I see a number of people with Hashimotos or auto-immune thyroid disease. In this disease your body makes anti-bodies that attack the thyroid tissue, these can cause more and more damage to the point where the thyroid is unable to make thyroid hormones.
I have Hashimotos, fortunately I am symptomless, and so no treatment is required, however my thyroid anti-bodies are high.
Since discovering this – in a general checkup a year ago, I have been researching how I can stop this attack and stay well.
I’ve discovered many treatments and attitudes to this problem are outdated, for example my Doctor said – “There is nothing you can do, we will just keep and eye on it and eventually your thyroid will become so damaged that you will need to take thyroid hormones.”
When I ask a Doctor – even a specialist “How can I stop the auto-immune attack?” “You can’t”
Fortunately there is a Scientist and Doctor who has researched this area and has successfully treated Hashimotos sufferers. His name is Dr Datis Kharrazian, and his book “Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal: A Revolutionary Breakthrough In Understanding Hashimoto’s Disease and Hypothyroidism” is an eye opener and absolute must read if you have any type of thyroid issue.
Dr K explains that Hashimotos is first and foremost an auto-immune disorder, where you are attacking the thyroid like foreign tissue. So you need to start by dealing with the environmental trigger that starts the auto-antibody attack against the thyroid. The primary trigger? Gluten, and it’s many related substances like gliadin. Dr K explains “Removing gluten is a vital first step if you have Hashimoto’s. Even if you don’t have Hashimoto’s, chances are removing this ubiquitous toxin from your diet will help you greatly. Numerous studies from several countries show a strong link between gluten intolerance and Hashimoto’s. When immune antibodies tag gluten for removal from the bloodstream, where it landed thanks to a leaky gut, this stimulates production of antibodies against the thyroid gland as well. In other words, every time you eat gluten, your immune system launches an attack not only against gluten but also against the thyroid gland. This immune response to gluten can last up to six months each time it’s ingested. It’s just not worth it. Also, as I continue my research and practice in neurology, I never cease to be amazed at how profoundly one’s brain health, a concern for all those struggling with hypothyroidism, can be impacted by removing gluten from the diet.”
Other issues include high blood sugar and insulin resistance, adrenal issues and leaky gut which all need to be addressed.
So if you have Hashimotos – STOP EATING GLUTEN NOW – no kidding, treat it as poison. It might save your health. I’ve stopped, gluten affects me in many ways, which I discovered since my health improved dramatically using the Paleo diet (I’m not only gluten, but grain and legume free)
The other thing you must not do is take iodine supplements – Hashimotos is not an iodine deficiency issue, and research shows you can make the problem dramatically worse by taking iodine. I causes a flare up of the auto-immune reaction and increases inflammation in the thyroid gland. I know this from my own experience – my TSH rocketed up and my thyroid enlarged after a few weeks taking iodine. Fortunately I read Dr K’s book and stopped it – and my thyroid returned to normal.
Read this article:
Iodine and Hashimotos
Read these article:
Changing your diet is the first step in addressing Hashimoto’s
Listen to this interview with Dr K:
Blog Talk radio
Buy this book, follow the protocol:
Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal: A Revolutionary Breakthrough In Understanding Hashimoto’s Disease and Hypothyroidism
By Datis Kharrazian
Read this excellent in depth series on thyroid disorders on “The Healthy Skeptic”
The Healthy Skeptic Blog “Thyroid Disorders” Series
This is a great overview of thyroid issues and treatments from Nutrition Bites ; Get acquainted with your thyroid
And this too: Celiac Causes Allergies and Autoimmune Diseases (Anti-Tissue Transglutaminase Can Lead to Hashimoto’s Thyroiditis)
Julianne,
Diagnosed with both Hashimotos and Graves disease (info in my blog), my endo says it is one of the most difficult things to treat because they contradict eachother. I have symptoms of both hyper and hypo and have been seriously ill for years. I recently started a blog and somehow found my way to yours. I wanted to thank you for posting about gluten in relation to Hashimotos. After being diagnosed with Celiac disease, I had to eliminate Gluten from my diet. My endo had never mentioned eliminating gluten. It is beleived, atleast by my team of doctors, that going untreated as a Celiac patient into adulthood is what led to my production of both Graves and Hashimotos anitbodies. Thank godmy daughter was recently diagnosed with Celiacs disease at the age of 12. Hopefully she will not have half the medical turbulance that I have.
