liver health, your thyroid and Hashimotos

Hashimoto’s Thyroiditis is an autoimmune disorder/disease in which the immune system attacks the thyroid gland.  Hashimoto’s Thyroiditis is also called Lymphocytic Thyroiditis.  

When the body is healthy the immune system protects the body from infection by identifying, seeking out and destroying bacteria, viruses, and other potentially harmful foreign substances.


This is the simple definition of Hashimoto’s Thyroiditis.  It doesn’t, however, stop there.

Hashimoto’s Disease can cause a host of other issues in many parts of the body.  Nowhere other than the gut are these more issues more prominent or prevalent than in the liver and the gallbladder.

Today we are going to discuss why liver health is so important in the maintaining of a healthy thyroid and the healing of Hashimoto’s. 

The liver and thyroid must co-exist with Hashimoto’s.

The body doesn’t exist in a vacuum.  Its systems do not work independently of one another, rather is one large holistic macrocosm in which individual systems are constantly communicating and influencing one another.  This influence can be either negative or positive.  An example of this would be the OAT Axis and the ways the thyroid affects the liver affects the gut affects sugar balance affects hormonal balance and so on.

Let’s think about some of the ways that the liver works with the thyroid:

*60% of thyroid hormone is converted from inactive T4 to active T3 in the liver. Both T3 and T4 undergo glucuronidation and sulfation in the liver. 

* Thyroid hormone influences the way that cholesterol and other lipids are synthesized and broken down which happens in the- you guessed it- liver. Hypothyroidism and Hashimoto’s often slow down this process resulting in cholesterol and imbalances in lipids like LDL and triglycerides.

* Thyroid hormone influences detoxification pathways in the liver and affects (IGF) insulin growth factor and cytochrome P450 enzymes which is responsible for the metabolization of a slew of lots of pharmaceutical and recreational drugs and environmental toxins. When this process slows down toxins build up. This process also is responsible for the detoxification and elimination of dirty hormones.  If this process is dysfunctional hormonal imbalance like estrogen dominance can occur.

* On the autoimmune side, research has shown a link between autoimmune thyroid and autoimmune liver diseases.

High levels of thyroid hormone (T3) can raise bilirubin levels which can be liver toxic as it damages mitochondria.

What’s the gallbladder got to do with this?

The liver is the main detoxification site in the body and has several pathways through which it metabolizes hormones, filters toxins, and cleanses the blood. What’s left over (the byproducts) from these processes are shuttled into the gall bladder to help move them out of the body.

Low thyroid function slows down this entire process, making both the liver and gall bladder congested, sluggish, or even grinding the process to a halt in the gallbladder which is what contributes to gallstones.

Gallbladder scans in hypothyroid patients often show an enlarged gall bladder that contracts sluggishly. This slows down the flow of bile which can lead to slower breakdown of fats and cholesterol and other toxins that are broken down in the liver.

As I said before this process can also lead to the formation of gallstones. Many people with Hashimoto’s also have gallbladder issues and even disease.  Many doctors routinely remove the gallbladder without taking into account what might be going on in the liver or the thyroid.  While extreme cases may result in the need to remove the gallbladder, I am someone who believes your gallbladder has a profound place of honor in your body and prefer to heal it rather than yanking it out.

Thyroid hormone and your liver.

60% of thyroid hormones are converted from inactive T4 to T3 (the usable form) in the liver.  Thyroid hormone is necessary to support that process so low thyroid function slows down that conversion ensuring there is utilizable T3. Low thyroid function then creates a vicious cycle whereby fewer thyroid hormones become the more sluggish the liver detox pathways and so it goes until you have classic symptoms of low thyroid hormone.  Common ones include fatigue, brain fog, joint pain, hair loss, anxiety and/or depression, weight gain and so much more.

Thyroid hormone is converted from T4 to T3 primarily through 2 processes called glucuronidation and sulfation.


Glucuronidation is an important process for converting thyroid hormone. This pathway is supported by B vitamins, magnesium, and glycine.  Methylation defects can affect this process and can need specific methylated B vitamins and chelated forms of magnesium along with food forms of glycine like gelatin to support this process.


Sulfation involves binding things partially broken down in the liver with sulfur containing compounds. It is one of the major detoxification pathways for neurotransmitters, toxins, and hormones (like thyroid hormones and estrogen).  Vitamin B6 and magnesium are important for sulfur amino acid metabolism, as are foods containing sulfur such as eggs, cheese, meat, poultry, leafy green vegetables, nuts, and legumes. (The latter two can affect the health of the gut, however, and should be eaten sparingly, if at all, if there is leaky gut present.  Hashimoto’s Thyroiditis and Leaky Gut go hand in hand as we will discuss in a subsequent post).  The process of sulfation requires sulfates which are often poorly metabolized by those with sulfation pathway defects and Hashimoto’s.  Many studies point to sulfation pathway defects being a common factor in Hashimoto’s but which came first, the chicken or the egg?  That’s still up for debate. 

