As a dietitian, I’ve been treating people with autoimmune conditions, including Hashimoto’s disease, for years.
Hashimoto’s is the most common type of hypothyroidism in the United States. It’s an autoimmune disease that damages the thyroid, a gland that releases hormones that control metabolism, growth, and a number of other bodily functions.
Through my patients, I knew how difficult Hashimoto’s disease could be to diagnose, treat, and manage.
However, I had no idea just how much this disease affects physical and mental health until I was diagnosed myself.
Here’s my story.
I started to feel off in the summer of 2019. I couldn’t sleep, was so tired during the day that I could barely finish my work, and felt hungover every morning even though I wasn’t drinking alcohol at the time.
I was also experiencing strange heart flutters, anxiety, brain fog, difficulty concentrating, extreme cold intolerance, joint pain, air hunger (a feeling of shortness of breath), and many other vague symptoms.
Over the next several months, I visited a number of specialists, including a cardiologist, pulmonologist, and rheumatologist. Every test came back normal aside from my white blood cell count, which was low. I was also slightly anemic.
Some people with Hashimoto’s disease have normal or only borderline low thyroid values in lab results. That’s because the thyroid destruction that happens during Hashimoto’s disease is intermittent.
Some of the doctors I saw were dismissive and chalked my symptoms up to stress and anxiety, which — by the way — is extremely common for people with Hashimoto’s.
After hearing several doctors tell me that everything was normal, I thought I was losing my mind. I started to question myself.
Were these symptoms seriously caused by stress and anxiety? No. I knew my body, and I knew that something was wrong.
As a last ditch effort, I made an appointment with an infectious disease doctor because I live on the East End of Long Island, where ticks are abundant. I thought my symptoms could be due to Lyme disease.
This doctor ran bloodwork, including a thyroid panel. As a dietitian, I like to review my own results as soon as they’re available. When I saw that my T3 was low, I called an endocrinologist with whom I work closely and made an appointment.
She was the one who finally diagnosed me with Hashimoto’s disease after an ultrasound of my thyroid and bloodwork that showed low levels of T3, a thyroid hormone, and elevated thyroid peroxidase (TPO) antibodies.
Getting a diagnosis took me about 7 months, which is very common for people with Hashimoto’s disease.
I was so relieved to get a diagnosis after months of being told that my symptoms were basically all in my head. But I was also worried about my health and resentful about the diagnosis.
Aside from having Raynaud’s syndrome, which reduces blood flow to the fingers and toes, and exercise-induced asthma as a kid, I was a healthy person with limitless energy. I took very good care of my health, exercised, didn’t smoke, and grew my own food.
However, I knew far too well that autoimmune conditions, as well as serious medical conditions in general, can affect anyone — even people who are physically healthy.
My endocrinologist thinks that, in my case, a viral infection triggered my Hashimoto’s disease. She started me on Armour Thyroid, a natural thyroid hormone replacement medication.
Although researchers are still unsure about the exact cause of Hashimoto’s, multiple factors, including genetic vulnerability and environmental triggers, are thought to be involved.
After starting on Armour, I thought I would start feeling better within a few weeks. Yet, although some of my symptoms like severe cold intolerance and joint pain improved, I was still feeling awful after about a month or so on the same dose.
Symptoms persisting even with medication is also prevalent among those with Hashimoto’s.
Although some people respond well to medication and start feeling like their old selves, others continue experiencing significant symptoms that affect their quality of life even when their thyroid function is considered normal.
In fact, many endocrinologists and researchers recognize that symptoms alone aren’t usually used to assess the effectiveness of treatment — laboratory values are.
Therefore, medications are prescribed and adjusted based on these values, including thyroid-stimulating hormone (TSH).
Thankfully, my doctor expressed interest in how I was feeling and whether my symptoms were being controlled. She was always open to trying new medications and doses until we found a treatment that made me feel better.
When I told her that I was still experiencing significant symptoms, she increased my dosage. After another few weeks, I finally started to feel better and get my energy back.
After starting the initial dose of medication, I also tried dietary and supplement protocols that I had previously encouraged my patients with Hashimoto’s disease to implement. These regimens had worked wonders for some of them — but not all.
Like anything else I recommend to my patients, these supplements and protocols are based on scientific research.
It’s important to work with a dietitian when making changes to your diet or supplement protocol. It’s just as necessary to let your healthcare provider know if you start taking supplements.
Experimenting with diets
I followed the protocol strictly, but it didn’t significantly improve my symptoms.
To be honest, I already ate plant-centric, paleo-style meals for many years before I was diagnosed. Not only did this eating pattern help manage my Raynaud’s syndrome symptoms, but it also made me feel my best.
Although I added back certain grains, some cheeses, and legumes, which are eliminated in AIP, I continued to avoid gluten and returned to my normal diet, which consists of plenty of veggies, fruits, healthy fats, and protein sources like fish, eggs, and chicken.
