If you have low thyroid chances are it’s due to an autoimmune disease called Hashimoto’s. Hashimoto’s is an autoimmune condition in which the immune system attacks and destroys the thyroid gland. For some, managing autoimmune Hashimoto’s is as easy as going gluten-free, a common trigger. For others, it requires trial and error to figure out what is triggering your flares. Managing Hashimoto’s low thyroid requires an approach that targets balancing the immune system.

Although going gluten-free is vital, it’s often not a stand-alone solution. Here are other things to consider if your low thyroid condition is not improving:

1. Leaving your thyroid care to conventional medicine alone. If you put the entirely of your thyroid care in the hands of the standard health care model, you may never see great results. Conventional medicine is based on lowering TSH into lab ranges with T4 medication. A person with Hashimoto’s needs to become self-educated for optimal results. A practitioner who understand functional medicine approaches to Hashimoto’s may still be necessary, but either way, patient participation is integral.
2. Skipping meals. Blood sugar dropping too low from skipping meals can cause thyroid flare-ups. Low blood sugar symptoms include shakiness, blurred vision, irritability, spaciness, fatigue, and loss of function. Feeling more energetic after eating means your blood sugar was too low. Skipping meals promotes Hashimoto’s flare-ups.
3. Ignoring blood sugar stability. Eating sweets and starchy foods make blood sugar spike and crash, which can trigger thyroid flare-ups. Symptoms of unstable blood sugar include fatigue, energy crashes, sugar cravings after meals, insomnia, and waking up feeling anxious at 3 or 4 a.m. If you are not conscious about maintaining stable blood sugar it will be difficult to manage Hashimoto’s low thyroid.
4. Ignoring health of your brain. Hashimoto’s low thyroid can degenerate the brain, causing symptoms that mimic Hashimoto’s, such as brain fog, depression, and memory loss. It’s important to actively support your brain health as part of your Hashimoto’s low thyroid protocol. 
5. Not really gluten-free. You can’t be only somewhat gluten-free, it’s all or nothing with autoimmune low thyroid. Gluten is a major trigger for most people with Hashimoto’s low thyroid. If you cheat on your gluten-free diet, are not careful about avoiding gluten, or eat foods that cross-react with gluten, you can hinder your recovery process. 
6. Consuming foods that cross react with gluten. Eating foods that cross react with gluten can sabotage your success managing Hashimoto’s low thyroid. Cross-reactive foods have proteins that are structurally similar to gluten. This can trigger reactions. Common cross-reactive foods include milk (casein), rice, corn, sesame, and oats.
7. Chronic stress. Stress is well known for triggering inflammation and autoimmune thyroid flares. Sources of stress include unstable blood sugar, gut inflammation, chronic infection, bad relationships, an unhealthy work environment, and a chronic negative attitude are chronic stressors. Do what you can to mitigate stressors give yourself regular time off.
8. Not going beyond thyroid meds. Many people think thyroid wellness will happen with the perfect thyroid medication. Although it’s important to find the best thyroid med for you, meds alone don’t address the complexity of autoimmune Hashimoto’s low thyroid. It requires functional medicine and lifestyle approaches. If you eat foods or do things that trigger your autoimmune symptoms that works against what meds can do. 
9. You take supplements that over stimulate your immune system. Some supplements can make your Hashimoto’s low thyroid worse or better depending on your immune system. For instance, echinacea, green tea, acai, Astragalus, and licorice may either help or aggravate autoimmunity, depending on whether you have TH-1 or TH-2 dominance. It’s important to be know this so you don’t inadvertently make yourself worse. Refer to Why Do I Still Have Thyroid Symptoms? for more information.
10. You react to thyroid med fillers. Many thyroid medications and supplements contain fillers that may trigger your autoimmune thyroid symptoms. For instance, some supplements contain gluten or are contaminated with gluten. Ensure your thyroid hormones are free of gluten and corn if you react to those. Always keep tabs the filler ingredients as they often change without notice.

How to learn if you have Hashimoto’s low thyroid

Many patients are not diagnosed with hypothyroidism or Hashimoto’s until after several years and going through several doctors. It is a demoralizing journey richly illustrated in my book The Truth About Low Thyroid: Stories of Hope and Healing for Those Suffering With Hashimoto’s Low Thyroid Disease, through real-life stories from patients in my practice. Managing Hashimoto’s goes far beyond using thyroid medication as you must work to stop the immune system from attacking the thyroid. For more information on identifying and managing Hashimoto’s low thyroid, contact my office.

About Dr. Josh Redd, Chiropractic Physician — Utah, Nevada, Arizona, Idaho, and New Mexico functional medicine

Dr. Joshua J. Redd, DC, MS, DABFM, DAAIM, author of The Truth About Low Thyroid: Stories of Hope and Healing for Those Suffering With Hashimoto’s Low Thyroid Disease, is a chiropractic physician and the founder of RedRiver Health and Wellness Center with practices in Utah, Arizona, and New Mexico. He sees patients from around the world who suffer from challenging thyroid disorders, Hashimoto’s disease, and other autoimmune conditions. In addition to his chiropractic degree, Dr. Redd has a BS in Health and Wellness, a BS in Anatomy, and a MS in Human Nutrition and Functional Medicine.  He speaks across the nation, teaching physicians about functional blood chemistry, low thyroid, Hashimoto’s, and autoimmunity. You can join his Facebook page here.