Hashimoto’s and Graves’ Remission after Helicobacter Pylori Eradication

While I have a lot of stories of people who recovered their health through removing reactive foods, adding in healing foods, and taking the appropriate supplements, I personally did not get my Hashimoto’s into remission by following those steps.

Sure, I felt much better, and my thyroid antibodies significantly dropped with the help of nutrition, but eventually my health problems began creeping back in. All of a sudden, I became sensitive to nuts, bananas, eggs, and all of the “nutrient-dense” Paleo foods that I began eating once I found out I was gluten and dairy sensitive.

I later learned that this was because I was unknowingly walking around with four different gut infections, including Helicobacter pylori, which is connected to both Hashimoto’s and Graves’ disease and can cause new onset food sensitivities!

I was shocked and in complete disbelief that I had all of those issues (this was after two years of eating a gluten-free/dairy-free diet). I began treating my gut infections one by one, and steadily saw improvement in how I felt, along with a reduction in thyroid antibodies.

At first, I was really embarrassed to speak publicly about having “gut infections,” as it sort of grossed me out. But when I began working with people with Hashimoto’s, I realized I wasn’t the only one, and that it was important for me to get past the ick factor to spread awareness.

In this article, I’ll dive a little bit deeper into:

• How infections can act as Hashimoto’s triggers
• The role of gut infections in autoimmunity
• How H. pylori affects Hashimoto’s
• Testing for H. pylori
• Conventional and natural treatment protocols

Hashimoto’s and Infections

Chronic infections are the Hashimoto’s triggers that get the least amount of attention, yet identifying and treating them can result in a complete remission of Hashimoto’s. (1) Additionally, some of the infections can be progressive, leading to more and more symptoms if not identified and treated accordingly. Thus, I want to make you all aware of them whenever I can.

Infections can live in our gums, sinuses, thyroid gland, stomach, intestines, and anywhere in our bodies. These infections can contribute to the development of autoimmunity through various mechanisms, depending on where they “live” (i.e. via molecular mimicry outside of the thyroid gland, or via the bystander effect inside of the thyroid gland). (2-7)

Infections that live in the gut, gums, or sinuses can also contribute to intestinal permeability directly, as they are connected to the digestive system.

Molecular Mimicry

Molecular mimicry is one of the leading theories of autoimmune disease. (8) In very simple terms, this theory hypothesizes that our immune system begins to attack our own thyroid gland because we are infected with a pathogenic organism (like a bacterium, parasite, or virus), that looks similar to components of the thyroid gland.

The immune system remembers isolated protein sequences on the pathogen (rather than the entire DNA sequence of the pathogen) and then looks for similar looking proteins as targets for an attack. If the proteins on the thyroid match the proteins the immune system remembers, then the thyroid will be targeted for attack as well. Therefore, the immune system attacks the thyroid gland due to a case of mistaken identity, when it is actually trying to attack an infection!

Bystander Effect

Another popular autoimmune theory that explains how infections can trigger autoimmunity, is known as the bystander effect theory. (9) This theory proposes that an infection inside the actual target organ leads the immune system to attack the “home” of the infection. In the case of Hashimoto’s, the infection is inside thyroid cells, and thus the immune system attacks the thyroid gland.

Scientists have noted that in people with the right genetic sequence, an infectious agent that resembles the thyroid gland can trigger Hashimoto’s. (8,9)

Gut Infections and Autoimmunity

In 2015, 80 percent of my clients who hit a plateau with nutrition and took the gut tests I recommended, tested positive for at least one gut infection.

We know that the three-legged stool of autoimmunity consists of a genetic predisposition, one or more triggers, and intestinal permeability (otherwise known as leaky gut). (10) All three are required to be present for an autoimmune condition to manifest. Eliminating the triggers and addressing the leaky gut are keys to getting autoimmune thyroid disease into remission.

While conventional medicine ignores the gut in relation to thyroid health, natural medicine also often misses the point in gut health by solely focusing on supportive and maintenance care of the gut, such as taking gut support supplements and probiotics, consuming nourishing foods such as bone broth, and removing reactive foods.

Of course, all of those steps are essential in restoring gut health when someone is nutrient depleted or has a strong reaction to a particular food (like gluten), but they do not get to the underlying root cause of most cases of intestinal permeability… gut infections!

Thus, I recommend a three-pronged approach to healing the gut:

1. Kill off any infections that may be irritating the gut wall and causing you to have a leaky gut.
2. Remove foods that have a large particle size (and are more difficult to digest) for 30 to 90 days, such as gluten, dairy, soy, grains, nightshades, nuts, and seeds.
3. Add supplements that accelerate gut healing.

