Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back by Izabella Wentz PharmD.
The DIG-AT-IT Approach In my first book, I introduced the DIG-AT-IT approach to identifying the triggers associated with Hashimoto’s. The acronym DIG-AT-IT stands for: Depletions, Digestion Iodine, Inflammation, Infection, Immune Imbalance Gut, Gluten Adrenals, Alkaline Phosphatase Triggers Intolerances Toxins
Does the practitioner have an account with functional medicine lab companies like Genova Diagnostics, Doctor’s Data, ZRT Laboratory, or BioHealth Laboratory?
National Academy of Clinical Biochemistry indicated 95 percent of individuals without thyroid disease have TSH concentrations below 2.5 μIU/mL, and a new normal reference range was defined by the American College of Clinical Endocrinologists to be between 0.3 and 3.0 μIU/mL. Functional medicine practitioners have further defined normal reference ranges as being between 1.0 and 2.0 μIU/mL for a healthy person not taking thyroid medications.
A congested liver is one of the many reasons why people’s bodies don’t utilize their thyroid medications effectively and don’t convert T4 to the active T3 hormone correctly.
Hashimoto’s. Liver dysfunction can present itself in many different types of signs and symptoms, including digestive problems, extreme sensitivity to supplements or medications, fatigue, skin breakouts, and more.
The gentle Liver Support Protocol has four steps: 1. Remove potentially triggering foods. 2. Add supportive foods. 3. Reduce toxic exposure. 4. Support detox pathways.
Sick building syndrome is a recently coined term to describe a collection of health symptoms experienced by one or more people due to exposure and time spent within a specific building. This is due to poor indoor air quality that may be caused by various airborne toxins, such as off-gassing building materials, volatile organic compounds (VOCs), air pathogens, pollens, or molds. This is usually combined with faulty heating, air-conditioning, and ventilation systems—up to 30 percent of buildings may be affected!
Mold does not necessarily cause Hashimoto’s—rather, it pulls the trigger of a loaded genetic predisposition. This is important to note, as it depends on the person’s genetic predisposition as to which type of autoimmune condition they will develop. It’s not
Xenoestrogens include a variety of substances like soy, BPA, phthalates, and parabens found in foods, plastics, and personal care products.
deodorants, hair sprays, and toothpastes. The structure of triclosan resembles the structure of thyroid hormones and has been associated with altered levels of thyroid hormone in animals. In fact, this ingredient has recently been banned by the FDA due to thyroid toxicity.
BPA also antagonizes T3 receptors, essentially shutting them down. Rats exposed to BPA showed a long-term disruption of intestinal immune function. They were more likely to develop gut infections and more likely to suffer from food intolerance.
° Fluoride: This thyroid-suppressing halogen is found in water, toothpaste, and some medications as well as in black, green, and red tea. Using a reverse osmosis filter is the best way to get rid of fluoride.
Lithium is found in varied amounts in our drinking water, and the amounts found in water can increase TSH and lower free thyroid hormones.
In research that was way overdue, a 2015 British study reported that medical practices in a fluoridated area of the UK (West Midlands vs. those in a nonfluoridated area, Greater Manchester) were twice as likely to report a high prevalence of hypothyroidism in their patients! Furthermore, analysis of different parts of the UK found that the rates of hypothyroidism were statistically matched to the rates of fluoride in the local water supply!
so I tested my urine for heavy metals through ZRT Laboratory. Sure enough, tests revealed that I had a urinary arsenic level of 810 mcg/g Cr, while the normal level should be somewhere under 138 mcg/g Cr!
The use of lipstick, in particular, has been connected with the development of lupus, another autoimmune condition. Absorption of toxins from the lips is more likely than from other cosmetics because the lips are a mucous membrane and because we may inadvertently ingest the products by licking our lips.
You can obtain the full report from http://www.environmentaldefence.ca to see the comprehensive details and products tested.
The Environmental Working Group also has a database of safer, cleaner alternatives (www.ewg.org/guides/cleaners).
difficult-to-digest food proteins, such as gluten, dairy, and soy proteins, can cause and perpetuate an autoimmune response due to molecular mimicry. If you have intestinal permeability (always a precursor to autoimmune disease), your body is more likely to recognize these proteins as foreign invaders and make antibodies to them. When this happens, you can develop a food toxicity reaction known as a food sensitivity. Food sensitivities are different from allergies in that they are produced by the IgG and IgA branch of the immune system, whereas food allergies are mediated by the IgE branch of the immune system.
eating foods that stimulate the release of the IgG antibodies and promote a type IV response will also increase thyroid antibodies and an immune response against the thyroid. Perhaps it’s a turning-on-the-faucet effect, or perhaps these proteins cross-react with the thyroid gland.
Circulating immune complexes (CICs), which are made up of an antibody and the reactive food protein, are produced in autoimmune disease whenever a reactive food is eaten, and the CICs accumulate in the liver, leading to impaired liver function.
autoimmune attack on the intestines occurs when someone with celiac disease eats gluten, and this attack leads to a destruction of the villi, which are delicate, hairlike projections that cover the intestines and help to digest and absorb nutrients from food. This damage of the villi causes people with celiac disease to become malnourished, no matter how much food they eat, because the body is not able to absorb the nutrients from the food that is consumed.
Up to 20 percent of people with celiac disease and Hashimoto’s can get Hashimoto’s into remission within a year of going gluten-free, and some may go into remission in as little as three months.
In 71 percent of people who strictly followed a one-year gluten withdrawal, there was a normalization of subclinical hypothyroidism. • Another 19 percent of people who followed the gluten-free diet were able to normalize their thyroid antibodies. “In distinct cases, gluten withdrawal may single-handedly reverse the abnormality,” the researchers concluded.
COMMON FOOD REACTIONS Body System Symptoms Lungs Postnasal drip, congestion, cough, asthma Gut Constipation, diarrhea, cramping, bloating, nausea, gas, acid reflux, burning, burping Heart Increased pulse, palpitations Skin Acne, eczema, itchiness Muscles Joint aches, pain, swelling, tingling, numbness Brain Headache, dizziness, brain fog, anxiety, depression, fatigue, insomnia
The Two-Week Liver Support Protocol Now it’s time to get into the specifics of the protocol. Here are the four steps: 1. Remove potentially triggering foods. 2. Add supportive foods. 3. Reduce toxic exposure. 4. Support detox pathways.
DAIRY REPLACEMENTS Dairy Type Replacement Options Milk Coconut milk, almond milk, cashew milk Butter Coconut oil, ghee Yogurt Coconut yogurt, almond yogurt Whey protein Pea protein, hydrolyzed beef protein, egg white protein* Ice cream Coconut ice cream, almond ice cream, or pureed frozen bananas Cheese Cashew and other nut cheeses; dairy-free, soy-free cheeses like the brand Daiya
The protein powders that are the best tolerated by people with Hashimoto’s are pea protein and hydrolyzed beef protein.
Rootcology AI Paleo Protein to contain hydrolyzed beef protein that is free of any fillers and compliant with even the strictest autoimmune protocol as well as the Rootcology Organic Pea Protein to be used for cleansing.
Furthermore, tea is problematic because of fluoride content, while coffee has the potential to contain mold or cross-react with gluten.