Thanks again for your post.
You’re welcome.
I found Dr K’s book particularly useful. Following Paleo food choices, grain, legume, dairy and egg free – is far better for me than just gluten free, as all these products have gut irritating properties, and can aggravate the gut like gluten causing leaky gut and setting up auto-immune issues.
Julianne
Enjoyed reading your post. I have a different issue with my thyroid but I enjoyed reading the info you shared. I started a blog to share my story in hopes of helping others. I have been looking into gluten free recipes just because I believe most people would benefit from avoiding gluten. Here is a good website I found with recipes and info. She uses agava and I don’t~ i use xylitol and stevia. http://www.elanaspantry.com/
My naturpathic doctor is very good if you ever need any help that way ~ his sight is http://www.getwellnaturally.net and he does phone consultation. Literally every issue I have had he has been able to help me to get better.
Wish you all the best!
Hello,
I’ve only just found your blog, so I’ve not had time to read round and discover whether you give advice to your readers … but just in case you do, I was wondering whether my symptoms ring any bells with you. I have had an ultrasound scan recently where 4 nodules were found on my thyroid gland. They don’t look suspicious. My last lot of blood tests taken in Feb 2011 showed my TSH was very low at 0.01, but my T3 and T4 were withint the normal UK ranges (though 2 months earlier my T3 had been high and outside the normal range.) Throughout 2010 I had occasional symptoms of hyperthyroidism – fluttering heart, clammy skin, hand jitters and so forth. Over the winter this year I caught a virus but after I recovered I noticed that my thyroid is nearly always constantly stinging. On occasions I still get hyperT symptoms – rapid heart and hand tremors. But I also feel, on occasions, so fatigued that I can’t work, which is more like a hypoT symptom. I’ve recently found out that with Hashimoto’s it’s possible to have hyperT and hypoT symptoms at the same time. I know I have to be responsible for making my own decisions, but if possible I wondered whether any of these symptoms sound familiar to you in your knowledge of Hashimotos? I don’t have a diagnosis yet of the doctor regarding the cause of the nodules, but as I feel so ill I’m desperate to find my own treatment, if poss. My next blood tests are due in 6 weeks. Thanks. Soz for making this post if your blog isn’t about giving advice. 🙂
I’m not a thyroid expert. I’d suggest reading Dr K’s book and then see if you can find someone who has knowledge of his testing and protocol, or work with an holistic doctor / endocrinologist if possible. With respect to diet, if you have an auto-immune condition, a paleo diet is the best one to trial.
Thank you. 🙂
Please read my blog maybe you know of someone who can help me.
http://gmjones7778.wordpress.com/my-journal-of-health-problems/
i’m always distressed to hear the injunctions against iodine…. apparently, it’s very important to have a good balance of selenium AND iodine, and the trials that showed trouble for Hashi’s sufferers didn’t pay attention to that. check out Mario’s postings on the subject at PerfectHealthDiet.com.
Yes – I’ve read those posts, however having had a nasty experience with iodine, it is not one I want to repeat. I have read those posts and currently I am trying out a larger dose of selenium, and I add a little iodine each day. So far everything is fine. But I still (despite the theories advanced) don’t see why one needs to increase iodine to such high levels. Chris Kresser reports that some of his Hashis patients react to small doses of iodine, even when they have plenty of selenium and the dose in increased slowly.
