Updated August 12, 2015.

Many thyroid patients ask me whether hypothyroidism - an underactive thyroid - can be "treated naturally," or whether there are holistic, alternative or nutritional approaches to treat a thyroid condition.

Here a few guidelines to consider.

When You Need Prescription Medication

First, if your thyroid gland is permanently incapable of functioning, you will need a prescription thyroid hormone replacement drug.

Some types of thyroid conditions require prescription thyroid hormone replacement, to replace the hormone your body can't produce on its own. In these cases, thyroid hormone is required for survival:

• If you were born with congenital hypothyroidism (no thyroid at birth, or a malformed and non-functioning gland)
• If you have had a complete thyroidectomy -- thyroid surgery for a goiter, nodules, Graves' disease, Hashimoto's, or thyroid cancer
• If you have had radioactive iodine ablation (RAI) for Graves' disease, and your thyroid function has been fully ablated (fully inactivated)
• If you have Hashimoto's disease, and antibodies have attacked your gland to the extent that it is unable to produce thyroid hormone

This is not to say that alternative and holistic approaches can not help improve your response to treatment, or resolve persistent symptoms, but there are no vitamins, herbs, or alternative treatments that can replace the prescription thyroid hormone replacement medication your cells, glands, tissues and organs need for survival.

When Holistic Approaches May Help

If you are hypothyroid due to autoimmune Hashimoto's disease, or if optimal prescription treatment for hypothyroidism is not resolving all of your persistent symptoms, there are some alternative approaches to consider. These include:

• A gluten-free diet. In a subset of patients, a gluten-free diet can reduce antibodies and even help some patients achieve a remission from Hashimoto's, restoration of optimal thyroid blood test levels, and relief of symptoms
• Selenium. At appropriate levels (no more than 400 micrograms from all sources, including supplements, and food, especially Brazil nuts), selenium has been shown to lower thyroid antibodies.
• Minimizing dietary goitrogens. A category of foods that includes cruciferous vegetables, soy, and some fruits are goitrogens, meaning that they promote development of a goiter, and can slow down the thyroid gland. For some patients, eliminating or minimizing these foods from the diet -- or in the case of the cruciferous vegetables, cooking or steaming them -- may help reverse mild hypothyroidism. (See a complete list of goitrogens.)
• Reducing or Eliminating Soy. Soy -- especially unfermented and processed soy supplements and foods that are high in soy isoflavones -- can bind to thyroid hormone and make it less effective. So for some patients, reducing or eliminating these forms of soy may help improve thyroid function. Reducing or eliminating exposure to your known food allergens may also help.
• Addressing iodine deficiency or excess. Iodine is the building block of thyroid hormone, and is an essential nutrient for proper thyroid function. Low iodine levels can contribute to or cause hypothyroidism, and when a low level is identified through testing, supplementation with an iodine/iodide supplement - under the direction of a physician - may help restore thyroid function to normal. At the same time, excessive intake of iodine - usually from high doses of iodine supplements when they are not needed -- can aggravate and worsen some thyroid conditions, and reducing excess iodine intake may also help restore levels to normal.
• Eliminating BPA and phthalate exposure. Phthalates -- chemicals that are also referred to as "plasticizers" -- are found in polyvinyl chloride (PVC), as well as many common products, such as toys, food packaging, raincoats, shower curtains, etc. Bisphenol-A -- known as BPA -- is a chemical found in certain plastic water bottles and even in the lining of canned foods. BPA and phthalates are endocrine disruptors, meaning that at certain levels of exposure, they can negatively affect endocrine function, including the testes, ovaries, and thyroid, among other endocrine glands. Eliminating exposure to these chemicals may help thyroid function.
• Stress reduction and management. Stress -- whether life stress, or stress from lack of sleep, poor nutrition, chronic infections, or other causes -- contributes to inflammation, and may aggravate autoimmune hypothyroidism. Active stress reduction approaches that generate the "relaxation response" -- lowered heart rate, lowered respiration, and lowered stress hormones -- may help improve thyroid function in some patients. These include meditation, prayer, gentle yoga, tai chi, and needlework, among other approaches.
• Yoga. Some yoga experts suggest that certain yoga poses --specifically shoulderstands, and inverted poses where the feet are elevated -- may be beneficial to blood flow to the thyroid gland, or to reduction of general stress that contributes to worsening hypothyroidism symptoms.
• Guided meditation. Some patients find that guided meditation is helpful for the thyroid. I have heard from a number of patients who have used a specific guided meditation developed by One Light One Spirit, known as the Thyroid Meditation, and have reported improvement in thyroid test levels after several weeks of regular practice.

Considerations

There are a few important issues to consider.

Some over-the-counter thyroid support supplements may put you at risk of being overmedicated. For best results, only use these supplements under the guidance of a knowledgeable practitioner.

There are no "secret cures" for hypothyroidism. Be wary of ebooks, websites, webinars and programs that claim that they have a cure.

Chiropractors can not prescribe thyroid medication or any other prescription drugs. So if you are hypothyroid and rely on medications, be careful about chiropractic thyroid programs that promise to cure hypothyroidism, or suggest that patients should follow "drug-free thyroid treatments." Some of these programs can be very costly, and are not a replacement for proper thyroid treatment from a licensed medical doctor, osteopath, nurse practitioner, physician's assistant, or other professional who can legally prescribe medications.