As I try not to adhere to a dogma of “there’s only one right way to healing,” my infection protocols will include supportive foods, herbs, and medications (and sometimes a combination of all of the above), to properly get rid of an infection.

Why Isn’t There More Focus on Infectious Origins of Autoimmune Disease?

Scientists have found a great deal of evidence which suggests that Hashimoto’s is caused by an infectious pathogen. (2-7) Many Hashimoto’s patients have received positive blood tests indicating a past or current exposure to an infection, and studies have shown that certain birth months when infections are more prevalent, produce more cases of Hashimoto’s.

One extensive research study showed that most people diagnosed with autoimmune diseases are born in April, while the fewest are born in October. (11) Many environmental factors, such as lack of sunlight (vitamin D), seasonal allergens, availability of certain foods, and the prevalence of specific pathogens, can all impact a person’s development in utero and play a role in determining future health conditions. (12)

Scientists have yet to say that Hashimoto’s is caused by an infection because they’re looking for “ONE” single infection in every person with Hashimoto’s… but it’s not a black and white issue.

It’s too simplistic to say that for an infection to be at the root cause, every person with the disease should have the same infection, and that every person without the disease will be infection-free.

Numerous infectious pathogens may have protein sequences similar to the thyroid gland, possess the ability to infect the thyroid gland, and cause leaky gut. (13,14)

Some new research even suggests that our friendly bacteria (Lactobacillus species) has a similar protein sequence to the thyroid gland, so in the case of leaky gut, the good bacteria can get into our bloodstream through tiny holes in a compromised gut and cause an immune response, which can potentially cross-react with thyroid tissue. (15,16)

There are many different scenarios that are potential mechanisms for how various infections could lead to developing autoimmune disease. Studies often fall short because they assume that one infection only applies to one condition.

In my observation, the equation is more akin to advanced calculus, rather than simple math. It looks more like this: genes combined with infection A, and perhaps infections B, C, and even D, in the absence of nutrients and beneficial bacteria, leads to the development of an autoimmune condition.

Now, let’s focus on one of the most common infections seen in Hashimoto’s, H. pylori.

Helicobacter Pylori Infections

Helicobacter pylori (H. pylori) is a gram-negative spirochete-shaped bacteria that burrows into our stomach lining and secretes urease, which neutralizes stomach acid. (1) The byproduct of the urease and stomach acid is toxic to epithelial cells (lining the surface), as are the other chemicals produced by this bacterium, leading to damage to cells, a disruption of tight junctions, and inflammation.

This bacterium is transmitted orally, from person to person, as well as potentially between people and their pets (who can resist doggie kisses, right?). It can trigger an immune response and has been implicated in numerous autoimmune conditions, including Hashimoto’s and Graves’ disease. (2-7)

H. pylori has also been implicated in ulcers and can contribute to low stomach acid, leading people to improperly digest their foods. In turn, the poorly digested foods are not broken down properly, and the person ends up with multiple food sensitivities as a result of this infection.

Marshall and Warren, the Original Root Cause Rebels

The story behind the discovery of H. pylori being the root cause of ulcers is one of my favorite stories and inspires me to keep doing what I’m doing, despite a lack of acceptance of a root cause approach to Hashimoto’s in conventional medicine.

As early as 1899, Professor Walery Jaworski of the Jagiellonian University in Krakow (one of the oldest surviving universities in the world that also happens to be on my bucket list as a place for future studies), found spiral bacteria in gastric washings of humans, and was the first to suggest that these bacteria may cause gut issues. He published his research in a medical handbook on addressing gastrointestinal issues, but as the handbook was only available in Polish, the research went largely unnoticed for almost a century!

In the 1980s, two young scientists from Australia named Barry Marshall and Robin Warren were convinced that H. pylori caused ulcers. However, their colleagues ridiculed them, as the conventional thought in those days was that no bacteria could survive the acidic environment of the stomach.

Furthermore, ulcers were “obviously” caused by stress and spicy food, as time and time again, a stressed out person was more likely to come down with an ulcer. (Of course, we know what happens when we are stressed out: our bodies become more susceptible to infections, as the microbes that we have living inside of us receive signals from our stress responses, showing them that we are weak, and giving them an opportunity to take over.)

Most “serious” ulcer researchers were focusing on optimizing ulcer repair surgeries, not looking for bugs in a place where bugs couldn’t grow! But Marshall and Warren kept going, though they had trouble growing the bacteria in Petri dishes… until one of them accidentally left the dishes in the incubator over the Easter weekend.

