If your thyroid is underactive and you are not producing enough thyroid hormone, it can harm your overall health. Nutrient supplementation can help improve thyroid function and enhance the effects of your thyroid treatments. The best way to approach hypothyroidism is to address the underlying cause with vitamins and minerals.
Naturopathic Medicine uses an evidence-based approach to health. Part of that approach is using dietary supplementation as a component of thyroid treatment. Many times patients will have a TSH that is between 2.5 and 4.5 and will be told they are fine. This in fact can be subclinical hypothyroidism. In Western Medicine patients are usually told not to worry about this and to come back in a year for repeat testing. However many patients are already feeling the effects of thyroid issues before it is out of range. It is important to note that lab ranges will vary from region to region and lab to lab and they are based on the median range of a sick population. Optimal values are often much different than lab ranges.
We will run further labs to see how your actual thyroid hormones are doing like FT3 and FT4. We can also run micronutrient panels like an Urinary OAT panel. We assess digestion and other underlying factors and then supplement with nutrients needed, not only to make thyroid hormones but also to act as cofactors that aid in the conversion of T4 to T3 in the body. T3 is the more active form of Thyroid hormone and when patients are low in nutrients like B6, B12, Magnesium, Selenium, and Zinc this conversion will be hindered. This Is why we will work on root cause issues even if you aren’t diagnosed with frank hypothyroidism. We are always working to optimize functions in the body.
This article will guide you through some well-known supplements, as well as lesser-known ones, to give you an idea of how nutrient supplementation serves as a solution in a holistic hypothyroid treatment plan.
Hypothyroidism is when the thyroid does not produce enough thyroid hormone, causing it to slow down and become underactive. Since the thyroid regulates metabolism, it affects nearly every system in the body. Over time, the slow metabolism will begin to cause health complications. Symptoms of hypothyroidism may include:
Standard western treatment for hypothyroidism usually includes medication to replace the lack of thyroid hormones. Levothyroxine is one medication that is commonly used in the treatment of hypothyroidism. If hypothyroidism is left untreated, it can lead to serious health complications. Otherwise, it is a very manageable disease.
Licensed Naturopathic Doctors (NDs) will approach hypothyroidism by addressing the root cause of why the thyroid is underactive in the first place. NDs use a combination of medication, dietary and other lifestyle changes, herbs, and nutritional supplements that are personalized for you.
Lifestyle factors, such as nutrition and dietary supplementation are typical first-line therapies when it comes to hypothyroidism. Addressing nutrient needs is an effective way to complement hypothyroid treatments that can help address the root causes of your condition and help manage thyroid function. Once the underlying cause of your condition has been identified, the right supplements can be very supportive for your thyroid function. Supplements that are commonly used to optimize thyroid function for hypothyroidism include iodine, selenium, zinc, iron, and vitamin D.
Iodine is critical to thyroid hormone production. Along with the amino acid and tyrosine, Iodine is a main building block of the thyroid hormones T4 (thyroxine) and T3 (triiodothyronine). When there is not enough iodine present, there will be a decrease in the release of T4 and T3. T3 and T4 are essential for normal metabolism. Without enough iodine, these thyroid hormones are not synthesized. Metabolism will slow, and potentially a myriad of health complications will be the result.
According to the National Institutes of Health (NIH), Iodine deficiency is the most common cause of hypothyroidism. If your underactive thyroid is caused by an iodine deficiency, it might be appropriate to focus on foods high in iodine, like seafood, sea vegetables (kelp, nori), sea salt, and animal protein. Additional supplementation may be warranted, based on the root cause of your condition. The Recommended Dietary Allowance (RDA) of iodine for adult men and women is 150 μg/day. But dosing for you may be different depending on your iodine levels.
If iodine deficiency is not the cause of your thyroid condition, supplementing will not help, and may make your disease worse. Studies show that too much iodine is dangerous and could cause hyperthyroidism– and overactive thyroid. Too much iodine can also shut down your thyroid and if someone has Hashimoto’s, it can make it worse. This is one reason it is important to work with a health professional before treating yourself with supplements. Work with your ND to figure out if iodine supplementation is appropriate for you.