Hi, Julianne,
I was diagnosed with Hashimoto a year and a half ago, self-diagnosed, really, because all of my symptoms were attributed to something else (sleep deprivation, work etc…)
When I, on my own, decided to check the levels of t3, t4 and tsh, my tsh was already higher than a hundred. Yes, you’ve read it right, over a hundred. Every symptom in the book I had, except the hair loss. I even lost my periods, but I attributed that to contraceptive (Mirena, hormone IUD). I had two children in 2001 and 2004, (I’m 32 years old now), and I suppose that the second pregnancy maybe triggered the Hashimoto, since when I look at the photos from that period, I kind of have that “Hashimoto look” if you know what I mean. (It’s a strange thing, three times I have had people asking me whether I had Hashimoto before I actually found out that myself. THird time I decided to give it a check.) About a year after being diagnosed, we decided to have another baby. Silly me, I thought it’ll be peace of cake, just like first two times. In February this year, I had a miscarriage (8th week). My TSH was around 7. I linked the miscarriage with the TSH level and decided to give it another try. This time, I checked the hormone levels at the very beginning and it was almost at the bottom range, something above 0. After 11 weeks I checked it again, 1,4, ideal, right? However, I started to bleed, just a bit, went to a gynecologist only to find out that the baby’s heart had stopped beating. This time, missed ab, in 12th week. When I asked my endocrinologist whether it had something to do with antibodies, she said “It could be all sorts of things”. I wasn’t happy with that answer and here I am, wondering whether my hypothyroidism has something to do with celiac disease (which I may or may not have, I do occasionally have problems with my digestion, but nothing too worrying). If it has, I suppose I only made it greater with my vegetarian diet (until I decided to get pregnant I was a vegetarian, eating mostly carbohydrates, milk, vegies and fruits).
I do take selenium supplements, 150 mcg (micrograms?), and folic acid, but nothing else. They didn’t even asked me to take blood for anti-thyroid antibodies, but, hey, I live in Serbia, and people are treated like s… here.
Another thing that I’ve read is that Hashimoto may be linked with antiphospholipid syndrome. Do you happen to know something about it? Sorry for the lengthy post.
Celiac and auto-immune Thyroid disease are highly associated http://www.medscape.com/viewarticle/547107_4
Miscarriages are a common symptom of gluten intolerance. Many of these auto-immune diseases cluster together, so it is possible you also have antiphospholipid syndrome, a test will confirm it. http://www.ncbi.nlm.nih.gov/pubmed/11421564
If you suspect Hashimotos – see if you can get your thyroid anti-bodies tested to confirm it.
I’d suggest being 100% gluten free, you can be gluten sensitive rather than have celiac disease and a gluten free diet will show this. I.e. health improves and symptoms like bloating decrease.
Julianne, thanks for your reply, it’s just what I needed,
I do feel like no one understands what I’m going through.
I’m facing a lot of skepticism. The comments are mostly: “What else do you think you have?”, like I’m some kind of hypochondriac.
Thanks a lot! I’ll check my antibodies and I’ll start gluten free diet and hopefully, we’ll see some changes!
Please, can you comment in relation to this recent publication? (I understand that this is a small sample size) thanks!
http://www.ncbi.nlm.nih.gov/pubmed/22126672
Scand J Gastroenterol. 2012 Jan;47(1):43-8. Epub 2011 Nov 30.
Gluten-free diet and autoimmune thyroiditis in patients with celiac disease. A prospective controlled study.
Metso S, Hyytiä-Ilmonen H, Kaukinen K, Huhtala H, Jaatinen P, Salmi J, Taurio J, Collin P.
Source
Department of Internal Medicine , Tampere University Hospital, Tampere , Finland.
Abstract
Abstract Objective. Early diagnosis and dietary treatment with a gluten-free diet might slow down the progression of associated autoimmune diseases in celiac disease, but the data are contradictory. We investigated the course of autoimmune thyroid diseases in newly diagnosed celiac disease patients before and after gluten-free dietary treatment. Material and methods. Twenty-seven consecutive adults with newly diagnosed celiac disease were investigated at the time of diagnosis and after 1 year on gluten-free diet. Earlier diagnosed and subclinical autoimmune thyroid diseases were recorded and examined. Thyroid gland volume and echogenicity were measured by ultrasound. Autoantibodies against celiac disease and thyroiditis, and thyroid function tests were determined. For comparison, 27 non-celiac controls on normal gluten-containing diet were examined. Results. At the time of diagnosis, the celiac disease patients had more manifest (n = 7) or subclinical (n = 3) thyroid diseases than the controls (10/27 vs. 3/27, p = 0.055). During the follow-up, the thyroid volume decreased significantly in the patients with celiac disease compared with the controls, indicating the progression of thyroid gland atrophy despite the gluten-free diet. Conclusions. Celiac patients had an increased risk of thyroid autoimmune disorders. A gluten-free diet seemed not to prevent the progression of autoimmune process during a follow-up of 1 year.
That is interesting, perhaps gluten is only part of the picture. Infection has been linked in other studies. My anti-bodies decreased most when I was on the auto-immune version of the paleo diet.
