Hashimoto's Thyroiditis
Autoimmune attack on thyroid causing subclinical hypothyroidism
The lab / n=1 experiments
Five diagnoses, one root cause, and the protocol that is reversing it. Every biomarker tracked, every intervention measured, every product I take listed with the reason.
01 · Conditions
Autoimmune attack on thyroid causing subclinical hypothyroidism
Positive CCP antibodies indicating potential RA development
Chronic Epstein-Barr virus reactivation from 2016 mono infection
Root cause identified: Staphylococcus overgrowth now reduced, Bifidobacterium restored
Morning cortisol was flat on the June four-point curve. The September retest has all four samples in range.
02 · Biomarker trends · Data-driven optimization
Four saliva samples across one day. The two tests were run by different labs, so each curve is scored against its own reference range.
| Sample | Jun 2025 | Sep 2025 |
|---|---|---|
| Morning | 0.49ref 1.8–3.8 · low | 3.9ref 1.5–9.6 |
| Noon | 0.82ref 0.3–1.4 | 1.2ref 0.6–4.1 |
| Evening | 0.6ref 0.2–1.1 | 0.8ref 0.2–2.3 |
| Night | <0.2ref 0.2–0.8 · low | 0.2ref 0.1–1.8 |
Jun 2025: Salivary cortisol panel · personal data · Sep 2025: Sleep and wake panel · personal data. Values in ng/mL.
Four saliva samples across one day, run alongside the cortisol curve. Melatonin should rise at night while cortisol falls.
| Sample | Sep 2025 |
|---|---|
| Morning | 8.4ref 3–19 |
| Noon | 1ref 1–5.8 |
| Evening | 1ref 1.2–10.6 · low |
| Night | 6.1ref 3.8–24 |
Sep 2025: Sleep and wake panel · personal data. Values in pg/mL.
03 · Body composition · DEXA · Kalos San Francisco
Four DEXA scans between January and September 2026. Fat mass down 9.6 lb, lean mass up 2.7 lb, bone density up 4.3%.
Latest scan · September 10, 2026
I started tirzepatide around early August. This scan shows 32.49 lb fat mass and 148.13 lb lean mass. The change since May covers four months, including time before I started this protocol.
Scanned mass in pounds. Lean includes bone mineral content.
Percent fat, September 2026 scan.
Down from 81.5 in January. Under 100 is the healthy range.
1.282 g/cm², up 4.3% since the baseline scan.
Age matched. It was the 47th percentile in January.
58th percentile. Arm and leg muscle responded best.
43rd percentile. The weakest number on the report.
Fat sits evenly rather than around the middle.
What the scan says to fix
Hologic Horizon Wi, NHANES reference. Percentiles are age matched. Scan mass is measured by the machine and runs below a scale reading.
04 · Genetics · DNA analysis
I went deep into my 30× whole genome sequencing. The analysis maps APOE, methylation, stress chemistry, sleep, and the gut–brain axis into a connected story, with the exact calls and bloodwork behind it.
Thirteen topics. Detailed mechanisms, personal interpretations, and a map of how the pathways connect.
Read my DNA analysis ↗05 · The stack · Daily protocol
Each supplement targets a specific dysfunction identified through testing. Grouped by the job it does, with the marker it moved when I have one.
Current GLP-1 protocol · Updated September 15, 2026
I take 0.5 mg per dose, for a total of 1 mg per week. I started around early August, about six weeks before this update.
My GLP-1 microdose protocol, started around early August 2026. About six weeks in as of September 15.

Thyroid hormone replacement for Hashimoto's hypothyroidism

Gut barrier repair, intestinal permeability healing

Short-chain fatty acid for gut lining and enterocyte fuel

Gut lining protection, ulcer healing

Targeted antimicrobial for Staphylococcus overgrowth

Antimicrobial, blood sugar regulation, gut pathogen control

Antimicrobial from lauric acid, biofilm disruption

High-potency Bifidobacterium probiotic for reseeding

Human milk oligosaccharides to selectively feed Bifidobacterium

Blautia suppression, urolithin A production for mitochondria

Blautia suppression, antioxidant, anti-inflammatory polyphenol

Partially hydrolyzed guar gum to feed butyrate-producing bacteria

Prebiotic fiber to feed butyrate-producing bacteria

Spore-forming butyrate producer to restore butyrate production

Spore-based probiotic for gut barrier integrity and microbiome diversity

Beneficial yeast for fungal balance and gut immune function

Selective antimicrobial for pathogen control, biofilm disruption

Gut mucosal barrier repair, joint and cartilage support

MTHFR mutation support - cannot use folic acid

MTR/MTRR mutations - impaired B12 recycling

Methyl donor for homocysteine management

Active B2 for MTHFR pathway cofactor

Master antioxidant, detoxification support

Glutathione precursor, liver support

Universal antioxidant, mitochondrial support

VDR mutation - reduced vitamin D sensitivity

Immune support, adrenal health, HPA axis

EBV viral suppression (high lysine/low arginine)