Selenium is responsible for the production and regulation of thyroid hormones. The thyroid stores selenium within the gland itself for this purpose. Studies show a direct correlation between selenium deficiency and thyroid disease. Maintaining a healthy level of selenium in the thyroid keeps it functioning normally and prevents hypothyroidism.
One of the roles selenium plays is that it supports thyroid enzyme functions for hormone regulation. Selenium creates 2 enzymes that are responsible for ensuring thyroid hormones aren’t too high or too low. These enzymes are called seleno-de-iodinases and glutathione peroxidase.
If there isn’t enough selenium to make these enzymes, hormone levels become dysregulated, which can lead to health complications. Selenium supplementation may be warranted in this situation. However, too much selenium can be toxic, and in extreme doses, it can be fatal. This is why it is crucial to get the support you need when deciding on supplementation. The typical dosing for selenium in hypothyroid patients is 100 to 200 mcg. Levels over 200 mcg per day can cause Selenosis. Work with your ND to test your selenium levels and to find out if additional selenium supplementation is appropriate for you, and if so, how much.
Selenium also provides antioxidant function for the thyroid, It reduces oxidative stress and prevents free radicals from damaging the gland. According to research, thyroid health and function were restored in patients with hyperthyroidism after supplementing with selenium.
Zinc is important for many body functions, including immunity, normal growth & development, and hormone function. In the thyroid, zinc is used to produce thyroid hormones. Without zinc, the production of T3, T4, and thyroid-stimulating hormone (TSH) is hampered.
According to NIH studies, zinc helps regulate the activity of deiodinase enzymes (enzymes necessary for the creation of T3), and the formation of thyrotropin-releasing hormone (TRH), and thyroid-stimulating hormone (TSH) by acting as a catalyst. Zinc also plays a key role in controlling the structures of essential transcription factors (proteins that read and interpret genetic information, and controls the rate of the process of copying DNA to messenger RNA) involved in the synthesis of thyroid hormones.
Studies show that hypothyroidism can be caused by a zinc deficiency. At the same time, thyroid hormones are necessary for the absorption of zinc. So as you can see, the relationship between zinc and the thyroid is complex.
In hypothyroidism, increasing zinc intake can help improve thyroid function. The RDA for zinc is between 8-11 mg, but you may need more if you are deficient. If you have hypothyroidism, it’s important to work with your ND to determine if zinc is playing a role in your disease and to discuss how supplementation may or may not benefit you. Your ND may recommend supplementation, and/or a therapeutic diet with zinc-rich foods, such as lean animal protein, eggs, nuts, seeds, and leafy greens.
As with other minerals like selenium, zinc, and iodine, iron also plays a valuable role in thyroid hormone production. The body uses iron to convert the thyroid hormone T4 to active T3. Without iron, this conversion is interrupted, causing low thyroid hormone levels. Research shows that iron deficiency can cause hypothyroidism.
Similarly, research also shows that hypothyroidism causes iron deficiency. One way this happens is that red blood cell production is hampered by an underactive thyroid. When thyroid hormone levels are low, bone marrow activity (where red blood cells are formed) gets suppressed. This lowers the production of red blood cells, which can cause iron deficiency and anemia.
Another way hypothyroidism can cause iron deficiency is by its effect on the gut. According to Dr. Jolene Brighten, a renowned hormone expert, T3 is required for a healthy gut. T3 allows for adequate production of hydrochloric acid (HCl), or stomach acid, which breaks down nutrients from food to ready it for absorption. If T3 is low, stomach acid production is hampered. Without stomach acid, the gut is unable to absorb nutrients, such as iron from foods we eat.
Studies show that supplementing with iron in hypothyroidism corrects anemia and iron deficiency and leads to improved thyroid health. It is now recommended that patients with thyroid disease be screened for iron deficiency and anemia and that treatment plans include nutrition and supplementation to address iron levels.
Dosage amounts may vary, depending on your iron stores and blood levels. The RDA for iron is between 8-18mg, but as always, your ND can help you do the right type of testing for iron levels, iron stores (ferritin), and thyroid hormones to look for the connections and create a customized treatment plan for you.
