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More and more people are turning towards vitamins, minerals, herbs, and other nutraceuticals to aid in the management of chronic medical conditions including thyroid disease. In fact, by 2024 the market for dietary supplements may reach close to $280 billion, up from $37 billion in 2015! 

In this article, we cover nine supplements that can help support thyroid health. 

Your Guide To The Genetics Of Thyroid Function

Knowing your risk for thyroid disease can help you stay in front of complications. Learn in this guide how genes impact your risk for hypothyroidism.

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Ashwagandha

Ashwagandha is known for its adaptogenic properties, meaning it may improve your body’s response to stress. Besides stress management, ashwagandha may be beneficial in those with hypothyroidism by:

• Enhancing sleep 
• Improving memory and attention
• Increasing thyroid hormone levels
• Lowering blood pressure
• Stimulating immune system activity

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The long-term effects of taking ashwagandha are unknown. Those that are pregnant or breastfeeding should not take it. Ashwagandha can interact with medications including ones used for:

• Diabetes
• High blood pressure
• Hypothyroidism
• Immunosuppression
• Sedative and sleep  

Iron

Iron is mainly known for its role in transporting oxygen to your muscles. But, it also helps convert thyroxine (T4) to triiodothyronine (T3), the active form of thyroid hormone, and maintains thyroid stimulating hormone (TSH) levels. Iron-deficiency anemia is relatively common in those with hypothyroidism with some studies reporting a prevalence of over 40%.

Taking your iron supplements with vitamin C increases iron absorption. But, iron supplements can interfere with levothyroxine absorption, as well as the effectiveness of several other medications. Avoid taking your iron supplement with or within 2-3 hours of:

• Antacids
• Antibiotics like ciprofloxacin or penicillin
• Thyroid medication, like levothyroxine
• Medications used for Parkinson’s disease and seizures

Magnesium

Magnesium is a cofactor for many enzyme-related processes in our body including energy production, blood sugar control, and muscle and nerve function. The benefits of taking magnesium in those with hypothyroidism include:

• Improvement in sleep
• Lowering blood pressure
• Optimization of bone health
• Reduction in headaches including migraines
  

Beware of magnesium-containing antacids and laxatives as taking too much magnesium can be harmful. Magnesium decreases the absorption of levothyroxine and bisphosphonates, a medication used to treat osteoporosis, and certain antibiotics. Take these medications 2-3 hours before or 4 to 6 hours after magnesium-containing supplements. 

Myo-inositol

Myo-inositol is essential for our signaling hormones, including TSH. Signaling hormones tell our cells when to start or stop a certain action. A change in myo-inositol levels may alter thyroid hormone production, secretion, and storage.

When myo-inositol and selenomethionine, a form of selenium, are taken together, those with Hashimoto’s thyroiditis or an underactive thyroid may experience a:

• Decrease in TSH and thyroid autoantibodies
• Increase in thyroid hormone levels
• Improvement in thyroid nodular disease

Selenium

Your thyroid gland contains high amounts of selenium, as selenium is important for converting T4 to T3 and healthy thyroid levels. Selenium may also:

• Improve immune system function
• Provide antioxidant properties 
• Reduce thyroid antibodies in Hashimoto’s‍

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Turmeric

Turmeric is commonly found in the spice aisle and contains curcumin. Curcumin is responsible for the medicinal effects and the bright yellow color of turmeric. 

In traditional medicine, turmeric helps reduce inflammation and oxidative stress markers in those with an autoimmune disorder like Hashimoto’s. Turmeric may also create an intestinal barrier to help with a leaky gut. This is beneficial to those with Hashimoto’s as leaky gut is thought to be one of the underlying causes. 

Vitamin B

Vitamin B, also known as thiamine, is one of the eight B vitamins that your body needs to make energy for your cells. Thiamine may decrease hypothyroidism-associated fatigue. 

Benfotiamine, a type of thiamine made in a lab, may block specific food compounds called advanced glycation end products from causing inflammation and oxidative stress in your body. Because of this, those with Hashimoto’s may benefit from benfotiamine as it targets two of the underlying causes. 

Vitamin B-12

Your body needs vitamin B-12 for forming red blood cells, proper cognitive function, and making new cells. Some refer to vitamin B12 as the energy vitamin as it helps improve:

• Energy levels
• Mood
• Cognitive function

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Nearly 40% of those with hypothyroidism have a B12 deficiency which may be caused by an autoimmune disorder called pernicious anemia. This is when your body can’t absorb vitamin B12 from the food you eat or from supplements. Because of this, your body doesn’t have enough red blood cells to carry oxygen to your muscles, leaving you feeling tired and fatigued. By managing your pernicious anemia with B12 injections, your energy levels and fatigue may improve. 

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Certain medications can interfere with vitamin B12 absorption including:

• Histamine 2 antagonist such as famotidine
• Metformin (Glucophage)
• Proton pump inhibitors like Prilosec or Nexium

Zinc

Zinc is a mineral that many people associate with helping to fight off colds. Besides helping our immune function, zinc also plays a role in producing thyroid hormones and healing leaky gut. 

Several prescription medications like antibiotics or diuretics can interact with zinc supplements. Thus, it is important to separate your zinc supplement from those medications. In general, take medications 2 hours before your zinc supplement or 4 to 6 hours after. 

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It depends on what works best for you. Some find it easier to take supplements in the morning while others prefer the evening. The key is to be consistent in how and when you take them. 

Consider the following questions when trying to determine a schedule:

• Do any of your medications or foods interact with the supplements? If so, how much time do you need between them?
• How many times a day do you need to take each supplement? 
• Can you take all supplements and medications in one sitting (as some pills can be large)?
• Should they be taken with food or on an empty stomach?

Your pharmacist or thyroid doctor can help you determine a schedule to take your supplements. 

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Vitamins and minerals play a key role in our body’s function. But, taking multiple supplements in addition to your medications may increase your pill burden. Consider Paloma's Daily Thyroid Care supplement. It is an iodine-free combination of nine essential nutrients your thyroid gland needs for optimal function.

Working with a Paloma Health dietician can help create a personalized supplement and nutritional plan to help lower antibodies and support optimal thyroid function.

Can supplements interfere with my thyroid medication?

Yes. Supplements like iron, magnesium, and calcium-containing antacids can decrease the absorption of levothyroxine and other thyroid medication, so it's best to separate them by 2 to 6 hours.

What is the best time of day to take thyroid supplements?

It depends on what works best for you. Some people prefer mornings and others evenings, but the key is to be consistent and to consider how your supplements interact with your medications and foods.

Can ashwagandha help with hypothyroidism?

Ashwagandha may help by improving sleep, memory, and attention, increasing thyroid hormone levels, and supporting stress management, though its long-term effects are not fully known and it should be avoided during pregnancy or breastfeeding.

Does taking myo-inositol and selenium together help Hashimoto's?

Some research suggests that taking myo-inositol and selenomethionine, a form of selenium, together may decrease TSH and thyroid autoantibodies, increase thyroid hormone levels, and improve thyroid nodular disease in people with Hashimoto's.

Why is iron deficiency common in people with hypothyroidism?

Iron helps convert T4 to the active T3 hormone and maintain TSH levels, and iron-deficiency anemia is relatively common in hypothyroidism, with some studies reporting a prevalence of over 40 percent.