If you have Hashimoto’s, then you may know how difficult it is to find a multivitamin that is safe for you. Most multivitamins, even the expensive practitioner brands, are frequently inappropriate for Hashimoto’s patients.
They have ingredients that can flare up your symptoms or work against your goal of reducing symptoms. They contain forms of vitamins that many people with Hashimoto’s are genetically not able to utilize, and they often contain herbs that do not consider the needs of the autoimmune patient.
As a result, many Hashimoto’s patients buy multivitamins unaware they are flaring their Hashimoto’s symptoms. Or they buy multiple bottles of various ingredients to piece together their own autoimmune-specific multivitamin, which is cumbersome and expensive.
As practitioners, we found recommending our patients buy multiple bottles of supplements each month, and take handfuls of pills several times a day for the rest of their life was simply asking too much.
Yet in working with thousands of Hashimoto’s patients across seven different clinics, we saw how dangerous conventional multivitamins were for many of our patients.
We simply could not find a multivitamin that met their unique needs and did not cause further harm.
Faced with no other option, Dr. Paul Stadler, set out to create the perfect multivitamin for patients with Hashimoto’s and autoimmunity. He started by researching nutritional needs that are common among all people. He then considered the unique nutritional requirements for those with Hashimoto’s. Lastly, he reviewed the latest research in products likely to cause problems for individuals with Hashimoto’s.
Three things a Hashimoto’s-friendly multivitamin must have—or not have
Below are the three things we needed this multivitamin to accomplish. These are the three things you also need to look for in a product you choose:
- First, it has to be free of iodine. This is extremely difficult to find as most multivitamins contain iodine at levels significantly over the maximum recommended daily allowance (RDA).
- It must contain bioavailable forms of vitamins, particularly B vitamins. Many Hashimoto’s patients have a genetic variation that makes it difficult for them to absorb and utilize conventional forms of B vitamins.
- It must contain immune regulators (meaning they support appropriate function of the immune system), NOT immune boosters. A number of herbs and other botanicals can flare autoimmunity because they stimulate immunity. Some multivitamins contain herbs that boost the immune system and tout this as a benefit of use. This can be a disaster for the autoimmune patient whose immune system is already overly active.
Instead, a Hashimoto’s-appropriate multivitamin will ideally contain nutrients that have been shown in studies to help balance and regulate the immune system, and in doses to be effective at doing this. This means avoiding immune-stimulating herbs and including a sufficient amount of vitamin D, which promotes T-cell regulation and reduces inflammation.
The ideal Hashimoto’s multivitamin
Because the market lacked a good multivitamin for our patients, we were forced to make our own.
Dr. Stadler used both peer-reviewed studies and his experience working with thousands of patients who have Hashimoto’s to formulate the ideal multi.
Following is an overview of our multivitamin, called Vicatalyst, and the reasoning behind the ingredients and dosages.
Does your multi have iodine in it?
The first and most important thing to look for in a multi when you have Hashimoto’s is whether it has iodine in it.
Numerous studies over many years have shown that high-dose iodine exacerbates Hashimoto’s. In countries that introduce iodized salt, the rates of Hashimoto’s-induced hypothyroidism go up. Additionally, studies show that when subjects eat a low-iodine diet, their symptoms and autoimmune flares decline.
In other words, if you have Hashimoto’s, do not willingly take iodine on a daily basis.
We see real-life examples of this in our clinics on a weekly basis — our Hashimoto’s patients get on a good protocol to manage their symptoms. Then suddenly their thyroid symptoms start flaring and they can’t figure out why.
Many times, we find out they had started taking a “high quality” multi that has 100-600 percent of the RDA of iodine.
By simply removing this multivitamin from their supplement regimen, their Hashimoto’s symptoms gradually improve again.
Iodine is necessary for thyroid function and in areas of the world where iodine deficiency is a problem (due to poor dietary options), people develop hypothyroidism and goiter. However, this is very rarely an issue in the United States. Our foods easily supply the trace amounts of iodine required on a daily basis, without the need for additional supplementation.
Research shows your body needs a total of roughly three-quarters teaspoon of iodine for your entire life! You should be able to get plenty of iodine from a balanced diet.
What forms of B vitamins does your multi have?
One of the best examples of what makes a good Hashimoto’s-specific multi is the type of B vitamins used.
Most multis contain high doses of the most economical but less bioavailable forms of B vitamins, such as cyanocobalamin for B12 and pyridoxine for B6. These B vitamins are used in amounts higher than what the body can absorb and are largely excreted in the urine.
