Hashimoto's: normal labs, still exhausted

Hashimoto's thyroiditis is an autoimmune disease in which the immune system attacks the thyroid gland. It is the most common cause of an underactive thyroid in the United States, and it's usually identified by antibodies against thyroid peroxidase (TPO antibodies).

Why am I tired when my thyroid labs are normal?

A TSH in the normal range is good news, but it doesn't measure everything. Iron stores, B12, vitamin D, sleep and other autoimmune conditions can all cause fatigue alongside Hashimoto's, and it can take time to find the right medication dose.

Should I go gluten-free for Hashimoto's?

Celiac disease is more common in people with autoimmune thyroid disease. If you're considering going gluten-free, ask about celiac testing first: the blood test only works while you're still eating gluten.

What does stomach acid have to do with Hashimoto's?

The cells in your stomach lining make both stomach acid and intrinsic factor, the protein you need to absorb B12. In some people with autoimmune thyroid disease, the immune system attacks those cells too, a condition called autoimmune gastritis.

Is there a food source of selenium?

Selenium is concentrated in the thyroid, and studies have looked at it in Hashimoto's. Our family gets it from food: one or two organic Brazil nuts a day, no more, plus sardines and eggs.

Questions to bring to your doctor

Each of our videos ends with questions like these. Write them on your Prep Pack or tracker and take them with you.

Has my B12 been checked, and would testing for parietal cell or intrinsic factor antibodies make sense?
Should I be tested for celiac disease before trying a gluten-free diet?

Sources

Each video description lists the full studies behind that episode.

This page is education, not medical advice. It doesn’t diagnose or treat any condition. Talk to your doctor before changing your care, and never stop or change a medication on your own.