Hashimoto's Thyroiditis


Address The

Root Cause

Testing and Treatment of Hashimoto’s in Cincinnati, OH

Hashimoto’s is an autoimmune disease that results in destruction of the thyroid gland. This damage eventually leads to inadequate thyroid hormone production. Hashimoto’s is the most common cause of hypothyroidism. Although Hashimoto’s results in low thyroid, the problem is not really with the thyroid, the problem is with the immune system.

What is an Autoimmune Disease?

Autoimmunity means that a person’s own immune system attacks itself. In the case of Hashimoto’s Disease, the immune system is primarily attacking the thyroid, but also affects other organs and systems (including the pancreas and

adrenal glands). Once someone has been diagnosed with one autoimmune disease, they are at risk for developing others. Traditional or allopathic medicine simply treats the disease. For example, thyroid patients are treated only with

thyroid hormones. We believe in treating the underlying cause of Hashimoto’s, which is a problem with the immune system. 80% of our immune system is located in our gut/GI tract, so this is usually where we start.

Functional Medicine Approach to Treating Hashimoto’s

Treating Hashimoto’s Thyroiditis is complex and requires patience. Reversing an autoimmune disease requires a fully integrated approach with advanced testing, lifestyle modifications and supplements. In most situations, monthly meetings with our providers and wellness coaches are needed to get to the root cause of disease.

Diagnosis Optimize Thyroid Gut Health Nutrient Support Reduce Antibodies

A comprehensive thyroid panel is needed, this includes: TSH, free T3, free T4, ReverseT3, Thyroid Peroxidase Antibody (TPO) and Anti-thyroglobulin Ab. Hashimoto’s is diagnosed when antibodies (thyroid peroxidase or anti-thyroglobulin) are present against

thyroid tissue. Thyroid antibodies are the first indication of a thyroid problem in many cases, as the antibodies can be elevated years before a change in TSH is detected.

Our goal is to optimize thyroid hormone dysfunction by achieving optimal levels of free T3, free T4 and TSH. We test thyroid levels every 4 to 6 weeks until optimal.

“Leaky Gut” (also called intestinal permeability) is a condition in which the gut barrier is compromised, allowing dangerous particles (like bacteria, viruses and toxins) to pass into the bloodstream. This process can often trigger an autoimmune disease. Our “Gut Health Program” includes a 30 minute visit with our wellness coach, plus a comprehensive stool analysis looking at:

– Infection: parasites, yeast (candida), H.pylori, bacterial infections, viruses

– Inflammation: detoxification, dysbiosis
– Digestion and absorption: pancreatic function, digestive enzymes
– Imbalance: intestinal barrier (“leaky gut”), gut immune system and good bacteria

An important part of any Gut Health Program to address autoimmune disease is removing potential environmental triggers. We often recommend eliminating gluten and dairy (in some cases

other foods as well) from the diet. According to Dr. Izabella Wentz, PharmD and author of The Root Cause, “In 2015, I did a survey of my readers consisting of 2232 people having Hashimoto’s. In that survey, 88 percent of people felt better off of gluten and 33 percent had a reduction in their antibodies on a gluten free diet.” Not only is gluten intolerance a common trigger of autoimmune thyroid, gluten is also a common cause for intestinal permeability (or Leaky Gut).

Modern agricultural methods have stripped our soil of vital nutrients. Essential minerals, like Iodine and Selenium, are not as readily available in our diets. This can contribute to thyroid

dysfunction, specifically poor conversion of T4 (pro-hormone) to T3 (active thyroid hormone). We will evaluate your nutrient status and make specific recommendations to fill in any gaps in your nutrition.

The desire of most patients with Hashimoto’s is to lower antibody levels and reduce the autoimmune attack on the thyroid gland. The first step in this process is to remove triggers.
These triggers can include:

1. Environmental toxins (for example mold, heavy metals, endocrine disrupting chemicals)

2. Infection (including gut infections with yeast, H.pylori, SIBO)
3. Food sensitivities/allergies (gluten, dairy, soy)
4. Stress (Hypothalamus-Pituitary-Adrenal Axis Dysfunction).
5. Dysbiosis, intestinal permeability (Leaky Gut)

Most patients will feel better and even reduce their antibodies by removing triggers, but in some cases, additional strategies to

modulate the immune response are needed. There are several strategies we use to balance Th1 and Th2 cytokines, which can strengthen cellular immunity and overall immune responses, these include: Low Dose Naltrexone, supplementation with Moducare, CBD/CBG, and immune Peptide therapy. Your provider will discuss which strategies are appropriate for you.