Maca latte: The adaptogen maca will support your adrenals and hormones, while the coconut milk will help your blood sugar stay stable throughout the day. Bonus: this tastes like a latte (see page 129)! • Green juice: This will give you plenty of nutrients and energy in a broken-down, usable form. • Turmeric tea: A great replacement for hot tea, turmeric tea is an excellent and delicious way to detox (see page 124). • Mint tea: This is a simple and delicious herbal tea. As a bonus, mint also suppresses SIBO, a common Hashimoto’s imbalance. • Dandy Blend: Enjoy this gluten-free herbal mix that tastes like coffee. • Spa water: Mix purified water with fruit for a fun way to quench your thirst.
can replace alcohol with my Fermented Margarita or Virgin Mojito (see pages 129–130). The probiotics in the drinks will support your liver and gut.
1. Hot lemon water: The cleansing properties in lemon juice support stomach and liver detoxification pathways. I recommend drinking hot lemon water alongside thyroid medication because the acidity from the lemon will aid in absorption.
The Root Cause Green Smoothie: This green smoothie is packed with nutrition for your thyroid and can help detoxify and reduce inflammation. It combines a hypoallergenic protein source (pea) with fat from coconut milk and fiber from veggies.
The coconut milk base is a hypoallergenic source of fat and can help reduce inflammation and stabilize blood sugar due to its good fat content. • Adding an avocado increases the fat- and blood-sugar-stabilizing content, and gives the smoothie a pudding-like consistency. • Veggies add fiber and micronutrients, which are more readily available due to using a blender to break the fiber and nutrients apart. • Sea salt can help with supporting the adrenals, which are often stressed in people with Hashimoto’s.
Root Cause Green Smoothie 1 cup mixed baby greens 2 large carrots 1 ripe avocado 1 stick celery 1 cucumber 1 bunch basil leaves 1 cup coconut milk 1 scoop pea protein powder Sea salt to taste
Optional additions include one tablespoon of any of the following: camu powder (boosts vitamin C), cod liver oil (anti-inflammatory), coconut kefir probiotics, maca root powder (helps increase body temperature and stabilizes hormones), or turmeric powder (anti-inflammatory).
you can make the following adjustments: • Skip the avocado and add a tablespoon of chia seeds instead. Chia seeds are a less creamy source of good fat. • Add the juice of one lemon or lime to make it more tropical and to support digestive juices. • Blend the contents with a cup of ice cubes to make the smoothie cold and give it a more milky consistency.
3. Beets: Beets are rich in phytonutrients, have anti-inflammatory and antioxidant qualities, and support detoxification.
Cruciferous veggies: Crucifers contain nutrients that help support the liver’s detoxification. These vegetables include cabbage, broccoli, cauliflower, kale, and turnips. I recommend buying organic, especially for kale because it tends to pick up a lot of toxins in the environment.
Cilantro: Cilantro is a natural chelator, which means it will bind to certain toxins and help excrete them from the body. Cilantro helps remove toxins in a gentle way and is delicious when added to salads, avocados, green juices, smoothies, and salsas. Please note that while chlorella and spirulina are also natural chelators,
Fiber: Fiber aids our ability to excrete toxins and excess hormones. Most people can tolerate natural fiber found in fruits and veggies, but be careful with fiber in supplement forms (such as inulin, fructooligosaccharide [FOS], or psyllium supplements), as these can aggravate intestinal permeability and SIBO. If you haven’t been in the habit of eating a lot of fiber, I recommend starting off slowly and gradually adding more to your diet.
7. Sprouts and seedlings: The sprouts and seedlings of plants have natural enzymes that break toxins apart.
Greens juices and chlorophyll: Green juices are full of healing nutrients! Since they are in liquid form, they also make the nutrients easily digestible and accessible.
10. Turmeric: Curcumin, the active ingredient in turmeric, is great for detoxifying various metals and toxins.
Turmeric Tea 1 teaspoon turmeric 1 teaspoon ginger Pinch of pepper Pinch of cinnamon Juice of 1 lemon Sweetener to taste (stevia and maple syrup are my top recommendations) 1 cup hot filtered water Put all the spices and lemon juice in the mug of your choice, top off with boiling water, and mix! Tandoori Chicken 1 teaspoon curry 1 teaspoon turmeric 1 teaspoon paprika (skip if you are nightshade sensitive) 1 teaspoon garlic powder ½ teaspoon pepper 1 teaspoon sea salt 2 cups coconut milk 1 whole chicken, cut up, or 8 chicken drumsticks Add all ingredients
Bottled water brands that contain less than <0.1 ppm of fluoride include Aquafina, Calistoga, and Dasani. Please be sure to periodically check http://www.fluoridealert.org/content/bottled-water/, as companies may change their practices without warning. Drinking from plastic bottles is not ideal due to the potential toxicity of the plastic—thus, in the long run, I do recommend investing in a fluoride filter. For brands of reverse osmosis filters, please go to
A less industrial and more decorative option includes getting the type of houseplants that act as natural air detoxifiers. Golden Pothos, corn plants, and any of the Sansevieria genus have been used as purifiers and have gained a reputation for even being able to mitigate the effects of sick building syndrome. Sansevieria absorb carbon dioxide and release oxygen at night, making them excellent bedroom plants. However, as their leaves are poisonous if ingested, they should be kept out of reach of children and pets. Pet lovers, be aware that all of these plants can be poisonous to cats and dogs if ingested by the critters, so remember to keep them away from your fur babies.
have found to be both low in toxins and effective: • Makeup: bareMinerals and Physicians Formula Organic Wear • Shampoo: Acure Organics • Body wash: Acure Organics, Dr. Bronner’s • Lotion: Acure Organics • Skin care: MyChelle, Annmarie Gianni Skin Care, The Spa Dr.
This process includes sulfation, glucuronidation, glutathione conjugation, acetylation, amino acid conjugation, and methylation. Methylation will be impaired if you have the MTHFR gene mutation. Phase 2 needs nutrients like methionine, cysteine, magnesium, glutathione, vitamins B5 and B12, vitamin C, glycine, taurine, glutamine, folate, and choline. Methylsulfonylmethane (MSM) and N-acetylcysteine (NAC) are also two helpful supplements to help this pathway along.
list of required nutrients for Phases 1 and 2 liver detoxification include B vitamins (B2, B3, B5, B6, B12), folate, glutathione, flavonoids, magnesium, vitamin C, and the amino acids methionine, cysteine, glycine, taurine, and glutamine.
L-methionine, taurine, inositol, choline, milk thistle, dandelion, artichoke, beets, beta-carotene, and ox bile supplements can help support the liver and bile flow to ensure proper absorption of essential fats and vitamins as well as elimination of toxins. Gallbladder-supporting supplements usually contain a mixture of the above ingredients.
NAC, which turns into glutathione, not only helps reduce thyroid antibodies by neutralizing hydrogen peroxide, but it also helps heal intestinal permeability and aids with detoxification. Doses of 1.8 g (1,800 mg) are usually recommended.
Supplements that contain amino acids and support liver detox (glutamine, glycine, taurine, alpha-ketoglutarate, glutathione, methionine, ornithine) are especially important.
Methylation-Support Supplements You can support methylation pathways by taking supplements with activated B6 (as riboflavin-5’-phosphate), activated folate, and B12 as methylcobalamin and trimethylglycine, which breaks down homocysteine. For most people with Hashimoto’s, I recommend this support for at least for two weeks during the protocol. Those with the MTHFR gene mutation will likely benefit from long-term supplementation.
Magnesium is a powerhouse nutrient when it comes to detoxification. Magnesium is required for the liver’s detoxification pathways, for alkalizing the body so that toxins can leave through the urine more readily, and for helping to rid the body of toxins with more frequent bowel movements.
