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Thyroid Health: How to Maintain or Improve

By Jessi Grajczyk, DO

November 5, 2025

Among the many health issues that are trending in the wrong direction, thyroid problems are on the increase largely because of poor nutrition, bad lifestyle habits, exposure to environmental toxins and other factors. Meanwhile, yes, genetics also play a significant role.

I see patients who come in with complaints about weight gain, hair loss, fatigue, feeling cold, etc. and often wonder if they have a thyroid problem. Often, yes, they do. They’re not alone, for approximately 12 percent of Americans will develop a thyroid condition during their lifetime, according to the American Thyroid Association. It’s more common among women, as one in eight female Americans will develop a thyroid disorder, while for American men, it’s one in twenty.

The most common thyroid problems include hypothyroidism (underactive thyroid), hyperthyroidism (overactive thyroid), goiter, thyroid nodules and thyroid cancer. Recent global data shows that autoimmune thyroid disease affects 11.6 million U.S. adults.

Fortunately, there are many things you can do to support your thyroid beyond just medication. While some people will require medication for symptom management, I’ve seen many people make a few dietary changes and reduce their antibodies by half, for example. Let’s get into it.

Below we discuss the following:

• What is the thyroid hormone?

• Types, signs and causes of thyroid conditions

• Thyroid tests to consider taking

• Remedies for some thyroid problems

• When to see a doctor

• Supplements that support the thyroid

What is the thyroid hormone?

The thyroid is a small, butterfly-shaped gland located at the base of your neck, just behind the Adam’s apple. It’s part of your endocrine system and produces two main hormones: triiodothyronine (T3) and thyroxine (T4). These hormones regulate your body’s metabolism — helping to convert food into energy.

These hormones play a larger role in our body than we think, for they influence nearly every organ and function in the body. This includes our heart rate, temperature, digestion and even mood.

The thyroid works in coordination with the pituitary gland to release thyroid-stimulating hormone (TSH), which signals the thyroid when to produce more or fewer hormones — helping to maintain balance throughout the body. TSH from the pituitary signals the thyroid; imbalances can stem from stress or nutrient deficiencies, per endocrine research.

Sometimes the thyroid produces either too much or too little of certain hormones. Either scenario can be problematic for things like body weight regulation and mood stabilization.

Indications of a thyroid problem can include the following early warning signs: weight gain or loss, fatigue and muscle weakness, occasional constipation, lack of focus, feeling cold, low libido, dry skin and thinning hair.

If you suspect there’s an issue, you should consult with your healthcare professional.

Types, signs and causes of thyroid conditions

1. Hypothyroidism

• It occurs when the thyroid doesn’t produce enough of the thyroid hormones T3 or T4 (or both), often due to Hashimoto’s thyroiditis, iodine deficiency or certain medications. The TSH goes high while the free levels of T3 and/or T4 go low.

• In the case of hypothyroidism, your body literally slows down. This is why symptoms like weight gain, brain fog and fatigue are common. Muscle weakness, dry skin, constipation and cold intolerance are also common.

• Hypothyroidism is the most common type of thyroid problem and affects an estimated 5-10 percent of the population worldwide.

• Hashimoto's thyroiditis, an autoimmune disorder, is the most common cause of hypothyroidism and accounts for about 80 percent of cases.

2. Hyperthyroidism

• It occurs when the body has too much of the needed thyroid hormones, commonly caused by Graves’ disease or toxic nodular goiter.

• Hyperthyroidism speeds up one’s metabolism, to the point that the heart may beat faster and the person may have a hard time eating properly or keeping enough weight on. As a result, symptoms can include weight loss, anxiety, sleeplessness, loose stools, thinning hair, rapid heartbeat and heat intolerance.

• Hyperthyroidism affects approximately 1-2 percent of the population worldwide.

• Causes include family history, autoimmune disorders, being female, older age and certain medications (such as lithium).

3. Goiter

• It’s an enlarged thyroid that can accompany either hypo- or hyperthyroidism or arise from iodine deficiency.

• It can cause neck swelling or discomfort.

• Goiters affect around 5 percent of the population worldwide but up to 15 percent in the U.S.

• Common causes include being iodine deficient, older age, being female, family history and autoimmune conditions.

4. Thyroid nodules

• These are lumps within the gland that are usually benign but may occasionally overproduce hormones or become cancerous.

• Thyroid nodules are very common and affect up to 50 percent of the U.S. population.

