11 things to know when newly diagnosed with Hashimoto’s or an underactive thyroid
Have you been recently diagnosed with Hashimoto’s or an underactive thyroid? Welcome to the club.
Hashimoto’s is a chronic autoimmune condition causing an underactive thyroid. You are not alone; there are millions of us living with this condition worldwide.
Soon, you’ll start noticing how different Hashimoto’s is in different people, and how all of us experience a palette of symptoms of differing intensities and durations. But there are many things we have in common, and some general ways to improve your health today and over time. So don’t panic! Read below for 11 actions you can immediately take to understand and manage your thyroid condition.
1. Adjust your exercise routine
Being physically active is necessary to maintain both a healthy body and high spirits. If you have an underactive thyroid, over-exercising might lead to a drop in thyroid hormone levels. If you do high intensity or long duration strenuous exercise, either allow yourself a couple days break in between your sessions or reduce the intensity (1–4).
2. Find a balanced diet that works for you
Eating healthy is especially important if you have Hashimoto’s. Certain foodsin particular may trigger your flare-ups. The trick is to know which foods and in which amounts are triggering digestive and other issues. Fortunately, you don’t need to make up a diet on your own — many eating regimens have been shown to help Hashimoto’s symptoms. How do you know which one to try? Pick one diet and measure the impact to seIf if your symptoms decline. It’s your choice from the bunch: autoimmune protocol, specific food group exclusion diet, the whole30, dairy free and many more (5–13).
3. Log your symptoms and tests
As you start to understand your Hashimoto’s or underactive thyroid, it can be handy to use digital tools to log your symptoms and your lab tests. This will give you an overview of your condition over time, and make it easier to talk to your healthcare provider about how your symptoms are evolving. For example, the symptoms you feel today might change or fully disappear, while you might start feeling a new symptom(s). Recording your lifestyle and health patterns can help you pinpoint potential origins of new symptoms.
4. Take your medications on time
When you were diagnosed, it’s likely you were put on hormone replacement therapy. There are three types. Levothyroxine is a synthetic hormone thyroxine (T4) replacement, most commonly used as a first line therapy and effective for about 8 in 10 patients. Combined synthetic Levothyroxine and Liothyronine, thyroxine (T4) and triiodothyronine (T3), work well for people unable to produce the active hormone T3 out of T4. Lastly, natural thyroid preparations are obtained from pigs or cattle and contain a mixture of natural T3 and T4 (14–23).
Your doctor will explain how important it is to take your medication on time. While people can occasionally miss Levothyroxine without feeling a major impact, the effect of Liothyronine is similar to a caffeine shot, and you are likely to notice each missed pill.
When taking your medication you should follow a couple of simple rules maximize its effectiveness,
Take your medication on an empty stomach
Do not eat for 30–60 minutes after taking the pill
Do not take supplements within 4 hours of taking your medication
If you are taking additional medication, talk to your healthcare provider to find out if it is safe to take them together.
You can set reminders in Boost so you never miss taking your medication.
5. Know your supplements
When searching online, you’ll inevitably run across ads for different supplements. It’s true that the thyroid needs certain vitamins and minerals in order to maintain its function, and at times our bodies may lack some necessary vitamins and minerals because of diet, lifestyle or our geography.
Some of the better known and researched supplements are iodine, selenium, vitamin D, vitamin B complex, omega 3 and zinc. A good balance of each supplement will ensure the thyroid not only produces enough hormone T4, but that both T4 and T3 can help each cell of the body to use the energy needed for its basic biologic processes (24–55).
It’s good to talk to your doctor before taking any supplement. If necessary, your doctor can do a simple blood test to check the levels of each vitamin and mineral in your body.
6. Connect with support groups
There are many of us around the globe living with an underactive thyroid who are happy to share our knowledge and experiences. Many online groups provide excellent support — and some of them have a good dose of humor about what we experience. You can ask your healthcare provider about patient support groups in your vicinity, or go online and check for non-profit organizations or patient groups (several of them are on Facebook).
7. Learn about thyroid biology
The more knowledge you have about your thyroid, the more power you will have over your condition. Aim for scientifically backed, trusted information, like on, WebMD or the American Thyroid Association’s website.
When surfing the vast amount of information online, try to be critical and check for scientific references in any written piece you read. If you find some advice radically different than on the mainstream pages and believe it can help you, it’s important to talk to your doctor before following any of the recommended routines.
8. Build a trusting and respectful relationship with your doctor
You and your doctor are in for a long ride together, so it’s important to have an honest and respectful relationship where you feel heard and taken care of. Try to help your doctor by providing systematic descriptions of your symptoms and your lifestyle. This will reduce the time your doctor will need to figure out what is really going on.
9. Reduce stress and increase your happiness index
Stress is one of the environmental triggers of autoimmune diseases. During high stress periods, both hormone balance and the immune system will change — and not for the better. Avoid stress, and work on feeling positive and happy about yourself. Start with tackling smaller grievances, and work towards the bigger issues. Remember to laugh, hug people and take it easy. Your body will say thank you by feeling better.
10. Listen to your body
We are all unique; perhaps symptoms you are experiencing have not been well researched or documented so far. That does not mean they are not real. They are, but you will need a bit more time and energy to get to the bottom of them with the help of your doctor. Also, if some things that worked for the others do not work for you, it’s also fine; we are all different. You will find your balance and your best zone by listening to your body and being in sync with it.
11. Set goals to improve your health, measure and visualize your progress
Changing habits and old ways takes time, but it is worth if it will result in you feeling better, healthier and happier. Set reasonable goals, perhaps not too ambitious, to avoid stressing yourself if you can’t follow through. Small steps and small improvements might be just enough to start this path.