Marshall was so convinced of his work that he actually drank a beaker of cultured H. pylori and became ill with nausea and vomiting several days later. He was found to have gastritis (inflammation of the lining of the stomach) and H. pylori. He then showed that taking antibiotics to treat the H. pylori could reverse gastritis.

Finally, in 1994, the National Institutes of Health stated that most ulcers were in fact caused by H. pylori, and recommended the use of antibiotics for the treatment of ulcers.

This big news was newly emerging research in 2002 when I started pharmacy school, 20 years after their initial discovery.

Eventually, the rest of the world caught up. Drs. Marshall and Warren were awarded the 2005 Nobel Prize in Medicine (23 years later), and slowly, physicians began to test for H. pylori in people with ulcers. (17-21)

I have seen plenty of recent research connecting H. pylori to autoimmune thyroid disease, but in my experience, most conventionally trained physicians are not aware of this connection, how to detect the infection, or how to treat it with anything other than super intensive antibiotics.

This is one of the reasons why, when I scour the medical databases for current research on Hashimoto’s, I look for articles not just in English, but also in Polish, Russian, Spanish, and Portuguese, and why I’m also super excited about my Hashimoto’s books being translated into those languages! (Please note: We are currently working on restocking the Portuguese edition of Hashimoto’s Protocol on Amazon.) With each passing year since I started my work on the root causes of Hashimoto’s, I’ve seen more and more proof that Hashimoto’s can be reversed by addressing root causes. 🙂

Symptoms of H. pylori Infections

While some individuals may be asymptomatic, there are various symptoms that can be associated with H. pylori, including:

• Acid reflux/GERD
• Food sensitivities
• Anemia, as in low iron or low B12
• Low stomach acid and/or a need for digestive enzymes
• Heartburn
• B12 deficiency
• Difficulty tolerating meat
• Nausea
• Belching
• Bloating
• Prolonged fullness after eating
• Feeling full soon after eating
• Past or current history of ulcers
• Period of high stress recently/around diagnosis
• Thyroid nodules
• TPO/TG thyroid antibodies over 500
• Hyperthyroidism
• Pernicious anemia
• Headaches or migraines
• Histamine issues
• Hair loss
• Belching or burping after taking certain supplements
• Muscle pains or weakness
• History of/existing reactive hypoglycemia
• Waking up at night hungry

If you have tested positive for H. pylori on a stool test or have a family or personal history of stomach cancer or ulcers, I encourage you to look into H. pylori. I also encourage you to do so if you have a family member who has been diagnosed with H. pylori or SIBO, has a history of Graves’ disease, has TPO antibodies over 500 IU/mL, has developed symptoms after a period of high stress (H. pylori thrives in stress!), has had previous mold exposure, or has taken acid-suppressing medications.

Note: The above list is based on assessments and observations from my clients. While these symptoms can be good indicators of an H. pylori infection, testing can be helpful to confirm that a person has H. pylori (read on for more information about testing for H. pylori).

How Common is H. pylori?

While only a small percent, perhaps 5-10 percent of those infected, will develop an ulcer with H. pylori, it is thought to affect as many as 50 percent of people worldwide. Many of these people may be considered “asymptomatic,” yet they may have acid reflux, Hashimoto’s, migraines, Graves’, or other conditions that conventional doctors seem to believe are unrelated, but that will disappear and/or improve once the H. pylori is treated. (2-7)

I believe that similar to all autoimmune triggers, H. pylori is part of the perfect storm in a genetically susceptible and vulnerable individual.

A 2013 Chinese study found a rate of H. pylori infection in 66 percent of people with Graves’ disease and 37.7 percent of people with Hashimoto’s. (6) As the rate of H. pylori in controls was 32 percent, the researchers concluded that H. pylori was not likely a causative factor for Hashimoto’s – but of course, they did not perform deeper tests such as genetic tests on the controls to determine if the controls had the correct genetic predisposition to develop Hashimoto’s after an infection.

After all, we know that autoimmunity develops due to a combination of genes and triggers. Additionally, the researchers didn’t perform antibody studies, conduct before and after studies of thyroid function, nor test for autoimmune markers after treating H. pylori in those with Hashimoto’s… Deeper studies have found cross-reactive antibodies with Hashimoto’s and H. pylori. (22)

These deeper studies also found better absorption of thyroid hormones, a reduction of thyroid antibodies, and in some cases, improvements in TSH, following the eradication of H. pylori! (2-5) I’ll share more about this later in this article, but for now, I wanted to mention that this is why I look at hundreds of studies and patient cases before I dismiss a trigger after just one study. 😉

Interestingly, I saw a similar rate of H. pylori when I reviewed around 300 GI-MAP stool pathogen tests that I conducted with my clients and readers with Hashimoto’s over a three year period. I found H. pylori tests to be positive in 21 percent of people.