Magnesium citrate and magnesium glycinate are great sources of oral magnesium supplements. Magnesium citrate has more stool-softening properties and also tends to be more calming than the glycinate, so this is something to consider based on your bowel function and may be more appropriate for people with anxiety. Usual starting dose ranges for magnesium are: magnesium citrate at 400 mg or magnesium glycinate at 100 mg at bedtime. Be sure to give yourself four hours between your thyroid medications and your magnesium dose.
LIVER SUPPORT SUPPLEMENTS Supplement How to Use Recommended Brands MTHFR support supplement with activated B6 (as riboflavin-5’-phosphate), activated folate, B12 as methylcobalamin and trimethylglycine Take daily during detox, and continue indefinitely if you have the MTHFR gene mutation. Rootcology Methylation Support, Pure Encapsulations Homocysteine Factors, Designs for Health Homocysteine Supreme Supplement containing amino acids to support phase 2 liver detox (glutamine, glycine, taurine, alpha-ketoglutarate, glutathione, methionine, ornithine) Take 6 capsules during 2-week liver protocol and continue during gut cleanse. Rootcology Amino Support, Designs for Health Amino-D-Tox Supplement containing gallbladder, liver, and bile flow supporting substances (L-methionine, taurine, inositol, choline, beta-carotene, ox bile, milk thistle, dandelion, artichoke, beet) Take 3 capsules daily during 2-week liver protocol. May continue beyond if experiencing fat malabsorption/gallbladder issues. Rootcology Liver Gallbladder Support, Pure Encapsulations Digestion GB, LV-GB by Designs for Health NAC Take 1,800 mg daily with food, starting with liver support, and continue for 3–6 months. Rootcology, Pure Encapsulations, Designs for Health Curcumin with bioperine Take 1–3 capsules daily during 2-week liver support. Pure Encapsulations Liver support powder containing amino acids, nutrients, and herbs Add 1 scoop to smoothies for 2 weeks. Rootcology Liver Reset Powder, Designs for Health PaleoCleanse Magnesium (citrate or glycinate) Take 1–4 capsules at bedtime starting with liver support and may continue for 3–6 months or as needed. Pure Encapsulations Additionally, some of my favorite high-quality brands include Pure Encapsulations, Designs for Health, Douglas Laboratories, Bulletproof, NOW Foods, Protocol for Life Balance, Metagenics, Vital
Nutrients, Thorne, and Allergy Research Group.
most blood tests will not reveal adrenal dysfunction. And most conventional medicine doctors won’t run any additional or proper tests for it, such as adrenal saliva or urinary stress hormone panels, because they do not consider adrenal dysfunction as a real condition.
five-step Adrenal Recovery Protocol will look like this: 1. Rest. 2. De-stress. 3. Reduce inflammation. 4. Balance the blood sugar. 5. Replenish nutrients and add adaptogens.
To help meet the demand for cortisol, your body will decrease the production of other hormones normally produced by the adrenals, such as progesterone, DHEA, and testosterone, as a protective mechanism. If this protective process continues for too long, it can lead to deficiencies in the other hormones
now recommend the BioHealth adrenal saliva test to all of my clients with Hashimoto’s, and I have found that 90 percent of the clients who do the test have some degree of adrenal dysfunction.
Sleep deprivation is a huge stressor on the body and contributes to adrenal imbalances, which then initiate the development of autoimmunity. Sleep deprivation is also the quickest way to get yourself into adrenal fatigue—in fact, sleep deprivation is what scientists use to induce HPA axis dysfunction in laboratory animals!
Sleep apnea is a chronic health condition that has been associated with low-grade inflammation in the body and is characterized by pauses in breathing while one is sleeping. As these pauses in breathing and lack of oxygen wake people up intermittently throughout the night, the result is often unrefreshing, fragmented sleep despite sleeping longer than usual.
OSA may be a causative factor for Hashimoto’s.
The most important strategy for combating adrenal fatigue is stress reduction.
Blood Sugar Imbalances People often ask me if there is one thing that people with Hashimoto’s could do right away to feel better, and the answer is yes: balance your blood sugar! Balancing blood sugar levels should be one of the priorities for anyone who is hoping to overcome autoimmune thyroiditis and adrenal fatigue. Reactive hypoglycemia, which is post-meal hypoglycemia that occurs within four hours of eating a high-carbohydrate meal, is in particular a huge stressor for the adrenals.
Inflammation signals the release of cortisol in the body and can result in hypersecretion or depletion of cortisol, which are two ways that the adrenals can dysfunction.
The five steps of the Adrenal Recovery Protocol will look like this: 1. Rest. 2. De-stress. 3. Reduce inflammation. 4. Balance the blood sugar. 5. Replenish nutrients and add adaptogens.
Step 1: Rest First and foremost, the most fundamental recommendation of all for adrenal health is sleep! If you are serious about overcoming adrenal fatigue, I suggest to committing to a solid ten to twelve hours of sleep each night for at least fourteen days.
In tracking my sleep and the sleep of my clients (I like the ŌURA ring for sleep tracking) with adrenal dysfunction, I’ve found my data seems to echo these hours—deep sleep has been shown to take place early in the night, between the hours of 10:00 P.M. and 2:00 A.M., while REM sleep seems to peak between 5:00 A.M. and 9:00 A.M.
“The Sleep Doctor”: Stages 3 and 4 sleep (known collectively as deep sleep) are the most physically restorative sleep. This is where the bulk of growth hormone is produced, and that helps repair and rebuild muscles as well as tell the brain where to distribute fat and glucose. REM sleep is the mentally restorative sleep. Here is where your brain moves information from your short-term memory to your long-term memory. Your brain is taking all the information you collected during the day, filtering out the unnecessary stuff, and then organizing the pertinent information for retrieval later.
Alan Christianson, author of The Adrenal Reset Diet. He describes the three stages of adrenal dysfunction as follows: • Stage 1: Stressed (edgy, difficulty falling asleep, mental function fast and scattered) • Stage 2: Wired (overwhelmed, difficulty staying asleep, erratic mental function) • Stage 3: Crashed (exhausted, unrefreshing sleep, unable to generate ideas)
Daily Epsom salt baths: These play a big part in helping me de-stress.
Root Cause Build Smoothie ½ cup baby carrots 1 avocado 1 cup coconut milk 1 cup greens 2 egg yolks (if tolerated) 1 scoop hydrolyzed beef protein
How Much Protein Should You Get per Day? • Low activity: Most people with low to moderate amounts of activity should aim for 1.2 g of protein per kilogram of body weight per day. • High activity: Those who are exercising and otherwise active should eat at least 1.2 g per kilogram of body weight per day (that’s about 0.5 g per pound). • Illness: Most older adults who have acute or chronic diseases can eat 1.2 to 1.5 g per kilogram of body weight per day. Older people with severe kidney disease (estimated GFR <30 mL/min/1.73 m2), but who are not on dialysis, are an exception to this rule; these individuals may need to limit protein intake. • Bodybuilding: Those lifting heavy weights can eat up to 2 g per kilogram of body weight per day.
To be considered an adaptogen, an herb must possess several qualities. First, it must be nontoxic to the patient at normal doses. Second, the herb should help the entire body cope with stress. Third, it should help the body to return to normal regardless of how stress is currently affecting the person’s functioning.