Download BOOST Thyroid app to better manage your thyroid health.
1. Warburton DE, et al. Health benefits of physical activity: the evidence, 2006
2. Lankhaar JA, et al. Impact of overt and subclinical hypothyroidism on exercise tolerance: a systematic review, 2014
3. Ciloglu F, et al. Exercise intensity and its effects on thyroid hormones, 2005
4. Al-Hashem F, et al. Exhaustive exercise and vitamins C and E modulate thyroid hormone levels at low and high altitudes, 2012
5. Vojdani A. A Potential Link between Environmental Triggers and Autoimmunity, 2014
6. Pabst O, et al. Oral tolerance to food protein, 2012
7. Ch’ng CL, et al. Celiac disease and autoimmune thyroid disease, 2007
8. Jenkins DJ, et al. Effects of high- and low-isoflavone (phytoestrogen) soy foods on inflammatory biomarkers and proinflammatory cytokines in middle-aged men and women, 2002
9. Doerge DR, et al. Goitrogenic and estrogenic activity of soy isoflavones, 2002
10. Santin AP, et al. Role of estrogen in thyroid function and growth regulation, 2011
11. Manzel A, et al. Role of “Western diet” in inflammatory autoimmune diseases, 2014
12. Effraimidis G, et al. Alcohol consumption as a risk factor for autoimmune thyroid disease: a prospective study, 2012
13. Grosso G, et al. Nut consumption and age-related disease, 2016
14. Chalmers JR, et al. The synthesis of thyroxine and related substances. Part V. A synthesis of L-thyroxine from L-tyrosine, 1949
15. Hoffenberg R. Primary hypothyroidism, 1978
16. Cotton GE, et al. Suppression of thyrotropin (h-TSH) in serums of patients with myxedema of varying etiology treated with thyroid hormones, 1971
17. Gorman CA, et al. Comparative effectiveness of dextrothyroxine and levothyroxine in correcting hypothyroidism and lowering blood lipid levels in hypothyroid patients, 1979
18. Jonklaas J, et al. American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement, 2014
19. Wieringa WM, et al. 2012 ETA guidelines: the use of L-T4 + L-T3 in the treatment of hypothyroidism, 2012
20. Kaufman SC, et al. Thyroid hormone use: trends in the United States from 1960 through 1988, 1991
21. Williams RH. The thyroid, 1955
22. Frawley TF, et al. Metabolic and therapeutic effects of triiodothyronine, 1956
23. Smith RN, et al. Controlled clinical trial of combined triiodothyronine and thyroxine in the treatment of hypothyroidism, 1970
24. Chung HR. Iodine and thyroid function, 2014
25. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc, 2001
26. International Council for the Control of Iodine Deficiency Disorders
27. Zimmermann MB. Iodine deficiency, 2009
28. Hess SY. The impact of common micronutrient deficiencies on iodine and thyroid metabolism: the evidence from human studies, 2010
29. Jameson JL, et al. Endocrinology adult and pediatric: the thyroid gland, 2013
30. Ventura M, et al. Selenium and Thyroid Disease: From Pathophysiology to Treatment, 2017
31. Sunde RA. Selenium, 2012
32. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: Vitamin C, Vitamin E, Selenium, and Carotenoids, 2000
33. Arthur JR. The role of selenium in thyroid hormone metabolism and effects of selenium deficiency on thyroid hormone and iodine metabolism, 1992
34. Rayman MP. Selenium and human health, 2012
35. World Health Organization, Food and Agriculture Organization of the United Nations. Vitamin and Mineral Requirements in Human Nutrition, 2004
36. Turker O, et al. Selenium treatment in autoimmune thyroiditis: 9-month follow-up with variable doses, 2006
37. Gartner R, et al. Selenium in the treatment of autoimmune thyroiditis, 2003
38. Nacamulli D, et al. Influence of physiological dietary selenium supplementation on the natural course of autoimmune thyroiditis, 2010
39. Mao J, et al. Effect of low-dose selenium on thyroid autoimmunity and thyroid function in UK pregnant women with mild-to-moderate iodine deficiency, 2016
40. Negro R, et al. The influence of selenium supplementation on postpartum thyroid status in pregnant women with thyroid peroxidase autoantibodies, 2007
41. Rasmussen L. B., et al. Selenium status, thyroid volume, and multiple nodule formation in an area with mild iodine deficiency, 2011
42. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D, 2010
43. Muscogiuri, G. et al. Vitamin D and thyroid disease: to D or not to D? 2015
44. Howick MF, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline, 2011
45. Cranney C, et al. Effectiveness and safety of vitamin D, 2007
46. Adoring L, Intervention in autoimmunity: the potential of vitamin D receptor agonists, 2005
47. D’Aurizio F, et al. Is vitamin D a player or not in the pathophysiology of autoimmune thyroid diseases? 2015
48. Tamer G, et al. Relative vitamin D insufficiency in Hashimoto’s thyroiditis. Thyroid 21, 891–896, 2011
49. Kriegel MA, et al. Does vitamin D affect risk of developing autoimmune disease?: a systematic review, 2011
50. Schwalfenberg GK, Solar radiation and vitamin D: mitigating environmental factors in autoimmune disease, 2012
51. Niche Y, et al. Zinc metabolism in thyroid disease, 1980
52. Prasad AS. Clinical, endocrinologic, and biochemical effects of zinc deficiency, 1985
53. Prasad AS. Impact of the discovery of human zinc deficiency on health, 2009
54. Baltaci AK, et al. Opposite effects of zinc and melatonin on thyroid hormones in rats, 2004
55. Ertek S, et al. Relationship between serum zinc levels, thyroid hormones and thyroid volume following successful iodine supplementation, 2010