In order for the body to be able to utilize them, the liver must convert these inactive B-vitamins into a bioavailable form using rate-limiting enzymes the body makes, and methyl donors the body acquires. Methyl donors help trigger many necessary processes in the body, as well as support liver detoxification.
However, many people with Hashimoto’s have a genetic variation that prevents them from being able to create sufficient quantities of these enzymes and absorb enough of the methyl donors. This plays a role in their thyroid autoimmunity.
A person with genetic methylation defects will need to take compounds that support methylation, such as methyl folate, for the rest of their lives to ensure better health.
One of the best ways to support this underactive methylation pattern is to use methyl forms of B vitamins, such as methylcobalamin for B12 and methyl folate for B9.
These forms not only help the Hashimoto’s patient methylate more efficiently, but they are also more easily absorbed by the body without placing extra burden on the liver.
This is important for people with Hashimoto’s, as low thyroid function bogs down liver and gallbladder function. The patients we see with Hashimoto’s often have a sluggish liver, gallbladder sludge or gallstones, and non-alcoholic fatty liver disease.
Also, chronic illnesses such as other autoimmune diseases, Epstein-Barr virus, Lyme disease, or even something like high blood sugar from pre-diabetes or diabetes, flood the liver with inflammatory immune cells that impair its function.
People with these conditions will not do as well with inactive forms of vitamins and other compounds that depend on the liver to be metabolized into a usable form.
How well does the multivitamin tablet or capsule break down for absorbability?
When formulating a multivitamin to meet the needs of a Hashimoto’s patient, one challenge was getting all the ingredients to fit into just a few tablets or capsules. We get it. We don’t like taking handfuls of pills every day either.
We personally opted for tablets because we can fit twice as many compounds into a tablet than a capsule of the same size. The concern with tablets is whether they break down quickly enough for proper absorption.
Vicatalyst was formulated with ingredients that allow micropscopic spaces throughout the entire tablet. This allows the tablet to swell and break apart quickly when exposed to liquid at body temperature.
Research shows that selenium can help prevent a Hashimoto’s flare in a patient who consumes excess iodine. While we advise our Hashimoto’s patients not to take supplemental iodine, we know they will likely get too much iodine in their diets if they are eating out with any regularity or eating packaged foods. This is due to the use of iodized salt in food manufacturing and the food service industry.
Adding selenium to the vitamin blend helps prevent flare-ups and the negative impact from these incidental iodine exposures for the Hashimoto’s patient.
Aside from helping prevent Hashimoto’s flares, selenium plays an important role in helping convert the thyroid hormone T4 into T3. It also plays important roles in immune function and cardiovascular health.
It is rare to see a Hashimoto’s patient who does not have a chronic blood sugar imbalance, whether it is low blood sugar, high blood sugar, or volatile blood sugar that can be too high and too low just hours apart.
Chromium is well established in its role in helping balance blood sugar by supporting the insulin receptors on cells.
Because we have patients on both ends of the spectrum with blood sugar, we didn’t want to include compounds that exclusively reduce high blood sugar or raise low blood sugar. Chromium is a good option for its regulatory effects and ability to address both ends of the blood sugar spectrum without exacerbating symptoms.
Multiple food-based phytonutrients
Inflammation and oxidative stress — or damage to cells and tissues — is an ongoing concern with all people, but especially those with autoimmune conditions such as Hashimoto’s.
The body makes most of its antioxidants in the liver if the liver is functioning optimally. However, some antioxidants are also available from foods and supplements we consume.
Vicatalyst was formulated with whole fruit and vegetable blends to supply extra antioxidants.
We include a wide variety of food-based nutrients for a simple reason: Research shows the body absorbs whole food-based blends of plant antioxidants, micronutrients, and phytonutrients better than isolated synthetic compounds due to the synergy between these compounds.
Focus on safety when looking for a multivitamin or other supplements when you have Hashimoto’s
I hope by now you understand the reasons why you must be discerning when choosing a multivitamin or other supplement when you have Hashimoto’s or another autoimmune disease.
With a focus on dampening inflammation and keeping the immune balanced, make sure your daily supplements will not inadvertently cause your symptoms to flare up.
Work with your prescribing physician to find the best thyroid medication option for you while also working on taming inflammation and thyroid autoimmunity.
About Dr. Redd
Josh Redd, MS, DABFM, DAAIM, is a chiropractic physician and author of the Amazon bestselling book The Truth About Low Thyroid. Dr. Redd owns seven functional medicine clinics in the western United States and sees patients from across the country and around the world who are suffering from challenging autoimmune, endocrine and neurological disorders. Dr. Redd also teaches thousands of health care practitioners about functional medicine and immunology, thyroid health, neurology, lab testing, and more.