Are you worried about catching cold or the flu this season? If you have Hashimoto’s, your immune system functions differently, so you have to be careful with immune supplements. Taking the wrong ones can make you feel worse or even trigger a flare. This article will cover why and how to choose the right immune support for yourself.
Because every case is different, please discuss any changes in diet or supplements with your doctor to ensure that they’re safe for you and to prevent any drug interactions. Also, a naturopathic or functional medicine doctor can recommend the right immune support based on your history and tendencies.
Autoimmune Patterns and Immune Support Challenges When You Have Hashimoto’s
Some parts of your immune system are hyperactivated in autoimmune disease . But do you ever wonder why you can still have symptoms of a weak immune system?
The human immune system is rather complex because it has a variety of shields and weapons to fight different germs.
Different types of germs require different weapons to attack. For example, you’ll fight off parasites differently than you fight off viruses. Then, after you fight off all the germs, your immune system needs to know to shut off and return to normal appropriately.
To successfully deploy the right types of weapons and shut off afterwards, your immune system has coordinators that are called Helper T cells (abbreviated Th). The important ones to know include :
Th1 mainly coordinates battles with germs that infect the inside of cells like bacteria and viruses. When Th1 doesn’t shut off appropriately, it often leads to autoimmune diseases . Generally, if your colds come on strongly and resolve in 2–3 days, it’s a sign you have strong Th1 immune function.
Th2 mainly coordinates battles with germs that infect outside cells, such as parasites. When Th2 doesn’t shut off appropriately, it often leads to allergic conditions like allergies, asthma, eczema, food allergies, and hives. Some autoimmune diseases also involve Th2 dominance .
Th17 coordinates battles with bacterial and fungal pathogens. When it fails to shut off, it’s a big contributor to all kinds of autoimmune and allergic diseases .
Regulatory T cells are the type of helper T cells that ensure everything shuts off after you finish fighting off an infection. It also makes sure your immune system doesn’t attack itself or harmless things like dust and food. Obviously, when your regulatory T cells fail, you can get autoimmunity or allergic diseases, depending on your tendency .
Having Hashimoto’s means you have low regulatory T cells, hyper-activated Th17 functions, and either overactive Th1 or Th2, or both.
Many immune support herbs stimulate Th17 and Th1, while some stimulate Th2. If your Hashimoto’s is driven by Th1 dominance, taking herbs that stimulate Th1 will make your Hashimoto’s worse.
Key insight #1: When you have an autoimmune disease, your immune system is imbalanced. So, you need to avoid immune support supplements that can worsen your specific imbalance pattern. Many common immune support and adaptogenic herbs tend to fall into this category.
I know this Th1 and Th2 thing can be quite confusing. The best way to know if you are Th1 or Th2 dominant is to get a blood test, which is not commercially available. Also, an herb can trigger flares in one person yet help another.
What you need to know includes:
- Avoid anything that stimulates Th1 and Th17, or reduces regulatory T cells in general.
- Provide your body with nutrients and take immune supplements that have balancing effects.
- A naturopathic or functional medicine doctor can help you determine your tendency and prescribe the right immune support based on your symptoms and history.
- Don’t push through and keep taking herbs that make you feel worse.
Avoid Immune-boosting Herbs that Are Contraindicated for Autoimmunity
Because your immune system is already overactive and imbalanced, many immune-stimulating herbs can further activate autoimmune responses, which can make things worse or cause flareups. For example, echinacea, astragalus, and elderberry are common immune-supporting benefits but should be avoided with Hashimoto’s. Here is why:
- Echinacea (may stimulate Th17 and Th2, while lowering regulatory T cells) is a popular common cold remedy. However, echinacea can contribute to a flareup by aggravating immune tendencies [6,7].
- Astragalus (may stimulate Th1 and Th17) has become a popular adaptogenic and immune support herb . It also may exacerbate autoimmune disease by heightening immune functions and can interact with immunosuppressive medications, dampening their effects [9,10].
- Elderberry (may stimulate Th17) has a long history in folk medicine of combating colds and flu. It increases the production of inflammatory molecules required to get rid of the pathogen. In Hashimoto’s, these pathways are already over-activated, and further stimulation could make your symptoms worse or cause flares .
Some over-the-counter products, even cough drops, may contain some of these herbs, so it’s always best to read the ingredient lists before taking such products. If you’re unsure, reach out to your healthcare provider to ensure they are safe for you.
Now that you’ve learned what not to do, let’s talk about safe immune support for Hashimoto’s.
How to Support Healthy Immune Functions with Hashimoto’s
Address the basics
When seeking to support immune function, don’t ignore the basics: nutrition, sleep, exercise, and stress management. Each of these is essential for healthy immune function in ways that you can’t make up with supplementation.
