Hashimoto’s: The Liver and The Thyroid


Hashimoto’s: The Liver and the Thyroid

Hashimoto’s can cause a host of problems all over the body, but one place in particular where we can see it’s influence is on the liver and gall bladder.

In this post we explore these relationships and explain why a healthy liver is so important for healing your Hashimoto’s.

With Hashimoto’s The Liver and Thyroid Affect Each Other In Many Areas

The body is not a machine, like our earth it is a group of interacting ecosystems that all talk to one another and influence each other in both good and bad ways.

The liver and the thyroid are a perfect example of this. Here is a brief breakdown of how they interact:

* 60% of thyroid hormone is converted from T4 to T3 in the liver. Both T3 and T4 are glucoronidated and sulfated there. (More on that in a minute).

* Thyroid hormone influences the way that cholesterol and other lipids are synthesized and broken down (and where does this happen? – yes, the liver). With Hashimoto’s and hypothyroidism, this is often slowed down resulting in high cholesterol and other lipids like LDL and triglycerides.

* Thyroid hormone affects detoxification pathways in the liver and affects insulin growth factor and cytochrome P450 enzymes which metabolize lots of drugs and environmental toxins. When this slows you can have toxins build up.

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

*Very high levels of thyroid hormone (T3) can raise bilirubin levels and can actually be toxic to the liver because it damages mitochondria.

How Does the GallBladder Fit In to This?

The liver has several pathways through which it metabolizes hormones, filters toxins, and cleans the blood. Byproducts from these processes are dumped into the gall bladder to help get them out of the body.

Low thyroid function slows down this whole process, making the liver and gall bladder sluggish and congested and helping to make gallstones.

Gallbladder x-rays in hypothyroid patients can show a bloated 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.

This whole process can also lead to the formation of gall stones. Many people with Hashimoto’s have gall bladder issues.

How Is Thyroid Hormone Converted in the Liver?

Thyroid hormones are converted into their usable form in the liver (60% happens there), you can see how low thyroid function can create a vicious cycle.

Hypothyroidism messes with liver function and fewer thyroid hormones become active. So it goes until you have all of the common symptoms of too little thyroid hormone: fatigue, brain fog, joint pain, hair loss, weight gain, depression, etc.

Thyroid hormone is converted primarily through 2 processes:

Glucornidation and sulfation, let’s break these down:

According to Dr. Datis Kharrazian, DC, these processes are supported in the following ways:


Glucoronidation is an important process for converting thyroid hormone.
This pathway is supported by B vitamins, magnesium, and glysine, click here to learn about food sources of B vitamins and magnesium.


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).

Vitamin B6 and magnesium are important for sulfur amino acid metabolism, as are foods containing sulfur such as: eggs, cheese, meat, poultry, nuts and legumes. Click here to learn more about food sources of vitamins and minerals.

Its important to choose animals products wisely, buy organic whenever possible because organic foods have far fewer toxins like antibiotics, hormones, and pesticides which can all cause problems of their own.

Another important point about sulfating is that it requires sulfate which is often poorly absorbed by the digestive system, especially by people with Hashimoto’s who often suffer from intestinal permeability or leaky gut syndrome. Sulfate is the oxidized, inorganic form of sulfur produced by an oxidation step called (you guessed it) sulfoxidation.

This step is made possible by an enzyme that is called sulfite oxidase which uses the essential mineral molybdenum, click here to see food sources of molybdenum.

 Problems with sulfoxidation can be seen in people who are sensitive to foods that contain sulfites (garlic) or dugs and food additives (in dried fruit and herbs, preservatives, in salad bars used to keep vegetables looking fresh).

(These people may also have an abnormally strong odor in their urine after eating asparagus. For these people one should consider molybdenum supplementation or organic sulfates like sodium sulfate or magnesium sulfate.)

The Emotions of the Liver & Gall Bladder

In Chinese medicine, we view interactions in the body in the context of body, mind and spirit. This can be really helpful to see how these physical problems can affect you emotionally and psychologically.

In the book, Between Heaven and Earth by Harriet Beinfeld, L.Ac. and Efrem Korngold, L.Ac., the liver is described as something like a military commander in the body. It formulates tactics and strategies, moving blood and energy (qi) throughout the body.

