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Ziva Health › Conditions › Thyroid Health

Your thyroid affects
everything. Isabella
helps you see it.

Whether you have Hashimoto's thyroiditis, hypothyroidism, or are managing thyroid levels after treatment - Ziva connects your daily symptoms, medication timing, nutrition, sleep, and lab results so you can finally understand why you feel the way you do.

For people living with Hashimoto's, hypothyroidism, and thyroid conditions - alongside their care team.

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🔒 HIPAA compliant 🧬 Lab result tracking ✦ Free to start
Isabella · Your thyroid health today
HRV ⌚
58ms
↑ from 38ms last week
Brain fog
Mild
improving
Medication
✓
taken · 6:52 AM
TSH trend — last 4 months
Oct
Nov
Dec
2.8
Jan
TSH 4.8 (high)TSH 2.8 ✓ in range
Isabella · Today's insight
"Your TSH has come down to 2.8 — well within your target range. Your recovery score — HRV and sleep from your Apple Watch — is the best it's been in three months, which tracks. You've taken your medication consistently this month, and that's the biggest reason for this improvement. Keep the same morning routine."
New to Ziva?

Ziva Health is an AI-powered health companion for managing chronic conditions. Isabella is Ziva's AI coach - she reads your daily symptom check-ins, tracks your lab results over time, monitors medication adherence, and shows you how sleep, nutrition, and stress are affecting how you feel with your thyroid condition.

How Ziva works for thyroid

Three steps to understanding why you feel the way you do.

📋
01
Daily wellness check-in
Tag symptoms as they happen - brain fog, cold sensitivity, fatigue, mood. Takes seconds. Isabella builds a picture of your symptom patterns over weeks and months.
⌚
02
Connect your wearables
Sync Apple Watch, Fitbit, Garmin, Oura Ring, and more. Sleep duration, resting heart rate, HRV, steps, and activity stream in automatically - no manual logging. Isabella uses this passive data to track lifestyle patterns your daily check-in can't capture.
💡
03
Labs, lifestyle, and coaching
Import TSH, Free T4, Free T3, and antibody results when you have them. Isabella layers your labs over wearable data, medication timing, and daily check-ins - and coaches you on exactly what's driving your symptoms and what to do about it.
20M+
Americans with thyroid disease - most underdiagnosed for years before treatment
Hashimoto's
Is the #1 cause of hypothyroidism in the US - an autoimmune condition, not just a hormone problem
Timing
Of thyroid medication matters enormously - missed or mistimed doses directly affect TSH and symptoms
Daily
Isabella check-ins track symptom patterns and connect them to labs, medication, food, and sleep
What Isabella tracks

Four things shape
how your thyroid functions day to day.

Your TSH lab result is taken once every 3–6 months. Isabella tracks everything in between - the daily habits that either support your thyroid or quietly work against it. Over time, the pattern becomes clear.

💊
Medication timing
Thyroid medication must be taken on an empty stomach, 30–60 minutes before food, and away from calcium, iron, and coffee. Consistent timing is more important than any other lifestyle factor.
🥗
Nutrition
Soy, large amounts of raw cruciferous vegetables, and certain supplements can affect thyroid hormone levels or medication absorption. Selenium supports T4→T3 conversion. Isabella coaches your specific needs.
😴
Sleep
Hypothyroidism commonly disrupts sleep architecture - making fatigue worse despite hours in bed. Poor sleep also raises cortisol, which suppresses the conversion of T4 to active T3. Isabella tracks the pattern.
😤
Stress
Chronic stress elevates cortisol, which actively interferes with T4-to-T3 conversion - the step that produces the hormone your cells actually use. High-stress weeks often correlate with worse symptoms even when TSH looks normal.
Isabella · What drove your symptoms this month
Missed medication (3 mornings)Fatigue spike week 2
High-stress week (work deadline)Brain fog scores ↑
Consistent 7h+ sleep (week 4)Recovery score ↑ best week
Selenium-rich diet (month-long)T3 improved on labs
Isabella · Monthly summary
"Your worst week was week 2 — three missed morning doses correlated with your highest fatigue scores of the month. Week 4 was your best: 7+ hours of sleep every night, medication on time daily. The pattern is clear. Consistent mornings are the single biggest lever you have."
Daily wellness check-ins

Thirty seconds a day.
A symptom picture your doctor can't get any other way.

Thyroid symptoms are subjective, variable, and hard to describe in a 10-minute appointment. A daily check-in solves this. Over weeks and months, Isabella builds a precise picture of your symptom patterns - connected to your medication, labs, sleep, and stress - so you stop arriving at appointments saying "I just feel off" and start arriving with data.

