027 // What is a Hashimoto’s flare and what do I do when I’m in one?

Health with Hashimoto’s is your free weekly podcast to discover true, simple, and sustainable tips to improve your energy and health.

What seems to be “common knowledge” for people who have struggled with an issue for a while, can puzzle those of us new to it. Join me today as I cover one basic term in autoimmune diseases: “a flare.” What is a Hashimoto’s flare up? How do you get out of this flare? And how do you get through the day when you are experiencing an autoimmune flare?

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Show Notes:


The Rube Goldberg Episode: 003 // What do my thyroid labs mean?

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Read the Transcript:

This transcript is auto-generated by OtterAI and may have slight errors.

Unfamiliar lingo: Hashimoto’s Flare-Up

What is a “flare?” This is what I wondered when I was first diagnosed with Hashimotos thyroiditis.

Because it seems like I had stepped into this world where there was a different language. And I was like, Well, what is a flare? How do I know if I’m having a flare? And then what do I do to get out of it?

So that’s what we’re gonna talk about today. I’m gonna answer three questions. Number one, what is a flare? Number two, how do I get out of it? And then number three, how do you make it through the day when you are in a flair?

Thank you so much for joining me on today’s podcast episode. Of course people listen to this podcast when you already are diagnosed with Hashimotos. But some of the women and men who listen don’t know yet if they have Hashimotos or if their thyroid is out of whack. They might be exploring it you might be exploring it.

4 Years & 4 Doctors

Did you know The average woman before she is diagnosed with hypothyroid or Hashimoto’s? She visits four doctors or specialists and it takes four years. Four years from the time she started to feel symptoms until she gets a diagnosis!

Don’t wait for a diagnosis to start healing

One thing that absolutely drives me crazy about Western medicine is that a lot of people they don’t feel like they can move on to a path of healing until they have a name a diagnosis. And that’s not true. You can move on to your path of healing anytime. You do not have to have a diagnosis. Now obviously some things when you have a diagnosis. It really helps because you can take different medications and stuff. But when you’re looking at the root, cause that root cause is happening, no matter if you know your diagnosis name or not.

So when we talk about a flare of an autoimmune disease that could be happening even if you don’t know the name of what is going on. Maybe you have not been diagnosed yet. Maybe you are still in that seeking process. It’s okay. You can still start on your path toward healing.

What is a “flare?”

So let’s talk about autoimmune flares and Hashimoto’s flares. What is it? I doubt that I am alone in googling this. Isn’t it nice that we have Google Now? If you don’t know something? You just hop on the internet and ask Siri for Ask Google or Alexa, whoever you’re asking how we can get answers. I felt kind of silly when I had to google it. I was like everybody talks about this as if it’s like common knowledge. You have an autoimmune disease or condition and all of a sudden you should know what a flare is. Well, I didn’t. So I googled it.

Basically, a flare is exactly what it sounds like. It’s a flaring up of your symptoms. Your symptoms are getting worse. Maybe you’re adding more symptoms, or maybe the symptoms that you had under control have been exacerbated. A flare is a return or the flaring up of something that’s going on.

Worsening old symptoms or additional symptoms

Now frequently, but not always the symptoms that are flaring up. are ones that you have experienced before. Like I said, sometimes you add on new symptoms, and there are a lot of symptoms that you could be experiencing with Hashimotos. I’ll read through it some that have been listed out before and of course because thyroid is needed for every single cell in your body the symptoms vary a lot.

They range from people feeling worthless or forgetful. Some said I don’t feel human. I thought I was losing my mind. People describe it as maybe I felt like I was in quicksand or my health kept declining. Others said that it was all my fault. I felt like I was letting everyone down. I didn’t feel like myself anymore. The exhaustion that gut problems the heart palpitations, anxiety, panic attacks, losing your hair, depression, brain fog, fatigue, oh my goodness! there are so many different symptoms and I’m not even reading the whole list that I have.

Your symptoms are valid

Your symptoms are valid. Thyroid affects everything. And you are a unique individual. When you are having a flare or when you’re experiencing Hashimoto’s symptoms, they are your symptoms. They don’t have to match up with somebody else. Some frequent things that cause a flare would be stress, medications that are interfering with your thyroid medications or that are interfering with your immune system, and nutrients.

What’s changed?

So has anything in your life changed that caused this flare? Obviously, if something changed you want to evaluate can I go back to what I was doing before that change? And these are the three most common things that seem to trigger a flare: stress medications and nutrients. So when you are having a flare or when something happens, there’s always an interference in the signals.

Remember the Rube Goldberg machine of your thyroid?

Now back in episode three, I described to you your thyroid workings, like a Rube Goldberg machine, and then a Rube Goldberg machine. It’s a huge complex machine to make one tiny little simple thing happen. So in this Rube Goldberg machine of your thyroid, there are so many spots where you can have interference.

So would that interference be between your brain your parathyroid and your thyroid? In my example, in episode three, I was telling you that it’s kind of like a light switch. Your brain says I want more thyroid so it’s hitting a light switch. So is that where this interference is is that where your flare is happening?

