by Jenny Lelwica Buttaccio
Posted 8/5/20

It’s not uncommon for Lyme patients to experience dysfunction of the thyroid gland while battling Lyme disease. The butterfly-shaped organ is small — it sits just below the Adam’s apple at the base of the neck — but its functions are intimately tied to every cell in the body. Indeed, this gland has a big job to do: It regulates metabolism, body temperature, cholesterol levels, weight, heart function, and more.

One condition that can develop in people with Lyme is hypothyroidism, where the thyroid becomes underactive. As a result, the gland stops producing sufficient amounts of hormones and makes it difficult for your body to operate at its best. No doubt, hypothyroidism alone can make you feel worn out, achy, cold, brain foggy, and overall lousy.

woman touching throat to check thyroid

But for the majority of people, the thyroid doesn’t just malfunction in a vacuum — there’s typically another underlying cause, says Dr. Bill Rawls, Medical Director of RawlsMD and Vital Plan: “Thyroid function can become disrupted by several factors,” says Dr. Rawls. “When the thyroid goes haywire in someone with Lyme disease, it’s most likely a manifestation of Lyme, not a separate thyroid condition.”

Factors that may contribute to a thyroid that’s working subpar include:

Here, we’ll examine some of the signs and symptoms of an underactive thyroid, testing options, and natural remedies to support and normalize your thyroid gland as well as contribute to your recovery from chronic Lyme disease.

The Most Common Symptoms of Hypothyroidism

Because many of the signs and symptoms of hypothyroidism overlap with those of Lyme disease, it can be confusing for patients to discern whether low thyroid function is a piece of the puzzle that’s contributing to illness. It helps to start by zooming out and looking at the body as a whole, rather than focusing narrowly on a single, small part of it.

“For the entire body to function properly, all cells and tissues must communicate with one another effectively,” explains Dr. Rawls. “When cellular communication breaks down, the systems in our body — including the thyroid — become disconnected, and efficiency falls to the wayside.” The result of a system-wide cellular communication malfunction can lead to thyroid dysfunction and a host of accompanying issues.

sick woman in bed with water and holding throat

The symptoms associated with hypothyroidism can differ from one person to the next but may include any combination of the following:

  • Fatigue
  • Lethargy
  • Weight gain
  • Puffy face
  • Hoarse voice
  • Intolerant to cold
  • Joint pain
  • Muscle aches
  • Constipation
  • Depression
  • Difficulty working up a sweat
  • Dry skin and hair
  • Brain fog (trouble concentrating or remembering)
  • Problems with fertility in women
  • Heavy or irregular periods
  • Changes in heart rate
  • Presence of a goiter

Before you get discouraged by the long list of symptoms, remember this: Many of the same natural interventions used for Lyme and coinfections apply to managing thyroid health, as well. Which means it’s best to come at your symptoms from an integrative medicine standpoint and address the critical question: Why have cellular communications been altered in the first place?

“If you have a dysfunctional immune system, you may have specific microbes impacting thyroid function, or you might have a breakdown in the microbiome, the collection of more than 100 trillion microbes we house in our body,” says Dr. Rawls. “These contributing factors become central to correcting the underlying cause, not just treating the symptoms.”

How to Test for Hypothyroidism

If you’re working with a Lyme-literate medical doctor (LLMD) or another healthcare provider, they may opt to perform some blood tests that measure your thyroid function to create a more holistic view of what’s going on in the body. However, similar to Lyme disease testing, thyroid tests don’t always provide conclusive answers. Therefore, it’s not uncommon for LLMDs and integrative physicians to consider both your symptoms and lab results.

laboratory scene with blood vials being sorted by gloved hand

Potential tests that can help evaluate your thyroid gland function include:

  • TSH (Thyroid Stimulating Hormone): Produced by the pituitary gland in your brain, TSH signals to your thyroid gland to generate more thyroid hormones. The lab test to measure your TSH is a blood test, and it helps gauge if your thyroid is making adequate amounts of the hormone.
  • Free T3 and Free T4: T3 (triiodothyronine) and T4 (thyroxine) are produced by the thyroid gland itself. Testing your free T3 and free T4 is the best way to measure your active thyroid hormone levels and how well the hormones are performing their job of regulating metabolism.
  • Thyroid Antibodies: Thyroid antibody testing helps to distinguish if thyroid dysfunction is the result of an autoimmune process. Typical tests that might be ordered include thyroid peroxidase antibodies (TPO) and thyroglobulin antibodies (Tg).
  • Reverse T3 (rT3): Though not routinely used to assess an underactive thyroid, rT3 — an inactive form of T3 — may provide some information if a person experiences the symptoms of hypothyroidism but other tests are normal.
  • Mineral Testing: Mineral deficiencies such as iodine, copper, zinc, selenium, and iron can affect how the thyroid gland functions and contribute to hypothyroidism.
  • Vitamin D: Vitamin D is known for aiding in disease prevention. Low levels of vitamin D may correlate with hypothyroidism, according to a study in the Indian Journal of Endocrinology and Metabolism. Sufficient vitamin D levels may improve TSH concentrations in the blood.

Any information you can gather about your thyroid is valuable, states Dr. Rawls. Regardless, the key to improved thyroid function involves a multi-pronged, therapeutic approach to recovery.

How to Treat Hypothyroidism

The first step to restoring healthy thyroid function is figuring out the stress factors that are causing the illness to be present, says Dr. Rawls. No surprise, they’re the same factors that make us more vulnerable to chronic illnesses like Lyme disease. The five primary culprits:

  • Chronic stress
  • A poor diet that’s high in processed, packaged foods
  • Exposure to environmental toxins
  • An inactive lifestyle
  • Exposure to or an overgrowth of problematic microbes like Borrelia, Bartonella, Babesia, or Mycoplasma

Ultimately, forward momentum comes when you have a clearer understanding of which of these factors are most contributing to thyroid dysfunction and what you can do to support its return to good health. But in addition to minimizing the stress factors in your life, there are a variety of prescription medications and herbal therapies that can be used to balance thyroid function, undo other damage done, and deliver relief from life-disrupting symptoms.


Thyroid replacement may be a challenge, and some people can be very sensitive to medications, notes Dr. Rawls. Consequently, there’s no one-size-fits-all approach to treating hypothyroidism, but synthetic and natural medications to consider are:

  • Synthetic T4
    Generic Name: Levothyroxine
    Brand Names: Synthroid, Levothroid, Levoxyl
  • Synthetic T3
    Generic Name: Liothyronine
    Brand Name: Cytomel
  • Natural Thyroid Medication (NDT)
    Generic Name: Natural desiccated thyroid (derived from pigs)
    Brand Names: Armour, Nature-Throid, WP Thyroid, NP

When it comes to medications, “Some people do better with synthetic T4, but it’s not the whole spectrum of thyroid hormones,” says Dr. Rawls. Some Lyme patients may not be able to properly convert T4 into the active T3 form, the very hormone the body needs. For people who don’t do well taking a T4-only preparation, the addition of synthetic T3 or a medication with a broader spectrum of thyroid hormones like NDT might be more appropriate to manage symptoms.

It can take some trial and error to find the drug or combination of drugs that are right for you. “Interestingly, many people with thyroid dysfunction find they no longer need thyroid medication after wellness is restored following a natural protocol,” says Dr. Rawls.