✓Recovery score (from your wearable) — HRV, sleep quality, and resting heart rate combined, charted weekly, correlated with labs
✓Brain fog tags — tap to log when you feel it. Timestamped and counted, then correlated with your labs and medication timing
✓Mood and emotional wellbeing — hypothyroidism commonly causes depression and anxiety; this is tracked separately
✓Physical symptoms — cold sensitivity, joint stiffness, hair texture changes, constipation, puffiness (weekly log)
✓Body temperature — from your Apple Watch or Oura skin temperature sensor, or log manually. Low basal temperature is a classic hypothyroid signal.
✓30-day wellness report — compiled automatically for your next appointment with your provider
Isabella · Wellness log — this week
M
T
W
T
7
F
Sa
Su
Recovery score (HRV + sleep · Apple Watch) · Mon/Tue lower after weekend stress · improving mid-week
Brain fog tags
2 this week
↓ from 4 last week
Cold sensitivity
Mild — ongoing
stable
Mood
Good — 4.2/5
best in 2 months
Body temp avg
97.6°F
↑ from 97.1°F last month
Isabella · Week review
"Your best week in months. Brain fog down to 2 days, mood scores highest since October, body temperature creeping up toward normal. This follows your lab improvement and consistent medication. Your provider will want to see this trend."
Symptom vs TSH correlation — 4 months
Oct — TSH 4.8Avg HRV 32ms
Nov — TSH 3.6Avg HRV 44ms
Dec — TSH 3.1Avg HRV 52ms
Jan — TSH 2.8Avg HRV 58ms ✓
Isabella · Lab results — last 12 months
TSH (target: 0.5–2.5 mIU/L)
In range
Feb
Apr
Jun
Aug
Oct
2.8
Jan
Free T4
1.18
ng/dL · in range ✓
Free T3
3.1
pg/mL · in range ✓
Isabella · Lab insight
"Your TSH is at 2.8 — within your personalised target of 0.5–2.5, and the best it's been in over a year. Free T4 and T3 both look good. Your symptom scores this month match the labs: energy up, brain fog down, mood improved. Next draw is in 10 weeks — I'll remind you."
Lab result tracking

A number every 3 months
finally means something in context.

Your TSH result is one number from one moment. Without context - what you ate the day before, whether you took your medication at the right time, how stressed you'd been - it tells your doctor very little. Isabella provides that context. Every lab result is layered over your symptom logs, medication history, sleep, and nutrition so you and your provider can finally see the full picture.

✓TSH, Free T4, Free T3 tracked over time — trend matters more than any single result
✓Antibody levels (TPO, TgAb) tracked for Hashimoto's — correlated with flare periods
✓Lab-to-symptom correlation — Isabella shows you how you felt in the weeks before each result
✓Next test reminder — Isabella alerts you when your draw is due based on your provider's schedule
✓Pre-appointment report — 30-day symptom summary, lab trend, medication adherence, and Isabella's notes, ready for your doctor
Why T3 matters alongside TSH
Some people convert T4 to active T3 less efficiently - meaning TSH can look normal while symptoms persist. Tracking Free T3 alongside TSH gives a more complete picture. Isabella flags when your T3 is low relative to T4 and suggests discussing this with your provider.
Medication adherence

Timing is everything
with thyroid medication.

Thyroid medication is highly sensitive to timing. It must be taken on an empty stomach, 30–60 minutes before food or coffee, and well away from calcium, iron, and certain other supplements. Inconsistent timing - not just missed doses - directly affects your TSH and how you feel. Isabella tracks every dose, reminds you at the right moment, and flags when timing patterns are affecting your readings.

✓ Take with
Water only · Empty stomach · Same time each day · At least 30 min before eating
✗ Avoid within 4h
Calcium · Iron supplements · Soy · Antacids · High-fibre supplements · Coffee
✓Morning reminder at your set time — with a 30-minute countdown before breakfast is cleared
✓Dose logged and timestamped — so your provider sees exact timing alongside your labs
✓Supplement timing warnings — Isabella flags if you've logged calcium or iron too close to your dose
✓Monthly adherence report — percentage on-time doses correlated with your TSH result
Isabella · Medication — this month
Monthly adherence
91%
27 of 30 days on time · 3 missed or late
This week — timing log
Monday · 6:48 AMOn time ✓
Tuesday · 6:52 AMOn time ✓
Wednesday · 8:31 AMLate · with breakfast
Thursday · 6:55 AMOn time ✓
Friday · 6:50 AMOn time ✓
Isabella · Timing note
"Wednesday's dose was taken with breakfast — food in your stomach significantly reduces absorption. This happens occasionally and one day won't affect your TSH much, but a pattern of it does. Try leaving your medication next to a glass of water the night before so it's the first thing you see."
Isabella · Nutrition — thyroid focus
Selenium-rich this week
Brazil nuts (×2), sardines, eggs - selenium supports the conversion of T4 to active T3. You're hitting your target. Isabella: keep this going, it's showing in your Free T3 result.
Goitrogen note — Tuesday
Large raw kale salad logged. Isabella: cooking cruciferous vegetables significantly reduces their goitrogenic effect. Steaming or sautéing is fine - raw in large amounts is worth limiting.
Soy — logged Wednesday
Soy milk in your smoothie. Isabella: soy doesn't need to be avoided entirely, but if consumed close to your medication window it can reduce absorption significantly. 4h gap is sufficient.
Isabella · Nutrition insight
"Your selenium intake has been consistent this month — two Brazil nuts daily covers most of your needs without overcorrecting. Your iodine looks fine from your diet; no supplement needed. The main thing to watch is the soy and calcium timing relative to your morning dose."
Nutrition coaching

