Your Hypothyroidism Webinar Questions, Answered

Thank you to everyone who joined our Holistic Approach to Hypothyroidism webinar with Functional Herbalist Alyssa Dalos in February.

We were overwhelmed by the number of thoughtful questions that came through on the night, and while we were not able to answer every one live, Alyssa has kindly shared responses to many of the questions we couldn’t get to during the session.

If you would like to revisit the full webinar, you can watch the recording here. You can also view the webinar slides here.

Testing & Diagnosis

Questions in this section relate to thyroid markers, lab ranges and symptom patterns.

What is the range and optimal level for TSH and and T4

Alyssa’s answer: For optimal ranges, I would use the functional lab ranges over the conventional ones, which are geared towards diagnosing full-blown pathologies. So 0.8-1.8mIU/L for TSH. For free T4, 13-19 pmol/L is optimal.

Recently my thyroxine has been increased due to higher levels of TSH but my eyes have become really sensitive, itchy and dry skin on eyelids and around eyes and loss of eyelashes. Is there a link here?

Alyssa’s answer: It’s unlikely, but it wouldn’t be possible to say without a more thorough assessment.

On Levo and my tsh is low normal now but my t4 can be at high end and sometimes it goes to the low end. How can I keep it at higher end without tsh going below normal?

Alyssa’s answer: While normal T4 levels are important, based on what you’ve said I would be curious where your T3 levels are as there might be a T4-T3 conversion issue that could be mildly improved with Ashwagandha and working on gut health.

Medication & Treatment

These questions focus on thyroid medication, long-term support and possible alternatives.

Please tell us about sintetic hormone pills replacement

Alyssa’s answer: This was discussed during the webinar. You can watch the full recording here.

I was diagnosed with hashimotos around 12/13 years ago. Struggle to get drs to understand that my tsh needs to be low and T4 needs to be high to feel good. Started ashwaganda and selenium 3 weeks ago. Are they both safe to take long term? I am also on Levothyroxin

Alyssa’s answer: This was touched on during the webinar i believe? But yes, both are safe for long term use.

Is there a herbal alternative to levothyroxine?

Alyssa’s answer: No there’s not.

Hi I am diagnosed hypothyroidism, not able to take conventional medication levothyroxine or liothyrine due to severe allergic reactions, any advice you can give regarding trying bring thyroid back from all the symptoms I get

Alyssa’s answer: I’d recommend asking your GP about a natural thyroid alternative (Desiccated Thyroid Extract) such as Armour® Thyroid in addition to a full autoimmune protocol under the guidance of a practitioner.

What do you think about replacing levothyroxine with other supplements . For some people levothyroxine stops working

Alyssa’s answer: I wouldn’t say that Levothyroxine stops working per say, but doses routinely have to be increased over time if the autoimmune attack on the thyroid gland is not halted and thyroid tissue continues to be destroyed, increasingly impairing its ability to make thyroid hormone and necessitating the increased dose. There are definitely other thyroid medications that can be more tolerable for some folks, but without addressing the autoimmune attack the dosages would still often need to be increased over time.

What are the contraindications of HRT with hypo - or in my case - subclinical hypothyroidism?

Alyssa’s answer: Estrogen (oral forms) can increase thyroid-binding globulin (TBG), which binds T4 in the blood. This can slightly lower free T4 levels. People on levothyroxine sometimes need closer monitoring initially and dose adjustment when starting oral HRT. Transdermal estrogen (patches, gels) has less effect on thyroid hormone levels compared to oral HRT.

Related Health Conditions

This section brings together questions on menopause, cholesterol, diabetes, PCOS, pregnancy and other related areas.

Is there a known correlation between hypothyroidism and menopause? I have a few friends where this started at menopause…..

Alyssa’s answer: This was answered during the webinar. You can watch the full recording here.

Are thyroid issues genetic?

Alyssa’s answer: All autoimmunity (including hashi’s) has a genetic component, so in that sense, yes. A family history of autoimmunity increases one’s likelihood of developing an autoimmune condition, but it does not mean it’s a certainty.

Are higher cholesterol levels and hypothyroidism linked and will taking extra vit D help with this, please?

Alyssa’s answer: Yes, thyroid hormone helps regulate how the body uses and clears cholesterol from the bloodstream. It increases LDL receptor activity in the liver (this clears LDL cholesterol from blood) and helps the body convert cholesterol into bile acids so it can be removed.

