Hypothyroidism — particularly when caused by autoimmune Hashimoto thyroiditis — commonly brings fatigue, brain fog, weight changes and persistent low energy even when thyroid hormone numbers are corrected with levothyroxine. Emerging research suggests photobiomodulation (PBM), often called red light or low-level laser therapy, may help by acting on cellular energy, inflammation and local immune processes in the thyroid gland. Below I explain the likely biology, summarise the clinical evidence to date, discuss realistic expectations, and point to a practical at-home device option.
How PBM (red/near-infrared light) works — the biological rationale
Photobiomodulation delivers red and near-infrared photons (typically 600–1000 nm) into tissue where key mitochondrial enzymes — most notably cytochrome c oxidase — absorb that light. That absorption can:
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Increase mitochondrial ATP production and transiently modulate reactive oxygen species (ROS), which then trigger beneficial cell signalling.
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Reduce pro-inflammatory signalling and oxidative stress, and encourage tissue repair pathways.
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Improve local microcirculation and nitric oxide dynamics, which supports cellular metabolism and immune regulation.
These mechanisms are now well described in preclinical and review literature as the core ways PBM alters cellular behaviour across many tissues.
Why this matters for the thyroid: the gland is metabolically active and sensitive to oxidative stress and autoimmune inflammation. By improving cell energy, reducing local oxidative stress and dampening inflammatory signalling, PBM may help restore more normal thyroid tissue function and reduce symptoms driven by tissue-level dysfunction (not just circulating hormone levels).
What clinical studies show (brief summary, evidence level)
Clinical data are preliminary but promising:
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A feasibility clinical trial in patients with Hashimoto thyroiditis found that a protocol of PBM (820 nm, specific dosimetry) combined with micronutrient supplementation produced greater improvements in biochemical and clinical markers (including TSH reduction, lower anti-TPO and anti-TG antibodies, reduced levothyroxine dose requirements and modest anthropometric improvements) compared with supplements alone during follow-up. The authors concluded PBM showed efficacy in restoring aspects of thyroid homeostasis and called for larger, longer trials. PubMed
Takeaway: early clinical evidence in autoimmune hypothyroidism (Hashimoto’s) is encouraging but not definitive — larger randomised trials with longer follow-up are required before PBM becomes standard of care.
Can PBM reduce fatigue in hypothyroidism?
Fatigue in hypothyroidism has multiple drivers: low hormone action, persistent autoimmunity, mitochondrial dysfunction, sleep disturbance and lifestyle factors. PBM targets several plausible contributors:
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By boosting cellular ATP production, PBM can improve the energy handling of local tissue and potentially systemic metabolic resilience.
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By lowering local inflammation/autoimmunity markers (as suggested in the Hashimoto trial), PBM might reduce a chronic inflammatory burden that contributes to fatigue.
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PBM’s benefits on microcirculation and nerve function can also help subjective wellbeing and recovery capacity.
In practice, some patients in pilot studies report improved energy and quality of life after PBM-augmented protocols, particularly when PBM is used alongside optimised thyroid medication, micronutrient repletion (e.g. vitamin D, selenium where indicated) and lifestyle measures. However, not everyone will experience the same benefit; individual response varies.
Realistic expectations and safety
Steel-manning the sceptic: it’s reasonable to be cautious — hypothyroidism is a complex endocrine condition and a single modality is unlikely to completely replace hormone replacement in typical practice. Many experts advise PBM as an adjunct rather than a standalone replacement for levothyroxine, especially when biochemical hypothyroidism is present.
That said, feel–felt–found framing helps explain why patients try PBM: people often feel frustrated after trying standard approaches for persistent symptoms; others felt sceptical about red light until they tried a course and found measurable improvements in energy, reduced antibody titres or reduced medication dose when PBM was part of a combined plan in clinical studies. The most responsible approach is to consider PBM as an adjunct under medical supervision, with realistic goals (symptom improvement, potential reduction in inflammatory markers, possible small adjustments in medication under medical guidance). PubMed
Safety notes: PBM is generally well tolerated when administered at appropriate dosimetry. Local transient warmth or mild erythema can occur. Avoid direct ocular exposure and follow device instructions. Discuss any new therapy with your treating endocrinologist or GP before changing medication.
Practical options — home devices vs clinic treatment
Clinical devices deliver precise dosimetry and are used in specialist settings; however, high-quality home devices have become available that offer therapeutic wavelengths and power outputs suitable for regular use under guidance. If considering at-home PBM, choose devices from reputable suppliers with clear specifications and follow evidence-based protocols where possible. For Australians seeking a home option, see the Pulsed Low-Level Laser Therapy device.
Bottom line
Photobiomodulation (red/near-infrared light) offers a biologically plausible, low-risk adjunct for supporting thyroid tissue health and may reduce aspects of fatigue in people with autoimmune hypothyroidism. Early clinical trials — including a recent feasibility trial in Hashimoto’s — suggest benefits in reducing autoantibodies, improving biochemical markers and lowering levothyroxine dose requirements when PBM is combined with supplements and standard care. However, evidence is still evolving: PBM should be discussed with an endocrine clinician and used as part of a broader, personalised treatment plan rather than as an immediate replacement for prescribed thyroid hormone therapy.
References:
Berisha-Muharremi V, Tahirbegolli B, Phypers R, Hanna R. Efficacy of Combined Photobiomodulation Therapy with Supplements versus Supplements alone in Restoring Thyroid Gland Homeostasis in Hashimoto Thyroiditis: A Clinical Feasibility Parallel Trial with 6-Months Follow-Up. J Pers Med. 2023 Aug 19;13(8):1274. doi: 10.3390/jpm13081274. PMID: 37623524; PMCID: PMC10455109.