Some foods support
thyroid function. Some work against it.

Thyroid nutrition is nuanced and often misunderstood online. Isabella cuts through generic advice and gives you specific, evidence-based guidance for your condition - including what to eat more of, what to time carefully, and what the research actually says about Hashimoto's and gluten.

✓
Selenium
Critical for converting T4 to active T3. Sources: Brazil nuts (1–2 daily), sardines, eggs, sunflower seeds. Isabella tracks weekly intake.
~
Goitrogens (cruciferous veg, soy)
Fine when cooked. Large amounts of raw cruciferous veg or soy close to your medication window can interfere. Isabella flags timing, not elimination.
~
Gluten (for Hashimoto's)
Some evidence links non-coeliac gluten sensitivity with Hashimoto's flares. Isabella tracks your gluten intake alongside antibody levels so you can see whether it's relevant for you specifically.
✓
Iodine (balanced)
Both excess and deficiency are problematic for thyroid function. Most people get adequate iodine from diet. Isabella flags if supplementation levels look excessive.
Wearable connectivity

Passive signals that show
what symptoms alone can't tell you.

Connect your wearable and Isabella starts reading signals you'd never think to log manually - resting heart rate trending down as your TSH improves, HRV dropping before a flare, weight shifting with fluid retention. These passive signals reveal what's happening with your thyroid in between lab draws and daily check-ins.

✓Sleep duration & stages — deep, REM, light, and awake time tracked nightly. Poor sleep raises cortisol, suppressing T4→T3 conversion; Isabella surfaces the pattern.
✓Resting heart rate — hypothyroidism commonly slows heart rate. As TSH normalises, RHR trends upward toward a healthy baseline. Isabella tracks this change over weeks.
✓Heart rate variability (HRV) — a sensitive marker of stress, inflammation, and recovery. HRV drops are often visible days before a symptom flare, giving Isabella early warning.
✓Respiratory rate — baseline nightly monitoring; hypothyroidism can affect breathing depth and airway muscle tone during sleep.
✓Blood pressure — hypothyroidism affects vascular tone; daily BP readings let Isabella track trends that a quarterly lab visit can't capture.
✓Weight — fluid retention is a hallmark hypothyroid symptom. Daily weight trends (not single readings) show whether swelling is resolving as levels improve.
✓Blood oxygen (SpO2) — overnight dips can indicate sleep-disordered breathing, which is more common in people with hypothyroidism. Isabella flags persistent low readings.
✓Steps & activity — Isabella correlates your daily step count with your energy score to validate fatigue patterns and track how your activity changes as treatment improves.
Works with Apple Health, Google Fit, Garmin, Fitbit, Withings, Oura, and more
Sync once and Isabella reads your signals automatically - no manual entry required. Your wearable data is layered alongside your symptom check-ins, medication logs, and lab results to give Isabella - and your provider - the full picture.
Isabella · Wearable signals — today
Sleep last night
7h 22m
Awake · 8% Deep · 24% REM · 34% Light · 34%
Resting HR
58 bpm
↓ from 64 last month
HRV
42 ms
↑ from 31 last month
Respiratory rate
14 br/min
normal range
Blood oxygen
97 %
overnight avg · normal
Blood pressure
115/72
in range ✓
Weight
142.4 lbs
↓ 1.2 lbs this week
Steps today
6,840
matches energy 6/10
Isabella · Wearable insight
"Your resting heart rate has dropped from 64 to 58 bpm over the past month — this closely mirrors your TSH coming down from 4.8 to 2.8. HRV is up from 31 to 42ms, your nervous system is less stressed. Weight is down 1.2 lbs this week — that's fluid, not fat, and it's a reliable sign your thyroid levels are normalising."
Daily routine

A thyroid routine that protects
your mornings above everything else.

With thyroid conditions, the morning window is critical. Everything else in the day follows from how that first hour goes. Isabella builds a consistent routine around it - and adapts the rest of the day to your energy levels, which vary more with thyroid conditions than almost any other chronic illness.