As a gluten-free diet has been
Experimenting with supplements
For supplements, I again turned to research to find the most evidence-based approach. Since I had been treating people with Hashimoto’s, I knew that anti-inflammatory supplements like fish oil and certain nutrients like zinc, selenium, and magnesium may be helpful.
I also knew that people with Hashimoto’s are more likely to be deficient in certain nutrients like vitamins B12 and D.
I was already taking a vitamin D/K2 supplement, B complex vitamin, and magnesium glycinate, so I added in selenium, zinc, and high dose fish oil.
Like the dietary changes, these supplements didn’t make me feel significantly better.
However, certain beneficial changes can’t be determined solely by how you feel. In general, taking certain supplements and following an anti-inflammatory, nutrient-dense diet may improve thyroid function, inflammation, and overall health.
Being treated with medication, taking certain supplements, and adhering to a nutrient-dense diet did help me feel better over time. Remember that managing an autoimmune disease is a marathon, not a sprint.
Explore more dietary and supplement tips for Hashimoto’s disease in my comprehensive, science-based article here.
Finding the right medication and dosage, following a nutritious diet, and taking supplements have significantly improved my quality of life.
Plus, giving my body time to recover was key.
When I was first diagnosed, I didn’t have the energy to exercise or do my favorite hobbies like hiking and gardening, so I let myself rest.
A lot of guilt and frustration accompanies feeling too unwell to do things that you love, being unable to exercise, and struggling to fully engage in life, which can take a toll on your relationships with friends and family.
I felt lazy and like I needed to push myself to do things. However, I quickly realized that letting myself rest when I needed to and showing myself compassion was much more important for my health.
I took it easy until I started to feel better. Although I’m mostly back to my normal energy levels and don’t experience significant symptoms that often, I still have off days when I know I need to let myself rest, and that’s OK.
I know what makes me feel worse — drinking alcohol, not getting enough sleep, and being overly stimulated or stressed. This is also true for many of my patients who have Hashimoto’s.
And here’s what makes me and most of my patients feel better:
- spending time outside
- stretching and restorative activities like yoga
- eating lots of anti-inflammatory foods, especially veggies
- following a nutrient-dense diet
- taking hot Epsom salt baths
- staying hydrated
- avoiding caffeine and alcohol as much as possible
- engaging in stress-reducing activities like gardening and hiking
- getting plenty of sleep
- taking certain supplements
- staying active
- letting myself rest when I’m not feeling well
Generally, following a nutritious, anti-inflammatory diet, reducing stress, and leading a healthy lifestyle are likely to reduce certain Hashimoto’s symptoms.
However, it’s important to note that no specific diet is currently recommended to treat Hashimoto’s disease. Just because something works for one person doesn’t mean it works for others, which is one reason why self-experimentation is so important.
I’m lucky that my endocrinologist is a wonderful doctor and personal friend with whom I feel comfortable asking questions and talking openly about my health.
For many people, this isn’t the case.
I’ve had patients who’ve been dismissed by numerous doctors, misdiagnosed, and not properly treated. Unfortunately, this is very common. In fact, up to
As mentioned above, it’s not uncommon for people to see multiple doctors before being diagnosed. Even after diagnosis, many people aren’t comfortable telling their doctor that their medication isn’t effective and that they’re still experiencing symptoms.
It may take your doctor several attempts to get the dosing and medication right before you start feeling better. Make sure you choose a specialist with whom you feel comfortable discussing your symptoms and treatment options.
You have the right to ask questions about your health, and your doctor should take your symptoms seriously. There are so many excellent doctors out there. If you’re uncomfortable with your provider, find another one.
Some people find success by working only with an endocrinologist, others feel better after working with a dietitian to overhaul their diet and lifestyle, and still others prefer to see a functional medicine practitioner. Remember that you always have options. Use them.
Moreover, try to work with a dietitian who specializes in hypothyroidism or autoimmune diseases if you decide to experiment with diet and supplements. These experts can help you determine the best regimen for your needs.
You need to be your own health advocate.
This is important for everyone with a medical condition to keep in mind. You know your body best. If you think there’s something wrong, keep digging.
Don’t give up. Find a healthcare provider who’s thorough and listens to you.
I know that going to numerous doctor’s appointments can be frustrating and time-consuming, as can trying various medications, dietary patterns, and supplements. Yet, I also know that these things are essential to improving your health and managing your symptoms.
Lastly, remember that you’re not alone. Get help when you need it from friends, family, and healthcare providers.
We’re all here to listen and support you on your path to feeling better.
Jillian Kubala is a Registered Dietitian based in Westhampton, NY. Jillian holds a master’s degree in nutrition from the Stony Brook University School of Medicine, as well as an undergraduate degree in nutrition science. Aside from writing for Healthline Nutrition, she runs a private practice based on the East End of Long Island, NY, where she helps her clients achieve optimal wellness through nutritional and lifestyle changes. Jillian practices what she preaches, spending her free time tending to her small farm, which includes vegetable and flower gardens and a flock of chickens. Reach out to her through her website or on Instagram.