Nearly every process of the body requires vitamin D to function properly. Vitamin D is a nutrient, a hormone, and an immune system regulator. It is critical for so many body processes, such as:
Vitamin D is required for most organ and gland functions, including the thyroid. Research has shown the association between Vitamin D deficiency and thyroid disease, including hypothyroidism and Hashimotos. There is a proven link between vitamin D deficiency and high levels of Thyroid-stimulating hormone (TSH). TSH is the hormone that tells the thyroid to produce T4 and T3, which are required for controlling metabolism. Without TSH, the thyroid won’t produce T3 & T4, which are needed to convert food into energy. Research shows that when patients with hypothyroidism are supplemented with vitamin D, their TSH levels improve.
Vitamin D is also a key player in immune function. Nearly all autoimmune conditions have been linked to low vitamin D, including Hashimotos. NIH Research showed that supplementation with vitamin D in patients with Hashimotos has significantly improved immune function.
When exposed to the sun’s rays, the body naturally creates vitamin D. If you have hypothyroidism, you may benefit from 30 minutes of direct sunlight daily, without sunblock. (sunblock blocks the beneficial sun rays from penetrating to make Vitamin D). We recommend doing this outside of the hours 10-2 pm so you don’t burn. It is important though to get sun when your shadow is shorter than you for the sun to be strong enough to create Vitamin D.
Other ways to supplement with vitamin D are through food, like fatty fish, eggs, cheese, dairy and fortified foods, and dietary supplements. The recommended dose can be anywhere from 2000-5000 IU/day. Get your baseline vitamin D levels tested to determine if you need supplementation. Based on the results, you and your ND on the best plan for how vitamin D fits into your treatment plan.
Ashwagandha is an herb known for its calming and rejuvenating properties. It is commonly used in traditional medicine as an adaptogen. Adaptogens help the body normalize when exposed to stressors. Scientific data supports ashwagandha to be a potent regenerative tonic, having demonstrated the following qualities:
There has been plenty of research on the effects of Ashwagandha for its efficacy in treating many diseases, including hypothyroidism. Studies on its effects on endocrine health show the remarkable effects on:
In clinical trials, after just 8 weeks of use, ashwagandha significantly improved levels of TSH and T4 levels compared to a placebo. TSH levels were normalized in the ashwagandha users.
Clinical studies show that the stabilizing effects of ashwagandha have a huge impact on keeping stress hormones down in anxious patients with hypothyroidism. This is important because stress can disrupt thyroid hormone regulation.
Another way Ashwagandha helps with thyroid function is its effect on oxidative stress. The antioxidant properties of the herb help prevent oxidative stress, creating an environment conducive to thyroid hormone synthesis.
Ashwagandha has a long history for its adaptogenic properties. Growing evidence supports its usefulness in an integrative treatment plan for managing hypothyroidism. As always, your ND will be able to assess if Ashwagandha is right for you.
Myo-inositol is the supplement form of the carbocyclic sugar, Inositol. Inositol is a type of sugar that is naturally produced by the body that helps with cell structure. The body needs inositol for healthy cell growth and function, acting as a “second messenger” of the brain by enhancing hormonal signaling. Inositol has been studied for its usefulness in treating various metabolic and hormonal disorders, and mental health disorders, such as:
Emerging research supports the use of Myo-inositol supplementation for restoring thyroid health in subclinical hypothyroidism and autoimmune thyroid disease. Myo-inositol helps keep thyroid hormones balanced which helps in thyroid hormone formation. It has the most beneficial effect when it’s used in combination with selenium supplementation. In clinical studies, a combination of Myo-inositol and selenium was given to patients with both Hashimotos and subclinical hypothyroidism. As a result, TSH levels improved to the point of normal levels, essentially restoring thyroid health.
Not only are TSH levels restored with Myo-inositol supplementation, but studies also showed a decrease in thyroid antibodies in those with Hashimotos. Symptoms like anxiety, depression, and mood swings also improved.
As stated, combining Myo-inositol and selenium seems to be the most therapeutic for hypothyroidism. Work with your ND to come up with a plan for implementing supplementation into your treatment protocol.
Tyrosine is one of the most important amino acids for thyroid health. Along with iodine, it is considered one of the main building blocks of the thyroid hormones and is responsible for normal thyroid hormone metabolism.
Tyrosine is naturally produced by the body, while iodine must be consumed. Tyrosine and iodine link up to create the thyroid hormones T3 and T4 without tyrosine and iodine, T3 and T4 cannot be created, causing an underfunctioning thyroid.
