Start with your experience.
Review your symptoms, when they began, previous diagnoses, treatments, and what has—or hasn’t—helped.
Conditions / Thyroid & Autoimmune Health
Hashimoto’s Doctor in New York City
Hashimoto’s.
Still not feeling like yourself?
You’ve tried treatment. You’ve had the bloodwork. But the fatigue, brain fog, or digestive symptoms keep coming back.
Let’s look deeper together. Dr. Raphael Kellman evaluates your thyroid, your symptoms, and the wider picture—including digestive health and the microbiome—to understand what deserves attention next.
In-person in New York City & telehealth consultations
Initial consultation $575. Private-pay visits. Some testing and labs may be covered by insurance. We provide billing codes for submission to your insurer.
Watch Dr. Kellman
Hashimoto’s and autoimmunity: let’s look deeper.
Watch Dr. Raphael Kellman discuss Hashimoto’s disease, autoimmunity, and the gut connection.
Explore the conversation, then bring your symptoms, previous results, and questions to a consultation.
Let’s Look Deeper Together →Understanding Hashimoto’s
There are two connected questions to ask.
How is your thyroid functioning—and what does the autoimmune finding mean for your care?
1. Your thyroid’s hormone output
Hashimoto’s can damage the thyroid and reduce its ability to produce hormone. TSH and free T4 help assess that function. When hypothyroidism develops, thyroid hormone replacement is an established treatment, with levothyroxine usually the first-line medication.
2. The autoimmune picture
Thyroid peroxidase (TPO) antibodies can support a diagnosis of autoimmune thyroid disease. Antibodies may be present before thyroid hormone levels become abnormal. Their presence, your current thyroid function, and how you feel need to be considered together.
An antibody result is part of the picture, rather than a score of how unwell you feel. Positive antibodies alone do not usually require thyroid medication when thyroid function is normal.
The Kellman approach
A closer look at the whole picture.
Choose tests with a purpose.
Interpret thyroid function tests in context. Consider antibody testing when it helps establish the diagnosis, and other tests when your history gives a reason.
Consider digestive health.
Explore relevant digestive symptoms, nutritional concerns, and factors that may affect medication absorption. Dr. Kellman’s microbiome perspective informs this broader assessment.
Build a plan from the findings.
Discuss thyroid treatment, nutrition, digestive care, and follow-up based on your needs. Supplements and changes to medication require individual consideration.
A lower antibody number alone does not establish recovery. Follow-up considers thyroid function, symptoms, and overall health; repeated antibody testing is not routinely needed for everyone.
The microbiome connection
Your gut, immune system, and thyroid belong in the same conversation.
In his thyroid ebook, Dr. Kellman explains why digestive health can be relevant to a more complete thyroid evaluation.
Digestion and nutrition
Digestion influences how you obtain nutrients. When symptoms or history suggest a problem, an evaluation may include nutritional adequacy, iron or B12 deficiency, or a digestive condition affecting absorption.
Immune regulation
The intestine participates in immune regulation, and researchers are studying the microbiome’s relationship with autoimmune thyroid disease. These findings support further investigation; they do not establish one microbial cause or a proven microbiome cure for Hashimoto’s.
Medication absorption
Gastrointestinal conditions and the way medicines or supplements are taken can affect thyroid medication absorption. When clinically indicated, reviewing these factors may help explain why treatment has been difficult to stabilize.
Thyroid and bowel function
Thyroid dysfunction can slow intestinal transit. Constipation and bloating may therefore belong in the thyroid discussion, while also deserving their own assessment. More than one contributor can be present.
When symptoms continue
Your results are information. Your experience matters too.
If you still feel tired, foggy, or unlike yourself, the next step is to review the full pattern: your symptoms over time, previous laboratory results, current treatment, and other explanations that fit your history.
That can include medication timing or absorption, anemia, nutrient deficiencies, sleep problems, or another condition. Looking beyond the thyroid can uncover a relevant contributor while taking your symptoms seriously.
As the ebook emphasizes, useful testing should clarify a decision. A larger panel is worthwhile when it helps answer a specific question about your care.
Prepare for a more useful consultation
Bring your history. Bring your questions.
Start with when you last felt well and what changed. Bring previous thyroid reports with dates and reference ranges, your medication and supplement list, and the treatments you have already tried.
You should leave with an explanation of what the findings support, what remains uncertain, and a next step that can be followed and reassessed.
Common questions
Questions you may be asking.
Can I have Hashimoto’s with normal thyroid hormone levels?
Yes. Thyroid antibodies can be present while thyroid function is normal. Treatment and monitoring depend on thyroid function, symptoms, and your circumstances; antibodies alone do not automatically mean you need thyroid medication.
Why am I still tired while taking thyroid medication?
Fatigue can have several causes. A clinician can review your thyroid results, dose and timing, possible absorption issues, and other contributors such as anemia or sleep problems. The next step depends on that assessment.
Can diet or supplements cure Hashimoto’s?
No diet or supplement has been established as a cure. Nutrition can support general health and address deficiencies. Supplements should be considered individually, including their risks and interactions, and should not replace prescribed thyroid treatment.
Do you offer in-person and telehealth consultations?
Both options are available. The office can confirm appointment arrangements and telehealth eligibility for your location.
What does the initial consultation cost?
The initial consultation is $575. Visits are private pay. Some testing and labs may be covered by insurance; we provide billing codes for submission to your insurer. Ask the office about additional costs before proceeding.
Your next step
Let’s look deeper together.
If you have Hashimoto’s and still don’t feel well, bring your questions, your history, and what you’ve already tried.
Book an In-Person or Telehealth Consultation →This page is educational and does not replace individual medical advice. Do not stop or change thyroid medication without your prescribing clinician.
Content adapted from The Thyroid Lab Lie: When the Limits of Testing Become the Limits of Your Care, Raphael Kellman, MD, Chapters 6–8. Further reading: American Thyroid Association: Hashimoto’s Thyroiditis · NIDDK: Hashimoto’s Disease