Seven things you can do about raised thyroid antibodies when you live with Hashimoto’s thyroiditis

Did you know that every cell, tissue and organ in your body has thyroid receptors? So, when your thyroid is not firing properly, it is little wonder that you can feel bleurgh in a dozen different ways at once, from sleepy mornings to a sluggish gut and a foggy brain.

If you have just been diagnosed with an autoimmune thyroid condition known as Hashimoto’s thyroiditis or you have discovered you have raised thyroid antibodies through a blood test, and you want to know what you can do about it from a nutrition and diet lifestyle, then this post is for you. I am going to walk you through seven practical, evidence-based steps that can help you feel better from the inside out.

This is the second post in a two-part blog series. If you have landed here first and you are still wondering whether Hashimoto’s could explain your symptoms, start with my companion post on recognising the hidden thyroid problem, then come back here for the practical plan.

Get our lovely Healthy Bites newsletter!

Each week, you’ll get an amazing recipe, a useful health tip, and an ingredient to jazz up your shopping basket!

A quick recap of what Hashimoto’s is

Hashimoto’s thyroiditis, often shortened to Hashi’s, is an autoimmune thyroid condition. That simply means the immune system has started attacking your own tissue, and in this case the target is your thyroid gland. Over time, this immune attack inflames the thyroid and reduces its ability to make enough thyroid hormone, which is why the symptoms overlap so much with those of an underactive thyroid: fatigue, brain fog, easy weight gain, feeling cold, low mood, dry skin and hair, sluggish digestion and disrupted periods.

You can measure the immune activity through two antibody blood tests: thyroid peroxidase antibodies and thyroglobulin antibodies. When one or both antibodies are raised, autoimmune thyroid activity is usually present. Standard thyroid medication such as levothyroxine tops up the missing thyroid hormone if the thyroid is also underactive, and it does a good job of that.

However, this medication does not calm the immune attack itself, so you need to take the ‘belt and braces’ approach and work on your nutrition alongside. The nutrition and gut health aspect is particularly vital for people with Hashimoto’s thyroiditis who are not prescribed any medication because they are still producing enough thyroid hormone, and are therefore expected to live with their symptoms. This is the gap that good nutrition and habit changes can really help to fill.

Seven ways nutrition can help your thyroid

If you have raised thyroid antibodies and you are looking for ways to feel better, here are seven things worth trying. Introduce them steadily one at a time, rather than all at once, so you can notice what helps you.

1. Steady your blood sugar at every meal

When your thyroid is underactive, your body finds it harder to handle glucose, which tips you into a rollercoaster of sugar highs and blood sugar crashes. You know the feeling: ravenous and hangry before meals, then a heavy energy slump shortly after eating. Those blood sugar swings are stressful for the body and can exacerbate your thyroid symptoms.

The foundations of good blood sugar balance are to build every meal around protein, add healthy fats and plenty of vegetables, and go easy on refined carbohydrates and sugar. A substantial breakfast such as eggs and feta or yoghurt with nuts, seeds and berries, rather than toast or cereal on the run, can steady your whole day and bolster your energy and vitality.

2. Give a gluten-free trial a proper go

This is one of the most talked-about steps to take when you have raised antibodies and are you are feeling exhausted, foggy and bloated. Coeliac disease and Hashimoto’s share some genetic risk factors and they sometimes occur together, so it is always worth ruling out coeliac disease first with your GP. This is ideally done before you cut gluten out, because the test may not be accurate once you have already stopped eating it.

It is not just coeliac disease. A 2023 analysis found that going gluten-free was linked to a fall in thyroid peroxidase antibodies in people with autoimmune thyroiditis, so it is worth giving a gluten-free diet a proper go for three months to see if you feel any better, even if you are negative for coeliac disease. At NatureDoc clinic, many women who consult with us tell us they feel noticeably less sluggish and less bloated within a few weeks of reducing wheat, rye, barley and conventional oats.

3. Try selenium

If there is one supplement with real weight of evidence behind it for Hashimoto’s, it is the mighty mineral selenium. Selenium is essential for both making your thyroid hormones and protecting your thyroid gland from inflammation. Since our soils can be depleted in selenium, many women fall short of this mineral, which has important antioxidant properties.

A large 2024 review found that selenium supplementation significantly lowered thyroid peroxidase antibodies, and helped nudge TSH in the right direction in people not yet on thyroid medication.

You will find selenium in Brazil nuts, and just two or three a day can be enough, as well as in eggs, fish and pulses. If you choose to supplement, a common approach is around 100 to 200 micrograms a day for 3-4 months, and it is best to do this with the guidance of a practitioner rather than taking it indefinitely, because selenium is one of those nutrients where more is not better.

4. Check your iron and ferritin, and top them up if they are low

Low iron stores and Hashimoto’s go hand in hand, partly because active autoimmunity and low stomach acid both make iron harder to absorb. Since iron is one of the building blocks your thyroid needs, running low in iron can drag your energy down further and get in the way of your body using thyroid hormone effectively.