Adaptogenic herbs include ashwagandha, astragalus, reishi mushroom, dang shen, eleuthero, ginseng, jiaogulan, licorice, maca, schisandra, spikenard, and suma.
I’d love to share the “Depletions and Digestion” chapter with you on http://www.thyroidpharmacist.com/gift.
Thiamine is one of the B vitamins, known as B1. It has the important roles of converting carbohydrates into energy and aiding with the digestion of proteins and fats. Thiamine is required for proper release of hydrochloric acid in our stomachs, which is needed for proper protein digestion.
VITAMIN B Vitamin Number Name Optimal Form B1 Thiamine Thiamine HCl or benfotiamine B2 Riboflavin Riboflavin-5’-phosphate B3 Niacin Niacinamide B5 Pantothenic acid D-calcium pantothenate B6 Pyridoxine Pyridoxal-5-phosphate B7 Biotin D-biotin B8 Inositol Myo-inositol B9 Folate Methylfolate, Metafolin, or NatureFolate B12 Cobalamin Methylcobalamin
Researchers in Italy found that taking a 600 mg dose of thiamine relieved fatigue in women with Hashimoto’s who were already taking thyroid medication. I have seen excellent results with thiamine
While thiamine in the recommended doses is extremely safe for most people, it should not be taken by people with advanced cancers. This is because thiamine is necessary for cell replication, and it’s possible that cancer cells will steal the body’s reserves of thiamine and use it to proliferate themselves. Providing just enough thiamine to correct the thiamine deficiency can help the tumor grow (the thiamine goes to the tumor instead of us), while megadoses of thiamine actually inhibit tumor growth. If you have a thiamine deficiency and cancer, I would advise you to work with a cancer specialist.
Selenium plays a very important role in thyroid function, acting as catalyst to convert the inactive T4 to the biologically active T3, and protecting thyroid cells from oxidative damage that occurs during the production of thyroid hormones.
Numerous studies have shown that a dosage of 200 mcg of selenium methionine per day has been found to reduce thyroid antibodies in clinical trials—in some studies selenium cut thyroid antibodies in half within three months. This is why I always recommend taking a selenium supplement in lieu of getting selenium from Brazil nuts.
my experience, a dose of 200 to 400 mcg per day of selenium methionine can help people with Hashimoto’s reduce thyroid antibodies and feel more calm, and can also improve energy levels and hair regrowth.
ADRENAL SUPPLEMENT OVERVIEW Preferred Products Description Adrenal Support by Rootcology, Daily Stress Formula by Pure Encapsulations, or Adrenotone by Designs for Health A mixture of adaptogenic herbs, vitamins, minerals, and amino acids to support the adrenals. Blends containing ashwagandha should be avoided in people with nightshade reactions.* B-Complex Plus by Pure Encapsulations, Selenium by Pure Encapsulation, or BenfoMax 600 mg by Pure Encapsulations B vitamins, especially pantothenic acid (B5) and thiamine (B1), support proper adrenal function, and methylcobalamin (B12) supports energy function. Some individuals may also benefit from sublingual B12 formulations. Thiamine and benfotiamine support energy levels in people with Hashimoto’s. Doses of 600 mg per day are recommended. Vitamin C by NOW Foods Vitamin C is an essential vitamin for proper adrenal function. Doses of 500–3,000 mg per day are helpful for adrenal function. Reduce dose if diarrhea occurs. Selenium Selenium is a nutrient that has been found to reduce thyroid antibodies and anxiety. Doses of 200–400 mcg of selenium methionine are recommended. Magnesium (citrate) by Pure Encapsulations Magnesium supports healthy DHEA levels and promotes a restful sleep. The citrate salt helps promote bowel movements. Reduce dose or switch to magnesium glycinate if diarrhea occurs. *See more information on nightshade sensitivity on page 105.
Interestingly, fetal origin of the thyroid gland is the same as the stomach, digestive tract, and tongue—thus we can consider thyroid cells as digestive tract cells. A rare birth defect can even place a fully functioning thyroid gland that makes thyroid hormones at the base of the tongue instead of inside of the neck. The “tongue thyroid” can even develop Hashimoto’s and become enlarged.
Here are some of the factors that contribute to increased intestinal permeability: • Adrenal fatigue • Alcohol • Capsaicin (in peppers and paprika) • Dysbiosis • Enzyme deficiencies • Food sensitivities • Gluten • Gut infections • Nonsteroidal anti-inflammatory drugs (NSAIDs) • Nutrient depletions • Psychological stress • Small intestinal bacterial overgrowth (SIBO) • Sinus infections, mouth infections • Strenuous exercise • Stress • Surgery or trauma • Toxins
Source: Adapted from Mark Hyman, The UltraMind Solution: Fix Your Broken Brain by Healing Your Body First (New York: Scribner, 2008) and The UltraMind Solution Companion Guide (Lenox, MA: UltraWellness, 2009).
There are four steps to my gut-healing protocol, which will remove some of the triggers I just listed and also help you build a stronger, more resilient gut. Here are the four steps: 1. Remove reactive foods. 2. Supplement with enzymes. 3. Balance the gut flora. 4. Nourish the gut.
Studies have found that people with Hashimoto’s and hypothyroidism often have a deficiency in the digestive enzyme hydrochloric acid, resulting in low levels of stomach acid (hypochlorhydria) or a complete absence of it (achlorhydria).
This is partially because these proteins are among the most difficult to digest and partially because they are also the most commonly eaten proteins in the standard Western diet. And eventually, you could develop IgG antibodies to these proteins, which are the very same antibodies that target the thyroid gland in autoimmune disease. When someone continues to eat these proteins, the immune system attack becomes upregulated as the influx of poorly digested proteins triggers the immune system to make more of these types of antibodies.
reactive proteins can attach to antibodies, creating what’s referred to as circulating immune complexes (CICs). Under normal circumstances, the body can break down CICs using self-made proteolytic enzymes, specific protein-eating enzymes released by the stomach and the duodenum part of the small intestine. However, the proteolytic system can become overwhelmed with too many CICs. As these complexes accumulate, they can contribute to liver congestion, autoimmune disease, and many associated symptoms, such as pain, inflammation, and even heart attacks!
such as grains, eggs, nuts, and seeds. Poorly digested proteins can also become “food” for opportunistic bacteria that live in our gut. The gut is a delicate environment, which functions best when there is a balanced ratio of probiotic (beneficial) and opportunistic (potentially problematic) bacteria.
Digestive Enzymes While thiamine can help with increasing stomach acid naturally, betaine with pepsin is another supplement that can be used to raise stomach acid levels. Betaine HCl and pepsin are naturally occurring components of the gastric juices that break down protein bonds in our food to make nutrients and amino acids more bioavailable. They are especially important for proper absorption of protein, calcium, B12, and iron. Betaine, also known as trimethylglycine, is a naturally occurring amino acid derivative that is isolated from beets, and the acidic HCl version of it promotes stomach acid. Betaine HCl used to be available as an over-the-counter drug, marketed as a stomach acidifier and digestive aid, but it was removed from over-the-counter use in 1993 due to “insufficient evidence of it working” and banished to being a dietary supplement by the FDA (dietary supplement companies cannot make claims of the effectiveness of their products, while drug companies can make specific claims). However, studies done in 2014 did indeed find that betaine HCl can re-acidify gastric pH.
trimethylglycine can be helpful for breaking down homocysteine, especially in those with the MTHFR gene mutation. Furthermore, it can be a helpful adjunct in depression through increasing endogenous amounts of SAMe, a naturally occurring substance with mood-boosting and pain-relieving properties.