L-tyrosine is a non-essential amino acid, meaning the body can make it on its own, But it can be increased through food sources like seafood, fowl, nuts & seeds, avocado, and dairy products. Dietary supplementation is another way to get l-tyrosine if necessary. While research is limited, tyrosine supplementation has been shown to decrease TSH levels to near-normal levels.
L-tyrosine is also effective in reducing the effects of stress, and improving depression and mental clarity, all of which can accompany hypothyroidism.
Probiotics are bacteria and yeasts (microbes) that live within our body and have beneficial health effects, especially in the digestive system. Probiotic supplements add to the population of beneficial microbes in your gut microbiome.
The health of the gut microbiome affects all systems of the body, including the thyroid. The gut and brain are connected through the gut-brain axis- a two-way communication system between the gut and your central nervous system. When the gut is in poor health, it can’t send the right messages to the brain to do the many jobs it’s responsible for, like signaling for hormone synthesis and regulation, including the thyroid hormones. According to NIH, not only is there a gut-brain axis, but there is a gut-thyroid axis. The state of your digestive health will also affect your thyroid health.
Studies also show a link between intestinal bacterial overgrowth and hypothyroidism. Probiotic supplementation can be used to rebalance the quality and diversity of the microbes in our microbiome. Research shows promise for restoring the balance of healthy microbes and healing the gut lining to help manage hypothyroidism. With a healthy gut, your body will be able to absorb essential nutrients and thyroid medications.
There are tests, like GI mapping that can be done to assess the state of your gut microbiome to help you and your ND determine if rebalancing and restoring is necessary.
Since hypothyroidism can have many different underlying causes, like nutrient deficiencies, using dietary supplements as part of an integrative treatment protocol makes sense. Combining the right supplements can maximize their efficacy and optimize thyroid health.
Emerging research suggests that when certain nutrients are taken together, they have a more profound impact on health than when taken alone. Supplements that have been shown to have a synergistic effect on thyroid health include:
Absorption of dietary supplements may also be enhanced through alternative delivery methods, such as a skin patch or liposomal preparation:
Research supports the promise these delivery methods make for ease, efficacy, and versatility for improved patient outcomes. Both patches and liposomal preps make it easier for the body to absorb the nutrients through the skin rather than having to go through the digestive process to be absorbed that way. These methods may be especially useful for patients who are working on restoring poor gut health.
Certain supplement combinations work synergistically to enhance medication absorption, But they can also interfere with medication. Supplementation with hypothyroidism must be done right. The right supplements at the right time and in the proper ratios are important for the best results. Utilizing different delivery methods of supplements can also enhance efficacy. Work with your ND to get the right supplement regimen for you. 
When it comes to supplement use while on thyroid medication, it’s important to monitor and adjust intake accordingly. Important things to consider when monitoring a thyroid treatment plan include:
Keeping a close partnership with your ND is the best way to maintain good thyroid health as life progresses and adjustments are necessary in your treatment plan. They will also help you determine the best quality ingredients you can, especially when it comes to thyroid health.
Not all supplements are created equal. Not all forms of vitamins or minerals may be appropriate for consumption, or may not be absorbed easily. Some manufacturers use additives or inactive ingredients that may be harmful, or at least not helpful for your condition.
When embarking on supplement use, ensuring the company that makes your supplements uses quality ingredients, the right type of nutrients, and the right ratios is crucial. Again, if you aren’t sure how to do this, your ND will be informed of the supplements with the highest standards and quality.
A holistic, patient-centered approach is key for supporting thyroid health. Supplements are one component of an integrative approach, along with diet, lifestyle, and mindfulness practices. Sleep, stress management, and exercise are also important factors in a well-rounded plan.
Finding a healthcare provider to collaborate and partner with to tailor and personalize your plan will ensure the most success in your treatment. He or she can work with you to figure out the underlying cause of your thyroid disease, including doing nutrient testing, gut health testing, and determining lifestyle factors that may be contributing to your state of health. By looking at all factors, a holistic, personalized plan will address all of the areas that are contributing to your hypothyroidism and lead you on a path to healing.
If you’re interested in looking for one, you can start through our 10-minute free consultation.
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