• Common causes include older age (over the age of 50), family history, iodine deficiency and smoking.

5. Thyroid cancer

• Though less common, it typically appears as a painless lump in the neck and is often highly treatable when detected early.

• Thyroid cancer is the most common type of endocrine cancer yet is only around 1 percent of all new cancer cases worldwide.

Thyroid tests to consider taking

If you have concerns about your thyroid, it’s important to speak with your healthcare professional. Once there, ask for thyroid tests beyond just the TSH. The TSH is the last hormone to be abnormal, so oftentimes these low-grade thyroid issues will persist for years without detection because only the TSH test was administered.

Instead, you want these five blood tests (the full thyroid panel) that measure how well your thyroid is functioning and help identify specific imbalances:

• Free T4 (free thyroxine): Measures the amount of unbound T4 hormone available in the blood. Low levels typically point to hypothyroidism; high levels indicate hyperthyroidism.

• Free T3 (free triiodothyronine): Assesses the active form of thyroid hormone circulating in the blood. It’s especially useful for diagnosing hyperthyroidism or assessing its severity.

• Thyroid antibody tests: Detect autoimmune thyroid disorders. Common ones include TPO antibodies (thyroid peroxidase antibodies) and TG antibodies (thyroglobulin antibodies), which are elevated in Hashimoto’s thyroiditis, and TSI (thyroid-stimulating immunoglobulin), which is elevated in Graves’ disease.

• Reverse T3 (rT3): Measures the level of an inactive form of T3 in the blood. Reverse T3 is produced when the body converts T4 into a form of T3 that cannot be used by cells. This process often occurs during times of stress, illness, fasting or calorie restriction, when the body intentionally slows metabolism to conserve energy. Doctors may use this test when a patient has thyroid symptoms but normal TSH and T4 results.

• TSH (thyroid-stimulating hormone): The most commonly used test. It measures how much TSH the pituitary gland is producing to signal the thyroid. High TSH usually indicates hypothyroidism, while low TSH suggests hyperthyroidism.

In my practice, I always check the adrenal glands, too. If your adrenal glands are really exhausted, this can affect your thyroid. The adrenal test most closely related to thyroid function is the cortisol test. When cortisol is chronically high, it can suppress TSH and reduce the conversion of T4 to active T3, leading to symptoms similar to hypothyroidism. Conversely, low cortisol can make it harder for thyroid hormones to enter cells, also impairing metabolism.

Because of this strong hormonal connection, many practitioners assess adrenal health — especially cortisol patterns — alongside thyroid testing to get a full picture of endocrine balance.

Remedies for some thyroid problems

Depending on the results of these tests, I often don’t jump my patients to medications. Instead, I prefer to recommend a series of dietary and lifestyle changes. More clean living and making sure you’re getting the most important nutrients for your thyroid is a great place to start.

The sooner you catch thyroid issues, you then may be able to avoid medication and see positive changes in your labs, including with your thyroid antibodies.

1. Go gluten-free

Going gluten-free can help support thyroid health, especially for people with Hashimoto’s thyroiditis or Graves’ disease, both autoimmune thyroid disorders. Gluten — a protein found in wheat, barley and rye — can trigger an immune response in sensitive individuals.

In those with autoimmune thyroid disorders, the immune system already mistakenly attacks thyroid tissue, and gluten may worsen this process due to a phenomenon called molecular mimicry — where gluten proteins resemble thyroid tissue, potentially confusing the immune system and intensifying inflammation.

Eliminating gluten can help reduce autoimmune activity, lower thyroid antibodies and improve gut health, which is key because much of the immune system resides in the gut. Going gluten-free may also enhance nutrient absorption — important for thyroid function since nutrients like selenium, zinc, iodine and iron are essential for hormone production.

While not everyone with thyroid issues needs to avoid gluten, many people with autoimmune thyroid disorders report improved energy, digestion and symptom relief after removing it from their diet. I’ve had patients decrease their antibodies in half by just getting rid of gluten.

2. Address nutrient shortfalls (especially 6 main nutrients)

The six main nutrients the thyroid needs are iron, iodine, vitamin A, vitamin D, zinc and selenium. A surprisingly high percentage of people have shortfalls in one or more of these nutrients that work together to support healthy thyroid function:

• Iodine: It’s the main building block of thyroid hormones. The thyroid combines iodine with tyrosine to make T3 and T4. Note that too much or too little iodine can disrupt thyroid function.