Sulfate is the oxidized, inorganic form of sulfur produced by an oxidation step called sulfoxidation.  This process requires an enzyme called sulfite oxidase which uses molybdenum, an essential mineral found in foods such as eggs, liver, oats, and sunflower seeds.

Problems with sulfoxidation can be seen in people who are sensitive to foods that contain sulfites such as garlic, onions or wine or drugs or supplements with sulfates (think magnesium sulfate, zinc sulfate and the like) and food additives such as those in certain canned goods or dried fruit.  

If you’ve ever eaten asparagus and had a very strong odor in your urine you may have a problem with the sulfation pathway. In my practice, these are the ones I generally give a molybdenum supplement in order to ease the sulfation pathway into a state of balance.

How can you support liver, gallbladder and thyroid function?

Here are some important herbs for helping the liver and gall bladder.

Ginger: this common rhizome contains chemicals that have been shown to increase bile secretion and to reduce cholesterol levels by upregulating an enzyme responsible for bile acid production (cholesterol-7-alpha-hydorxylase).

Dandelion: The root of this common weed promotes the production of bile and its delivery to the gall bladder. It causes the gallbladder to contract and release bile.  (However, one must be careful not to use dandelion or milk thistle if there is leaky gut present until leaky gut is healed as both dandelion and milk thistle can stimulate detox pathways and, if leaky gut is present, toxins can recycle through the permeable gut lining into the blood stream and back into the liver).

Milk Thistle: This potent herb increases the solubility of bile and has been shown to significantly lower cholesterol concentrations in the gall bladder. It has powerful antioxidant properties which supports detoxification and it prevents depletion of glutathione in the liver. Hashimoto’s patients are often glutathione depleted.   It also has anti-inflammatory properties and it promotes protein synthesis to replace damaged liver cells.

Panax ginseng: This herb has been shown in several studies to have numerous positive impacts on liver function. It has been shown to reverse fatty liver in animals and can be really helpful in cleaning toxins out of the liver. It also has really important benefits for the immune system like promoting Kupffer cells (specialized immune cells located in the liver) and can be beneficial in balancing the immune system by increasing key proteins like IL-8. I find it to be more masculine of an herb so I rarely prescribe it to women but find it beneficial in many men.

 Herba sargassi, Laminaria Kombu: These seaweeds have important detoxification properties and can be used to treat metabolic toxicosis with arthritis, rheumatism, dermatitis and psoriasis. They are quite mild and have very few if any side effects. In addition, they are rich in trace minerals and are helpful in reducing swelling, particularly in the lymphatic glands.

A word of caution with seaweeds: They contain iodine which can be problematic in some Hashimoto’s cases depending on iodine status.

Fructus Gardeniae: This herb is the seed pod of the gardenia plant. It has potent anti-bacterial and anti-viral properties and can be used to reduce liver and gallblader congestion and sluggishness.

Rhubarb Root: This herb is a potent laxative that can be used to treat acute gall bladder and pancreatic infections. (If one has Lyme or EBV along with Hashimoto’s this can keep the viruses at bay.) It has potent anti-bacterial, anti-fungal and anti-viral properties.

Hashimoto’s Thyroiditis requires a holistic approach!

Hashimoto’s Thyroiditis affects so many systems of the body that you really need to have a treatment strategy that looks at all these different areas and gives you solutions for all of them. 

If you have Hashimoto’s Thyroiditis or suspect you might booking in a Discovery Call is your first step to wellness.

6 replies
  1. Julin
    Julin says:

    Hi Jacqueline, nice to know you. You have already shared many important news for health, so i could know more how to keep healthy life, thank you!
    Now i want to ask you about my mom’s complaint.she has already felt thick and dry in her lip for about 10 years.Do you have any idea for the solution?
    Looking forward to your reply. Thank you.

  2. Mary Beth Smith
    Mary Beth Smith says:

    I’ve know I had Hishamoto for over 20 years diabetic type 2. HD my gallbladder removed 20years ago. Now my doc has ordered a liver scan my enzymes are elevated, I have meniers with vertigo. esophagus reflux, IBS
    I feel like I’m falling apart. Fatigue. My endocrinologist did not tell me any of these problems could be related to my thyroid
    I even complained that skin feels very dry and itchy. I know I need more medical help than I’m getting but still I read this article and would like to contact a specialist before I’m diagnosed with something else. I live in Birmingham. Can you give me direction?

    • elanwellness
      elanwellness says:

      You aren’t falling apart but your doctors are not unwinding the root cause and this is the issue. You need a doctor, functional medicine specialist or the like to listen to you and timeline the symptoms and see where the intersections are. THIS is where you begin. When I do this with my clients we experience great results!!


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