Healing Hashimoto's thyroid disease can be complex. Hashimoto’s thyroiditis or hypothyroidism is a condition where your immune system attacks your thyroid, a small (but powerful) gland at the base of your neck.
I’m Dr. Jolene Brighten and this is a true story that might hit close to home if you or a loved one have suffered from Hashimoto’s thyroiditis.
The story starts in the same way so many patient stories begin…
Maddie’s* doctor looked at her labs and told her, “I don’t think your thyroid is your problem. Instead, I’d like to refer you to a psychiatrist because I think your problems are largely due to stress.”
It’s true, Maddie was stressed.
And if you looked at her chart without hearing her story, you might also think it's “all in her head.”
But Maddie knew her fatigue, hair loss, anxiety, and pain weren’t all in her head. So, she sought out yet another doctor.
That’s right – by the time Maddie made her way into my clinic I was her 11th doctor.
Eleventh! Not, 3rd or even 8th, but instead Maddie’s last attempt (she promised herself) to get better.
The truth is…many of my patients feel they have “seen everyone” and tried everything before they come to me.
What is Hashimoto’s Thyroid Disease?
Before we fully dive into Maddie’s story, it’s important to understand what Hashimoto’s thyroid disease really is.
The thyroid is responsible for body temperature regulation and metabolism, but it really affects every organ in the body.
Hashimoto’s is an autoimmune disorder that causes white blood cells and Hashimoto’s antibodies to see your thyroid as “foreign” and attack it. This leads to thyroid dysfunction that can cause a laundry list of symptoms.
Hashimoto’s thyroiditis is the number one cause of hypothyroidism in the United States.
Because the thyroid is responsible for so many bodily functions, the symptoms are often mistaken for other conditions. In Maddies case, her doctors simply thought she was stressed.
Symptoms of Hashimoto’s Thyroid Disease
Common symptoms of Hashimoto’s thyroid disease include:
- Fatigue
- Trouble sleeping
- Cold intolerance
- Thinning hair
- Slow digestion
- Constipation
- Depression
- Anxiety
- Fertility problems
- Irregular or heavy periods
- Dry skin
- Hoarse voice
- Hashimoto’s rash
But this isn’t a complete list of Hashimoto’s symptoms. It’s a nuanced disease that can sometimes present in different and complex ways. Plus, there’s more to healing than checking off a list of signs and symptoms of Hashimoto’s.
Maddie’s fatigue, constipation, anxiety, and daily joint pain were a constant reminder that something was wrong. Even when her doctors told her she was fine.
She listened to her body, she sought help, but every doctor, and other healthcare provider would eventually give up on her case too.
There’s a fundamental difference between me and these other docs. Sure, we may have started out on the same journey to attain our medical education, but for me — Hashimoto’s is personal.
You see, I have Hashimoto’s Hypothyroidism too.
Mine developed after having a baby, so my doctors were quick to chalk my symptoms up to being a new mom.
This is when my life took a huge turn. I found myself digging deep into the research and educating the world on everything that I was learning about Hashimoto’s disease.
When I resurfaced out of the depths of the scientific abyss I found that others were now looking to me as one of the leading authorities in thyroid disease.
Through what I learned I was able to reverse my autoimmune diseases (yes, I was lucky enough to develop more than one), put them into remission and reclaim my life.
I was also able to go on and conceive naturally at 39 years old and have a healthy pregnancy.
And I’ve helped thousands of other women do this too.
So, I know a thing or two about thyroid disease and today I want to share with you what 10 of Maddie’s other doctors missed.
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7 Ways to Healing Hashimoto's Thyroid Disease
1: We Tackled The Stress
Her doctors weren’t wrong about her stress levels. And some of them even prescribed meditation and deep breathing — you know those common things all of us know we should be doing, but don’t actually follow through with.
The problem was, these were just words and honestly, Maddie admitted if one more person told her to meditate she was going to lose it—big time.
I asked Maddie one simple question that changed everything—”What do you do when you feel the stress bubbling up?”
You see, it’s one thing to set aside the time to de-stress and relax, but it is entirely another to make a conscious effort to disrupt the pattern in the moment.
Make no mistake, this does take work and effort. But recognizing and disrupting the stress patterns is a literal rewiring of your brain. Of course, that’s going to take some effort. But it is so worth it!
You know what Maddie did when she was stressed?
She ate ALL THE THINGS. But mostly salty things.
Sound familiar? So many of us do this that it is not even worth the conversation of saying we shouldn’t judge. But seriously, let’s not judge.
Because the judgment Maddie was feeling from her doctors for not doing [fill in the blank] enough kept her from sharing this crucial information.