Ask for both iron and ferritin, your iron stores, to be tested alongside your antibodies. Many women feel much more energetic once ferritin is comfortably within range rather than bumping along the bottom. Iron-rich foods such as red meat, liver, pulses and dark leafy greens, paired with a little vitamin C to boost absorption, are the foundation for healthy iron levels. Top up with an iron supplement if your ferritin (a blood marker for iron stores) is below 70 µg/L.

5. Optimise your vitamin D

Just as every cell has a thyroid receptor, almost every cell has a vitamin D receptor too, and vitamin D is a key regulator of the immune system. Low vitamin D is common in people with Hashimoto’s, and when researchers gathered together the randomised trials, they found that supplementing vitamin D helped lower thyroid antibodies, especially when taken for more than three months.

Here in the UK, where sunshine is in short supply for much of the year, a daily vitamin D supplement through the darker months is sensible for most adults. It is worth testing your level and working towards a comfortably healthy range of around 100 nmol/L.

6. Try vitamin B1

Vitamin B1, or thiamine, helps your cells turn food into usable energy, so it acts a little like the spark plugs that get your engine firing each morning. A small case report described marked relief from the deep fatigue of Hashimoto’s with thiamine.

Although thiamine is generally considered safe, higher doses are best taken with practitioner guidance. It is often depleted, especially in people who drink alcohol regularly or follow a grain-free diet. Thiamine is found naturally in pork products, fish, beans, pulses, sunflower seeds and whole grains such as wholemeal flour.

An unexpected clue that your thiamine might be low is reacting strongly to insect bites or feeling seasick or car sick easily. If bone-deep exhaustion and brain fog are your worst symptoms, this is an inexpensive and low-risk vitamin to explore with your practitioner.

7. Look after your gut

Many women experience gut symptoms in the lead up to their diagnosis of Hashimoto’s, such as reflux, slow digestion, bloating and constipation. It is also thought that out-of-sync gut function and the gut microbiome can influence the immune system to skew toward autoimmunity. And one of the first steps in your Hashimoto’s journey should be working on your gut health as not only can this help to reduce your gastric symptoms, it can in turn help with the other symptoms associated with an autoimmune thyroid such as thinning hair, foggy brain and fatigue, as you will be digesting and absorbing your food and nutrients more efficiently.

Many women with raised antibodies have a raised stomach acid pH above 2.6 (too alkaline), which may show up as reflux, heartburn, burping and a feeling of slowly digesting food that sits heavily in the upper gut. The stomach is where you absorb much of your iron, vitamin B12, calcium, magnesium and zinc, so this is why you need to optimise the stomach’s digestive juices.

Chewing bitter leaves such as rocket, chicory and endive before a meal, and adding a little lemon juice or apple cider vinegar to salad dressings (or dilute these with water and sip through a straw), can gently support your own stomach acid capabilities and enzymes. Eat slowly, chew properly and give your digestion the calm it needs to do its job.

Supporting the wider gut health, including working on the balance of your friendly bacteria in the gut microbiome will help to dial down the inflammation associated with the autoimmunity. So prioritise consuming yoghurt and kefir, as well as fermented foods such as sauerkraut and kimchi which can all be invaluable. A gut microbiome and gut function test can help pinpoint whether you have any specific missing microbes that need bolstering.

The integrity of the gut lining and healing any gut permeability (also known as leaky gut) is also important to get your symptoms under control. Start by prioritising bone broths, omega 3 rich oily fish as well as grass-fed butter and ghee. Consulting with our clinical team can point you to supplements that can further help with improving gut lining integrity.

Constipation is one of the most stubborn and annoying symptoms of Hashimoto’s, and a sluggish bowel also means you are more likely to retain more toxins in the body as well as excess oestrogen.If contsipation and incomplete evacuation is the bane of yorr life, start the morning with a cup of warm water and fresh lemon juice and a few minutes of slow, deep belly breathing to wake your digestion up.

Build in plenty of fibre and fluid across the day, and if things stay sluggish, ground flaxseeds, prunes and two kiwi fruits eaten with the skin on can all help to keep everything moving. Magnesium oxide or magnesium citrate taken in the evening is another natural support that many women find helpful for keeping their bowels regular.

Round Up

Raised thyroid antibodies can feel frightening when you first see them in your blood test results, but they are also vital information, and there is a great deal you can do to support yourself.

If you have been back and forth to your GP with thyroid symptoms and you are still feeling rotten, please do not resign yourself to living like this. Our NatureDoc practitioners who specialise in thyroid health can support you with tailored nutrition and supplement guidance, organise private tests to dig deeper into your thyroid, gut and nutrient status, and build a personalised plan around how you feel. Come and work with us, and let us help you build yourself back up from the inside out.

Ask me what supplements can help… or anything else!

NB. This is an update of a post from 29 July 2022.