Pepsin is a naturally occurring digestive enzyme (derived from porcine sources in supplements) that breaks proteins into smaller pieces so they can be properly absorbed by the small intestine. Taking betaine with pepsin while eating protein-containing meals can really support your digestion and boost energy. After beginning to take betaine with pepsin along with my protein-containing meals, the debilitating fatigue I had been dealing with for almost a decade went away practically overnight.
Start by taking just one capsule (most brands have around 500 mg of betaine and around 20 mg of porcine-derived pepsin per capsule) right after you’ve eaten a protein-containing meal.
If you do feel a burning in your throat, you do not need the supplement or you did not have enough protein in your meal. Drink a cup of water with a teaspoon of baking soda to relieve any continued burning sensation. If you didn’t feel anything, increase your dose to two capsules at the end of your next protein-containing meal. Then, keep increasing by one capsule until you feel a slight burning or discomfort. Once you’ve reached this point, you will know that your target dose is one capsule less. For example, if you felt nothing at one capsule, nothing at two capsules, and nothing at three capsules, but a burn at four capsules, your target dose would be three capsules. This supplement can help fatigue dramatically, and I recommend that you start working on finding your right dose as soon as possible.
It should be noted that there are some important restrictions to consider before taking betaine with pepsin: • Betaine with pepsin should not be used with current ulcers or a history of ulcers, as stomach acid can further aggravate ulcers. • As NSAIDs and steroid medications can increase the likelihood of developing an ulcer, I do not recommend using this supplement while taking either of these medications. NSAIDs include aspirin, ibuprofen, and naproxen (Bayer, Advil, Aleve, and many others). Steroid medications include prednisone, hydrocortisone, and others. • Acid-suppressing medications including the popular PPIs mentioned earlier and over-the-counter acid blockers like Pepcid can negate the effects of betaine with pepsin, so I don’t recommend taking them together.
Proteolytic Enzymes Proteolytic enzymes, also known as systemic enzymes, act as natural immune modulators, meaning they can help bring our immune system into balance. Systemic enzymes are a blend of plant- and animal-derived enzymes and may contain a mix of some of the following ingredients: • Bromelain (from pineapple) • Papain (from papaya) • Rutin or rutoside trihydrate (bioflavonoid) • Chymotrypsin (porcine) • Trypsin (porcine) • Pancreatin (porcine) Systemic enzymes break down inflammatory cytokines that are seen in autoimmune disease and contain proteases that may also be involved with breaking down pathogens such as bacteria and parasites. These enzymes also speed up tissue repair by reducing inflammation. Additionally, the enzymes reduce the antibodies to foods and to the thyroid by breaking down the CICs that are formed in autoimmune disease.
In the study, Hashimoto’s patients on levothyroxine were given systemic enzymes for three to six months. Not only did patients report a reduction of thyroid symptoms, but thyroid ultrasounds also showed normalization, and there was a reduced number of inflammatory cells in the thyroid and significant decreases in TPO and TG antibodies.
The key to remember about these enzymes is that they are to be taken without food. This means either on an empty stomach, at least forty-five minutes before a meal, or an hour and a half after a meal.
The key with probiotic supplementation is not to overdo it right away but instead to focus on starting small and then gradually increasing the dosage until a die-off reaction is felt. A die-off reaction—also known as a Jarisch-Herxheimer reaction, or sometimes just Herxheimer or Herx—occurs when the dying pathogenic bacteria release endotoxins at a quicker rate than the body can clear them. Symptoms of a die-off reaction include lethargy, difficulty concentrating, cravings for sweets, diarrhea, rash, irritability, gas, bloating, headache, nausea, vomiting, congestion, and increased autoimmune symptoms.
I’ve found three types of probiotics to be helpful for people with Hashimoto’s: lactic acid, Saccharomyces boulardii (S. boulardii), and spore-based probiotics.
While I recommend starting low (1 to 10 billion CFUs per day) and increasing slowly, doses of 50 billion to 3,600 billion CFUs per day are needed for therapeutic effect. Oftentimes, the lactic acid probiotics may be mixed in with bifidobacteria-based probiotics and sometimes Streptococcus probiotics. I have found that high-dose blends of multiple strains seem to do best. Lactobacillus casei has specifically been found to aid with healing the gut. Pediococcus acidilactici is a lactic acid probiotic that has been found to downregulate autoimmunity by increasing the expression of T-regulatory cells, which help to reduce the inflammatory autoimmune cascade.
PROBIOTIC BLENDS Probiotic Type Best Products Lactic acid based VSL#3, Ther-Biotic Complete by Klaire Labs, Probiotic 50B by Pure Encapsulations Yeast based Saccharomyces boulardii by Pure Encapsulations Spore based MegaSporeBiotic, Rootcology MegaSpore These probiotics can be very helpful for people with Hashimoto’s who often show low levels of them on gut lab tests.
Beneficial yeast-based S. boulardii is a beneficial yeast that helps to raise our secretory IgA, which acts as a protective barrier in the gut, leading to a removal of opportunistic and pathogenic organisms from the gut and preventing new infections as well as reinfections. This type of probiotic is an excellent tool for addressing dysbiosis, yeast overgrowth, and parasitic infections, and it can be used concurrently with antibiotics. Furthermore, yeast-based probiotics do not have a propensity to increase SIBO. I recommend a dose of 250 mg to 2,000 mg per day.
Spore-based probiotics are natural and soil-based and have a unique mechanism of action, which allows them to directly modulate the gut microbiome. Spore-based probiotics have shown promise in various autoimmune diseases and in reducing allergies and asthma. Spore-based probiotics also have an ability to boost Lactobacillus colonies, so they can be used concurrently with Lactobacillus probiotics as well as in place of them. Unlike the Lactobacillus probiotics, spore-based probiotics can reduce SIBO and increase gut diversity by boosting the growth of other beneficial flora.
Glutamine Glutamine is the best-studied substance for healing intestinal permeability. Supplementation of this important amino acid has been found to reduce the leaky gut associated with the use of NSAIDs and abdominal surgery. A deficiency in glutamine is also known to cause increased intestinal permeability in mouse models and malnourished children. New gut cells are produced within the GI tract every three to six days, and glutamine can help repair the GI lining in collaboration with other amino acids such as leucine and arginine. The recommended adult dose is 5 g three times per day; however, higher doses have been used.
Zinc Zinc is an essential element for our well-being. Zinc acts as a catalyst in about a hundred different enzyme reactions that take place within the body, and it is involved in DNA synthesis, immune function, protein synthesis, and cell division. It is required for proper sense of taste and smell, detoxification, wound healing, and thyroid function. One in four individuals in the general population may be zinc deficient, including most people with hypothyroidism. Zinc deficiency prevents the conversion of T4 into the active T3 version. You also need zinc to form TSH, which is why people who are constantly producing TSH—those with hypothyroidism—are more likely
Zinc plays a specific role in gut health, as deficiency has been associated with increased intestinal permeability, susceptibility to infections, and reduced detoxification of bacterial toxins. In conditions such as Crohn’s disease, replenishing zinc has shown to help repair intestinal permeability. Because zinc is not stored in the body, a daily intake is recommended even for the general population, and people with Hashimoto’s and other autoimmune conditions should consider zinc supplementation
I prefer the zinc picolinate version because it is absorbed better.