The thyroid is part of the endocrine system which is viewed as qi and is derived from the yang energy of the kidneys. So the ancient Chinese recognized this relationship and how important one is for the other. The liver needs that qi to have the energy to do its job, and if it is clogged or blocked it can’t facilitate the movement of that energy throughout the body.

Anger, Irritability and a Short Fuse Are Symptoms of Liver Issues

When the liver gets stuck or clogged, the most common emotion that people experience is anger. This can be directed outwardly at people you know (usually people closest to you: family, co-workers, or friends), or this anger can be directed inwardly and result in depression and feeling of self-hatred and low self-worth. Or sometimes you have a combination of these two.

It is also interesting to note that in Chinese medicine the nervous system, tendons and ligaments and the eyes are thought to be part of the sphere of influence of the liver. So many people with Hashimoto’s also have issues in all of these areas: eye problems, tendon issues, and cognitive issues affecting the brain.

Gall Bladder Issues Make You Unable to Make Decisions

The Gall Bladder stores and secretes bile, this stimulates flow through the stomach and intestines and is very important in helping us to absorb and eliminate different foods as well as different ideas and concepts.

So proper bile flow and production also help us with proper judgment, clear thinking and decision making. If there are Liver/Gall Bladder issues we can end up taking actions without thinking them through, or making decisions and not following through on them or simply getting stuck, unable to decide what to do.

How Can You Help the Liver, Gall Bladder and (Indirectly) The Thyroid?

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

Ginger: this common food contains chemicals that have been shown to increase bile secretion and to reduce cholesterol levels by up regulating 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 gall bladder to contract and release bile.

Milk Thistle: This herb increases the solubility of bile and has been shown to significantly lower cholesterol concentrations in the gall bladder. It has potent anti-oxidant activity which supports detoxification and it prevents depletion of glutathione in the liver, which is often depleted in people with Hashimoto’s.

 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.

Herba sargassi, Laminaria Kun Bu: 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 with some Hashimoto’s folks.

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 infections.

Caution: Liver infections can be quite serious, consult a trained physician if you suspect that you have any form of hepatitis or liver disease.

Rhubarb Root: This herb is a potent laxative that can be used to treat acute gall bladder and pancreatic infections. It has potent anti-bacterial, anti-fungal and anti-viral properties.

Dosage is critical with this herb and too much can cause gastric pain and diarrhea. Never use during pregnancy or lactation or with gout, hemorrhoids or oxalic acid stones. Consult a trained professional before using this herb.

Herbs That Help With Anger and Irritability

There is a very effective herbal formula in Chinese Medicine whose name is translated as Rambling Powder. The name comes from the title the first chapter of a book by Zhuang Zi, “Rambling Without A Destination” that includes stories about wandering freely with an open mind. It is a reference to how this combination of herbs can help one feel less constrained emotionally, feel happy and less stressed.

It has several variations and contains a number of herbs that are very helpful for the liver including buplerum, mint, atractylodes and more. With modifications, it has also been used successfully to treat eye issues, hypertension, hepatitis, anemia, depression, irritability and anger.

Hashimoto’s Requires A Multi-Prong Approach

Hashimoto’s has so many moving parts and 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.

That’s why I developed my program: Healing Hashimoto’s: The 5 Elements of Thyroid Health. In in we explore the 5 major systems of the body and learn how they impact us physically, emotionally and spiritually.

Because true healing requires more than simply taking a few pills or herbs. It requires a complete overhaul of your body, mind and spirit. And it is a tremendous opportunity for growth and for healing all aspects of your life. Click here to learn more.


Between Heaven and Earth, Harriet Beinfeld, L.Ac. and Efrem Korngold, L.Ac., Ballantine Books, New York, 1991

Chinese Herbal Medicine Formulas and Strategies, Dan Bensky & Randall Barolet, Eastland Press, 1990

Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal? Datis Kharrazian, DC, Morgan James Publishing, 2010

The Thyroid, A Fundamental and Clinical Text, Ninth Edition, Lewis E. Braverman and Robert D. Utiger, 2005 Lippincott Williams and Wilkins

Severe hyperthyroidism induces mitochondria-mediated apoptosis in rat liver.
Upadhyay G, Singh R, Kumar A, Kumar S, Kapoor A, Godbole MM.
Source: Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Laukkarinen J, Kiudelis G, Lempinen M, Raty S, Pelli H, Sand J, Kemppainen E, Haglund C, Nordback I. Increased prevalence of subclinical hypothyroidism in common bile duct stone patients. J Clin Endocrinol Metab. 2007 Nov;92(11):4260-4. Epub 2007 Aug 28