Another version of this study would be gluten or gluten free diet compared in people with Hashimotos but not measuring positive for celiac. Or look at progression in people who have celiac but not gluten free and those who are gluten free.
Something to look into.
There is one intresting factor regarding gluten and Hashimoto’s, Bromine. Yes there is evidence that a gluten free diet seems to help in Hashimoto’s cases. However, after WW II someone got the bright idea to add Bromine to bread in many areas. The amount of Bromine that can be ingested in bread appears to be much more that people often consume in iodine. Removing gluten from one’s diet could also tend to remove one of the largter sources of Bromine unless the person drank certain brominated sodas and other drinks. So can we be sure it really is the gluten removal helping the Hashimoto’s, or removal of the Bromine that was ingested with much of it? Bromine and Iodine are very similar halogens so it is easy to see how a high intake of Bromine relative to Iodine could stress the thyroid. There is a lot to this. Hashimoto’s cases seem to have increased considerably since WW II along with diabetes and cancer of the female reproductive organs, all diseases there is evidence that iodine helps prevent.
More detail can be found at: http://www.optimox.com/pics/Iodine/opt_Research_I.shtml
Thanks for the links.
I’m sure bromine, fluoride and chlorine (all of which have increased in our diet / environment dramatically in the last 100 years) displacement of iodine can all contribute to thyroid issues. I’m not sure that it would be the only thing to contribute to auto-immune thyroid disease. There is such a strong link between celiac disease / gluten sensitivity and Hashimotos this can’t be ignored.
Personally a bunch of issues cleared up when I cut gluten / grains. It was only later I discovered I had Hashimotos.
It is definitely wise to cut all sources of these other halogens for anyone, but especially for those with thyroid issues
Oh and here is another interesting research article, http://www.ncbi.nlm.nih.gov/pubmed/6548284
It is interesting that this has not been looked at more in U.S. research, rather they seem to avoid measuring such data. The policy reports that decided some Bromine was safe in bread looked for Bromine build up in their animal model in just about every body system except the animals thyroid.
One theory of the gluten/Hashimoto’s relationship is that chemically gluten is very similar to certain thyroid tissue. However, I have not been able to fine a scientific validation of this and wonder if you are aware of any? If true it would provide good evidence of how gluten antibodies could cause a thyroid problem.
Here is an interesting post explaining the possible link
http://coolinginflammation.blogspot.com/2009/07/celiac-causes-allergies-and-autoimmune.html
Need to look more into this
This is interesting http://www.ncbi.nlm.nih.gov/pubmed/6895564
The percentage of thyroglobulin-bound 131I obtained by in vitro iodination of thyroglobulin in Hashimoto’s thyroiditis appeared to be decreased in 2 cases of hypothyroid group. Some immunological reaction occurring in Hashimoto’s thyroiditis may change the structure of thyroglobulin and in turn the normal iodination of thyroglobulin may be disturbed.
Hashimotos may be the cause of altered iodine uptake in the thyroid, not a result from deficiency of iodine / high bromine.
Oh, that is a good write up I will also have to look into more. Thanks.
On another topic, do you have an opinion on the value/accuracy of the stool IgA testing for gluten intollerance rather than full celiac?
Glad I found this article. It’s sometimes hard to convince people, including my endocrinologist, that I not only don’t need grains but feel better without them, and my Hashimoto’s may be one reason why. Your experience sounds a lot like mine: pretty much asymptomatic so not taking meds, although my TSH was pretty high at last check (and coming due for the next one). Thanks for taking the time to list the links as well for further reading. 🙂
There is a recent study about on gluten and Hashimotos – Dr K has written an excellent article. You might was to give the article reference to your endo.
http://thyroidbook.com/blog/eating-gluten-increases-need-for-thyroid-hormones/
Glad to find this site =)
I presented with an extremely itchy rash that started in Feb. I went for allergy testing. Had some blood draws. (After a month, doc’s ofc still hadn’t gotten back with me with lab results. So I finally called & got the results). Tested positive for thyroid antibodies.
The doc wants to put me on low-dose Synthroid for a few months, to reduce antibodies, then recheck them in a few months. Then possibly discontinuing meds. I’ve been reluctant to get on meds & have been trying acupuncture, Selenium, Mg, Vit D., krill oil, double dose of probiotics, and some other Chinese herbal suppplements, for the itching, which has subsided, but still comes & goes. I’ve also gone gluten-free. Have been reading more & more about Paleos diet & hear many positive outcomes.