GUT BALANCE SUPPLEMENTS Systemic enzymes (see recommended brands): 10 capsules or tablets, 3 times per day on an empty stomach Probiotics: Work your way up to target dose L-glutamine powder: 5 g, 3 times per day Zinc: 30 mg per day NAC: 1,800 mg per day Omega-3s: 1–4 g per day Vitamin D: 5,000 IU per day
Fundamental Tests: Ferritin, Vitamin D, and B12
The Full Fundamental Protocols Here’s an overview of the complete Fundamental Protocols and the steps of each individual protocol contained within. Focus and Length Overview Liver (2 weeks) Overview: Remove potentially triggering foods, add supportive foods, reduce toxic exposure, support detox pathways Diet: Root Cause Intro diet: remove gluten, dairy, soy, sugar Supplements: Liver reset powder, NAC, methylation support, magnesium Benefits: Eliminate overall toxic exposure, improve body’s detoxification abilities, reduce body’s toxic burden Adrenal (4 weeks) Overview: Rest, de-stress, reduce inflammation, balance the blood sugar, replenish nutrients and add adaptogens Diet: Root Cause Paleo Diet: remove grains Supplements: Adrenal adaptogens, B vitamins, magnesium, selenium, thiamine, vitamin C Benefits: Shift body into a regenerative process, increase strength and resilience, rebalance inflammatory hormones Gut (6 weeks) Overview: Remove reactive foods, supplement with enzymes, balance the gut flora, nourish the gut Diet: Root Cause Autoimmune Diet: remove gut-reactive foods including eggs, nightshades, seeds, nuts Supplements: Betaine, L-glutamine, omega-3 probiotics, systemic enzymes, vitamin D, zinc Benefits: Renew bacterial and microbial balance, eliminate digestive distress, reduce autoimmune expression
Absorption of thyroid hormones requires the presence of stomach acid, which is why impaired absorption may be seen in patients with low levels of stomach acid (hypochlorhydria) and in those who do not make any stomach acid (achlorhydria). Some of my clients and readers with low stomach acid have found that taking thyroid medications with hot lemon water (the juice of one lemon in an eight-ounce glass of water) or with apple cider vinegar (one teaspoon per eight-ounce glass of water) can help provide enough acidity to
If you are currently taking acid-suppressing medications for acid reflux, I suggest that a careful reevaluation of these meds be done with your doctor. Acid-suppressing medications can exacerbate low stomach acid, which is again common in Hashimoto’s and has symptoms identical to those seen in acid reflux.
Tirosint is a gelcap formulation of levothyroxine that showed adequate absorption even when taken with PPIs and coffee.
Top hypoallergenic choices are Tirosint, WP Thyroid, and compounded T4/T3 medications.
clients will report that they feel best with a TSH between 0.5 and 2 μIU/mL and when their free T3 and free T4 are in the top half of the reference range. Meanwhile, a TSH as high as 10 μIU/mL may be considered normal by some clinicians.
A TSH below 0.3 μIU/mL, with or without a free T3 or free T4 above the reference range, may suggest that you are overdosed on your medications. • A TSH above 2 μIU/mL, with or without a free T3 or a free T4 below the reference range, may suggest that you are underdosed on your medications. • In contrast, a TSH below 0.3 μIU/mL with a free T3 or a free T4 below the reference range may suggest a communication breakdown between the thyroid and the pituitary. • When free T3 is below or within the low end of the reference range while free T4 is above the reference range or in the optimal upper part of the reference range, this suggests that a person may benefit from a T4/T3 combination medication due to impaired conversion. • An elevated reverse T3 may suggest that a person may benefit from a higher dose of T3 while working on stress reduction and other triggers that may elevate reverse T3.
However, low doses of this medication have been found to modulate the immune system and have shown promise in improving cases of autoimmune disease, including Crohn’s, multiple sclerosis, and Hashimoto’s as well as other immune system–related conditions such as cancer and HIV/AIDS. Doses of 1.5 to 4.5 mg every night at bedtime are usually recommended and have been reported to enhance immune function through increasing our endogenous endorphin production, reducing inflammation, promoting DNA synthesis, and slowing down motility in the GI tract to facilitate healing.
Dr. Kent Holtorf, LDN can improve the transport of thyroid hormones into cells, improve T4 to T3 conversion, and reduce the conversion of T4 to reverse T3.
As LDN can produce a rapid decline in autoimmunity, cases of hyperthyroidism necessitating a lowering of thyroid medications have been reported in people who have Hashimoto’s and take thyroid medications. A starting dose of 0.5 mg is recommended in Hashimoto’s, with periodic dosage increases of 0.5 mg until a target dose of 3 to 4.5 mg is reached.
Low-Level Laser Therapy LLLT is a clinically researched option for Hashimoto’s that can regenerate thyroid tissue and reduce thyroid autoimmunity, restoring thyroid function! While most body organs are not accessible to laser therapy, the thyroid gland is close enough to the skin surface that the laser can penetrate it. Additionally, this therapy is painless, noninvasive, low cost, and low risk, as it does not use ionizing radiation.
Dr. Kirk Gair from West Covina, California, who is also a Hashimoto’s patient, has used cold lasers in his clinic since 2004 and has developed protocols that combine LLLT with functional medicine modalities. He is also working to train other practitioners and spread awareness about LLLT with autoimmune thyroid disease. For updates and a listing of clinicians who specialize in LLLT, please be sure to go to http://www.thyroidpharmacist.com/action.
Essential oils can be diffused in the air with an oil diffuser, taken internally, or applied topically. One of my colleagues Carrie Vitt swears by using a blend of essential oils like frankincense, clove, myrrh, marjoram, basil, and lemongrass applied topically to the thyroid gland to support thyroid function naturally. Myrtle and lavender (Lavandula angustifolia not Lavandula × intermedia) may also help. Myrtle is a potent adaptogen. Lavender helps with restoring hair and calming anxiety. Caution should be exercised when using essential oils. Please keep the following in mind if you’re thinking about incorporating essential oils to your routine: • Many oils need to be properly diluted with carrier oils like coconut oil or jojoba oil before applied to the skin to prevent irritation. • I don’t advise ingesting essential oils internally unless you’re working with a qualified aromatherapist, as some oils may be toxic when taken internally.
food allergies, which are governed by the IgE branch of the immune system. Food sensitivities, though similar sounding, are a different type of immune reaction governed by the IgG or sometimes the IgA and IgM branch of the immune system. Food allergies are widely accepted as true medical conditions by conventional practitioners, while food sensitivities are considered experimental and not recognized by conventional medicine or insurance companies. In Hashimoto’s, I’m specifically interested in IgG food sensitivity testing. IgG food reactions are known as type IV hypersensitivity reactions. Hashimoto’s, too, seems to be governed (at least partially) by the IgG branch of the immune system and is considered a type IV hypersensitivity reaction. Though there is no research supporting this yet, anecdotally, I have seen that eating IgG reactive foods does seem to fuel Hashimoto’s.
I’ve found that the Alletess food sensitivity test has been the most accurate for my clients and myself.
The lab will also send me updates on the most reactive foods for people with Hashimoto’s who have gotten the tests so that I’ll be able to share this information with you in future newsletters. For more information, please go to http://www.thyroidpharmacist.com/action.
you are an athlete or find yourself more tired on the traditional Paleo or Autoimmune Paleo diets, or if you have excess cortisol, elevated reverse T3, and hormonal abnormalities, you may benefit from getting more carbohydrates. Rather than filling up on processed grains, I recommend adding more real food carbohydrates, such as pumpkin, squash (butternut squash is an excellent choice), sweet potatoes, plantains, bananas, apples, cassava flour, legumes, and grain-like seeds such as buckwheat, quinoa, or white rice (as long as you’re not sensitive).