Symptoms of Hypothyroidism
or Low thyroid function

  • Weight gain
  • Difficulty losing weight
  • Dry skin
  • Hair loss or thinning hair
  • Swelling in face, hands, ankles, or feet
  • Feeling cold – especially cold hands and feet
  • Hertogue’s sign (lateral eyebrow thinning)
  • Heavy periods or irregular bleeding
  • Fatigue
  • Constipation
  • Slower thinking
  • Goiter (swelling of the thyroid gland that is visible in the neck)
  • Feeling down or depressed
  • Memory loss
  • Anxiety
  • Arthralgias, muscle aches
  • Headaches
  • Hoarseness
  • Too tired to exercise
  • May have heat intolerance as well as cold intolerance
  • Fluid retention
  • Periorbital or ankle edema
  • Hypertension (elevated blood pressure)
  • Brain fog
Thyroid Testing Process

The step-by-step patient experience.

Assessing gut health is vital to understand the root cause of thyroid disease. Diet, exercise, strategies for treating gut health, optimal supplementation to support thyroid function, as well as additional testing and resources within our office, are all discussed as an important part of this treatment plan.

Step 1 Step 2 Step 3
Step 1

The Consultation

Your initial consultation with one of our providers will begin with a thorough look into your past medical and surgical history, family history, and current medications, with specific attention paid to the symptoms you are struggling with. This visit will be billed to your insurance company.

Step 2

Make the Correct Diagnosis

What is a comprehensive thyroid panel? The thyroid is best tested with a blood test. The labs that we look at include: TSH, Free T4, Free T3, Reverse T3, Thyroid peroxidase (TPO) and Anti-thyroglobulin antibodies. Other useful tests include: vitamin/nutrient testing, 4 point salivary cortisol kit, food sensitivity/allergy testing.

Step 3

Follow up & Results

We will see you back in the office in 1 to 2 weeks, review your test results and initiate therapy if appropriate. This visit is billed to your health insurance company.

Additional Information
Testimonials Resources FAQ's

Thank you, thank you, thank you to Dr. Thieman for listening to me and taking care of me these past few months. I am such a better version of myself now!"



Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause by Izabella Wentz

Stop the Thyroid Madness by Janie A. Bowthorp



Why is treatment with Synthroid or Levothyroxine alone unsuccessful in many patients?

Levothyroxine (brand names Synthroid, Levoxyl, Tirosint) is T4 hormone. The thyroid gland secretes T4 in response to TSH and the body’s needs for thyroid hormones. However, many patients don’t adequately convert the prohormone, T4, into the more active hormone, T3. When this conversion is not happening adequately, symptoms of hypothyroidism will occur – even with a “normal” TSH! Therefore, our approach to treating thyroid dysfunction is often to use a combination of T3 and T4 hormones, as well as optimize the T4 to T3 conversion. This approach has been shown in the literature to be more effective than using T4 alone to address hypothyroid symptoms.
Traditionally – perhaps because of large pharmaceutical companies, doctors have been trained to test only the TSH and occasionally the T4 levels and thus, replace only the T4 hormones.

My doctor told me that my low TSH would put me at risk for osteoporosis and atrial fibrillation. Is this true?

In the traditional medical community, there is a lot of concern that suppressing the TSH will cause medical conditions such as osteoporosis and atrial fibrillation. It is true that endogenous hyperthyroidism (patients developing hyperthyroidism on their own – not treating hypothyroidism) is associated with osteoporosis. There is medical literature on both sides of the fence as to whether bone loss occurs or not with suppressed levels of TSH. We monitor bone turnover closely in our patients who have a suppressed TSH.

It's simple— identify the problem areas of your body and we will recommend the right treatment plan for you.