The Specialist: Hashimoto's Thyroiditis

Donna Mazzola PharmDDr. Donna Mazzola

“I always thought of myself as healthy. Never in my wildest dreams would I have imagined that I would have Hashimoto's disease.”

When Donna Mazzola, PharmD, found out in 2015 that she had Hashimoto's Thyroiditis, it completely changed her life. She has a doctorate in pharmacy. Her knowledge of the body was very extensive — and yet she still felt gobsmacked by the diagnosis. “I always thought of myself as healthy. Never in my wildest dreams would I have imagined that I would have Hashimoto's disease,” she says.

Hashimoto’s often does not cause obvious symptoms (especially in the early stages), and Dr. Mazzola didn't recognize any of the usual telltale signs. She was training for a half-marathon and found herself gaining weight even after eating healthfully and running six to ten miles per day. Her hair was also incredibly dry. “My physician checked my thyroid stimulating hormone (TSH) and it was normal, but what tipped her off was that my cholesterol was elevated,” she says. “Fortunately, she also checked my thyroid antibodies because they were through the roof!” 

“I now tell patients and colleagues all the time, if you have elevated cholesterol and you know it doesn’t make sense because you know your body, dig deeper!”

Recognizing the symptoms of a Hashimoto's flare-up

Dr. Mazzola looks back on that time and says she realizes now that she was shocked by the diagnosis: “I was disappointed with myself. I felt like it was my fault, like it was something I did wrong.” This sort of thinking is all too common among people who are diagnosed with chronic illnesses, although there is no shame in a diagnosis — something Dr. Mazzola makes a point to emphasize these days when she's treating others.

Initially, she thought the diagnosis had something to do with the fact that she was pregnant around the time, as estrogen can play a role in autoimmune diseases. 

Dr. Mazzola started taking thyroid medication after her diagnosis, but also wanted to learn more about what else she could do in order to feel her best again. “At that point in time, I didn't know a thing about functional medicine or managing autoimmune disease. And that’s what took me on my learning journey.”

In 2017, Dr. Mazzola obtained a Master’s Degree in Functional Medicine, which is the practice of determining and treating the root cause of an illness. Rather than treat the symptoms with meds alone, functional medicine practitioners also consider diet, stress levels, allergens, genetics, and other factors that can contribute to overall health and wellness.

Experiencing symptoms of Hashimoto's herself taught Mazzola a lot about health in general and her own thyroid issues. For one, she had a shift in mindset, and she no longer blamed herself for her diagnosis. 

Experiencing symptoms of Hashimoto's herself taught Dr. Mazzola a lot about health in general and her own thyroid issues. For one, she had a shift in mindset, and she no longer blamed herself for her diagnosis. While adding functional medicine to her understanding of pharmacology, she became interested in chronic inflammation and how it can affect disease development, as well as the importance of lifestyle, nutrition, environmental toxins, and gut health, all of which she says were not discussed in her conventional medical school training, aside from a single elective course in basic natural medicine.

Armed with that new knowledge and all the variables that can play into thyroid disease, Dr. Mazzola began paying more attention to inflammation, both in herself and her patients. When a person has Hashimoto’s, inflammation can contribute to fatigue, weight gain, dry hair, memory issues, constipation, and a whole host of other symptoms characteristic of the disease.

Dr. Mazzola says she began embracing new ways of eliminating inflammation and supporting her overall health, and it helped. “When I changed my diet and implemented several lifestyle changes, I was able to lower my thyroid antibodies and never felt better. I was also able to reduce the amount of medication I was taking,” she says.

Functional medicine tips Dr. Mazzola recommends for patients in addition to thyroid medication to reduce symptoms of Hashimoto's disease based on her own experience dealing with the condition: 

Eat real food

Avoid processed foods and reach for colorful, nutrient-rich greens, veggies, and fruits. 

Take a probiotic

Probiotics may help balance the microbiome, proliferating “good” bacteria and reducing the bad, which can lead to inflammation. 

Take vitamin D

 “It’s great for gut health, for immunity, and for the thyroid,” she says. Vitamin D is actually a hormone, as it impacts the immune system by promoting protective T-cells. Dr. Mazzola also recommends vitamin A and zinc, both of which can help support a healthy thyroid.

For a healthy hashimoto's diet, avoid foods that can cause inflammation

Dr. Mazzola says that she tries to avoid gluten, dairy, and soy, as they can cause low-grade inflammation in the body.

Don’t underestimate the physical effects of stress hormones like cortisol and adrenaline on hypothyroidism

Even Dr. Mazzola isn’t immune to the stress of the ‘new normal’ during COVID-19. In 2020, she experienced a bad Hashimoto's flare-up, which reminded her of the importance of stress management. Before the quarantine hit, she was able to get into the yoga studio to move and de-stress. However, lockdown changed her routine quite a bit, a story we all know too well.

“My disease spiraled out of control. I was eating even healthier due to being home for meals, but my antibodies were through the roof.” She says she gained weight, felt irritable, and would crash in the afternoon — often relying on coffee to get her through the day.

“Then I put it all together: It was stress,” she says. It took her many months to start feeling like herself again, but she gradually felt better as she started to make time for yoga at home and quiet time for herself in the mornings before her family woke up and needed her.

Get enough sleep

“I can't stress how important that is,” Dr. Mazzola says. “Sleep is that time to regenerate and recover. You have to shut down for eight hours because your body needs a break.”

Getting good sleep nightly — by going to bed and waking up roughly at the same time each day, if you can — means more energy during the day, which is helpful when you’re fighting fatigue and inflammation.

Unfortunately, many people with hypothyroidism battle sleep issues such as sleep apnea, so it’s important to focus on good sleep hygiene. 

Get a full thyroid panel regularly, including regular antibody testing

What can patients do to keep up with their thyroid health? “It’s important to ensure they are getting a full thyroid panel checked regularly and that includes regular antibody testing. While an endocrinologist would disagree with this recommendation, antibodies give us an idea on the level of inflammation in the body,” she says.

“I hate that we often tend to view medicine as conventional or functional,” Dr. Mazzola says. “You need both." It’s important to take medication while also embracing meaningful lifestyle changes to create balance — or even to figure out how to lose weight with Hashimoto's.

“I hate that we often tend to view medicine as conventional or functional,” Dr. Mazzola says. “You need both.” She says she believes it’s important to take medication while also embracing meaningful lifestyle changes to create balance — or even to figure out how to lose weight with Hashimoto's.

Dr. Mazzola runs the popular Instagram account @DrAutoImmuneGirl. There, she offers accessible, scientific information to people who want to support their health and explore how to live well with chronic illness that integrate both her conventional and functional medicine knowledge.

“Everyone is different and finding the root cause and what flares your condition is challenging,” she says. “This journey is a long one. It’s definitely a marathon and not a sprint.”

Dr. Mazzola received a Doctorate of Pharmacy from Ferris State University in 2006 and went on to complete a residency at the Detroit Medical Center and a board certification in Geriatric Pharmacy. In 2015 she graduated with her Master’s in Business Administration from Central Michigan University. She recently graduated from the University of Western States with a Masters of Science in Human Nutrition and Functional Medicine.

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