Menstrual cramps, migraines, restless leg syndrome, constipation, anxiety: You may benefit from magnesium citrate. • Muscle wasting: You can benefit from a potassium bicarbonate supplement, a magnesium supplement, a multivitamin supplement like Nutrient 950 (iodine-, iron-, and copper-free) from Pure Encapsulations, and an amino acid powder like Amino-NR from Pure Encapsulations. • Pain, inflammation, dry skin, oily hair, acne, eczema: You may benefit from 1–4 g of fish oil per day. • Fatigue, brain fog, low blood pressure, adrenal issues, carbohydrate intolerance: You may benefit from 600 mg of thiamine per day or more. • Vertigo, seizures, H. pylori infection, history of vegan or vegetarian diet: Try methylcobalamin sublingual tablets, liquid vitamin B12, or B12 injections (testing of levels recommended before supplementing). • Epstein-Barr virus, swollen glands, frequent colds: You may benefit from 500–3,000 mg of vitamin C per day, or IV vitamin C. • Postpartum, breastfeeding, pregnancy, low reverse T3, adverse reaction to selenium, fibrocystic breasts: You may benefit from an iodine supplement of up to 200 mcg per day. • Fat malabsorption (greasy, floating, or light-colored stools, gas or belching, dry skin, gallbladder pain, gallstones, gallbladder removal, nausea, hormonal imbalances, vitamin ADEK deficiency): You may benefit from the Rootcology Liver & Gallbladder Support, the Digestion GB supplement from Pure Encapsulations, or the LV-GB supplement from Designs for Health. • Pancreatic enzyme insufficiency (weight loss, diarrhea, gas, oily stools, bloating, stomach pain a few hours after eating): You may benefit from the Rootcology Liver & Gallbladder Support, Pancreatic Enzyme Formula from Pure Encapsulations, or the LV-GB supplement from Designs for Health. • Skin rashes, dryness, breakouts associated with sulfur sensitivity: You may benefit from zinc picolinate doses above 30 mg and 100–600 mcg of molybdenum per day. • Fat malabsorption, living in a northern climate, low intake of fatty fish, low exposure to sunlight, history of Hashimoto’s: These suggest the need for vitamin D (testing of levels recommended before supplementing). • Hair loss, anemia, pale skin, fatigue, ice cravings, carrot cravings: These suggest the need for ferritin or iron (testing of levels recommended before supplementing).
Adrenal Hormonal Protocols per Saliva Test Results Stage 1: High-cortisol stage: In this initial stage, the HPA axis is overresponsive. An adrenal saliva test would reveal high total cortisol and borderline, low, or normal DHEA. Protocol: • Pregnenolone: 6–8 mg, 2–3 times per day for 3–6 months • DHEA: 4 mg, 2–3 times per day for 3–6 months • Phosphatidyl Serine (soy free) by ProThera: Take 30 minutes prior to high cortisol reading for 1–2 weeks Stage 2: Cortisol-dominant stage: Now DHEA is either low or borderline, and overall cortisol levels are normal, but an adrenal saliva test may reveal fluctuations in the cortisol rhythm, such as excessively high cortisol in the morning but lowered later in the day. As this continues, the adrenals eventually become exhausted and start to burn out, progressing to the third stage. Protocol: • Pregnenolone: 8–12 mg, 2–3 times per day for 3–12 months • DHEA: 2–3 mg, 2–3 times per day for 3–12 months • Phosphatidyl Serine (soy free) by ProThera: Take 2–4 hours prior to high cortisol reading for 1–2 weeks Stage 3: Low-cortisol stage: In this stage, DHEA is either low or borderline low, and the total cortisol is low. Protocol: • Pregnenolone: 10–15 mg, 2–3 times per day for 3 months to 2 years • DHEA: 1–3 mg, 2–3 times per day for 3 months to 2 years • Hydrocortisone: 5–15 mg per day in divided doses, if total cortisol is under 15, for 1 to 6 months • Licorice drops: 5–10 drops taken 4 hours prior to low cortisol readings for 3–6 months (do not use with high blood pressure) Cautions: While most of the supplements I recommend in this book are generally well tolerated and highly unlikely to cause adverse reactions, the hormonal protocol supplements are an exception to this. All of the above-listed supplements have the propensity to impact hormone levels, and while they are available without a prescription, I do recommend that they be used only under the supervision of a trained practitioner. Pregnenolone: Not to be taken with history of hormone-dependent cancers or tumors or with hyperthyroidism.
PHARMACOLOGIC TREATMENT • For hydrogen-producing bacteria: Rifaximin 1,200 mg daily for 14 days • For methane-producing bacteria: Rifaximin 1,600 mg per day for 10 days, combined with neomycin (1,000 mg daily for 10 days) or metronidazole (750 mg per day for 10 days) HERBAL AND ALTERNATIVE TREATMENT • CandiBactin-BR: 2 capsules, 3 times per day for 60 days • Oil of oregano 150 mg: 2 capsules, 3 times per day for 60 days • For methane-producing bacteria, add Allicillin (garlic extract): 2 capsules, 3 times per day for 60 days SUPPORTIVE TREATMENT • Peppermint tea: 2–3 cups per day • Physicians’ Elemental Diet by Integrative Therapeutics used as meal replacement for 2–3 weeks (may exacerbate adrenal issues) • Specific carbohydrate diet for 60–90 days • GAPS diet for 60–90 days • Low-FODMAP diet for 60–90 days
Retesting To ensure that the SIBO has indeed been eradicated and not just reduced, it’s important to retest with another breath test within two weeks of finishing SIBO treatment.
Root Cause Broad-Spectrum Gut-Cleansing Protocol • Oil of oregano 150 mg: 2 capsules, 3 times per day for 60 days • CandiBactin-BR: 2 capsules, 3 times per day for 60 days • S. boulardii: 5 billion–15 billion CFUs, 2–4 times per day (up to 8 per day) for 60 days • Wormwood-containing antiparasitic: 600 mg, 2 times per day for 7 days, repeat in 2 weeks (Do not use if you have a history of hepatitis or elevated liver enzymes.)
French-Canadian dentist Dr. Mark Bonner has found that most cases of periodontitis are caused by two parasitic infections of the gums: Entamoeba gingivalis and Trichomonas tenax.
Dr. Bonner has created a protocol that involves the use of pharmaceuticals (antiparasitics, antifungals, antibiotics) and advanced dental cleaning methods and testing of the periodontal pockets to ensure eradication of Entamoeba gingivalis and Trichomonas tenax and a return of healthy gum flora. He reports that this method is a cure for periodontitis and has trained over six hundred dentists on the method. For more information on Dr. Bonner’s protocol and additional dental guidance, I recommend his book To Kiss or Not to Kiss and the website http://www.parodontite.com.
Using probiotic toothpaste: Designs for Health makes PerioBiotic toothpaste, a special probiotic toothpaste that is free of fluoride and triclosan and packed with probiotics.