Vitamin D supplementation won’t fix this on its own, but reasonable supplementation of Vit D is part of a good autoimmune protocol (with regular testing to make sure levels are not pushed too high)

Is there a link between hypothyroidism and T2diabetes? I've been advised that a lower carb diet is good for lowering blood sugars but is it bad for your thyroid?

Alyssa’s answer: To my knowledge, a low-ish carb diet would not negatively affect the thyroid (as long as it’s not ULTRA-low carb or keto, that is not advised, especially for female bodied people). There is definitely a link - thyroid hormones influence how your body uses insulin, metabolizes glucose, and manages energy.

can you talk about the cross over between PCOS hypothyroidism and gluten intolerance

Alyssa’s answer: This is a massive subject and I would need a more specific question in order to know where to start! Hypothyroidism’s affect on blood sugar regulation could contribute to insulin resistance, which is the cause of a significant percentage of PCOS. Gluten intolerance is a sign that leaky gut is at play and would exacerbate everything else.

Is there a known link between gall bladder removal and hypothyroidism or Hashimotos?

Alyssa’s answer: Yes! Because of the absolutely critical role of gut health in autoimmunity, gallbladder removal would make it harder to maintain robust digestion and regular bowel movements, which would exacerbate the autoimmune attack.

Does it often start after pregnancy? Mine started after the birth of my third child

Alyssa’s answer: Yes, pregnancy is known to have a causal link with hypothyroidism.

Diet, Prevention & Lifestyle Support

These questions focus on prevention, nutrition, gut health and day-to-day symptom support.

I am hashimotos, ive had hypotyroid for14 years. last year I asked for tpoab which was elevated, so I realised hashis. ive been gluten intolerant 8 years and now have a dairy allergy. I am vegetarian. How important are meat proteins. I repeatedly become deficient in iron and b12. is this related. I started reacting to tablet levo and got moved to liquiid 2 years ago. Since then I have developed cardiac issues, is this the levothyroxine? recent levels ok but symptomatically not. I have gut issues also.

Alyssa’s answer: It’s quite difficult to avoid nutrient deficiencies while vegetarian without a consistent and strategic diet and intentional supplementation. With the addition of gut issues I would highly recommend seeing an autoimmune-literate functional practitioner.

I am keen to know how to prevent hypothyroidism. It's in the family so I just want to be able to look after myself and not get it. Especially if there aren't herbs when you have it, perhaps there are herbs to help you not to get it?

Alyssa’s answer: The best thing(s) you can do would be: be very intentional about your stress management, get adequate sleep, exercise regularly and vigorously in whatever way works best for you, and eat whole, nutritious foods to the greatest extent that you can. Maintaining your gut health is also extremely important - fiber, probiotics, etc.

What remedies you suggest for terrible feeling of cold, body constantly cold, under 3 woolly jumpers and 2 socks, to the point I feel it as pain not even cold anymore (hashimoto and hypothyroidism diagnosed 20 years ago but no treatment from GP because results differ every year). What herbs to warm up from inside? Xx

Alyssa’s answer: Cold intolerance is a common symptom of hypothyroidism - I’d recommend addressing the underlying root cause of the autoimmune attack through a supervised autoimmune protocol, as well as warming circulatory stimulants like ginger, cinnamon and cayenne.

s it possible that your diet can be full of everything needed, but a leaky gut means that the nutrients are not absorbed enough?

Alyssa’s answer: Yes it’s tecnically possible, but I have never seen anyone whose diet is full of everything they need - it’s extremely difficult to do that under the conditions of modern life and we all could use some help with it now and again!

Are nightshade family supplements not counterindicated for thyroid issues

Alyssa’s answer: Not necessarily, no. Only if someone has a known nightshade sensitivity. I’d also look to do a temporary elimination/reintroduction if joint pain were a primary symptom.

I think a few of us sub clinical folk are interested in whether we can put prevention methods in place?

Alyssa’s answer: Alyssa shared best practices on this in the webinar slides, which you can view here.

Yes preventative herbs/support please so we have less chance of developing it

Alyssa’s answer: Alyssa touched on prevention methods in the webinar and also included support on this in the slides, which you can view here.