I’m so tired lately!!! Wondering if I should pursue getting on a low dose of NatureThroid? For a few months, at least, and then have antibodies level re-checked?
Would really appreciate your input.
Thanks!
I can’t comment on medication needs. I would follow a paleo diet, the auto-immune version and retest in 4 – 6 weeks.
Dr K has a guidline also http://thyroidbook.com/blog/autoimmune-gut-repair-diet/
Add omega 3 to your supplements too.
Great links. I have many family members who have celiac or just gluten issues. All their symptoms were different, chronic sickness, or constipation or skin rashes… But all symptoms disappeared when they went gluten free. I had a physical done just because. I am a healthy, very in shape 34 year old with a 3,5, and 7 year old. Everything was fine except my tsp levels were 14. The dr wanted to put me on thyroid medication but I asked for other tests. I do have antibodies and hashimotos so of course I went gluten free two months ago. I feel fantastic. Although I don’t have any hypothyroid symptoms at all or even to begin with, it makes it hard to know if gluten free will help my thyroid until i get more blood work next month. Some things i have noticed is that I no longer get bloated ( which i thought was from dairy) and acne that started ten months ago and would not go away with anything i tried disappeared after being gluten free for a month. It took more then two weeks for me to see results. Me dr doesn’t thing that gluten has anything to do with my thyroid and i hope i can prove her wrong! Thanks for information so i can do my own research!!
I completely believe in the correlation between GF and thyroid. I have been GF for only 2 months and my thyroid levels have changed drastically. In Oct my TSH was 6.420, I had bloodwork done yesterday and my TSH is now 3.940. In only a couple of months, my levels have improved dramatically. I am eating and exercising the same- the only difference is that I have eliminated gluten and replaced gluten products w/ GF options. Crazy but this works!
IN LESS WORDS CURE THE LEAKY GUT ,SO THE AUTO INMMUNE ATTACK WON’T MANIFEST ANYMORE.
In the conclusions of that pubmed.gov post, the authors conclude that there wasn’t really any benefit to a gluten free diet at the one year follow up. But here’s the problem with an autoimmune disorder like this… Remember first that your body is masts kingly attacking its own tissue along with the gluten/gliadin. After this auto immune reaction rages on for a while, the focus of the immune targeting fatigues and starts attacking things ‘similar’ such as your body’s own tissue (in the case of Hashomotos, it’s the thyroid, in the case of celiac’s it attacks the gut tissue). Why? Because they have similar amino acid chains (protein structure). So the study really fails because it doesn’t look at other foods also know to cross-react (just as the body tissue in Hashimoto or Celiac). there are some grain like substances that paleo dieters will consume that aren’t technically grain and don’t have gluten but are ‘similar’.
Next, one must not only address the immune reaction by removing gluten and all things that cross react as gluten, but address how the gluten is getting into the system in the first place- The Leaky Gut.
One must calm the immune system AND repair the leaky gut. However there may be other issues at hand as well. Which is why a good evaluation and perhaps blood work (as Kharrazian discusses in his thyroid and brain health books).
First step is to get on a strict paleo diet for 2-6 months WHILE you search for your answers. Remember though that when you get on a gluten free, grain free (cross reactive food free) eating regimen, some lab work for auto immune could come back negative because you have removed the toxin. But look at the entire picture, put that in context with all the pieces and you’ll start to find some answers.
Good luck.
Do you have an opinion on cross-reactive foods, such as dairy and chocolate? I’ve been gluten/grain free for a long time, but have small amounts of cross-reactive foods. I don’t actually take thyroid medication, but recent blood work shows low T3. Any thoughts on further diet restrictions based just on low T4 – T3 conversion? Thanks!
after severe attack in upper left side under ribs(after a Chinese buffet) diagnosed with Hypo.Doc prescribed meds said we are going to have to get aggressive. Armour reaction . Synthroid reaction ,weight went thru roof, blood pressure went from normal to 200/112 (n 3 wks)sent me to ER (Sept 13). I should say Doc who put me on meds never followed up w me in hospital or after. PRIOR to belly ache I was very active looked 35( was 52) nice skin and hair. When diagnosed and put on meds Doc said you will feel like getting up, running , happy, gain strength. Prior to meds there wasn’t many men my age that could keep up. Other than the belly ache I had no Hypo symptoms or any other issues.. After MEDS I bottomed, my hair turn to singed dried out, skin to leather, face droop, no energy, OMG the joint pains and swelling was unbelievable. my legs an knees look like and elephant and my chins like memory foam.