Maddie was in need of support and some killer lifestyle strategies if she was going to achieve her goal of putting her autoimmune disease and her symptoms into remission. And that includes dietary changes.
But the best diet for Hashimoto’s disease depends on the patient.
So, I prescribed a session with my Functional Nutrition and Lifestyle Consultant who helped instill the confidence Maddie needed to master her diet and lifestyle changes.
In my practice, I have my patients do at least two sessions with my personally trained consultants to help ensure success. Before I was ever a doctor I was a nutritional biochemist, so me and food go waaaay back. It was back then that I came to understand the profound power of “Food as Medicine.”
What you put at the end of your fork truly has the power to keep you out of the doctor's office and in good health!
I truly believe this. And you know what…this is part of the secret sauce that gets my patients better faster and for good!
2: We Started Healing Her Gut
When I asked Maddie, ”What do you do when you feel the stress bubbling up,” her answer provided some huge clues. The first one was that Maddie was eating when stressed. A stressful state shunts blood away from your gut and to your large muscles.
In other words, your gut can’t properly digest your food and your gut bacteria are having a field day with the smorgasbord you so graciously ate for them.
She couldn’t rest, let alone digest.
So, all those gut healing therapies her other doctors had given her made little difference because Maddie was in sympathetic overdrive. Instead of resting and digesting, her nervous system was in overdrive, a mode that tells your body to fight, flee, or just plain freeze.
No wonder her gut wouldn’t move! And she was relying on over 600 mg of magnesium (prescribed by a previous doctor) every day just to have a bowel movement.
Note: It is not normal or acceptable to indefinitely require a daily supplement to have a bowel movement.
3: We Started Strengthening the Adrenals
The second major clue was that Maddie was craving salty foods. Hello, adrenals!
Your adrenals do more than just pump out stress hormones. They also regulate your blood pressure… and salt has a thing or two to do with that system. This is why we crave salt when we're stressed.
Yes, we needed to work on the lifestyle piece, but her adrenals were in need of some serious love.
Maddie had adrenal testing done in addition to her blood tests for Hashimoto’s. And based on the results, she was given adrenal glandulars on multiple occasions.
While this might seem reasonable in theory, these supplements were too much, too fast. Every time Maddie took them she felt more anxious, irritable and as she described it “not in control of my own body.”
Some of her doctors said to take more. Some of them told her she must be taking them wrong. (I don’t like either of these answers.)
What Maddie actually needed was adaptogenic herbs, along with nervines to nourish the parasympathetic nervous system. Say what?
She needed herbs that would not only push the gas on the adrenals, but also put the hush on the way stress was driving Maddie’s nervous system crazy.
I got her going with a combination of Rhodiola, Ashwagandha, and Licorice as part of my Adrenal Support formula. This supplement is a pillar in our Thyroid Support Kit.
And we fed her adrenals — B vitamins, vitamin C, healthy fats, quality proteins and no blood sugar swings!
Maddie’s other doctors were more concerned with “pushing those adrenals to work,” than asking, “why is the body responding in this way?”
4: We Found All The Underlying Infections
As it turned out, Maddie’s body was under stress for another reason: She had several underlying infections.
When there are chronic infections, the immune system gets to work trying to clear them out of the body. The result? Tons of inflammation.
Your adrenal glands should be keeping inflammation in check so things don’t get out of control. They do this by making cortisol.
But when conditions are right, as is the case with chronic infections, HPA dysregulation (commonly known as adrenal fatigue) can occur. When this happens, inflammation goes up, cortisol goes down, and every single cell in your body feels it.
Maddie’s doctors told her that her inflammation was only moderate and they rushed in with all the natural anti-inflammatory herbs and supplements that they knew of.
There’s a fundamental issue with this—when you replace medications with herbs without regard for the root cause you are still symptom chasing. It’s actually a phenomenon that is referred to as green allopathy.
Now let me be clear—I’m not judging another doctor for using natural therapies instead of drugs in an attempt to help a patient. Nor am I judging the allopathic approach to medicine, which we can agree is profound in acute situations, but not necessarily the most satisfying for the patient in resolving their chronic isues.
But with that said, I want to share with you a very important distinction that is often overlooked.
If your doctor uses the same logic, but different tools, you will not achieve root cause resolution. The idea of doing the same thing and expecting different results is what many brilliant people have defined as insanity…including Albert Einstein, who I think we can agree was a legit genius.
You can replace your “pill for every ill” with “a supplement for every ill,” but won’t necessarily get the results you need because there is a fundamental flaw in your logic.
It is agreed that supplements are necessary, especially in the healing phase, and that symptoms should be addressed. But it is important that we make a distinction between when we're treating symptoms and when we are treating the root cause.
