A Case Study of Functional Nutrition Management of Hashimoto’s Thyroiditis

The following case study details the personalized management of a 34-year-old female diagnosed with Hashimoto’s thyroiditis, iron deficiency, and vitamin D deficiency.

The presence of thyroid antibodies characterizes Hashimoto's thyroiditis and can present with normal thyroid function, subclinical hypothyroidism, or overt hypothyroidism. Its development is believed to result from immune defects, genetic susceptibility, and environmental factors such as infections, medications, smoking, iodine levels, soil selenium content, and gut dysbiosis. Additionally, untreated celiac disease may predispose individuals to Hashimoto's, and nutrients like zinc, copper, selenium, iron, thiamine, and vitamin B12 are beneficial in managing the condition.

Declining conventional thyroid replacement therapy, she sought an alternative approach focused on nutritional and lifestyle modifications to address her symptoms, which included ravenous hunger, low energy, low libido, bloating, heart palpitations, cold extremities, and mental sluggishness.

At her initial consultation with a licensed functional nutritionist, the patient was advised to follow a modified phytonutrient-rich diet that eliminated gluten, soy, raw vegetables, and foods enriched with folic acid or cyanocobalamin.

She was encouraged to increase her intake of omega-3-rich foods (such as organic flax, walnuts, wild salmon, and sardines), fermented foods, berries, quality fats (like coconut oil, cold-pressed olive oil, butter, or ghee), and water (6–8 cups per day).

In addition, she began a regimen of nutritional supplements, including magnesium, coenzyme B complex, vitamin D3, probiotics, α-lipoic acid, and EPA/DHA, along with a customized herbal tincture and herbal tea, coupled with recommendations for mindfulness practices and regular exercise.

Practitioner Recommended Supplements

• Magnesium 300 mg Once daily
• Coenzyme B complex 100 mg vitamin B1, 20 mg vitamin B2, 50 mg niacin, 20 mg vitamin B6, 200 mcg folate, 500 mcg vitamin B12, 300 mcg biotin, 50 mg pantothenic acid, 100 mg choline, 100 mg TMG, 40 mg inositol Once daily
• Vitamin D3 2000 IU 2 tablets daily
• Probiotic Flora 50-14: 50 billion live organisms from 14 strains (B lactis, L acidophilus, L casei, L plantarum, L rhamnosus, L salivarius, L brevis, L bulgaricus, L gasseri, L lactis, B longum, B bifidum, B infantis, S thermophilus) 2 tablets daily
• Coenzyme Q10 100 mg Once daily
• α-Lipoic acid 200 mg Once daily
• DHA/EPA (omega-3) 1000 mg 2 tablets daily
• Zinc citrate 30 mg Once daily
• L-Glutamine (free form) 1500 mg, pyridoxal alpha-ketoglutarate 500 mg, fatty acids (as vegetable stearate) 7 mg, magnesium (as vegetable stearate) 6 mg, kosher gelatin capsules 350 mg 2 tablets daily
• Quercetin dihydrate 1000 mg Once daily
• Activated B12 (hydroxocobalamin) 2000 mcg Once daily
• Customized Tincture: Ashwagandha root, milky oat spikelet, damiana, holy basil, cinnamon bark
• Customized Tea: Chamomile flowering tops, ginger rhizome, agrimony herb

Biomarkers

During follow-ups, the patient reported significant improvements in energy, reduced anxiety, and enhanced memory. However, she experienced some symptom flares after dietary lapses and consumption of certain foods like dark chocolate and red wine.

Adjustments were made to her supplementation protocol, including pausing and then gradually restarting the herbal tincture, discontinuing the herbal tea blend, and replacing α-lipoic acid with L-glutamine, quercetin, and activated B12.

Her progress demonstrates the potential benefits of a personalized, nutrition-focused approach in managing Hashimoto’s thyroiditis and improving overall wellness.

Reference

Dolan, Keren et al. “Managing Hashimoto's Thyroiditis Through Personalized Care: A Case Report.” Alternative therapies in health and medicine vol. 24,3 (2018): 56-61. https://todayspractitioner.com/wp-content/uploads/2018/08/hashimotos_alt-therapies-.pdf