Muscle recovery, cellular energy, cognition

Mitochondrial support, cardiovascular health

Mitophagy activation, mitochondrial renewal

Inflammation reduction, cardiovascular health

Thyroid support, muscle function, sleep quality

Sleep quality, collagen synthesis

HPA axis support, COMT mutation management

GABA modulation, bile acid support, sleep quality

Serotonin and melatonin precursor for deep sleep

Natural flavonoid for sleep onset, CD38 inhibition for NAD+

Anti-inflammatory, gut healing support

Joint lubrication, skin hydration, connective tissue support

Fat-soluble B1, neuroprotection

Adrenal support, cortisol production

Sulfite metabolism, detox enzyme cofactor

Testosterone support, calcium/magnesium metabolism, bone health

Electrolyte balance, hydration, adrenal support

Mitochondrial function, thyroid support, tissue healing

Vagus nerve stimulation for HRV, sleep, and parasympathetic tone

Combined BPC-157 and KPV peptides for gut barrier repair and mucosal inflammation
Immune modulation, T-cell regulation for autoimmune support
Tissue repair, inflammation reduction, wound healing peptide
Eliminated · Strict AIP + high lysine protocol
Complete elimination of inflammatory triggers to heal the gut, suppress viral activity, and reduce autoimmune inflammation.
This is not medical advice. I am not a doctor. Everything shared here reflects my personal experience and experimentation. Consult a qualified healthcare provider before starting any supplement or health protocol.
06 · Skincare protocol
Cleanse, exfoliate, actives, barrier, sunscreen. AM and PM marked on the rail. One step alternates nightly.










