My Hashimoto's Flared, Again... Here's What I Changed
May 25, 2022
Rhya Pachin, RDN, LDN, CLT

Hashimoto’s has been a part of my health journey since I was first diagnosed at age 22, probably not coincidentally right after shattering my ankle (unfortunately not even a cool story) which required 2 metal plates and 9 screws to repair. I knew even that that with my family history of autoimmune and thyroid issues on both sides of my family that having a foreign metal implant placed in my body was not a great option. I instantly gained 15 lbs, accompanied by fatigue and constipation. I was miserable, but found help from a holistic physician who prescribed Armour thyroid and a gluten-free diet, which helped resolve my symptoms. I was able to stop the medication about a year later, and was feeling pretty good until after the birth of my second daughter 8 years later.


After that first flare, many tears and a long, frustrating search for an obliging physician (because of course my labs were “normal”) I went back on medicine for about 2 years. I didn’t feel as good as I did the first time on meds, and discovered that my cortisol (or lack thereof) was a persistent root cause of my yo—yo-ing thyroid. I changed my sleep routine (less screen time, earlier bedtime); changed my exercise (no running or HIIT), and added supplements to reduce inflammation and support stress management. Again, I was able to stop medication (suggested by my doctor due to heart palpitations), but it took me about 6 months to wean off because my dose this time around had been much higher.


Fast Forward to This Year

So it’s been 4-5 years since that last flare, and I’ve felt pretty good following a gluten-free diet, and minimizing alcohol, soy, canola, dairy, and corn. I was still supplementing with adrenal/cortisol support as my workload increased, but other than that I was doing pretty well with just the basics.

Honestly, I felt like this flare sort of came out of nowhere, which was sort of discouraging. I am pretty darn good about my diet—the worst thing that might sneak in is junky Halloween candy once a year, or a cocktail a few times a year. Yeah, really pretty good, right?! But…… I’m working more than I ever have (easy to do when you do what you love!) and juggling a house and kids and all the things. So maybe it makes sense?



I took a look at my labs...

As I looked at my labs objectively (hard to do when they’re your own and you feel like you’ve been doing EVERYTHING), there were definitely a few clues as to why my thyroid was inciting a riot.

  • My Vitamin D level had dropped from the 60’s to the 30’s.
  • My selenium, Vitamin K1, and zinc were in the lower-normal range (per the full micronutrient panel I ran), and my cortisol was not optimal (more like under-the-ground low--see below).
  • As a result, my labs showed very high anti-thyroglobulin antibodies, and
  • low-normal Free T3 (see below).

What I changed


I had two choices—feel sorry for myself or fix it. So here we are.

  • I increased my Vitamin D,
  • got dogmatic about taking my multi which has 200mcg selenium and plenty of K1 in it (but only useful if I take it!), and
  • increased zinc
  • I also added a thyroid glandular supplement (work with a practitioner to do this) which probably contributed to the significant decrease in TSH, and the jump in my Free T3.


With just a few simple changes, my labs improved! I’m not there yet, but I’m on the right track (see below).


Ongoing Preventative Steps

Now, I’m adding more NAC and glutathione in hopes to further reduce my antibodies, and adding more aggressive cortisol support which includes ashwagandha, a wonderful adaptogenic herb that has been shown to regulate the body’s stress response and support the thyroid. If I had to guess, this is probably my root cause and will require more consistent attention long-term. Stress is powerful (!) and as I get older I have a greater respect for the boundaries it requires us to keep.


And so this is my journey. It’s not always easy, but there are tools and resources available to help us find and maintain the best health possible. You’re not alone, and the journey is worth it!


*Please note this is not intended in replacement for specific, personalized medical recommendations.

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About the Author

Rhya Pachin is a licensed dietitian nutritionist who employs an "integrative" approach to support overall health rather than addressing just one symptom. As a certified LEAP therapist, she designs and supervises custom elimination diets. Her focus areas include gastrointestinal conditions like IBS and IBD, autoimmune diseases such as rheumatoid arthritis and Hashimoto's, persistent weight issues, food sensitivities, and chronic inflammatory conditions in both adults and children.

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