Thyroid Health, Hashimoto’s, and Ashwagandha: What You Need to Know

Amanda Queen, PA-C

Thyroid disorders are among the most common—and most misunderstood—chronic health conditions we see in practice. Many patients come to us feeling exhausted, foggy, anxious, inflamed, or frustrated after years of being told their labs are “normal,” yet they feel anything but.

At Revival Integrative Health, we specialize in identifying and addressing the root causes of thyroid dysfunction, particularly Hashimoto’s thyroiditis, the most common cause of hypothyroidism in the United States. One frequent question we hear is: “Should I be taking ashwagandha for my thyroid?”

The answer is: it depends—and provider oversight is key.

Let’s break it down.

Understanding the Thyroid–Immune Connection

Hashimoto’s thyroiditis is not just a thyroid problem—it’s an autoimmune condition. In Hashimoto’s, the immune system mistakenly attacks thyroid tissue, gradually impairing the gland’s ability to produce hormones.

This means that treatment should never focus solely on replacing thyroid hormone. A comprehensive approach considers:

• Immune system regulation

• Inflammation and gut health

• Stress physiology and adrenal function

• Nutrient status (selenium, iron, zinc, iodine balance, etc.)

• Environmental and lifestyle triggers

  
  

When these factors are overlooked, patients may continue to feel unwell even if their TSH appears “in range.”

Stress, Cortisol, and the Thyroid

Chronic stress plays a powerful role in thyroid dysfunction and autoimmunity. Elevated or dysregulated cortisol can:

• Suppress conversion of T4 → active T3

• Increase reverse T3 (inactive thyroid hormone)

• Worsen autoimmune activity

• Exacerbate fatigue, anxiety, and sleep disruption

  
  

This is where adaptogenic herbs, most notably ashwagandha, enter the conversation.

Ashwagandha: Potential Benefits (and cautions)

Ashwagandha (Withania somnifera) is an adaptogenic herb traditionally used to support stress resilience, nervous system balance, and energy regulation. Some studies suggest it may:

• Improve perceived stress and anxiety

• Support healthy cortisol rhythms

• Enhance T4 → T3 conversion in certain individuals

  
  

Sounds promising, right? Sometimes it is. But in thyroid care, especially autoimmune thyroid disease, context matters enormously.

When Ashwagandha May Be Helpful

Ashwagandha can be beneficial for:

• Individuals with hypothyroid symptoms driven primarily by chronic stress

• Patients with low or flattened cortisol patterns

• Those without active autoimmune flares

• Patients under provider supervision with appropriate lab monitoring

  
  

When Ashwagandha May Be Problematic

Ashwagandha is not universally safe for everyone with thyroid disease. It may:

• Overstimulate the thyroid in some individuals

• Worsen hyperthyroid symptoms (palpitations, anxiety, insomnia)

• Potentially aggravate autoimmune activity in susceptible patients

  
  

This is why blanket supplement recommendations, especially those found online or on social media, can do more harm than good.

Why Provider Oversight Is Essential

Thyroid health is not a “one-size-fits-all” situation. At Revival Integrative Health, we emphasize individualized care, guided by:

• Comprehensive thyroid labs (not just TSH)

• Autoimmune markers (TPO and thyroglobulin antibodies)

• Adrenal and stress hormone assessment when indicated

• A full clinical picture, not just numbers on a page

  
  

Ashwagandha may be an appropriate tool for the right patient, at the right time, in the right dose. But it should never be used as a standalone or unsupervised solution for Hashimoto’s or thyroid dysfunction.

A Truly Integrative Approach to Hashimoto’s

Managing Hashimoto’s effectively requires more than medication alone. Our approach includes:

• Optimizing thyroid hormone therapy (when needed, utilizing a variety of thyroid medications including T4 and T3 therapy)

• Supporting immune balance and gut health

• Reducing systemic inflammation

• Addressing nutrient deficiencies

• Regulating stress physiology and sleep

• Thoughtful, targeted use of supplements, when appropriate, and ONLY purchased through regulated supplement dispensaries like Fullscript (P.S. - you’ll always save 15% on every order automatically when shopping through our link, and clients save 30%!).

  
  

For some patients, this may include adaptogens like ashwagandha. For others, different strategies are far more effective and safer.

How Revival Integrative Health Supports Thyroid Patients

We understand just how complex and personal thyroid conditions can be. Many of our patients come to us after years of feeling dismissed or under-supported.

Amanda Queen, PA-C and Jessica Meyers, PA-C are deeply experienced in:

• Hashimoto’s thyroiditis

• Hypothyroidism and subclinical thyroid dysfunction

• Medication optimization and transitions

• Integrative, evidence-based supplement strategies

• Long-term autoimmune management

  
  

Most importantly, we partner with our patients. Thyroid healing is not about chasing a perfect lab value, it’s about restoring energy, clarity, resilience, and quality of life.

If you’re struggling with thyroid symptoms, autoimmune thyroid disease, or confusion around supplements, you don’t have to navigate it alone.

At Revival Integrative Health, we are adept at managing complex thyroid conditions and committed to helping you feel well again - safely, strategically, and sustainably. If you're ready to take back your thyroid health, become a patient today.

Sharma AK, Basu I, Singh S. Efficacy and safety of ashwagandha root extract in subclinical hypothyroid patients: A double-blind, randomized placebo-controlled trial. J Altern Complement Med. 2018;24(3):243-248. doi:10.1089/acm.2017.0183