• Iron: Essential for the enzyme thyroid peroxidase (TPO), which helps produce T3 and T4.

• Zinc and selenium: They convert inactive T4 into active T3, with zinc also helping to regulate TSH secretion from the pituitary gland and selenium protecting the gland from inflammation.

• Vitamin A: Helps regulate thyroid hormone metabolism and enhances the uptake of iodine by the thyroid gland.

• Vitamin D: Helps regulate the immune system, lowering thyroid antibody activity in autoimmune conditions.

You can maintain healthy levels of these key thyroid-supportive nutrients through a balanced diet and mindful lifestyle habits:

• Iodine: Best sources include seaweed (kelp, nori), iodized salt, fish, eggs and dairy products. Be cautious with excessive seaweed intake, as too much iodine can disrupt thyroid balance.

• Iron: Found in red meat, poultry, fish, lentils, spinach, and pumpkin seeds. Pair plant-based sources with vitamin C–rich foods (like citrus or bell peppers) to boost absorption.

• Zinc: Rich in oysters, beef, chicken, pumpkin seeds, chickpeas and cashews; deficiency is more common in people with restricted diets.

• Selenium: Found in Brazil nuts, tuna, sardines, eggs, and mushrooms; just one or two Brazil nuts per day can meet your daily needs.

• Vitamin A: Obtained from liver, eggs, dairy, and colorful produce like carrots, sweet potatoes and leafy greens — rich in beta-carotene, which the body converts to vitamin A.

• Vitamin D: Produced naturally from sunlight exposure and found in fatty fish (salmon, sardines), egg yolks, fortified dairy, and supplements — especially helpful in low-sunlight months.

Combining nutrient-rich foods, moderate sun exposure and high-quality supplements like a multivitamin (many contain adequate amounts of all six nutrients) when needed helps ensure your thyroid has the raw materials it needs to function optimally.

3. Consume adequate protein

Getting enough protein into your diet is very important for thyroid health. Protein provides the amino acid tyrosine, a key building block of thyroid hormones T3 and T4. Adequate protein also supports the transport of these hormones in the bloodstream, since thyroid hormones bind to carrier proteins to reach cells throughout the body.

In addition, eating sufficient protein helps maintain your muscle mass and metabolic rate, both of which can decline with hypothyroidism. Protein-rich foods — like fish, eggs, poultry, grass-fed meat, legumes and high-quality protein powders — also help stabilize blood sugar and support adrenal function, which works closely with the thyroid to regulate energy and stress response.

Without enough protein, hormone production, conversion and delivery can all become less efficient, leading to fatigue, sluggish metabolism and poor recovery.

4. Introduce stress relief

Chronic stress can significantly disrupt thyroid function by altering hormone production, conversion and signaling. When you’re under prolonged stress, your adrenal glands release cortisol, which helps the body cope short-term but can interfere with thyroid health over time.

High cortisol levels suppress the release of TSH from the pituitary gland, reducing thyroid hormone production. Cortisol also blocks the conversion of T4 (inactive hormone) to T3 (active hormone), while increasing production of reverse T3, an inactive form that can further slow metabolism.

In addition, stress interferes with healthy inflammation levels and can worsen autoimmune activity in conditions like Hashimoto’s thyroiditis or Graves’ disease. It may also strain the adrenal–thyroid connection, leading to symptoms such as fatigue, weight gain, mood swings and poor stress tolerance.

In other words, it’s important to try and get a handle on your stress levels. You can help manage stress through practices like deep breathing, exercise, good sleep, time outdoors, and supportive nutrition helps maintain both thyroid and adrenal balance.

5. Avoid excessive intermittent fasting

For anyone dealing with thyroid issues, I encourage them not to fast because that can stress the adrenal glands more. I believe that our body was made to fast from supper to breakfast, but not this 18-hour extended fast that has become popular. That's when it can harm our body, especially if our adrenal glands are struggling, because it's going to raise cortisol levels and potentially suppress TSH.

In women especially, prolonged fasting may also disrupt reproductive hormones and blood sugar balance, which indirectly affects thyroid health.

6. Get enough sleep

Sleep is essential for thyroid health because it helps regulate the delicate balance between the thyroid, adrenal and pituitary glands — key players in hormone production and metabolism. During deep, restorative sleep, the body reduces stress hormones like cortisol and supports the release of TSH, which signals the thyroid to produce T3 and T4.