Or perhaps is the next step down where your thyroid is producing T4 which is the inactive form of thyroid hormone, perhaps that’s where things are going wrong. And if you’re on a levothyroxine or Synthroid type of medication, that’s T4. So maybe your dosage changed.

After the T4 is created, then that T4 the inactive form of your thyroid, it goes to the cells in your body and they convert it to active form the T3 or if you’re under stress, they block it and they convert it to reverse T3, reverse T3 is the brake system saying “No Nope. There’s other stuff going on that we need to address. We need to just chill, relax and heal.” So your cells convert it to the active form or like the brake system. So perhaps in your flare, the interference is at the cellular level. It’s your cells not converting the T4 to T3, or is the cells converting more of it into reverse T3, which is the brake system.

A flare is feeling worse

So that in a nutshell is what a flare is. You’re feeling worse. A lot of times you’re going to be feeling the same symptoms as what prompted you to seek a diagnosis or to seek care in the first place. Because that’s what your body does. First everybody’s body has like this, this fast track like oh, if something happens, this is immediately what I am going to do. And a lot of that is genetics.

I’m sure you’ve heard the phrase Oh, this runs in my family, whether it’s high blood pressure or Alzheimer’s or whatever things run in your family. That doesn’t mean it’s going to automatically happen. It means that your predisposition towards that thing is going to happen easier than something else is the same way with your thyroid. When you have thyroid symptoms. Your symptoms are usually going to be consistent when you’re having your initial problems and then also when you are having a flare, your symptoms are probably going to stay consistent. And then typically with any autoimmune disease, you keep the same symptoms you might add more symptoms to what you’re experiencing. But typically, what you’re feeling is consistent and it’s going to stay that symptom.

How do I get out of a Hashimoto’s flare-up?

So now that you know what a flare is, the big question is how do I get out of it? And here we go back to the beginning. If you’ve downloaded the Hashimotos 101 guide, flip to the page where it says day one, do those things again, or look to that next page where it says getting started and it tells you the biggest goals of Hashimotos how you want to work on getting well.

It can be frustrating to feel like you’re going back to the beginning. Perhaps you feel like you’ve made so much progress you’ve put so much work into this and it’s just crushing to feel like you have to go back to the beginning but you’ve learned so much. And you have realized different things that work for you and for your body. So maybe you quit doing some of those things. You kind of fell off the bandwagon and you quit doing them.

Evaluating lifestyle changes

Maybe you were spending a 10 minutes a day in silence breathing. Just focusing on the present moment and you kind of quit doing that. Or maybe you’re feeling really well. And so You increased your exercise and You increased your high-intensity exercise, which added a stressor to your body. Well, maybe it’s time to cut back on that. You are the CEO of your own health. So you get to look at that and say, Oh, when I was doing these things, I felt better.

When you haven’t changed what you’re doing

But perhaps this flare, there’s nothing specific that you can point to and say this is what I’m doing different and this is what I need to change. So then look back at that Hashimotos 101 guide and look at those getting started. What are your first priorities and go back to those and work through them again.

Back to the beginning, but not starting over

It’s okay. You have made progress even though you feel like you’re having a flare and that maybe everything is back to day one. But it’s not. You have made so much progress over your journey. And that’s going to make this next step easier.

Work through this Hashimoto’s flare-up with a coach

And of course I am always here for you. I have Hashimoto’s health sessions available if you feel like “oh I need some clarity on this next step. I have no idea what’s going on in this flare. I don’t know what to do. I don’t know how to get out of it.” Well book a coaching call with me and we can talk through it together. I can listen to your story. And a lot of times women figure it out as they’re talking to me like oh, that’s what I’m doing differently. Sometimes you just need an impartial listener to help you sort through what you’re saying.

Listening without judgement

In fact, this is what one coaching client said. She said:

The best thing about working with Esther was having someone else to hear what I’m saying—listening without judgement or thinking about what tests or medications.

I love that testimonial because I’m not your doctor. I’m not going to prescribe. I’m going to listen I’m going to educate you. I’m going to empower you.

Nurses help you implement

That’s what nurses do. We listen we teach, we empower, we help you figure out how to apply your ideal next step to your actual life. How do you make this work for you for your situation? Nurses excel at that. Doctors are really good at giving you medications and giving you a path forward. Nurses are really good about helping you make it practical to your own life so that it matters.

Making it through today

So that leaves us today when you might be experiencing a “flare.” How do you make it through today? How do you make it through tomorrow? But first, let’s just focus on today. Let’s just focus on maybe this hour, maybe this 10 minutes? How are you going to make it through?

First Rest

Number one, prioritize rest. When you are having a flare of any type, regardless of what’s causing it, your increased symptoms mean that you need to take a step back. When I say take a step back, I mean take a step back in your work in doing, going, and stress.