I previously would only recommend treating H. pylori if someone had a positive test result for it. However, as I began speaking to other clinicians about this test, I learned that some clinicians treat any detected levels of H. pylori with more natural, gentle protocols (instead of antibiotics). The GI-MAP test reports on the various bugs that live in our stools and will mark a test as positive when the threshold of the DNA of the particular bug is above a lab determined marker, but will also let clinicians know if any DNA of H. pylori is present. I hope to share the full results of my review of the test results soon.

When looking at the results of people who had any level of H. pylori on the GI-MAP (not just what the lab showed to be positive), it ended up being 33 percent of people that had the pathogen present.

I’ve had H. pylori a few times myself. Treating it has helped me reduce my thyroid antibodies, reduce acid reflux and food sensitivities, eliminate voice hoarseness, and get rid of headaches.

In my own practice, I’ve also had numerous readers and clients with Hashimoto’s report that their symptoms were greatly improved following the treatment of an H. pylori infection. Most of them showed a reduction in thyroid antibodies following the eradication of H. pylori; a few even put their Hashimoto’s into remission!

Here are some messages from my readers and clients:

• “I have been reading your book and decided to tackle any infections in my body… through this investigation I found I had H. pylori and two tooth infections. I have taken care of these infections to the best of my knowledge… a few weeks later my hair-loss is at an all time low!! Yessss… and with the addition of T3 my hair texture feels better too. I wouldn’t have known to look into this so thank you! On I go to the next step of healing my gut now!”

• “Dr. Izabella, I think you are on the right track… I have had Hashimoto’s for 20 years… recently I found out I had H. pylori. I have done the antibiotic treatment and my TPO just came back 17 kU/L! I think the antagonist has been killed off! Haven’t felt this good in 20 years!”

• “I have an exciting update! Last week I finished the H. pylori protocol you recommended and am now migraine free for almost two months! My joint pain is gone too! I just tested my antibodies, and they’ve gone from 953 to 366 kU/L!”

• “After 20 years of having Hashimoto’s, I was treated for H. pylori. I feel better than ever; my TPO antibodies are in the normal range, and my doctor just reduced my medication!”

Studies on Antibodies and H. pylori

Antibodies produced in response to H. pylori can cross-react with many normal tissue antigens, such as gastric cells and even thyroid tissue.

Studies have shown antibodies to H. pylori were found in 46.5 percent of patients with Hashimoto’s in a small study in Iran, compared to just 11 percent in the general population. (1)

Research has shown that the level of TPO (thyroid peroxidase) antibodies was higher in people with Hashimoto’s with H. pylori, compared to those without H. pylori, though there was no correlation between TG (thyroglobulin) antibodies and those with H. pylori. (4,5)

In another study, researchers tested 25 patients with TPO antibodies greater than 700 kU/L (or 700 IU/mL). Of the participants, 72 percent tested positive for H. pylori via a urea breath test. (23) (So if those antibodies of yours are >700 IU/mL, get checked for H. pylori STAT!)

Researchers in Italy identified 10 patients with Hashimoto’s and H. pylori. They treated half of the patients with medications to eradicate the infection, and did not treat the other half. The results were astonishing – the people who were treated for H. pylori saw a 50-78 percent reduction in TPO antibodies, as well as a significant reduction in symptoms! (23)

One patient with H. pylori who started with a TPO antibody count of 4745 kU/L and TG antibody count of 1783 kU/L, was able to see a reduction in TPO antibodies, from 4745 to 45 kU/L, over the course of 21 months; and TG levels from 1783 to 94 kU/L, with treatment for the infection.

The person was tested a total of six times — at the start of treatment, three months in, then nine, 14, 16, and 21 months after eradication. A pattern of reduction was seen within three months, and between month 16 and 21, the TPO count dropped from 100 kU/L to 45 kU/L, while TG dropped from 283 kU/L to 94 kU/L.

The other patients in the treatment group also showed patterns of reduction in TPO and TG antibodies. Reduction in TPO antibodies ranged from 50 to 99 percent, while reduction of TG antibodies ranged from 31 to 95 percent over the course of 17 to 22 months. (23)

(Source: Bertalot et al, 2004)

The five patients with Hashimoto’s and untreated H. pylori continued to have high TPO and TG levels. One person’s TPO antibodies stayed the same, another person’s decreased, while the three others had theirs decreased between 5 to 26 percent. Three people saw an increase in TG antibodies from baseline, and the other two saw a decrease of 6 percent and 16 percent over the course of 9 to 28 months.