07 · Health log
28 entries, newest first. Coral dots are setbacks and mixed results. Acid dots are wins.
Root cause analysis
The May 2025 panel was not a random collection of issues. It was a stress signature. Years of chronic stress triggered a cascade that depleted every system simultaneously.
A major life stressor sustained over years. It demanded far more sleep than normal. The body was in survival mode.
Sustained stress depleted the HPA axis. Morning cortisol hit 0.49 ng/mL, barely detectable. The adrenals were exhausted, unable to mount a proper stress response.
Without cortisol to regulate it, the immune system lost its brakes. T-cell regulation failed. The body could no longer distinguish self from threat.
Epstein-Barr virus, dormant since a 2016 mono infection, reactivated. The weakened immune system couldn't keep it suppressed.
EBV shares molecular structures with thyroid tissue, molecular mimicry. The confused immune system began attacking the thyroid (Hashimoto's) and joints (early RA).
Chronic stress burns through zinc, magnesium, vitamin D, and CoQ10. Every cofactor the immune system needed to self-correct was depleted.
Stress + nutrient depletion broke down the intestinal barrier. Staphylococcus overgrew to the 99.9th percentile. Bifidobacterium crashed. The gut, where 70% of the immune system lives, became the epicenter of dysfunction.
The final domino. Testosterone suppressed by stress and inflammation. Prolactin elevated. The endocrine system reflected the damage of every upstream failure.
The log
I am taking tirzepatide at 0.5 mg per dose, twice per week, for a total of 1 mg per week. I started about six weeks ago, around early August 2026. This entry records my current schedule.
My September 10 Kalos DEXA measured 17.3% body fat, 32.49 lb fat mass, and 148.13 lb lean soft tissue. Since January, fat mass is down 9.62 lb and lean mass is up 2.70 lb. Since May, fat mass fell 3.85 lb and lean mass fell 5.44 lb. Bone mineral density reached 1.282 g/cm², up 4.3% from January, with a T-score of +0.8. Visceral fat area is 44.6 cm². I started tirzepatide around early August; the May-to-September comparison covers a longer period than this protocol.
Tiny Health stool sample collected August 27; report issued September 9 (kit SJB636, version 5.3.2). Microbiome score fell from 81 to 76. Streptococcus increased from 0.054% to 1.482%, and Bifidobacterium fell from 0.691% to 0.069%. Butyrate capacity fell from 503 to 413 rpkm; acetate from 429 to 302; propionate from 310 to 244. Beta-glucuronidase fell from 1810 to 1323 rpkm and is now rated Great. Klebsiella and Staphylococcus are reported at 0%. Top focus areas: Streptococcus, antibiotic-resistance richness index (0.2), and acetate. Microbiome age is 35.7 years; gut type is Lachnospiraceae. The report evaluates 106 metrics: 5 Support, 3 Improve, 73 Okay, 25 Great. Tiny Health versions differ between samples; results remain separate from Thorne tests. Context from Nick: I took antibiotics after food poisoning in Mexico and stopped my probiotics 10 days before the August sample. My working hypothesis is that the antibiotics contributed to the lower score. The probiotic pause also matters when I compare this sample with earlier tests.
Why do excellent omega-3s (index 8.8) and pristine inflammation (hs-CRP 0.3) coexist with a Pattern B particle profile? Different circuits. Omega-3 and clean metabolic markers set your cholesterol concentrations and inflammation — both optimized. But particle quality (Pattern B, small-dense LDL, low HDL-Large) is set by triglyceride throughput, and the leading driver here is dietary: white rice at every meal → postprandial glucose → hepatic de novo lipogenesis → VLDL-TG → CETP/hepatic-lipase remodeling into small, dense particles. (Corrects an earlier read that assumed a zero-grain diet ruled out de novo lipogenesis.) The three-panel triglyceride creep (61→73→84) fits the same carb-flux mechanism. Meanwhile ~4 months of half-marathon training (~25 mi/week) pushes the other way — upregulating lipoprotein lipase, clearing particles (LDL-P 2230→1460) and lifting HDL (47→56); LDL-C has trended 126→110→97→102→82 over the training year. Net: training is winning on particle count and HDL, the rice is holding back triglycerides and size. Highest-yield levers: cut rice frequency and time remaining carbs peri-workout, re-up EPA/DHA, shift some saturated to monounsaturated fat. Retest NMR + lipids in ~3-4 months, standardized (48-72h off hard running, fasted), before any pharmacology — count is trending down on its own. (diet.json is stale — still says zero grains.)