Prioritize rest during sleep that’s when your body heals and restores so maybe rest for you looks like you need to add on an hour or two of sleep or maybe more tonight and maybe the next couple of nights increase that sleep so your body has a chance to heal.

Maybe it means that for the next days or weeks, you take 10 minutes two or three times a day and you just sit you’re just letting yourself be I read a book a couple years ago called True You by Michelle DeRusha and it is great. It’s about a pruning process. And she just sat on the same park bench every single day for 10 minutes and just observed nature and it was such a healing process for her. Maybe you need something like that to just sit and be for 10 minutes a day. Maybe 10 minutes, two times a day. Maybe instead of going for exercise today. Maybe you need to take a nap.

Prioritize rest because wherever your breakdown was in your group Goldberg Machine of your thyroid, you want to make sure that by the time it gets to the end, and your cells are supposed to convert that inactive T4 to the active form, you want to make sure that it is being converted to T3 and not reverse T3 which is the brake system. You want to make sure that your body is in a spot where it’s healthy enough to say yes, let’s activate my cells, let’s turn on the metabolism. Let’s get up and going and to get up and going. Sometimes we need to rest first. So in getting through today, you’re getting through this week with a flare, prioritize rest.


The next thing to do today this week while you’re going through this flare is look at your diet. Reduce processed foods as much as possible. Reduce the inflammatory foods. It’s easy to say “processed foods.” When I say processed foods, you probably immediately have a little visual of your home pantry or your refrigerator and you know what’s processed and what’s not. If I say “inflammatory foods” that might not bring up quite a clear picture in your mind.

Inflammatory foods are usually processed. Inflammatory foods can also include things like gluten, sugar, dairy, and soy. And I talked to you about that in episode 11. If you want to go back and listen to that one I explain why those particular foods and some tips on how to cut them out of your diet because saying cut it out, doesn’t necessarily make it easy to actually cut them out. Because then you’re left with well what do I eat instead? of questions like that, so you can go back to episode 11 If you feel like yeah, I have a lot of inflammatory and processed foods in my diet, cutting those out and filling those spaces with an abundance of vegetables and healthy proteins. That’s key when you’re healing. You need to give your body all the vegetable micronutrients that you can and make sure you’re getting enough protein and healthy fats.


So look at rest. Look at how you can address your diet. And then number three and getting through this flare getting through today. Well Did your own triggers. If you looked at your triggers after you downloaded that Hashimotos 101 guide you probably felt like oh, it’s this particular trigger or these triggers are definitely on my list. Some people can look at it and like they’ll just know “that was it for me.” And some people you might not know. But if you know, then work on those triggers again evaluate “are those triggers an issue again?”

Viruses as triggers

Maybe it was something like a virus and that triggered you into developing an autoimmune condition? Well, some viruses lay dormant in our lives, in our bodies, and when things get bad, like stress, those viruses can come back out to antagonize us again. Some viruses, you get it and then it’s gone. So maybe you’re having a flare because your body is fighting a cold virus. Or maybe you are having a flare because the stressors have increased and that dormant virus is now activating again. Either way, you’re ready to go back to rest. When your body is at rest and when you are in the parasympathetic or the rest and digest side of your nervous system. That’s when your body can prioritize healing and restoring and renewing the things that were broken.

So prioritize rest and make sure you’re getting all of the micronutrients. Like I said, increase your veggies so that you’re getting all of those if you’re not getting all of the micronutrients that you need, which, if you’re average, you’re not getting. Then make sure that you’re looking at your supplements and your activators and make sure that you are getting what you need. If you can’t get it through your diet, then that’s where supplementation comes in.

You can look at the supplements that I use personally [down below.] You can see everything that I use. And of course, if I’m going to use it, you can be absolutely positively sure that I have researched the quality and the ethics and that I stand by these products.


So if you are experiencing a flare, now you know what it is. It’s feeling worse when you were starting to feel better. How do you get out of it? You have to go back to the beginning and look at well what worked in the first place and take steps, maybe the same steps that you did in the beginning. You get to do those again. And then prioritize rest. Look at your diet and look at your triggers and reduce the triggers where you can and most of all, give yourself grace.

You’re not a robot; give yourself grace

You’re not a machine you’re not a robot. You’re a human being. And that means that every day is a little bit different. And it means that we get to adapt to what’s going on. Robots and machines don’t necessarily have different needs, but you’re a whole person; you are a body, a mind, a soul. You exist within it in an environment and the foods that you eat impact everything. All of those five things body, mind, spirit, diet, environment, you can’t separate one from the other.

I know that in our culture we like to be all fractionated and think that just one specialty matters. Like when you go to a doctor. Maybe it’s a GI doctor and they’re just looking at your gut. It doesn’t work that way in your life. You are a whole person. You’re not a robot. You’re not a machine. Give yourself grace. Because there’s a lot to balance. And I know that you’re doing the best that you can in this moment. Keep going. You can do it. You can get through today. You can get through this week. You can do this.

Images used in this post include those from Anthony Tran on Unsplash

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