(Source: Bertalot et al, 2004)

The treatment used in this study was known as the triple antibiotic therapy:

• Amoxicillin – 1000 mg twice per day, for 7 days
• Clarithromycin – 500 mg twice per day, for 7 days
• Esomeprazole – 20 mg twice per day, for 7 days

(If you’re wondering why the researchers did not treat everyone, it turns out that the five controls all refused H. pylori treatment! Four did not have symptoms, and one was allergic to antibiotics.)

Autoimmune Gastritis, Hashimoto’s, and H. pylori

Autoimmune gastritis is a chronic inflammatory condition that often results in B12 and iron deficiency, low stomach acid, cancerous gastric lesions, and the destruction of parietal cells of the corpus and fundus of the stomach. Parietal cell antibodies (PCA) are the self-antibodies that are produced in autoimmune gastritis. (24)

This condition was previously reported to affect 10 to 40 percent of people with Hashimoto’s. (25) A 2014 study looked at the co-occurring rates of autoimmune gastritis in people with Hashimoto’s, as autoimmune gastritis may contribute to the malabsorption of thyroid medication and require a person to need a higher dose of thyroid hormone. (26)

Fifty-five people with Hashimoto’s had their B12, ferritin (iron storage protein), and PCA levels measured. Of these people, 12.9 percent were found to have PCA, and all of them had an H. pylori infection. Interestingly, six months after these patients were treated for H. pylori, their PCA antibodies reversed, and they no longer met the diagnostic criteria for autoimmune gastritis.

The researchers thought it was peculiar that all of the PCA antibodies were due to an H. pylori infection and probably not due to “per se” autoimmune gastric damage. I think they missed the forest for the trees, as H. pylori has been implicated as a trigger for autoimmune thyroid disease!

I can’t locate the reference at the moment, but another study found autoimmune gastritis (AIG) to be present in 33.3 percent of people with autoimmune thyroid disease. In this study, around 40 percent of the patients had an H. pylori infection. Anti-parietal cell antibodies were correlated with TPO antibodies, and parietal cell antigens in the stomach are very similar to the thyroid peroxidase enzyme. I always recommend investigating H. pylori in AIG and B12 deficiency!

Testing for H. pylori

If you have Hashimoto’s and elevated thyroid antibodies and/or signs of autoimmune gastritis, there is a high possibility that you have an underlying H. pylori infection. You have a few different testing options available to you, which include the following:

• Blood tests: Blood tests are available for antibodies to H. pylori, but they may not always differentiate between past and current infections.
• Breath tests: Conventional doctors may recommend an H. pylori breath test, but a positive result will only be found in severe cases.
• Stool antigen tests: I prefer stool antigen tests like the GI-MAP test, which can uncover many additional low-grade infections. Such advanced functional medicine tests often require the ordering practitioner to have an account set up with them. You can order them through a functional medicine practitioner, or go to Direct Labs for self-order options. (Note: self-order options are generally not insurance reimbursable.)

H. pylori Protocols

When it comes to treating an H. pylori infection, pharmacological and natural treatment options are available.

Pharmacologic Treatments

Pharmacologic treatments are generally based on using acid-suppressing medications combined with two to three antibiotics – or as I like to call them, “the big guns.” Multiple drugs are used due to the issue of antibiotic resistance.

• Triple Therapy Option 1: omeprazole, amoxicillin, and clarithromycin (OAC) for 10 days, as directed by your doctor and pharmacist
• Triple Therapy Option 2: bismuth subsalicylate, metronidazole, and tetracycline (BMT) for 14 days, as directed by your doctor and pharmacist
• Triple Therapy Option 3: lansoprazole, amoxicillin, and clarithromycin (LAC), which has been approved for either 10 days or 14 days of treatment, as directed by your doctor and pharmacist
• Quadruple Therapy: Proton pump inhibitor, bismuth, tetracycline, and metronidazole, as directed by your doctor and pharmacist

Please note: Most doctors will prescribe triple therapy or quadruple therapy to address this pathogen in the presence of a positive breath test and symptoms. 

The above-mentioned treatments can take a toll on your gut health, leading to further dysbiosis. Adding an S. boulardii supplement to this treatment can increase the rates of eradication, and reduce the rates of dysbiosis from the use of antibiotics.

Natural alternative protocols are also effective for suppressing H. pylori. They may take longer, but are more gentle on your gut flora. Of course, the choice is between you and your doctor as to which path to take.

Natural Treatment Options

Some physicians may not recommend antibiotic treatments when H. pylori is found through a stool antigen test, or when a person is asymptomatic – but you may benefit from the use of herbal protocols to address such an infection.