And we should be careful, because this symptom chasing logic is the same logic that assumes every thyroid patient presents the same way, that everyone feels best somewhere within a broad lab reference range, and that every patient will be just fine on Synthroid.
None of this is true, in case you’re wondering.
This was Maddie’s issue. Her doctors recommended excellent supplements to keep inflammation at bay, but they didn’t dig deep enough to figure out why she was inflamed in the first place.
Turns out, Maddie had methane dominant SIBO, reactivated epstein barr virus (EBV), antibodies for cytomegalovirus (CMV), and periodontitis (a dental infection). Previous providers had found the SIBO, but no one thought to check her mouth.
If you have an issue in the large intestine then we need to find out what is happening in the small intestine. And if you have an issue in the small intestine then you need to ask, what is happening in the stomach? And so on.
Your gut is a tube – a twisty turny tube, but nonetheless, a tube.
If you’ve got an issue at the terminal end then it only makes sense to ask what is going on upstream.
In Maddie’s case she had a gum infection, low stomach acid, a parasite and SIBO. Plus, she was hypothyroid (I'll get to that later).
She’d received four rounds of antibiotics for the SIBO. None of them helped. Not the first one, not the second one and so they just kept prescribing, until Maddie said no more.
She was then given a recommendation for high-dose magnesium and was sent on her way.
Here’s what I did differently:
I sent Maddie to a biological dentist to have an exam. When the diagnosis of gum disease was in, her dentist and I went to work to clear that infection with a new morning and evening routine.
5: Maddie Started Low-Dose Thyroid Hormone
While we worked on the mouth infection, I started Maddie on a very low dose of Natural Desiccated Thyroid hormone for 5 reasons:
Maddie didn’t have enough thyroid hormone
According to her thyroid blood test, Maddie didn’t have enough thyroid hormone.
Maddie’s Hashimoto’s thyroiditis lab values showed that T4 and T3 were low, indicating she was having issues with making and converting thyroid hormone.
Without enough thyroid hormone for her cells, Maddie was tired, anxious, constipated, and it explained why she was shedding more hair than she was growing aka, Hashimoto’s hair loss.
Maddie was inflamed
Her labs and symptoms also indicated she was inflamed. That means that less thyroid hormone was getting converted and the cells were unable to use it effectively. So, she wasn't making enough thyroid hormone and what she was making wasn't being well utilized.
Maddie had poor motility and low stomach acid
Thyroid hormone stimulates the production of hydrochloric acid. Hydrochloric acid, in turn, helps you absorb the nutrients your thyroid needs to function, stimulates other digestive juices to start flowing, and defends against any more unwanted critters from getting in.
No thyroid hormone means the gut and the thyroid get worse. Plus, you simply can't heal without it.
No one had tried it
With all of her symptoms, she was never given a prescription for thyroid medication. All because her labs were “normal.” She recalls her primary care doctor briefly mentioning it, but then dismissed the idea that it could help.
Other providers felt they could help her thyroid to function again naturally. I'm a big fan of this too. But sometimes you need more than a handful of herbs and supplements.
If Maddie hadn't shared her entire health story with me I may have thought we could give a trial of natural therapies too.
But there’s something important to understand about natural therapies — they’re just that — a trial, not an indefinite prescription.
If your hypothesis is that natural therapies will restore thyroid function and the expected outcome is improved symptoms and lab markers, then you should certainly be monitoring for the expected outcome. If the expected outcome is not achieved (i.e., feeling better and better labs) then you must formulate a new hypothesis to test.
In Maddie's case, it was time to test Natural Desiccated Thyroid hormone.
She had symptoms of hashimoto’s disease (hypothyroid)
Sure, her labs were semi-normal from a conventional perspective, but were less than optimal from a functional medicine perspective. But basing my recommendations (like her other doctors did) on her labs alone would have been a great disservice to her.
Her story had provided me with the data I needed to make the call to prescribe. She was presenting with signs and symptoms of hypothyroidism, and my clinical experience has taught me that patients in this scenario need at least a little thyroid medication to help them feel better.
This was another fundamental issue lacking in her previous care — if Maddie didn’t have the energy to do the work she was never going to heal.
Healing takes effort and energy, which is why I make sure my patients get symptom relief sooner than later so that they can do the necessary work to heal.
After two weeks on thyroid medication and some other holistic therapies, Maddie’s digestion began to improve, her energy was beginning to climb, and she felt less anxious. She continued to improve at this low dose while also working to resolve the root cause of her symptoms.
We also focused heavily on getting the parasympathetic system going before and during meals. This was so that Maddie’s gut could do what it was designed to do.
Instead of eating every time Maddie felt stressed she now stopped and asked, “Is this food really what is best for me?” Yeah, I know it’s nothing glamorous or even a hint of revolutionary, but this one little act is pure magic for changing habits.
