When to Medicate for Hashimoto’s

In the video “When to Medicate for Hashimoto’s” by Martin Rutherford, he discusses the timing for medication in the treatment of Hashimoto’s Thyroiditis. As a functional medicine practitioner, he provides a unique perspective on when to consider taking thyroid medication. Rutherford explains that the first step is to dampen the immune response, as Hashimoto’s is primarily an autoimmune problem. By addressing factors like food sensitivities, leaky gut, chronic stress, parasites, and viral infections, the inflammation causing thyroid symptoms can be reduced. Once these aspects have been addressed, natural support methods can be attempted before considering medication. Rutherford also emphasizes the importance of properly dosing medication and working closely with a doctor throughout the treatment process. Remember, this video is not a substitute for professional medical advice. Always consult with your healthcare provider for personalized guidance.

Why is Hashimoto’s So Common?

Hashimoto’s Thyroiditis, also known as Hashimoto’s disease, is one of the most common autoimmune disorders in the United States, affecting millions of people. But why is it so prevalent? The answer lies in a combination of genetic and environmental factors.

The Role of Genetics

Genetics play a significant role in the development of Hashimoto’s. Research has shown that certain genes can increase a person’s susceptibility to autoimmune diseases, including Hashimoto’s. If you have a family history of thyroid disorders or other autoimmune conditions, you may be at a higher risk of developing Hashimoto’s.

Environmental Triggers

While genetics set the stage, environmental factors can trigger the onset of Hashimoto’s in individuals who are predisposed to the disease. Some common triggers include:

  • Stress: Chronic stress can wreak havoc on the immune system, increasing inflammation and making the body more susceptible to autoimmune conditions.
  • Viral Infections: Certain viral infections, such as Epstein-Barr virus (EBV), have been linked to the development of Hashimoto’s.
  • Toxic Exposures: Exposure to certain toxins, including heavy metals and pesticides, can disrupt the immune system and contribute to the development of autoimmune diseases.

Understanding the underlying factors that contribute to the development of Hashimoto’s is crucial for both conventional and functional medicine approaches.

Understanding Functional Medicine Flow

Functional medicine takes a comprehensive approach to healthcare, focusing on the root causes of disease rather than merely managing symptoms. In the context of Hashimoto’s, functional medicine aims to address the underlying factors contributing to the immune dysregulation and thyroid dysfunction.

The Conventional Approach

In the conventional approach to Hashimoto’s, the primary focus is on prescribing medication, typically levothyroxine (T4 hormone), to replace the insufficient thyroid hormone production. While this can provide temporary relief from symptoms, it does not address the root cause of the disease or help prevent further autoimmune damage.

The Functional Approach

The functional approach to Hashimoto’s takes a broader perspective, focusing on dampening the immune response, addressing underlying factors, and utilizing natural support and medication when appropriate.

When to Medicate for Hashimotos

Dampening the Immune Response

As Hashimoto’s is primarily an autoimmune condition, the functional approach aims to dampen the immune response to reduce the inflammation and damage to the thyroid tissue. This can be achieved through various strategies, including:

  • Identifying and Eliminating Food Sensitivities: Food sensitivities can trigger immune reactions and contribute to the autoimmune response. Identifying and eliminating these trigger foods can help reduce inflammation.
  • Addressing Leaky Gut: Leaky gut is a condition where the intestinal lining becomes permeable, allowing toxins and undigested food particles to enter the bloodstream. This can trigger immune reactions and worsen autoimmune conditions. Healing the gut lining is an essential part of dampening the immune response.
  • Managing Chronic Stress: Chronic stress can dysregulate the immune system and exacerbate autoimmune conditions. Techniques such as mindfulness, meditation, and stress-reducing activities can help manage stress levels and support immune balance.

Addressing Underlying Factors

In addition to dampening the immune response, functional medicine aims to address underlying factors that contribute to Hashimoto’s development. These factors may include:

  • Infections: Chronic viral infections, such as Epstein-Barr virus (EBV), can trigger or exacerbate Hashimoto’s. Identifying and treating these infections can help reduce the autoimmune response.
  • Nutrient Deficiencies: Deficiencies in nutrients like selenium, iodine, and vitamin D can negatively impact thyroid function. Addressing these deficiencies through targeted supplementation can support thyroid health.
  • Toxic Exposures: Environmental toxins, such as heavy metals and pesticides, can increase inflammation and disrupt thyroid function. Detoxification protocols may be considered to minimize toxic burdens.

A comprehensive functional medicine approach aims to create a supportive environment for the thyroid to heal and function optimally.

When to Medicate for Hashimotos

Trying Natural Support

After addressing the underlying factors and dampening the immune response, natural support options can be explored to enhance thyroid function. This may involve the use of herbs and botanicals that promote thyroid hormone production or support the conversion of T4 to the active form T3. Some commonly used natural support options include:

  • Ashwagandha: This adaptogenic herb has been shown to support thyroid function and reduce stress.
  • Selenium: Selenium is an essential mineral for thyroid function and can help optimize hormone production and conversion.
  • L-Tyrosine: L-Tyrosine is an amino acid that serves as a building block for thyroid hormones and may support thyroid function.

It’s important to note that natural support options should be personalized and tailored to each individual’s specific needs and should be used under the guidance of a healthcare professional.

Considering Medication

While the functional approach emphasizes natural support and addressing underlying factors, medication may still be necessary for some individuals with Hashimoto’s. The decision to introduce medication should be based on various factors, including the severity of symptoms, the extent of the autoimmune damage, and the response to natural support methods.

If medication is required, healthcare professionals will typically prescribe levothyroxine (T4 hormone) or other thyroid hormone replacement medications. The dosage of the medication should be carefully monitored and adjusted as needed based on symptoms and regular thyroid function testing.

When to Medicate for Hashimotos

The Importance of Dosage

Finding the right dosage of thyroid medication is crucial for individuals with Hashimoto’s. Overmedication can lead to symptoms of hyperthyroidism, such as palpitations and weight loss, while under-medication can result in hypothyroid symptoms like fatigue and weight gain.

In the functional medicine approach, the dosage of thyroid medication is typically considered after addressing the underlying factors and optimizing the thyroid’s baseline function. Once the immune response is dampened, and the thyroid is functioning better, the dosage can be more accurately determined to provide adequate thyroid hormone support.


Hashimoto’s Thyroiditis affects a substantial number of individuals, and understanding why it is so common is essential in developing effective treatment strategies. The functional medicine approach to Hashimoto’s aims to address the underlying factors, dampen the immune response, and provide natural support to optimize thyroid function. Medication may be necessary in certain cases, but finding the right dosage is crucial for optimal symptom management. It is important to work with a knowledgeable healthcare professional to develop an individualized approach that addresses the unique needs of each person with Hashimoto’s.

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