintaining your weight with Hashi’s is really difficult, but by eating this way, I find I’m satisfied between meals, have no cravings and can eat as much as I feel like without gaining weight.