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Hashimoto's Functional Medicine

Hashimoto’s is an autoimmune disorder affecting the thyroid gland. Many people with this disorder remain undiagnosed or continue to experience symptoms despite taking medication. In this article, we’ll explain how we treat Hashimoto’s with a functional medicine approach. 

What is Hashimoto’s?

Hashimoto’s thyroiditis is an autoimmune thyroid disease leading to progressive damage and inflammation of the thyroid gland. Your thyroid is a small, butterfly-shaped gland at the front of your neck that produces thyroid hormones affecting a wide range of functions like metabolism, body temperature, red blood cell production, your menstrual cycle, and more.
The resulting damage from Hashimoto’s prevents the thyroid from producing adequate levels of thyroid hormones, leading to a more well-known condition known as hypothyroidism. Hashimoto’s is the most common cause of hypothyroidism in the United States. While around 5 to 10 percent of the general population suffers from Hashimoto’s, women are 10 times more likely to have this disease than men (1).
Of note, there are two types of autoimmune thyroid disorders. Hashimoto’s is the most common cause of hypothyroidism, and Graves’ disease is the most common cause of hyperthyroidism. Learn more about the difference between Hashimoto’s vs. Graves’ disease

Symptoms of Hashimoto’s

Symptoms of Hashimoto’s correlate with those of hypothyroidism. Although, if Hashimoto’s is caught early enough, some people may only have one or no symptoms.

People with Hashimoto’s disease may experience the following:
  • Constipation
  • Brittle nails
  • Thinning hair or hair loss (alopecia)
  • Weight gain
  • Difficulty losing weight
  • High cholesterol
  • Fatigue
  • Muscle cramps
  • Cold intolerance
  • Mood disorders
  • Heavy or irregular periods
  • Infertility


A full thyroid panel is recommended to diagnose Hashimoto’s thyroid disease. This would include:
  • TSH
  • Free T4
  • Free T3
  • Thyroid Peroxidase Antibodies (TPO Ab)
  • Thyroglobulin Antibodies (TG Ab)
If you have hypothyroidism, your TSH is high and T4 is low or normal. Elevated thyroid antibodies confirm the diagnosis of an autoimmune thyroid disorder.  Unfortunately, Hashimoto’s is often missed in the conventional health model because many providers are not ordering complete thyroid panels to evaluate thyroid antibodies. We often order a full thyroid panel with antibodies for  Root members.

Conventional Treatment of Hashimoto’s

Hashimoto’s is usually not treated in the conventional health model unless the individual has subsequent hypothyroidism. The conventional range for a normal TSH is approximately 0.5 - 4.5 mIU/L. However, most thyroid functional medicine doctors prefer a narrower and more optimal range for TSH of 1.0 - 2.5 mlU/L.
If your TSH is higher than what is considered “normal” from a conventional standard, your doctor will likely prescribe a thyroid hormone replacement medication. While this medication can sometimes reduce thyroid antibodies (the hallmark feature of Hashimoto’s), this is not always the case.

Hashimoto’s Functional Medicine Treatment

The main downside in the conventional treatment of Hashimoto’s is the failure to treat the root cause of the disease. 
While taking medication may lower TSH into the normal range and reduce some hypothyroid symptoms, many people continue to feel unwell. 
A functional medicine approach to Hashimoto’s aims to identify and treat the root cause of this autoimmune condition. We talk more about using functional medicine for autoimmune disease in this article.

Here are a few key aspects of a functional medicine plan for Hashimoto’s.

Personalized Testing

Functional medicine is an individualized approach that incorporates personalized testing to best tailor the treatment plan to you. In an individual with documented or suspected Hashimoto’s, we would order a comprehensive thyroid panel with antibodies, vitamin D, zinc, and B12.  We would also assess dietary intake of magnesium.  These are some of the key nutrients involved in producing thyroid hormones and converting T4 into the active T3 version your body can use.
Depending on your results, our Root dietitians may recommend specific foods to replete these nutrients, like pumpkin seeds for boosting magnesium and oysters or grass-fed beef for zinc and vitamin B12. Our Thyroid Health Bundle was specifically designed by our team to provide the necessary nutrients to optimize thyroid hormone function, support the immune system, and reduce inflammation. 

Reducing Inflammation

One of the key objectives to treating Hashimoto’s with functional medicine is to reduce total body inflammation as this is often a root cause of autoimmune disease. We often evaluate inflammation levels in our members with a blood test called hs-CRP. There are many ways to lower inflammation naturally, like following an anti-inflammatory diet, boosting omega-3 intake, and improving gut health. 

Optimizing Gut Health

Poor gut health may cause Hashimoto’s by disrupting the immune system. Plus, once the autoimmune disease is present, ongoing gut issues worsen symptoms of Hashimoto’s. For example, hypothyroidism slows the movement of food through the GI tract, which is why many individuals with this condition complain of constipation. Over half of patients with hypothyroidism also have bacterial overgrowth in their gut (2). We may recommend a comprehensive stool test to assess your gut bacteria and evaluate for any signs of parasites, yeast overgrowth, and infection. A functional medicine doctor is the best provider to order these stool tests, as our Root doctors are trained in how to analyze the results and create personalized treatment plans to correct any gut imbalances. A functional medicine plan for gut health may involve a short-term elimination diet and appropriate supplements, like those found within our Gut Health Bundle.

Lower Stress Levels

Stress is toxic, especially if you have an autoimmune disease like Hashimoto’s. In fact, reducing stress may even lower thyroid antibody levels (3). While we can’t always remove stress from our life, we can change how we respond to it. Implementing stress management techniques like deep breathing, mindfulness, meditation, and vagus nerve activation are helpful methods to reduce stress hormone levels and its negative effects on thyroid function. Adaptogenic herbs, like the ashwagandha found in our Thyroid Support supplement, are also effective in balancing stress hormones.
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Thyroid Support

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Key Takeaways

A Hashimoto’s functional medicine approach is a collaborative method that treats the root cause of your symptoms by using personalized testing, tailored food and supplement recommendations, interventions to optimize gut health, and stress reduction techniques. 
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