There is a vast variety of natural treatments and remedies that can be used for H. pylori.

The most well known protocol used by functional medicine practitioners is focused on using mastic gum and DGL. (31)

• Mastic gum has been used traditionally to help treat stomach pain, and modern research has shown it to be effective against multiple strains of H. pylori. (32)
• Deglycyrrhizinated Licorice (DGL) is a well-researched botanical that coats and soothes the intestinal lining and also promotes the healing of ulcers, a common complication attributed to H. pylori. (33,34)

I’ve personally had excellent results with many clients and the first time I cleared out H. pylori in myself, using a 60-day natural protocol involving mastic gum, DGL, and S. boulardii.

• S. boulardii is a beneficial yeast that I like using to raise our own body’s immune defenses, and can be helpful in the body’s fight against various infections, including H. pylori. While using it by itself won’t take care of an H. pylori infection, I often like to add it to H. pylori protocols. (35)

I have also used the following research-backed natural therapies for H. pylori, sometimes alone, sometimes in combination, depending on the needs of the client.

• Aloe – One 2014 study in Italy sought to evaluate the antibacterial activity of aloe vera inner gel against both susceptible and resistant Helicobacter pylori strains. (30) The inner gel of leaves of a 5-year-old plant of aloe was extracted and tested against 15 different strains of H. pylori. Fifty percent of the strains were inhibited in their growth by the addition of aloe vera, and researchers determined that aloe vera inner gel expresses antibacterial properties against both susceptible and resistant Helicobacter pylori strains.

• Andrographis – This is an herb often used for immune support, and may also help with fighting Helicobacter pylori. (36)

• Berberine – Berberine has been shown effective in treating Helicobacter pylori strains, including those resistant to antibiotics. (37)

• Black seed oil – This is a natural herb that is being shown in more and more studies to help eradicate H. pylori infections. Black seed oil is derived from the plant Nigella sativa, and has historically been used as a remedy for a variety of health conditions — most notably, for inflammation, cardiovascular health, infections, and skin issues. (38) The antibacterial properties of black seed oil may play a role in the treatment of H. pylori. Thymoquinone (TQ), one of the active compounds found in black seed oil, acts as a biofilm disruptor, meaning that it can break free from the protective coating that H. pylori uses to protect itself, allowing antibacterial components to reach the H. pylori bacteria and eradicate it. (39) What’s more is that black seed oil has been shown to be gastro-protective in both human and rat studies. One rat study specifically looked at gastritis in rats with hypothyroid function, and found that low thyroid function can be a trigger for gastritis. It also found that black seed oil can play a therapeutic role by inhibiting free radical generation and increasing levels of antioxidants that protect against oxidative stress in gastric tissue. (38,39) Most studies on the use of black seed oil to treat various conditions, including infections, have found a dose of two grams per day to be effective. (28,29,40)

• Broccoli sprouts – These have been found helpful in the treatment of H. pylori. (41,42) I recommend checking out your local health food store for broccoli sprouts, or taking a supplement like BroccoProtect by Designs for Health. (Taking broccoli sprouts in supplement form can help ensure your body absorbs glucosinolates and other nutrients properly.) I also like Sungarden’s BrassiPeak broccoli sprouts, which come in a convenient powder form that can be added to your smoothies (and you can use code DRWENTZ to save 5% off your order). In addition to helping with H. pylori, I love recommending broccoli sprouts to boost our detoxification pathways.

• Cabbage juice – I have found cabbage juice, being rich in glutamine, can also help support gut healing and suppress the H. pylori bacteria, allowing the gut to heal and clear the infection. Simply place the cabbage in a masticating juicer and drink four ounces of cabbage juice daily to suppress H. pylori.

• Cranberries – Cranberries (and their juice) have been studied for their abilities to treat H. pylori. Cranberry juice has been the focus of several studies for its ability to inhibit the growth of H. pylori and other bacteria (E. coli and Streptococcus) and for its anti-adhesion activity, which allows the pathogens to be cleared from the digestive tract more easily. (43-47)

• Fish oils – Fish oils have in vitro antibiotic activity against H. pylori, and have also been studied for their anti-inflammatory activity and ability to protect against ulcer formation. (48)

• Herbs and spices – A 2005 paper which reviewed 25 plants concluded that these eight spices had the strongest bactericidal effects against H. pylori (in declining order): turmeric, cumin, ginger, chili, borage, black caraway, oregano, and licorice. The study also showed that turmeric, borage, and parsley, in extract form, prevented the adhesion of H. pylori to the stomach. (49)