Inkinen J, Sand J, Nordback I. Association between common bile duct stones and treated hypothyroidism.  Hepatogastroenterology. 2000 Jul-Aug:47(34):919-21

About the Author Marc Ryan

Leave a Comment:

mary docherty says

i have hashimoto hypothyroidism
my g.p here in germany has told me to erase all iodine from my diet
he also said not to take magnesium
i am relatively new to my disease so any and all information
would be gratefully appreciated..i do try to eat and live healthily
please,any and all info on this..please,please send..i was enthralled reading this article …many,many thanks x

    Marc Ryan says

    Hi Mary,

    Thanks for your comment! I recommend that you read my blog posts and join us on Facebook where I regularly post lots of great information. I am also offering a 6 week program starting the second week of July that will go in depth into 5 different systems that are vitally important for thyroid health. If you were enthralled by this article, that program will blow your mind!


Maria Uceda says

I have been diagnosed with Hashimoto’s 7 years ago and recently a Hydra scan revealed that my gallbladder is working at 10%. Can your program help avoid surgery and help me reclaim my health? I am worried about my liver and tests come back normal for my thyroid but I know my Levothroxyn is not helping me. I loved your article and how timely for me! Thanks!

    Marc Ryan says

    Hi Maria,

    Thanks for your comment and for reaching out! I can not promise that my program can prevent you from getting surgery when your gall bladder is currently functioning at 10%, but I can promise that what I will teach will give you the tools to dramatically improve your quality of life. And I am adding an additional bonus to the program, which is the opportunity to work with me one on one. I will help you craft a detailed action plan that includes diet, lifestyle changes and supplement recommendations so that you reclaim not only your health but your life.


Susan Howard says

Unfortunately, my endo has never told me about any of this so I spent years wondering my why liver enzymes were high and my cholesterol out-of-whack. I’ve had gall bladder discomfort as well as unending plantar faciitis in my feet. I’ve done the research and learned that all the above are symptoms of Hashimoto’s so I no longer feel like a hypochondriac and deal with the above nutritionally and with supplementation.

    Marc Ryan says

    Hi Susan,

    Thanks for your comment. Unfortunately, far too many Endocrinologists seem to be clueless about these interactions. I am repeatedly mystified. This is precisely why you need to take matters into your own hands and learn all that you can to better manage your disease. So glad you are dealing with this yourself nutritionally!


Suzan Erritzoe says

Hi Marc,

I have just dived into your website today, so there is a lot for me to look into and learn from I see – Thank you for your work!

I have been diagnosed with Hashimoto, after having suffered from a hyper thyroid,for some years, on and of medication.
I have antibodies and no doubt an autoimmune disease. (First “Graves”, and now apparantly “Hashimoto”)
At the moment my TSH is 10 ( last month when I was in stressfull circumstances it was at one point 78! it is supposed to be below 5)
Free T4 and Free T3 is now in the normal range.
I am staying in Canada at the moment, and get guidance from an endocrinologist i Denmark (where I come from), based on blodtests I have taken here.
At the moment I am not on medication, but based on the last tests I am sure he will advice me to do so, and – I definately need to do something.
Is it recomendable to start on the medication and follow your instructions at the same time?
Should I wait a little with the medicine, and follow your program for some time first?
Or what is your recommendation concerning traditional medicine?

Thank you in advance,

    Marc Ryan says

    Hi Suzan,

    Thanks for your comment! I’m so glad you reached out. With regard to medication, I can not advise you on that because it is not within my scope of practice and because there are so many variables with Hashimoto’s. There are many things to consider, like how much of the thyroid has been destroyed at this point, how well is the autoimmune part of the disease being managed, if at all, etc. (Most doctors don’t even acknowledge this.)

    I recommend following the advice of your doctor. That being said, there is a good deal for you to learn about how to properly manage this disease. I am continually astounded by the complexity and variability of it. I certainly believe that taking my program will help you make much better decisions and will help you to determine whether or not your doctor is aware of some very important things regarding your care. This is invaluable.