Nutrition tips for immune support:
- Aim for plenty of vegetables and fruits for antioxidants and fiber to feed your gut flora. This usually includes 10 servings (1 cup raw and ½ cup cooked per serving) daily.
- Eat probiotic-rich foods, such as sauerkraut and kombucha, (if tolerated) to support your gut flora, and promote regular bowel movements and digestive health.
- Eating sugars and having high blood sugar are bad for your immune system. So, avoid simple sugars, such as candies, desserts, and highly processed foods to balance your blood sugar.
Inflammation can worsen the immune imbalance and become even more heightened when you are sick, as your body tries to fight off the infection . Increasing your intake of anti-inflammatory foods such as fatty fish (e.g. salmon, mackerel, and tuna), berries and other fruits, and leafy greens can support the inflammation balance and healthy immune function. Also, avoid highly processed foods which may further contribute to inflammation.
Exercise temporarily reduces your immune system response, especially if you work out hard and long. However, over the long term, exercise strengthens your immune system . The key to exercising with Hashimoto’s is to not overdo it. This is why I advise keeping your sessions short but challenging enough to push yourself. The recovery between sessions is also essential to grow muscles and maintain healthy immune function. In Thyroid Strong, I recommend training only 3 days a week, resting 4 days per week, and walking up to 10,000 steps per day.
Key insight #2: The most important part of immune support with Hashimoto’s is the basics. These include eating to nourish your immune system and manage inflammation, regularly exercising without overdoing it, sleeping well, and managing oxidative stress. Lastly, you want to wash your hands often and take precautions to minimize your exposure to germs.
Sleep well and manage stress
When sleep-deprived, you become more inflamed, and less able to fight off infections. This is why people tend to get sick after a bout of sleep deprivation . Both sleep and being stressed out increase cortisol and oxidative stress, which weakens your immune system .
It is, therefore, important to adopt good sleep hygiene practices and make efforts to manage your stress.
Minimizing exposure to germs and hydrating your airways
Often overlooked is modifying risk exposure, including avoiding others who are sick and events involving large crowds. If you really have to, then take proper precautions if you find yourself in these situations. Wash your hands, and don’t touch your nose and eyes.
Respiratory illnesses spread more in colder months because dry air in heated indoor spaces dries out your airway, making germs transmit and infect more easily . When humidity is higher, infectious particles transmitted via respiratory droplets die off faster, decreasing the risk for transmission.
You can increase indoor humidity with a humidifier, aiming for relative indoor humidity between 40-60%, as too much can increase the risk for mold growth .
Flying, especially during the day, can increase your radiation exposure and oxidative stress, which weaken your immune system . The air inside planes also tends to be dry . The good news is you can support your immune system and respiratory health by:
- Sleeping well before and after the flight
- Increasing your antioxidant intake, like vitamin C and glutathione
- Drinking plenty of water
- Using a portable humidifier during the flight
Provide your body with enough micronutrients and antioxidants for your immune function
Vitamin D is critical for proper immune functioning during winter . Typically, our bodies produce vitamin D through the skin after sun exposure. However, with shorter days, colder temperatures, and fewer opportunities to get outdoors comes an increased risk for deficiency. Most Hashimoto’s patients are also deficient in vitamin D and may find it harder to get their vitamin D into optimal levels .
Vitamin D aids T cell responses and immune balance, making it an ideal immune support, even with Hashimoto’s. In general, a dose of 4000 IU per day is very safe, but it might be helpful to test your vitamin D status before supplementing .
Zinc is a micronutrient involved in over 300 reactions in your body, especially for your thyroid . It supports proper hormone signaling, and balanced T3 and T4 levels . Zinc is also important for your own natural antiviral responses. Having healthy zinc levels can help your immune system self-balance between tolerance and defense. Because zinc can deplete copper over time, it should only be taken when you feel something coming on, or in combination with a small dose of copper .
Selenium is vital for the proper functioning of both the immune and thyroid systems . Having optimal selenium levels enables your immune system to function more optimally and robustly, while remaining balanced .
Your liver needs selenium to produce glutathione, the most important cellular antioxidant. So, a selenium deficiency can increase oxidative stress, increasing inflammation and potentially damaging your thyroid gland.
Key insight #3: Providing your immune system with the nutrients and antioxidants it needs will allow it to function at its full potential. These nutrients include vitamin D, vitamin C, zinc, selenium, antioxidants, and glutathione.
Oxidative stress is a big factor in autoimmune diseases . The high oxidative stress can also rob your immune system of the ability to fight off germs effectively. The good news is that you can take more antioxidants to counteract these, especially when you’re more concerned about immune functions .