Herbal Therapy

ashwagandha rhodiola licorice omega3 vitamind

Whether you end up taking thyroid medications or not, incorporating herbal therapy into your healing regimen is wise for anyone, but especially those struggling with chronic Lyme disease. That’s because herbs work to address the underlying issues that contribute to illness in the first place, in addition to helping you feel better now. The right herbal therapy can help:

  • Normalize thyroid function and hormone production
  • Restore microbiome balance
  • Reestablish normal communication between cells
  • Modulate the immune system to restore healthy function
  • Ease the stress that allows unsavory microbes to flourish
  • Alleviate the most troublesome symptoms of both hypothyroidism and chronic Lyme

Dr. Rawls’ herbal remedies of choice are as follows:

1. Ashwagandha

Ashwagandha is one of the best herbs for normalizing thyroid function,” says Dr. Rawls. It’s believed to encourage the scavenging of free radicals that cause cellular damage to the thyroid. Native to India and Africa, the herb contains anti-inflammatory, antioxidant, antiviral, antimicrobial, and immune-enhancing properties, too.

Ashwagandha’s adaptogenic properties also work to balance the hypothalamic-pituitary-adrenal axis or HPA axis, improving resistance to stress. That in turn allows for better sleep, reduces brain fog, and quells fatigue — some of the top complaints associated with hypothyroidism.

2. Rhodiola

Like ashwagandha, rhodiola is an adaptogenic herb that promotes balance in the HPA axis and bolters your tolerance to stress. The herb is mildly stimulating and enhances cardiovascular and immune function, and it protects nerve and brain tissue. Rhodiola may also increase oxygen delivery to various tissues throughout the body, and contains immunomodulating properties.

3. Licorice

Known for its ability to revive the adrenal glands, licorice aids in the restoration of normal blood pressure and cortisol rhythms. Licorice also contains potent antiviral properties and supports the immune system. It works best when used in conjunction with other herbs, and it should never be used alone or for periods longer than six weeks, advises Dr. Rawls. (Prolonged use can result in sodium retention and potassium loss with high blood pressure and swelling.)

4. Omega-3 Fatty Acids

Omega-3 fatty acids are essential fats that you must obtain through food sources or supplements — your body can’t manufacture them itself like it can nonessential nutrients such as certain amino acids. These fats are integral to mitigating inflammation, influencing the structure and function of the cell membrane, and improving cell-to-cell communication.

Omega-3s with the most benefit to the body are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). They are derived from marine sources, including krill oil, fish and fish oil, seafood, and sea vegetables. Although flaxseed and flax oil provide a range of benefits, you must consume a significant amount of them to raise your blood levels of omega-3s sufficiently.

5. Vitamin D

Vitamin D is best known for promoting bone health, but it plays a vital role in many other functions of the body, such as the immune system and the thyroid gland. Many people are deficient in vitamin D, especially in areas where winter is present or sun exposure is low in general.

To increase your vitamin D levels, strive to get 30 minutes to an hour of sun on your arms, chest, and face without sunscreen, says Dr. Rawls. If that’s not possible, a vitamin D supplement may be necessary to maintain levels in the normal range.

Because the thyroid gland is involved in regulating numerous processes in the body, optimizing its function is paramount to improving symptoms like fatigue, brain fog, and immune function. Combine these medical and natural interventions with a healthy diet, suppressing harmful microbes, managing chronic stress, reducing environmental toxins, staying as active as possible, and prioritizing sleep to assist in your recovery from Lyme disease and hypothyroidism.

“Correcting abnormal thyroid function can accelerate recovery,” says Dr. Rawls. “Once you minimize or eliminate the root causes, amazing things happen, and healing can occur.”

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.


1. Betsy A, Binitha M, Sarita S. Zinc deficiency associated with hypothyroidism: an overlooked cause of severe alopecia. Int J Trichology. 2013;5(1):40-42. doi: 10.4103/0974-7753.114714
2. Hypothyroidism. MedlinePlus website.
3. Thyroid Antibodies. Medline Plus website.
4. Talaei A, Ghorbani F, Asemi Z. The Effects of Vitamin D Supplementation on Thyroid Function in Hypothyroid Patients: A Randomized, Double-blind, Placebo-controlled Trial. Indian J Endocrinol Metab. 2018;22(5):584-588. doi: 10.4103/ijem.IJEM_603_17