When sleep is short or disrupted, cortisol levels rise and TSH rhythms become irregular, leading to reduced thyroid hormone production and a slower metabolism. Poor sleep further amplifies fatigue, mood swings and weight gain — symptoms already common in thyroid imbalance.

Getting 7-9 hours of quality sleep each night helps restore hormonal balance, supports metabolism and allows the thyroid to function efficiently.

7. Moderate amounts of exercise

Moderate exercise is important for thyroid health because it helps stimulate metabolism, improve hormone sensitivity and support overall endocrine balance without overtaxing the body. Regular movement encourages better circulation of T3 and T4 throughout the body, helping cells use them more efficiently. It also enhances mitochondrial activity, supporting the energy production that thyroid hormones regulate.

Unlike intense, prolonged training — which can elevate cortisol and suppress thyroid function — moderate exercise such as brisk walking, strength training, yoga or cycling helps reduce stress, improve mood and balance blood sugar, all of which support healthy thyroid function.

For those with hypothyroidism, it can help counteract fatigue and weight gain, while in hyperthyroidism, gentle movement can reduce anxiety and muscle weakness. The key is consistency — regular, moderate activity strengthens the thyroid-adrenal connection and promotes metabolic resilience.

8. Reduce toxic exposure

Environmental pollutants can disrupt thyroid health by interfering with hormone production, conversion and signaling. Many chemicals act as endocrine disruptors, meaning they mimic or block the body’s natural hormones.

Substances such as bisphenol A (BPA) from plastics, phthalates from personal care products, polychlorinated biphenyls (PCBs), flame retardants (PBDEs), and heavy metals like mercury or lead can all affect thyroid function.

These pollutants may inhibit iodine uptake, which the thyroid needs to make T3 and T4, or damage thyroid cells directly. Some also increase the breakdown of thyroid hormones in the liver, lowering circulating levels, while others alter TSH regulation from the pituitary gland. Long-term exposure is linked to higher rates of hypothyroidism, autoimmune thyroid disease and other potential thyroid issues.

It’s important to reduce contact with these chemicals by using glass instead of plastic, choosing clean personal care products, filtering water and avoiding excessive pesticide exposure. These changes can help protect thyroid health and overall hormonal balance.

When to see a doctor

It’s important to see a doctor for your thyroid health whenever you notice persistent symptoms or have risk factors suggesting a thyroid imbalance. You should schedule an evaluation if you experience:

• Unexplained fatigue, weight changes, or mood shifts (depression, anxiety, irritability).

• Changes in heart rate — either unusually fast (palpitations) or slow.

• Temperature intolerance, such as feeling unusually cold or hot compared to others.

• Changes in skin, hair, or nails, including thinning hair, brittle nails or dry skin.

• Neck swelling or lump near the throat, which could indicate a goiter or thyroid nodule.

• Menstrual or fertility problems, which can stem from thyroid hormone imbalances.

• Family history of thyroid disease or autoimmune conditions (like Hashimoto’s or Graves’).

• Recent pregnancy, since postpartum thyroiditis can develop within a year after delivery.

• Persistent brain fog, constipation, tremors or unexplained anxiety.

Early testing and treatment are key because thyroid disorders can progress gradually. A doctor can run blood tests (TSH, free T3, free T4, antibodies), check for underlying autoimmune issues, and recommend personalized treatment — whether that’s medication, lifestyle changes, or monitoring.

Supplements that can support the thyroid

While some people may struggle with thyroid health, there are many who simply want to support their already-healthy thyroid. If that’s you, then you can ensure you follow a thyroid-healthy diet and lifestyle, including some supplements that can support thyroid health.

Certain supplements can also support your thyroid health. You may consider Ancient Nutrition’s Thyroid supplement, which includes thyroid-specific superfoods and clinically studied ashwagandha. It includes organic fermented kelp, astragalus root and eleuthero root — all traditionally used to support the health of your thyroid. Additionally, ashwagandha is one of the most-researched adaptogenic herbs and helps support healthy energy levels, mental clarity and concentration, and restful sleep.

Dr. Jessi Grajczyk, D.O. (doctor of osteopathic medicine) and OB/GYN (obstetrician-gynecologist), is a Wellness Roundtable member and Ancient Nutrition Paid Partner. Hailing from North Dakota, her strong family roots influenced her approach to practicing medicine, always seeking to find a balance between traditional and alternative methods of healing.