- Vitamin C can support the function of skin and mucous membrane barriers, counteract oxidative stress, and support healthy immune readiness . High doses of 1000 mg/day (and sometimes more) are safe and effective . For supporting everyday health, fruits and vegetables are great 
- Glutathione is one of our body’s most abundant antioxidants – our bodies can produce it in the liver and then use it for immune functions . Many people with autoimmune diseases produce less glutathione, making it harder to fight infection. Glutathione supplementation may support immune balance, which may translate into improved immune responses [35,36]. Look for liposomal forms which enhance absorption .
Use safe immune support herbs in moderation
While you need to avoid many herbs that activate your immune system, some other herbs are safe. These include:
- Garlic, a safe culinary herb that works with your immune system 
- Some medicinal mushrooms, which are immunomodulating . They support the aspects of your immune function that your body needs.
Given the complexity of Hashimoto’s, please consult with your naturopathic doctor or healthcare provider prior to initiating any changes to your current treatment program, to avoid any contraindications or interactions with your current medications.
How Thyroid Strong Can Support Immune Health with Hashimoto’s
Thyroid Strong is a comprehensive self-care program aimed to help you thrive despite Hashimoto’s and get in shape. Aside from my optimized exercise program, it also includes 20+ hours of bonus content with functional medicine doctors diving deep into ways to support various aspects of your health, such as the immune system. It’s the program I wish I had when I started my Hashimoto’s journey over a decade ago because this information would help me avoid many mistakes that slowed down my progress. No exercise program covers the functional medicine part, while most functional medicine programs don’t address the exercise piece. Join the Thyroid Strong community today and take control of your health.
1 Sweeney, L. B., Stewart, C. and Gaitonde, D. Y. (2014) Thyroiditis: an integrated approach. Am. Fam. Physician 90, 389–396.
2 Skapenko, A., Leipe, J., Lipsky, P. E. and Schulze-Koops, H. (2005) The role of the T cell in autoimmune inflammation. Arthritis Res. Ther. 7 Suppl 2, S4–14.
3 Ademokun, A. A. and Dunn-Walters, D. (2010, September 15) Immune responses: Primary and secondary. eLS, Wiley.
4 Kim, C. H. (2009) Migration and function of Th17 cells. Inflamm. Allergy Drug Targets 8, 221–228.
5 Kondĕlková, K., Vokurková, D., Krejsek, J., Borská, L., Fiala, Z. and Ctirad, A. (2010) Regulatory T cells (TREG) and their roles in immune system with respect to immunopathological disorders. Acta Medica 53, 73–77.
6 Bax, C. E., Chakka, S., Concha, J. S. S., Zeidi, M. and Werth, V. P. (2021) The effects of immunostimulatory herbal supplements on autoimmune skin diseases. J. Am. Acad. Dermatol. 84, 1051–1058.
7 Kim, H.-R., Oh, S.-K., Lim, W., Lee, H. K., Moon, B.-I. and Seoh, J.-Y. (2014) Immune enhancing effects of Echinacea purpurea root extract by reducing regulatory T cell number and function. Nat. Prod. Commun. 9, 511–514.
8 Wang, G., Liu, C.-T., Wang, Z.-L., Yan, C.-L., Luo, F.-M., Wang, L. and Li, T.-Q. (2006) Effects of Astragalus membranaceus in promoting T-helper cell type 1 polarization and interferon-gamma production by up-regulating T-bet expression in patients with asthma. Chin. J. Integr. Med. 12, 262–267.
9 Chu, D. T., Wong, W. L. and Mavligit, G. M. (1988) Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo. J. Clin. Lab. Immunol. 25, 125–129.
10 Sun, Y., Hersh, E. M., Lee, S. L., McLaughlin, M., Loo, T. L. and Mavligit, G. M. (1983) Preliminary observations on the effects of the Chinese medicinal herbs Astragalus membranaceus and Ligustrum lucidum on lymphocyte blastogenic responses. J. Biol. Response Mod. 2, 227–237.
11 Barak, V., Halperin, T. and Kalickman, I. (2001) The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur. Cytokine Netw. 12, 290–296.
12 McCulloch, M. (2015, April) 5 foods to help fight inflammation.
13 Nieman, D. C. and Wentz, L. M. (2019) The compelling link between physical activity and the body’s defense system. J Sport Health Sci 8, 201–217.
14 Pizzino, G., Irrera, N., Cucinotta, M., Pallio, G., Mannino, F., Arcoraci, V., Squadrito, F., Altavilla, D. and Bitto, A. (2017) Oxidative Stress: Harms and Benefits for Human Health. Oxid. Med. Cell. Longev. 2017, 8416763.
15 Garbarino, S., Lanteri, P., Bragazzi, N. L., Magnavita, N. and Scoditti, E. (2021) Role of sleep deprivation in immune-related disease risk and outcomes. Commun Biol 4, 1304.