Focused lipid fractionation + partial thyroid (fasting). Strong reversal of June's spike: LDL-P -35% (2230→1460), small-dense LDL -35% (462→302), medium LDL -41% (598→352), LDL-C 82, ApoB 80, non-HDL 98, total chol 154. Protective side improved too: HDL crossed into optimal (47→56), ApoA1 144, chol/HDL 2.8, ApoB/A1 0.56, LDL/HDL 1.5. Tracks ~4 months of half-marathon training (~25 mi/week) upregulating lipoprotein lipase. Two things did NOT improve: particle size is stuck (peak size flat 215.6, still Pattern B — fewer small particles rather than bigger ones), and HDL-Large fell below range (10725→5115, the June value was likely an outlier). Triglycerides rose a third straight panel (61→73→84). Diet correction: currently eating white rice at every meal — the most plausible driver of the triglyceride creep and persistent Pattern B via postprandial de novo lipogenesis, despite pristine fasting metabolic markers. hs-CRP 0.3, Lp(a) <10. Thyroid: Total T4 8.4, Free T4 Index 2.6 (optimal), T3 uptake 31, TgAb 3; TPO pending.
Lipoprotein quality reversed. Unlike April's benign fat-loss mobilization (Pattern A, rising peak size), everything moved the wrong way together: LDL-P rose again to 2230 (1269→1724→2230), small-dense LDL jumped to 462, LDL Pattern reverted A→B, and peak size fell to 215.7 — remodeling toward small, dense particles, not mobilization. April's prediction that LDL-P would normalize didn't hold. Top action item: lipidology follow-up. Standard lipids drifted up but stay fine (LDL 102, HDL 47, TG 73, ApoB 85 <90). Thyroid mixed: TPO ticked up for the first time in months (522→571), TgAb steady at 3, TSH low-normal 0.56 — watch on next retest. Total testosterone up to 929 but free T dipped to 101.3 as SHBG stays elevated (58) — likely from optimized thyroid + low insulin + leanness, not estrogen (E2 optimal at 32). Metabolically excellent: hs-CRP down to 0.2, HbA1c 5.2, insulin 7.5, leptin 1.3. Zinc above range (135) — ease supplementation.
First Tiny Health shotgun-metagenomic sample (provider switch from Thorne Onegevity, so not directly comparable to prior gut panels) — but a strong picture versus the dysbiotic 2025 baseline. Score 81/100, 55% beneficial / 0% unfriendly, Bacteroides gut type. Robust beneficials: Faecalibacterium prausnitzii ~10.6% across strains (major butyrate producer, anti-inflammatory), Akkermansia muciniphila 0.680%, Bifidobacterium 0.691% (all 'great'). SCFA capacity high across the board (butyrate 503, acetate 429, propionate 310 rpkm, all above reference). Diversity solid; phyla balanced (F/B ratio 0.93). Two focus areas: Klebsiella at 0.009% (trivial in absolute terms) and beta-glucuronidase capacity 1810 rpkm ('needs support') — elevated, recirculates conjugated estrogens/toxins via the estrobolome. With E2 optimal, the lever is fiber (ground flax), faster transit, and probiotics rather than DIM/calcium-D-glucarate. Microbiome age 38.6 years.
Infinite Allergy Labs retest, same lab as June 2025 — ~11 months of elimination diet plus gut healing. Every previously-elevated IgE (true allergy) is now below range: Egg White (IgE >100 → undetectable, and C3b/d complement cleared from Detected → Not Detected), Egg Yolk (24 → <0.5), Gluten (7.3 → 0.6), Walnut (6.4 → 0.8), plus Bean, Beef, Hazelnut, Tomato, Goat Milk, Peanut, and Cashew. IgG4 sensitivities dropped sharply too (Egg White IgG4 27 → 3). A handful of IgG exposure markers rose with food reintroduction (almond, white potato, wheat) — expected, and not a returning allergy. Tally: 11 resolved, 3 improved.
TPO antibodies down 22% (672→522, trend: 739→680→522). TgAb down 59% (7.4→3), approaching normal. TSH dropped to 0.76 (lower end of range). LDL particle counts rose (LDL-P +36%, LDL Small +19%, LDL Medium +39%) but every quality marker improved: LDL Peak Size continued year-long uptrend (215→217→217.9→219.5), Pattern B→A shift, HDL Large surged 43% into optimal range. Divergence between particle count and quality is classic signature of fat loss-driven lipid mobilization — not metabolic deterioration. Prediction: LDL-P should normalize once weight-stable 8-10 weeks.
TSH trending down (3.05→2.83). TPO antibodies rebounded (555→672), indicating autoimmune flare despite TA-1 treatment. Testosterone strong at 839 ng/dL. SHBG elevated at 56. Bilirubin high at 2.2 (Gilbert's pattern). EBV Early Antigen D slightly improved (38.7→36.1). Cystatin C added for kidney monitoring.
Week 4 on Thymosin Alpha-1. TPO antibodies dropped from 739→487 IU/mL (-34%), the largest sustained drop from any single intervention. Free T4 improved (1.2→1.47). Thyroglobulin antibodies improved (10→7.4). TSH stable at 2.27 (optimal range). Free T3 dipped slightly (3.5→3.0) but still normal. TA-1 appears to be directly modulating the autoimmune attack via Treg upregulation.
Initiated TA-1 subcutaneous injections for immune modulation. TA-1 directly modulates T-cell function at the thymus level: upregulates Tregs, shifts Th1/Th2 balance, reduces autoreactive immune activity. Targeting the core autoimmune dysfunction driving Hashimoto's.
3-month follow-up on gut healing protocol shows dramatic Bifidobacterium recovery (+385%, from 15.5→75.3 percentile) - the primary target of Bifido Maximus supplementation. Staphylococcus reduced 32% (99.9→67.5 percentile), no longer in extreme overgrowth. Beta diversity improved 47% (66→35). However, concerns emerged: Blautia spiked 65% to 96.4th percentile (autoimmune-associated), butyrate production collapsed 75% (72→18 percentile), and total fungi increased to 88.1 percentile. Dysbiosis score unchanged at 69.8. Next phase: address new overgrowths while supporting butyrate production.
