Can Probiotics Help With Hashimoto’s Thyroiditis?

Hashimoto’s disease is a chronic and incurable condition that causes an underactive thyroid. However, you can manage it with medication. Many people with Hashimoto’s thyroiditis also find certain lifestyle changes helpful.

One of the things you might have heard mentioned is probiotics. Are they a good treatment for Hashimoto’s? What probiotics should you consider?

Although you should always talk to your doctor before trying any type of supplement, exploring probiotics is not a bad idea if you have difficulty managing your condition.

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We make it easy for you to participate in a clinical trial for Hashimoto's disease, and get access to the latest treatments not yet widely available - and be a part of finding a cure.

What is Hashimoto’s thyroiditis?

Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the United States. It happens when your immune system mistakenly attacks your thyroid gland, causing inflammation and reducing your thyroid gland’s ability to produce vital hormones.

As your thyroid manages many of the systems in your body, Hashimoto’s thyroiditis can cause a variety of symptoms, including:

Not everyone will get the same symptoms as everyone’s body reacts differently to insufficient thyroid hormones.

If left untreated, Hashimoto’s thyroiditis can increase your risk of high cholesterol, heart disease, and high blood pressure. However, most patients can lead a normal life with proper treatment.

What are probiotics?

Some alternative practitioners recommend probiotics as a complementary treatment for Hashimoto’s disease.

Probiotics are live, beneficial microorganisms, and our bodies are covered with microorganisms inside and out. While we tend to think of microbes and bacteria as harmful agents, many are vital. For example, we can’t properly digest our food without them, which is why oral antibiotics tend to cause gastrointestinal upset.

The most common beneficial bacteria are Lactobacillus and Bifidobacterium. These are entire groups of bacteria, and different kinds can be helpful in different situations.

Probiotics should not be confused with prebiotics, which are substances that encourage the growth of desirable microorganisms.

Can probiotics help with symptoms of Hashimoto’s thyroiditis?

Probiotics have been shown to have beneficial effects on thyroid function¹. Additionally, it is not uncommon for Hashimoto’s thyroiditis to coexist with both celiac disease and non-celiac wheat sensitivity. Because of this, some nutritionists recommend that people with Hashimoto’s try a gluten-free diet.

The treatment for Hashimoto’s, i.e., replacement thyroid hormones, acts to control symptoms by supplementing what your thyroid is not producing. In this scenario,  inflammation can remain.

Balancing your gut health can reduce systemic inflammation, which can cause symptoms such as fatigue and brain fog. 

Another study speculates that bacterial overgrowth can result in the need for a higher dose of levothyroxine². So, while probiotics can’t replace hormone therapy, they may allow you to take lower doses.

A lot of research still needs to be done, particularly on individual gut imbalances and how they might affect treatment. Most research so far has been animal model studies.

Can probiotics harm you?

Probiotics are generally safe, but they can be dangerous if you have a weakened immune system. Also, it’s essential to purchase high-quality probiotics from a reputable company, as it is possible for them to be contaminated.

Probiotics are not a substitute for thyroid medication. You should always consult your doctor and your nutritionist, if you have one, before taking any supplement, including probiotics.

Meanwhile, studies have shown that consuming probiotics does not interfere with levothyroxine absorption³ if taken two hours after taking levothyroxine. Thus, it will not affect your treatment or result in a loss of stability of thyroid levels.

What is the best probiotic for Hashimoto’s thyroiditis?

The jury is still out on whether probiotics help Hashimoto’s disease not associated with gluten intolerance, but taking a broad probiotic containing Lactobacillus and Bifidobacterium is slightly supported by current evidence.

Probiotic foods are typically better than supplements as they have a broader range of helpful bacteria, and some also contain antioxidants and other micronutrients.

Foods considered probiotics are typically fermented and include:

  • Yogurt

  • Chicory

  • Kimchi

  • Sauerkraut

  • Kefir

  • Kombucha

  • Pickles

  • Miso

  • Tempeh

  • Sourdough bread

There is typically no harm in consuming probiotic foods, although some can have stronger flavors than you might prefer. Again, it’s a good idea to talk to your doctor first and make sure they are on board with what you are doing.

Given the relative safety of taking probiotics, it is often worth experimenting with some of these foods and seeing if they help with any ongoing symptoms you are experiencing.

Other treatments for Hashimoto’s

The standard treatment for Hashimoto’s remains hormone replacement therapy with levothyroxine. This is a cheap, well-tolerated medication taken as a once-daily pill, typically an hour before breakfast. People with Hashimoto’s disease take this medication for life.

You might also be told to avoid some foods that affect levothyroxine absorption or not consume them too close to taking your medication. These include grapefruit, espresso, soy, and supplemental iron or calcium. You should also avoid eating seaweed or taking iodine supplements.

Other than that, guidelines are generally to eat a healthy diet, get plenty of sleep, and stay active. While untreated Hashimoto’s can cause exercise intolerance, most people have no problems with exercise once their hormone levels are stable.

The lowdown

While there is no clinical evidence that probiotics help people with Hashimoto’s disease, there are some indications from animal studies that they may be useful. Foods containing probiotics are safe for most people, but you should not take supplemental probiotics without consulting your doctor.

Probiotics do not work for everyone, but anecdotally they seem to help with some symptoms such as brain fog. If you also have celiac disease or non-celiac wheat intolerance, probiotics can help your gut health. However, you should discuss this first with your doctor and your nutritionist.

  1. Thyroid-gut-axis: How does the microbiota influence thyroid function? (2020)

  2. Microbiota and thyroid interaction in health and disease (2019)

  3. Hypothyroidism (2018)

Other sources:

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