16 Dhabhar, F. S. (2014) Effects of stress on immune function: the good, the bad, and the beautiful. Immunol. Res. 58, 193–210.
17 (2020, December 21) The role of dry winter air in spreading COVID-19, University Hospitals.
18 Verheyen, C. Keeping indoor humidity levels at a “sweet spot” may reduce spread of Covid-19. MIT News | Massachusetts Institute of Technology.
19 CDC. (2022, December 19) Radiation from air travel. Centers for Disease Control and Prevention.
20 Leder, K. and Newman, D. (2005) Respiratory infections during air travel. Intern. Med. J. 35, 50–55.
21 (2013, August 1) Autoimmune thyroid disease: Treating with nutrients and botanicals. Naturopathic Doctor News and Review.
22 Ucan, B., Sahin, M., Sayki Arslan, M., Colak Bozkurt, N., Kizilgul, M., Güngünes, A., Cakal, E. and Ozbek, M. (2016) Vitamin D Treatment in Patients with Hashimoto’s Thyroiditis may Decrease the Development of Hypothyroidism. Int. J. Vitam. Nutr. Res. 86, 9–17.
23 Amrein, K., Scherkl, M., Hoffmann, M., Neuwersch-Sommeregger, S., Köstenberger, M., Tmava Berisha, A., Martucci, G., Pilz, S. and Malle, O. (2020) Vitamin D deficiency 2.0: an update on the current status worldwide. Eur. J. Clin. Nutr. 74, 1498–1513.
24 Wessels, I., Maywald, M. and Rink, L. (2017) Zinc as a Gatekeeper of Immune Function. Nutrients 9.
25 Chen, L., Shi, T., Wang, Y.-T., He, J., Zhao, X., Wang, Y.-K., Giesy, J. P., Chen, F., Chen, Y., Tuo, X., et al. (2021) Effects of acute exposure to microcystins on hypothalamic-pituitary-adrenal (HPA), -gonad (HPG) and -thyroid (HPT) axes of female rats. Sci. Total Environ. 778, 145196.
26 Duncan, A., Yacoubian, C., Watson, N. and Morrison, I. (2015) The risk of copper deficiency in patients prescribed zinc supplements. J. Clin. Pathol. 68, 723–725.
28 Avery, J. C. and Hoffmann, P. R. (2018) Selenium, Selenoproteins, and Immunity. Nutrients 10.
29 Rayman, M. P., Winther, K. H., Pastor-Barriuso, R., Cold, F., Thvilum, M., Stranges, S., Guallar, E. and Cold, S. (2018) Effect of long-term selenium supplementation on mortality: Results from a multiple-dose, randomised controlled trial. Free Radic. Biol. Med. 127, 46–54.
30 Ramani, S., Pathak, A., Dalal, V., Paul, A. and Biswas, S. (2020) Oxidative Stress in Autoimmune Diseases: An Under Dealt Malice. Curr. Protein Pept. Sci. 21, 611–621.
31 Carr, A. C. and Maggini, S. (2017) Vitamin C and Immune Function. Nutrients 9.
32 Maggini, S., Beveridge, S. and Suter, M. (2012) A combination of high-dose vitamin C plus zinc for the common cold. J. Int. Med. Res. 40, 28–42.
33 Vitamin C.
34 Dröge, W. and Breitkreutz, R. (2000) Glutathione and immune function. Proc. Nutr. Soc. 59, 595–600.
35 Sinha, R., Sinha, I., Calcagnotto, A., Trushin, N., Haley, J. S., Schell, T. D. and Richie, J. P., Jr. (2018) Oral supplementation with liposomal glutathione elevates body stores of glutathione and markers of immune function. Eur. J. Clin. Nutr. 72, 105–111.
36 Ghezzi, P. (2011) Role of glutathione in immunity and inflammation in the lung. Int. J. Gen. Med. 4, 105–113.
37 Bruggeman, B. K., Storo, K. E., Fair, H. M., Wommack, A. J., Carriker, C. R. and Smoliga, J. M. (2019) The absorptive effects of orobuccal non-liposomal nano-sized glutathione on blood glutathione parameters in healthy individuals: A pilot study. PLoS One 14, e0215815.
38 Mirzavandi, F., Mollahosseini, M., Salehi-Abargouei, A., Makiabadi, E. and Mozaffari-Khosravi, H. (2020) Effects of garlic supplementation on serum inflammatory markers: A systematic review and meta-analysis of randomized controlled trials. Diabetes Metab. Syndr. 14, 1153–1161.
39 Lull, C., Wichers, H. J. and Savelkoul, H. F. J. (2005) Antiinflammatory and immunomodulating properties of fungal metabolites. Mediators Inflamm. 2005, 63–80.