    I think traditional medicine has a lot to offer and what I teach are strategies and techniques for utilizing traditional medicine in a clinically effective way. And if you take my program, you also get the added benefit of working with me one on one. I will examine your blood work and do an exhaustive analysis of all the systems of your body so that we can develop an action plan that will incorporate diet, natural supplements and lifestyle choices to get you feeling your best whether you decide to be on medication or not.

    I am currently completing the first week of this run of the six week program and I generally don’t allow people into it after the first week because we cover so much material, its easy to fall hopelessly behind. So if you are considering doing it, I would recommend getting started as soon as you can.

    Whatever you decide to do, know that I am dedicated to helping you and others like ourselves who struggle with this disease and I will continue to offer quality content to help people better understand what is going on. I hope we have an opportunity to work together!

    If you any additional questions, please feel free to contact me. You can email me at [email protected] .


anabelle mayle says

hi, marc. been ill- exteme fatigue, weakness, dizziness, etc for 10 mos., been tested for everything under the sun, no findings. my pmd thinks it’s all in my head, that am depressed and prescribed me anti depressant which i did not take knowing all the side effects and deep within me i know there’s something medically wrong with me…. finally, diagnosed with hashi a couple months ago by a holistic doctor.. was put on gluten free diet, i read as much as i can on this. bought supplements such as selenium, CQ10, probiotic, etc, but am hesitant to take them as my liver enzymes are greatly elevated. not taking any thyroid med, my last tsh is 2.15 and according to my holistic md my t4, t3 are normal. she gave me thistle milk caps to aid with the liver. am i on the right track?…. i sleep well now since i started taking mag, am able to do a little walk here and there but still get easily fatigued. am still anxious, though not as worse as before. … btw, my glucose level is low, have to eat every 2 hours as i get jittery and panicky if i dont eat right away….. marc, hope you don’t mind, are you a doctor? thanks, …. your additional help will be greatly appreciated!

    Marc Ryan says

    Hi Anabelle,

    Thanks for reaching out! Yes, I am a licensed acupuncturist and I practice functional medicine which is a mix of Western diagnostic tests and natural solutions like diet, supplements and lifestyle changes.

    You may have been tested for everything under the sun, but they may not have done the right tests or not know what to do with the information in those tests. Many doctors don’t know how to help Hashimoto’s patients. This is all I do. Anxiety and depression are caused by what is going on in your brain, in large measure this is caused by hypothyroidism. When people work with me, I also do a complete brain workup and treat the imbalances that lead to anxiety and depression. Blood sugar imbalances, as you see, also can have a big impact on your brain.

    There is a reason why your liver enzymes are elevated. Do they know what that is? If you would like my help, I offer a free 30 minute Hashimoto’s Healing Discovery Session. In it you can share where you are and where you want to be, I can share some solutions that will help right away and we can discuss how I might be able to help. If that interests you, please click on the button in the right column of the home page to schedule.


Jannifer Kincaid says

I have had my gallbladder removed, and it seems like eversince then the symptoms of my Hashi’s has been worse. Why might this be the case?

    Marc Ryan says

    Hi Jannifer,

    One reason for this is that when your gall bladder is removed, your body doesn’t stop needing the function of the gall bladder. Usually the liver or the remaining duct take up the slack and perform the job of the gall bladder. However, they don’t work as well as the gall bladder and the issues that led to gall bladder problems in the first place remain. Namely, hypothyroidism. This can cause sluggish gall bladder activity. This, in turn, can block the liver’s detox pathways, so hormones, toxins and other metabolites build up and you get a flare up of symptoms because these things can be very stimulating to your immune system. So you have to support gall bladder function and clean up the liver.


      Jannifer Kincaid says

      Thank you for answering my question! How do I go about cleaning up my liver or even finding out how it’s functioning or how it has been affected?

        Marc Ryan says

        Hi Jennifer,

        Work with me. 🙂 We’ll get to the bottom of it. With the liver there are some lab tests available to measure detoxification and certain metabolic pathways. You can also measure liver enzymes, but these don’t usually show much unless you have serious inflammation. To clean it up we do a proper work up and then use diet and supplements to make both the liver and whatever is now functioning as your gall bladder work better. Best, Marc

Hashimoto's Diet in 5 Steps - Hashimotos Healing says

[…] this period, it’s also a great time to detoxify your liver, work on healing leaky gut, boost stomach acid, balance blood sugar and work on all the systems of […]

Add Your Reply