6: We Replenished Nutrient Stores
Eventually, we did treat the SIBO directly, but after 2 years on a Low FODMAP Diet, my priority was getting Maddie away from such a restrictive diet and figuring out which foods were actually problematic.
Two years is about 21 months too long to be on that diet, which was why we were also working on replenishing the nutrient depletions that were brought on by restricting too many foods for too long.
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7: We Healed The Terrain
Maddie’s SIBO, constipation, and mouth and parasitic infections told me something that was huge in turning her health around. Maddie’s terrain had been compromised.
Her gut was no longer the glorious and nourishing microbial environment it once was. Think of going from a lush jungle to the desert…no one has an easy time surviving in the desert.
Blastocystis hominis is a common infection in Hashimoto’s thyroid disease. Historically, many people thought of it as a harmless parasite. In fact, the recommendations were only to treat if there were symptoms.
Note: We only test for this when there are symptoms.
The classic approach of decimating every organism in her gut to treat the bacterial overgrowth with antibiotics and a Low FODMAP Diet was a good idea in theory.
But it was the opposite of what Maddie needed.
She needed her gut motility supported, her microbiome restored, and a good dose of healing herbs to get back on track.
We started with healing her gut, reintroducing foods, and getting her a sense of normalcy. Important after being “the freak who brought her food everywhere for 2 years,” as she put it.
I kept Maddie on a dose of Gut Rebuild at 3 caps twice daily for 6 weeks. But at the end of 6 weeks, she was feeling so good with this product that she asked to continue. I highly value my patient’s opinions about what is working and not working.
After all, they are the only ones living in their bodies. So they are literally the experts on what is helping.
She continued the Gut Rebuild for an additional 6 weeks. And added in the Women’s Probiotic that contains spore based organisms, along with Lactobacillus species that are specific to women’s health needs, and a prebiotic that is SIBO friendly.
What Healing Hashimoto’s Thyroid Disease Looks Like
After 6 months of working with me, Maddie’s constipation was gone. Her Hashimoto’s antibodies were down, she had forgotten all about the pesky anxiety issue, and she was more active than ever!
In other words, her symptoms of Hashimoto's disease were in remission and she went from barely getting by to thriving.
Read Healing Anxiety with Functional Medicine.
With more energy and no joint pain, Maddie became more active. She picked up paddle boarding and trail running with new friends.
When she first came to see me, Maddie explained she had been socially isolated because her pain and energy were keeping her from playing!
This newfound community was breathing life back into Maddie and she was now spending time with more like-minded health warriors.
I never told Maddie to go out and make friends. I didn’t have to.
You see, as we bring the body back into alignment and commit to showing up more present in this world, we effortlessly move towards those things which serve us. And that builds us up even more.
All I needed to do was show Maddie the whole picture and give her the personalized roadmap back to health.
This is also where I differ from other doctors — I don’t heal my patients, I teach them to heal themselves.
My perspective is this — you know what you need to heal, in fact, you have all the answers.
How do you think I figured it out? It’s you, silly!
You give me what I need. Your story and experience tells me everything I need to know to determine which labs to test, what tools to use, and which therapies will work. All of it comes from you.
You Don’t Have to Fight A Hashimoto’s Diagnosis Alone
This is what I tell my patients:
Navigating your own health is like reading a book that is too close to your face. You know all the answers are right there, but it’s just way too close to make out the words.
Enter: Me. I stand back at the right distance to clearly read those words back to you. I take your entire story, along with your labs and paint a clear picture. How you got to where you are, what to do to fix it, and what’s coming. If we don’t act now.
But make no mistake, while I am guiding you and giving you direction, it is YOU who takes the step. It is you who does the work.
So in my mind—I don’t heal people. They heal themselves.
And if I’ve done my job right, we won’t have to meet constantly. Maybe just a few times per year.
Why? Because Docere (the root for doctor) literally means teacher.
My job is to teach you how to care for your body so well that you know exactly what to do when things get off a little off balance. And for when things get really out of balance…I am here.
Wishing you love and an abundance of support on your healing journey!
Dr. Jolene Brighten
Oh and one more thing I'd like to say because I would feel remorse not to have said it.
Maddie's doctors are not bad doctors. Instead, I'd like to think that they are just at a different place in their journey. They are discovering their own unique gifts and talents for enabling people to heal.
For them, Hashimoto's may not be the condition they love to treat—for me it is. And that's another fundamental difference in how I helped Maddie heal her Hashimoto's hypothyroidism.
*My patient's name was changed to Maddie in this Healing Hashimoto's Thyroid Disease story. I received full permission to share her journey with you.