I have been passed around 5 diff docs. The Endo doctor nonchalantly says Hashimotos.. WHAT IN THE WORLD IS THAT.
My antibodies then said Nov13 was 500, Then Jan 14 1313 then in Apr 14 when the WORD came into play was up to over 2200
I have been on NO meds since Nov 14, I was told I am complicated, From Nov 13 til Apr 14 I have been a pin cushion to 2 diff docs who keep pushing me back and forth between the 2.
My last visit to ENDO I was trying to show her my very enlarged fingers and crooked toes that hurt so bad, I tried to tell her how I felt Satan had taken over, I tried to show her my pictures of my legs. My face that looked as if someone was pulling my skin down.(all overnight this happened) She wouldn’t even look at me kept her fingers on her keyboard and scheduling me another appointment in 6 month follow up to be stuck again.
I asked her , Are you saying im basically SCREWED,,, The ENDO doc replied “YES” ( pay on your wasy out)
Im finding that what I do for HYPO is opposite of what you do for HASHI,
Iodine for HYPO not for HASHI
The Vegatables for HYPO but for HASHI no Nightshades
There is so much that’s conflicting out there that I do feel screwed.
I went to the local Vitamin Helath Store , she looked up HYPO protocol , I came home 3 diff Thyroid supports
2 have iodine in , to find I cant take.
1 is called THYTROPHIN PMG,Bovine thyroid, which is said if I take it gives the HASHI something else to attack instead of my THYROID.
in addition enlarge goiter, liver off, tested a couple times high calcium in blood.. Fat miserable and lack in motivation and absent minded.
Feeling SCREWED..feeling emotional at this point. and satan hasn’t left..my poor family and husband.
There are Only 3 Science-Backed Reasons for Some People to Avoid Gluten
There are three conditions where people generally need to be on a gluten-free diet:
Celiac disease.
Wheat allergy.
Gluten sensitivity.
I have hashimotos and went gluten free it did not reduced my antibodies. I got off Synthroid and went on NDT got regulated which takes time and got a new lease on life the best I felt in 4 years and this is before I stopped eating gluten. I stopped eating gluten and gained 15 pounds in 3 1/2 months. All the weight I lost going off of synthroid was gone.
I also noticed how extremely high in carbs the starches are. WAY higher then wheat. I call these gluten-free replacement ingredients junk carbs. I have gained weight being gluten free!! Whole wheat 23 carbs g / oat flour 26 carbs g / potato starch 40 carbs g / arrowroot 28 carbs g / brown rice flour 31 carbs g / white rice flour 32 carbs g / sweet rice flour 49 carbs g..and it gets worse. If you are not an athlete this is not good!
The thing that’s so troubling about gluten is that, like most things, it’s complicated. There are many people with celiac disease for whom gluten is extremely dangerous, and the scientific story on non-celiac gluten sensitivity is far from settled.
Yet people don’t want to admit that uncertainty. They either want to crucify gluten as the cause of all modern health scourges or they want to say, well, gluten-free dieting is complete B.S. The truth is somewhere in between those two poles.
I suggest reading the work of Fasano, and the leak between leaky gut and auto-immune disease. Zonulin is triggered by gluten and causes loosening of tight junctions and intestinal permeability. Many auto-immune diseases are more common in those who have celiac disease particularly Hashimotos. http://www.ncbi.nlm.nih.gov/pubmed/22109896
I am not a fan of gluten free replacement refined carbs – as you said they are high GI and high in starch. Taking out refined grains altogether is my choice. Gluten is not the only factor for Hashimotos but worth considering. Dairy is an issue for others and red meat has been clinically shown to be for some as well. http://perfecthealthdiet.com/2015/02/neu5gc-autoimmunity-hashimotos-hypothyroidism/
I wrote this post some time ago early on in my Hashimotos journey. I need to revise it. Thanks for your comments