Hi @R-S – how wonderful it is to hear that you’re finally progressing and in a much better place. It really warms my heart and I’m so happy for you!

I’m also glad to hear that your appetite is returning – this is the power of working on the nervous system! Just keep in mind that it remains your biggest priority as you begin to move “South”. 🙂

In terms of next step, the priority should be to support stomach acid, bile flow and enzymes (in that order) – the 3 main digestive players. Since you cannot do betaine HCL yet given the mild gastritis, the next options are digestive bitters which stimulate all three.

From the list you shared, I can see 3 different options for bitters:

-Iberogast, Digestive Bitters (Dr. Mercola) and Ginger Root Tincture. Given your sensitivities, beginning with single-ingredients makes more sense instead of multi-herb formulas to help isolate what’s bothering you if it doesn’t suit you.

Remember to only introduce 1 new supplement/food at a time, and give your body at least 3 days to adjust and notice any symptoms.

If all goes well with the ginger root tincture, you can decide if layering in additional enzymes is warranted to help break down food better. If it’s working, you’ll notice less fullness after meals, less bloating, gas, etc. If you’re taking too much, you’ll get loose stools. Keep these tips in mind. Taking enzymes mid-meal or 3/4 way through your meal can ensure that your body still produces it’s own enzymes.

Once that’s on board and you’re doing well, you can choose to bring on board more gut healing support (DGL / zinc carnosine) or selenium to support T4 to T3 conversion. It all depends on how you’re feeling. If your gut is still doing well, then start with selenium as that’s part of the “root cause” for lower stomach acid production given suboptimal thyroid function. If your gut feels like it needs some TLC, then you can go back to marshmallow root if that suited you better. You don’t need to do all of the gut healing therapies – these are all options. Stick to what feels best for you.

Once selenium has been brought in successfully for at least 2 weeks and you’re symptom-free, kelp can be added in by sprinkling it over food as you would salt. A little goes a long way.

As for aloe, you literally scoop out the gel and add it to a smoothie. It’s not as convenient as other therapies, so you can leave this one out if others are working.

Let me know if you have any other questions. You’re doing a great job!