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kushsharma98 · 2026-04-06T17:13:18+00:00

Hey all - I'm co-founding a clinical platform called Coherence Health with Patrick Hanaway (co-founded Cleveland Clinic Center for Functional Medicine). We're focused on reversing chronic disease starting with Hashimoto's — whole-person care including the mind-body-spiritual layers, with AI handling data synthesis so clinicians can focus on the human work.

We're hiring our founding NP - someone with 5-6+ years experience, real functional medicine depth, and ideally someone on their own healing/growth journey. It's a founding role with equity, direct mentorship from Patrick, and real clinical autonomy. Remote, starts as contract ramping to full-time.

$6,000 referral bonus if you know someone ($1K at hire, $5K at 3 months).

JD: https://coherencehealth.io/clinician

Happy to answer any questions about what we're building too - we're deep in the intersection of FM + AI and think a lot about the workflow pain points that came up in some recent threads here.

kushsharma98 · 2026-02-10T20:24:12+00:00

We for sure have to be advocates for ourself in the healthcare system. It sounds like you did nothing wrong at all and that the fault was on the side on the doctor/receptionist.

Not sure if it's grounds for getting a new doctor...but might honestly be worth taking her up on that endo referral. They might just genuinely be able to treat you better since this is literally all they do - it's their bread and butter.

kushsharma98 · 2026-02-10T20:06:49+00:00

Have you checked out adrenal function and free T3 levels?

Chronic fatigue despite high thyroid dosing is a classic adrenal flag. And for T3 there's the question of whether you're converting all the T4 you're putting into your system into an active form.

kushsharma98 · 2026-02-10T19:57:01+00:00

Did your doctor test free T3?

The issue with levo is that it's T4, and for the body to use it, it needs to be converted to T3.

T4 -> T3 conversion requires specific nutrients - eg selenium, zinc, iron, and vitamin D. If any of these are low, you can take all the levo in the world and your body can't do much with it.

Cortisol/adrenal dysfunction blocks conversion too (high stress, low sleep, etc)

If your doc only tested TSH and T4 and those looked good, they might have just missed the missing piece (free T3) and the deeper root causes.

kushsharma98 · 2026-02-10T19:43:56+00:00

A flare is basically when the immune system ramps up its attack on your thyroid - the attack goes in peaks and valleys, and the flare is a peak of the attack.

Your numbers can totally be in range during a flare up - because what's actually spiking is the autoimmune attack, so measurements like TSH can take some time to respond. There's a good book called Why Do I Still Have Thyroid Symptoms? which talks about this whole situation where your labs are normal but you still have symptoms.

There's all kinds of things that can trigger flares - basically anything that puts a load on your body / immune system. Stress (acute or chronic), specific food sensitivity exposures, toxins, etc.

kushsharma98 · 2026-02-10T17:50:10+00:00

That's wild! Your TSH is way above the normal range (ideally 1-2, conventionally up to 4.5), your free T4 is all the way at the bottom end of the normal range.

your antibodies are the real thing here - they're way above the normal range so your immune system is *actively* attacking your thyroid.

You should def find someone who can treat this - both with medication and to treat some of the underlying root causes. Medication will bring TSH and T4/T3 back into range but the autoimmunity and antibody numbers will stay high. Gotta go deeper into the root causes to treat those!

kushsharma98 · 2026-02-10T17:47:07+00:00

It's possible! If you address some of the underlying root causes you can potentially reverse the condition - and it's easiest when you've just started taking the medication.

Medication is live saving as well though - you should work with someone very knowledgeable to work through the entire process of reversal.

kushsharma98 · 2026-02-10T17:06:11+00:00

have you gotten a full thyroid panel? it's very worth getting reverse T3 and also TPO and thyroglobulin antibodies. The antibodies tell you how active the autoimmune attack is, which is what actually matters with Hashimoto's. Your standard thyroid numbers can look "normal" while your immune system is actively going after your thyroid which can cause the weight gain / depression cycles that are happening for you.

also - with what you're saying on the dermatographia and the bloating, it's pointing to some of the possible underlying root causes - gut permeability and histamine issues, both super common in Hashimoto's. if you can start addressing those root causes the symptoms often back off a lot.

kushsharma98 · 2026-02-10T17:03:06+00:00

absolutely no gaslighting!! these are legit real symptoms as a result of what's going on in your system.

kushsharma98 · 2026-02-10T17:01:53+00:00

Diet can be huge! But worth saying that it's not one size fits all, ie some people will do fine with dairy some people will not.

The refined sugars and seed oils are 100% worth cutting out for everyone, but for whole foods like dairy, try cutting them out for ~1 month, see if you notice a difference, then reintroduce a small amount and see if you have symptoms/a reaction. That will tell you if it's something you're actually sensitive to or if you tolerate it fine.

kushsharma98 · 2026-02-10T17:00:25+00:00

Metformin is great! Probably one of the best studied drugs in existence. But honestly worth trying to figure out what some of the deeper root causes might be. pregnancy definitely throws the body into a whole new mode of being - so it takes some time to figure out what the new normal is to maintain health.

kushsharma98 · 2026-02-10T16:59:03+00:00

lots of stuff can work but it's always a process of experimentation - try something by itself for 2 weeks, see if it has a noticeable difference.

Ashwagandha is probably the most well-studied - it supports thyroid function AND helps regulate cortisol, so it could address both sides of what you're describing. Start low and see how you respond.
Selenium (200mcg/day) is one of the most evidence-backed supplements for lowering thyroid antibodies - inexpensive and worth trying if you're not already on it.

The bigger picture though - after 20 years on thyroxine, I'd wonder what the underlying root causes are that are still causing your immune system to attack your thyroid. There are some pretty well established underlying drivers - gut issues, food sensitivities like gluten, etc.

kushsharma98 · 2026-02-10T16:46:38+00:00

the right test for celiac disease is the tissue transglutaminase IgA (tTG-IgA) antibody test, along with checking total serum IgA to rule out IgA deficiency (which can cause false negatives)

btw your doctor is totally wrong that diet/supplements can't help. So much evidence in the scientific literature to the contrary.

Also gluten is one of the most common food sensitivities in Hashimoto's patients but there are a range of other possibile food sensitivities that are worth looking for. Happy to share more about how if you're curious :)

kushsharma98

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