TSH now fully optimized at 1.22 mIU/L (-66% from Oct). Testosterone excellent at 895 ng/dL (+28%). Omega-3 index at 10% (excellent). Homocysteine improved to 7.6. However, TPO antibodies increased to 739 (+18%) and CCP to 25 (+14%) - autoimmune activity persists despite optimal thyroid function. EBV reactivation worsening (36.2, +17%). Gut protocol needs more time.
Bumped Armour Thyroid from 30mg to 60mg daily based on continued optimization. TSH was improving but wanted to push further into optimal range. No adverse effects from the increase.
First thyroid panel after starting Armour Thyroid 30mg in September. TSH dropped 42% (6.20→3.57 mIU/L), now in normal range. TPO antibodies also declined: 799→627 (-22%). Decided to increase dose to push TSH further into optimal range.
Initiated targeted gut dysbiosis treatment for Staphylococcus overgrowth and Bifidobacterium restoration. Protocol: BPC-157 (500mcg 2x/day), HMO prebiotic (15g/day), Bifido Maximus (5 caps/day), Oregano oil (4x/day), Berberine (1000mg/day), Monolaurin (2400mg/day). Expecting 12 week timeline for significant results.
Omega-3 index +51% (4.9→7.4%), EPA +133%. HDL +31% (49→64). LDL particles -46% (2,284→1,243). Small dense LDL -55% (544→243). Morning cortisol fully restored +697% (0.49→3.9) - HPA axis dysfunction RESOLVED. Vitamin D corrected +89% (27→51). However, TSH worsening (5.91→6.20), indicating need for thyroid medication.
Microbiome analysis revealed ultimate upstream driver of autoimmune cascade: extreme Staphylococcus overgrowth (99.9th percentile - higher than 999/1000 healthy adults) combined with severe Bifidobacterium deficiency (15.5th percentile). Gut dysbiosis score 69.8. This explains the entire causal chain: dysbiosis → intestinal immune activation → molecular mimicry → autoimmune attack → thyroid destruction.
Initiated thyroid hormone replacement with Armour (natural desiccated thyroid) at 30mg daily. Decision made after TSH continued worsening despite all other interventions improving. Armour chosen over synthetic levothyroxine because it provides both T4 and T3. Goal is to eventually wean off as gut heals and antibodies decline.
Started methylation support for MTHFR/MTR/MTRR/CBS mutations: L-Methylfolate 5mg, Methylcobalamin 3mg, TMG 1.8g, NAC 600-1200mg, Liposomal Glutathione 500mg, Riboflavin 5'-Phosphate 90mg. Goal: support impaired methylation pathways, reduce homocysteine, improve detoxification capacity.
Comprehensive genetic panel revealed SEVEN methylation-related mutations: MTHFR (reduced folate conversion by up to 70%), MTR & MTRR (impaired B12 recycling), CBS (rapid homocysteine conversion), COMT (slow catecholamine clearance), VDR (reduced vitamin D receptor sensitivity), MAT1A (impaired SAMe production), NOS3 (reduced nitric oxide). This rare combination (<1% of population) explains severity of symptoms.
IgE/IgG/IgG4 panel identified severe reactions: EGG WHITE (extreme - IgE >100), Egg Yolk (severe), Gluten (severe - IgG 34.84), Walnut (severe). High reactions to: beans, beef, whitefish, hazelnuts, tomatoes, pineapple. This explained chronic inflammation and guided strict elimination diet.
Beginning of systematic health optimization. Starting weight: 208 lbs. Symptoms: requiring 14+ hours sleep daily, chronic fatigue despite being physically active, brain fog, exercise intolerance, cold intolerance. Initiated strict elimination diet and targeted supplementation.
For years, I knew something was deeply wrong but couldn't prove it. Every doctor visit ended with 'your labs look fine.' This panel finally gave me answers: TPO antibodies at 900 (normal <35) - active thyroid attack. EBV reactivated from 2016 mono. Early RA markers positive. Morning cortisol at 0.49 (barely detectable) - adrenal collapse. Pattern B dyslipidemia with dangerous small dense LDL. Every major system was failing simultaneously.
A major life stressor that had been ongoing for years finally resolved. During this period, sleep needs ran well above normal. This chronic stress likely exacerbated autoimmune conditions and contributed to immune dysregulation. Following resolution, sleep normalized.
Tonsils surgically removed after becoming enlarged to the point of nearly touching. Had completed 6-week antibiotic course with no improvement. Post-surgery: morning headaches resolved completely, speech became noticeably clearer. In retrospect, tonsils likely contained EBV viral reservoirs or antibiotic-resistant Staph. Removing them reduced immediate load but infection may have migrated to gut.
Contracted mononucleosis (Epstein-Barr virus) and streptococcal infection simultaneously. This was a major immune system event. EBV establishes lifelong latency and can reactivate during immune stress. The 2025 testing showing active EBV reactivation indicates the virus acquired here has reactivated due to immune dysfunction from gut dysbiosis.
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How a Staphylococcus overgrowth at the 99.9th percentile was driving my autoimmune cascade, and the protocol that started reversing it.