Step 2: Follow your new dental routine: 1. Start your day with oil pulling. Swish around approximately 1 tablespoon of sesame oil or coconut oil in the mouth, between the teeth, first thing in the morning for 5–20 minutes, until the oil turns white. 2. Swish and spit with 1 teaspoon of colloidal silver liquid 3 times per day for 60 seconds. (Please note: Do not attempt to make your own colloidal silver solution. Improper preparation methods have resulted in argyria, or blue man syndrome. I recommend the following brands only: Designs for Health, Sovereign Silver, and my specially formulated Rootcology brand.) 3. Spray xylitol spray on your gums and teeth 3 times per day to help break up bacterial biofilms, or chew xylitol gum (do not chew xylitol gum with amalgam fillings, as mercury vapor is released with any kind of chewing). You can make your own xylitol spray by purchasing bulk xylitol powder (Designs for Health is one brand I like). Then use 1 teaspoon of powder in 8 oz. of fluoride-free water. 4. Use a fluoride- and triclosan-free toothpaste to brush your teeth in a jiggling motion as described previously 3 times per day. 5. Take oral probiotics 3 times per day. Garden of Life Probiotic Smile is an excellent brand. You also have the option of using a probiotic-rich toothpaste.
the symptoms associated with sinusitis, I recommend implementing the following: a nasal rinse like the neti pot once or twice daily, the Root Cause Broad-Spectrum Gut-Cleansing Protocol, the Yeast Overgrowth Protocol, and using a silver nasal spray like Argentyn 23. To use Argentyn 23 nasal spray, administer five to ten sprays in each nostril for seven to fourteen days, then two sprays in each nostril twice per day until the infection resolves.
Strategies for Overcoming MCS The Cyrex Laboratories Array 11—Chemical Immune Reactivity Screen can help you determine if you are sensitive to any of nineteen chemical substances. If you are found to be reactive, you may require major environmental changes to recover your health. See the Household Toxins table for guidance. HOUSEHOLD TOXINS Chemical Found In Strategy Bisphenol A (BPA) Plastics, receipts Remove plastics from your cooking and food storage utensils. Formaldehyde Furniture made from particle board, car seats Air out car before getting in. Avoid buying new particle board furniture. Benzenes In blackened food Avoid charred, grilled, and burned foods. Tetrachloroethylene In dry cleaning Opt for only “green” dry cleaning that avoids the use of these chemicals, or skip dry cleaning altogether. Air out dry-cleaned clothes before wearing. Tetrabromobisphenol A Flame retardants, especially in mattresses Purchase a bromine-free mattress made of naturally flame-resistant substances like wool. Parabens Personal care products such as makeup, shaving cream, lotions, and shampoos Purchase paraben-free, organic personal care products.
Testing for Mold You can run a RealTime Laboratories test for mold metabolites in your urine to determine if mold has taken up residence in your body. Additionally, it may be helpful to do the mold panel from ALCAT lab to see which molds are reactive in your body. If you’ve done stool testing, sometimes the tests may reveal mold overgrowing in your gut. The mold will show up as “yeast present—taxonomy unavailable.” If you suspect there may be mold in your home, you can work with a mold inspector in your area or self-order a mold test like MOLDetect.
• Antifungal medication like fluconazole or itraconazole: for 30–90 days for killing mold in body • Cholestyramine powder: for 30–90 days for binding mold to carry out of the body HERBAL AND ALTERNATIVE TREATMENT • Oil of oregano: 2 capsules, 3 times per day for 30–60 days • S. boulardii: 5 billion–15 billion CFUs, 2–4 times per day (up to 8 per day) for 60 days • Argentyn nasal spray: 1 spray in each nostril, 1–2 times per day (for mold in sinuses) • Activated charcoal: 2 capsules at bedtime (may cause magnesium depletion) • CholestePure by Pure Encapsulations (soy derived): 1–2 capsules, 3 times
Strategies for Overcoming Metal Toxicity Rather than forcefully pushing out heavy metals, I like to usher them out gently and politely by reducing exposure, using competitive nutrients to our advantage, and incorporating sauna therapy, especially infrared sauna, which can be very helpful in healing. We’ll look at these strategies as well as an overall Gentle Metal Detoxification Protocol first. Then I’ll go into specific protocols for sulfur and copper.
Some especially useful vitamins and minerals are selenium, zinc, molybdenum, iodine, and B vitamins. It’s also important to make sure you have sufficient levels of glutathione, an important molecule that detoxifies heavy metals. I’ve already recommended NAC and selenium methionine, which boost your glutathione levels, but you can also take oral liposomal glutathione to increase levels.
Gentle Metal Detoxification Protocol Two important parts of detoxification involve mobilizing the toxins and adsorbing the toxins. Mobilizing toxins can be done with prescription chelating agents or cilantro in concentrated form. As I often find that people with Hashimoto’s report feeling worse rather than better after prescription chelation agents, I prefer to use cilantro to start. The second important part of detoxification is adsorbing the toxins so they stick to the substance and are ushered to removal rather than roaming free within the body. Various substances are used for adsorbing toxins, such as chlorella, activated charcoal, and fiber as apple pectin or psyllium. I personally have preferred activated charcoal and psyllium husk fiber, as chlorella can be problematic for some with Hashimoto’s due to high iodine content and immune-modulating properties associated with seaweeds.
The following is a gentle protocol for heavy metals. The duration of treatment will depend on the toxic load. • A psyllium mixture can help adsorb toxins from the gut and prevent their reabsorption by stimulating bile excretion. Psyllium has the added benefit of lowering cholesterol and blood sugar, preventing gallstone formation, and increasing colonic butyrate, which boosts good bacteria. Charcoal and psyllium should be used together, as psyllium can prevent charcoal-induced constipation. Add 1 teaspoon of psyllium husks to 8 oz. of water and mix. Drink mixture, and then follow with one more 8 oz. cup of water. Be sure to separate from food and other supplements by 2 hours. Utilize this mixture 1–3 times per day. • Activated charcoal can help clear toxins from the intestinal tract and appendix and prevents hepatic recycling of toxins. Start with 1 capsule of activated charcoal daily apart from meals (midday around 3:00 to 4:00 P.M. usually works best for most people), and then work your way up to 3 capsules. Be sure to supplement with magnesium citrate, as activated charcoal can deplete magnesium and lead to constipation and other symptoms of magnesium deficiency. • Cilantro mobilizes toxins. Take 2 drops twice per day before meals (or 30 minutes after charcoal or psyllium mixture) for 1 week on, then 3 weeks off. May repeat for 1 week each month to move toxins out gradually and gently. • Apple pectin or rice bran fiber may also be used as sources of fiber that can help with clearing out toxins from the body. Take 7 to 10 g per day. • Alpha-lipoic acid is a sulfur-containing supplement that can help reduce heavy metals and increase glutathione levels. Take 100 to 300 mg per day. (Avoid with CBS gene mutation.) A note about fiber: Ideally, you will have cleared out any gut infections, especially SIBO, as you’re working on detoxification. Detoxification protocols that contain fiber can aggravate SIBO, dysbiosis, and other types of gut imbalances. If you do have toxins in your body, it may also help to continue taking vitamin C, a multivitamin, betaine with pepsin (heavy metals deplete…
MTHFR MUTATION PROTOCOL Rootcology Methylation Support, Pure Encapsulations Homocysteine Factors, and Designs for Health Homocysteine Supreme are MTHFR support supplements with activated B6 (as riboflavin-5’-phosphate), activated folate, and B12 as methylcobalamin and trimethylglycine. Homocysteine Test Results Number of Capsules per Day <6 μmol/L 1 6–9 μmol/L 2 9–15 μmol/L 3 9–15 μmol/L 5