The Ultimate Guide to Managing Hashimoto’s Thyroiditis: Expert Tips from McCall McPherson, PA-C

Struggling with Hashimoto’s and not sure where to begin? In this guide, drawn from a recent AMA podcast episode, McCall McPherson, PA-C (@mccallmcphersonpa) offers actionable, data-driven strategies to help you manage symptoms, optimize your thyroid function, and feel better—faster.

🔍 What You’ll Learn:

• First steps after a Hashimoto’s diagnosis
• Hormone replacement therapy done right
• Advanced ways to lower high antibodies
• How thyroid ultrasound findings affect your care
• Why your labs can look “normal” but you still feel awful
• The truth about EBV, MTHFR, T3, and more
• How to support fertility when managing thyroid issues
• How to exercise safely with thyroid dysfunction

1. 🧩 First Steps in Managing Hashimoto’s

McCall’s initial approach is science-backed, personalized, and designed for measurable results.

✅ Start Here:

• Low Dose Naltrexone (LDN): Helps reduce inflammation and modulate the immune system.
• Baseline Antibody Testing: Track TPO and thyroglobulin levels before any intervention. Retest every 90 days.
• Dietary Strategy:
  • Try gluten-free or dairy-free first.
  • Retest antibodies after 90 days.
  • If no change, switch or combine.
• Selenium (200 mcg/day): Shown to support thyroid health and reduce antibodies.
• Gut Health:
  • Use high-quality probiotics (e.g., Just Thrive, MegaSpore).
  • Test for candida or dysbiosis if GI symptoms persist.
• Red Light Therapy: Use 10 min/day, 1–2x, 6 inches from thyroid. Helps with antibody reduction and conversion.

Pro Tip: Don’t let lab access be a barrier. Use direct-to-consumer testing (e.g., Any Lab Test Now) if needed.

2. 💊 Hormone Replacement Therapy (HRT): The Stepwise Method

Instead of jumping into full hormone replacement, McCall recommends a phased approach:

💡 Prioritize Based on Symptoms:

• Progesterone: For anxiety, insomnia, heavy periods, mood swings
• Testosterone: For low libido, energy issues, muscle loss
• Estrogen: Last to drop, often during peri/menopause

👣 Action Plan:

• Begin with the hormone causing the most distress.
• Add others gradually as needed.
• Monitor thyroid labs carefully—HRT affects thyroid med needs!

3. 🧬 When Antibodies Stay High

Eliminated gluten/dairy but antibodies won’t budge? Try this:

• Glutathione Support:
  • Oral (500 mg), topical, or combine with resveratrol/NAD (NMN, NR).
• Lifestyle Shifts:
  • Red light therapy
  • Intermittent fasting
  • Sleep and stress regulation

Remember: Hashimoto’s is multi-layered—addressing inflammation from multiple angles matters.

4. 🖥️ Thyroid Ultrasounds Decoded

Seeing “hypervascular” in your results?

• This is a common, non-cancerous sign of Hashimoto’s.
• Nodules are not always present.
• Monitor but don’t panic.

5. 📊 Monitoring Without Medication

If your labs are normal but you feel anything but…

• Test Every 3 Months if symptomatic
• Use optimal ranges (not just “within normal”)
• Grab McCall’s Free Thyroid Lab Guide to understand your numbers

6. 🦠 Epstein-Barr Virus: Let’s Clear the Air

• Almost everyone has EBV antibodies
• No strong evidence it causes Hashimoto’s
• Many patients achieve remission without touching EBV

🔥 Focus on what works—not viral rabbit holes.

7. 🏃‍♀️ Exercise the Right Way (Yes, Really)

Your body needs restorative movement, not punishment.

✅ Best Starting Points:

• Walking
• Slow weight training with full recovery between sets

🚫 Avoid:

• CrossFit, OrangeTheory, and HIIT (until stabilized)

If you feel worse after workouts (fatigue, naps, illness), scale back immediately.

8. 👶 Thyroid + Fertility + IVF

• Optimize thyroid function before IVF.
• Monitor both thyroid and progesterone pre- and post-embryo transfer.
• Don’t let clinics skip progesterone labs—advocate for yourself!

❗ Thyroid imbalances can increase miscarriage risk.

9. 😵 When T3 Meds Aren’t Tolerated

Rare, but it happens. Here’s what to do:

• Focus on:
  • Anti-inflammatory diet
  • Stress reduction + rest
  • Micronutrients + protein
  • Fixing gut health
• These help your body make more T3 naturally.

10. 🧬 Cholesterol + Hypothyroidism

High cholesterol?

• Fix your thyroid first.
• You may not need statins once your thyroid hormones are balanced.

11. 🌎 Nationwide Care is Coming!

McCall and her team are expanding services across the U.S.—making it easier than ever to access expert thyroid care, no matter your zip code.

12. 🧪 MTHFR and Methylation

• MTHFR mutations are real but not a sentence.
• Be cautious with methylated supplements—they can worsen symptoms.
• Focus instead on gut health, nutrition, sleep, and reducing inflammation.

💬 Final Thoughts

Hashimoto’s is not one-size-fits-all. Your body is unique, and your treatment should be too. Use labs, data, and your own symptoms to guide care—and don’t be afraid to advocate for what you need.

🎧 Want even more details?
Listen to the full AMA episode of the Modern Thyroid and Wellness Podcast wherever you get your podcasts.

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