• Methylmethionine Sulfonium (MMS) – This is a derivative of the amino acid methionine that is found in raw cabbage. Raw cabbage juice has long been used to treat ulcers. It helps to support the mucosa throughout the gastrointestinal tract. (50,51)

• Oil of Oregano – Supplemental forms of oil of oregano can be helpful with killing H. pylori since it promotes intestinal cleansing and a healthy balance of gut bacteria. It also contains high levels of antioxidants, which may be beneficial for supporting the immune system and the body’s inflammatory response. I often like to use oil of oregano because it’s also helpful for SIBO and yeast, common co-occurring conditions with Hashimoto’s. (52,53)

• Probiotics – I generally use them in conjunction with other protocols (especially antibiotics), as they play an important role in creating a healthy gut environment and may crowd out the mean H. pylori buggers. 😉 (54,55)

• Propolis – Derived from bee pollen, propolis is an interesting option that has shown promise with inhibiting H. pylori. (56)

• Turmeric supplement – Taking a turmeric supplement may help with slowing down the growth of H. pylori. (57)

• Zinc Carnosine – Research has shown zinc to be effective in combating H. pylori, supporting the mucosal layer, and protecting against ulceration. When zinc is combined with the amino acid L-carnosine, the zinc can more effectively penetrate irritated tissue in the gut. (58,59)

• Vitamin C has anti-H. pylori activity and can help with tissue regeneration, in the case of ulcers. (60)

Thyme, mint, purple coneflower, and chamomile are examples of plants which seem to demonstrate anti-H. pylori activity, and plenty of other herbs could offer protection due to their antibacterial properties, although I have personally not used them as standalone treatments. (27)

I also recommend biofilm busters like Systemic Enzymes and NAC. These can also be helpful in addressing a healthy microbial balance because they break up the bacterial colonies. (61,62)

Another thing to keep in mind is that H. pylori can be spread between family members (even furry ones), as well as through breast milk, and we can even get reinfected by using our old toothbrushes! Thus, if you are someone undergoing an H. pylori protocol, it is imperative to throw away your old toothbrush (every two weeks or weekly while you are on the protocol), and even test/treat your family members.

Natural Protocol Options/Dosing

If you’re looking for an option that combines several of the natural therapies in one bottle, I am excited to announce that I just added Rootcology HP Restore to my product line, which is a combination product that uses therapeutic doses of mastic gum, methylmethionine sulfonium, DGL, zinc carnosine and vitamin C, which support a healthy microbial balance and a healthy gut lining.

Rootcology HP Restore is designed to provide comprehensive gut support and can be a tool when addressing H. pylori naturally. I recommend taking two capsules, twice per day, between meals (at least 90 minutes after eating and 45 minutes before eating). Remember to take them 30-60 minutes away from thyroid medications.

This product, like all natural H. pylori protocols, should ideally be used for 8 weeks.

If you prefer standalone products, here are a few options:

Three supplement 60-day protocol:

• Mastic Gum (500 mg): Take two capsules, three times per day (breakfast, lunch, dinner).
• DGL Plus: Take one capsule, three times per day (breakfast, lunch, dinner).
• S. Boulardii: Take two capsules, three times per day (with or without food). S. boulardii is a probiotic yeast that can help eradicate H. pylori. Studies show that it can counterbalance the overgrowth of opportunistic bacteria and yeast, which can be a side effect from treatments like antibiotics. (35,63)

Children/Nursing Moms/Those Unable to Tolerate Other Protocols:

Potential options for children/nursing moms and others who can’t tolerate the other protocols include MegaGuard, which contains ginger, artichoke, and licorice, PyloGuard, which supports gut health by using probiotics to rebalance the gut flora, and black seed oil. I suggest trying them individually, or using a combination of the three. MegaGuard and PyloGuard provide doses on the package. For black seed oil, doses as low as one drop per day have been helpful in children, but I recommend checking with your practitioner. (39,64-67)

I have personally used black seed oil for the two additional flares of H. pylori I had after the birth of my son. I’ve always considered childbirth to be an important Hashimoto’s trigger and exacerbating factor, and boy, do I now know why! One of these days I’ll share more on getting Hashimoto’s back into remission after childbirth, lol. In the meantime, I wanted to share some alternative protocols I had to seek out for myself while nursing my son.

Flare #1

Around four months after the birth of my son, I started to experience hair loss and new food sensitivities. I also found that my voice was becoming more hoarse. I tested my thyroid antibodies and they were elevated above 100 IU/mL — my Hashimoto’s was no longer in remission! (Under 100 IU/mL is considered in remission by many professionals.)

While the antibodies weren’t as high as they were when I first started my journey (at over 2000 IU/mL), I was concerned. I wasn’t sure if the Hashimoto’s was flaring up, or if it was postpartum thyroiditis. Luckily, I knew a thing or two about reducing Hashimoto’s antibodies and getting Hashimoto’s back into remission (the same principles apply to postpartum thyroiditis).

At that point, I tested myself with the GI-MAP test and found that I had H. pylori. I was excited because I knew that treating this infection usually results in a reduction of thyroid symptoms and thyroid antibodies, but wasn’t sure about which protocol I would use, as many of the treatments I would typically use for H. pylori are not safe to take while breastfeeding. I reached out to my friend and colleague Dr. Maya Shetreat-Klein, and learned that black seed oil could be used against H. pylori. Within a few weeks, my hoarse voice was gone, my hair stopped falling out, and my follow-up tests showed no more H. pylori.

Flare #2

I had a flare of H. pylori during the initial 2020 quarantine period. This time I found myself waking up at night with burning in my throat, headaches, acid reflux (for the first time since 2011, when I cut out dairy, and an overall feeling that I just wasn’t digesting my foods). I decided to try black seed oil again. However, this time I used a gel capsule, instead of a liquid, and this helped my symptoms somewhat, but not all the way. I went back to the liquid version, and added zinc carnosine and DGL.

While it’s ultimately up to you and your practitioner as to the right protocol to choose, I generally advise my clients to think about their symptoms, past reactions to antibiotics, and health timeline when choosing a treatment approach. For example, if someone had a prior negative reaction to antibiotics, they may want to consider the alternative route; and if someone felt an urgent need to address their infection due to severe symptoms, taking antibiotics may be a faster and more appropriate approach.

Monitoring Your Thyroid Hormones When Taking Herbal Supplements

Whenever you start a lifestyle or complementary intervention to address Hashimoto’s, I encourage you to work with your doctor to monitor your thyroid symptoms, thyroid hormones, and thyroid antibodies. This is a great idea for any lifestyle intervention, but a must for lifestyle changes that could impact your TSH, especially if you are already taking thyroid medications.

Mastic gum may help with reducing H. pylori-induced malabsorption of thyroid hormones, and may result in lowered requirements of thyroid hormones. (68) Similarly, berberine, aloe, and black seed oil can have thyroid-modulating activity and may result in needing to adjust thyroid medications. (69-72)

So as you move forward with supplementation, please look out for the following symptoms of being overmedicated: rapid or irregular heartbeat, nervousness, irritability or mood swings, muscle weakness or tremors, diarrhea, heat intolerance, menstrual irregularities, hair loss, weight loss, insomnia, chest pain, and/or excessive sweating.

I recommend testing thyroid hormone levels every six to 12 weeks to ensure your thyroid medication dosage is optimized, or sooner, if you are showing any of the above symptoms. Thyroid medications are goldilocks hormones – they need to be used in just the right dose!

Testing TSH, T4, T3, and the two most common Hashimoto’s antibodies (TPO and TG antibodies – you can read more about thyroid tests here) is an important part of ensuring that the lifestyle changes you are making are both safe and helpful. 🙂

If your doctor is ordering these thyroid labs for you, be sure to request a copy so that you can see them for yourself and ensure that they are interpreted correctly. If you aren’t able to use your physician for ordering, you may also wish to self-order your own thyroid monitoring labs. I recommend the Ulta Labs thyroid panel for monitoring your progress, which can be ordered anywhere in the U.S. (Some, but not all, insurance companies may reimburse you for self-ordered labs, so please be sure to check with your plan.)

The Takeaway

Gut infections lie at the root of many cases of Hashimoto’s, and eliminating the source of these infections can bring a relief of symptoms — and even remission — to many people. H. pylori is one of the most common infections that we see in those with thyroid conditions, and studies show that even those that are asymptomatic may still be harboring the infection.

The good news is that, once identified, H. pylori can be eradicated through a combination of antibiotics, or through more natural herbal treatments, and health is usually greatly improved!

For more information on treating H. pylori and other gut infections, I encourage you to pick up a copy of my book Hashimoto’s Protocol.

I’d love to hear from you! Have you been tested for H. pylori? What has your experience been?

P.S. You can download a free Thyroid Diet Guide, 10 thyroid-friendly recipes, and the Nutrient Depletions and Digestion chapter of my first book for free by signing up for my newsletter. You will also receive occasional updates about new research, resources, giveaways, and helpful information.

For future updates, make sure to follow us on Facebook and Instagram too!

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Note: Originally published October 14, 2016, this article has been revised and updated for accuracy and thoroughness.