Your thyroid daily routine
Thyroid focus
6:45 AM
💊
Medication — first thing, before anything else
Water only, empty stomach. Isabella reminds you and logs the time. Place your medication next to your glass of water the night before - this one habit improves adherence more than anything else.
7:30 AM
🥗
Breakfast — after the 30-minute wait
Isabella clears breakfast after your medication window closes. A protein-rich breakfast supports stable energy. If you take calcium or iron, log it here - Isabella checks the timing gap from your dose.
8:00 AM
📋
Morning wellness check-in
30 seconds: energy level, brain fog, mood. Isabella logs it, spots the week's trend, and flags if your scores are dropping ahead of your next lab draw.
Midday
🚶
Gentle activity — energy-matched
Isabella coaches activity to your current energy score. High energy days: longer walks, light gym. Fatigue days: a 10-minute walk is enough and still supports sleep quality and mood.
Evening
🍽️
Dinner — selenium-aware
Isabella tracks selenium-rich foods across your day. Two Brazil nuts, some sardines, or eggs a few times a week supports your T4→T3 conversion without overdoing it.
9:00 PM
😴
Sleep — prioritised, not optional
Sleep deprivation raises cortisol, which suppresses T3 conversion. Isabella tracks your sleep quality and correlates it with your next-day symptom scores and body temperature - making the connection personal, not theoretical.
Hashimoto's is an autoimmune disease. The thyroid is the target - not the cause.
With Hashimoto's, the immune system attacks the thyroid gland, gradually reducing its ability to produce hormones. This means inflammation management - through sleep, stress reduction, and potentially diet - matters alongside hormone replacement. Isabella tracks both dimensions.
What consistent tracking achieves
Medication adherence impact on TSHDirect & measurable
Symptom-to-lab correlationVisible within months
Lab frequency with Hashimoto'sEvery 6–12 months stable
Selenium's T3 conversion roleWell established
Based on published clinical evidence. Results vary individually.
The evidence

Why daily tracking changes thyroid outcomes.

Thyroid management is typically reactive - quarterly labs and an annual appointment. Continuous symptom tracking and habit correlation changes this entirely.

60%
Of people with thyroid disease are undiagnosed
The American Thyroid Association estimates 60% of those with thyroid disease are unaware of their condition. Even among diagnosed patients, symptom burden remains high due to suboptimal treatment, missed doses, and lifestyle factors that aren't monitored between appointments.
Adherence
Is the #1 modifiable driver of TSH control
Studies consistently show that inconsistent thyroid medication timing - not just missed doses - is the primary reason TSH remains out of range despite optimal dosing. Tracking and educating patients on timing has been shown to significantly improve lab stability and symptom scores.
Selenium
Reduces TPO antibodies in Hashimoto's
Multiple randomised controlled trials have shown selenium supplementation (or adequate dietary intake) reduces thyroid peroxidase (TPO) antibody levels in Hashimoto's patients - the marker of immune activity targeting the thyroid. Isabella tracks selenium intake daily as part of nutrition coaching.
Work with your care team

Your endocrinologist
should see what Isabella sees.

Whether your doctor or endocrinologist already uses Ziva or is hearing about it for the first time - there are two things you can do right now.

Care team not on Ziva yet?
Send them a link. When your provider joins Ziva, they see your symptom trends, lab history, medication adherence, and wellness logs - and can update your targets and coaching goals remotely between appointments.
Refer Ziva to my care team
Already seeing your provider?
Bring your Ziva 30-day report - symptom scores, lab trend, medication adherence, nutrition, and sleep data. Your doctor can review it in 2 minutes and make more informed decisions about your dosage and plan.
Bring my data to my appointment →
Ziva Provider Report
30-day thyroid summary · Generated by Isabella
PDF ready
TSH (latest)
2.8
↓ from 4.8 in October
Avg energy score
6.4/10
↑ from 3.8 in October
Medication adherence 91% ✓ Good
Brain fog days this month 8 days ↓ from 18
Avg sleep duration 7.1h ✓
Body temperature avg 97.6°F ↑ improving
Isabella · Summary for provider
"Strong improvement since October. TSH down from 4.8 to 2.8, energy scores up significantly, brain fog days halved. Medication adherence 91% - 3 late doses, including one taken with food (Wednesday). Sleep has improved to 7.1h average. Cold sensitivity persists but trending better. Consider reviewing dose at next appointment given sustained improvement in symptoms."
Understanding your condition

Hashimoto's vs hypothyroidism - what's the difference?

Hashimoto's thyroiditis is an autoimmune disease - one of the most common autoimmune conditions in the world. The immune system mistakenly produces antibodies that attack the thyroid gland, causing chronic inflammation. Over time, this damage reduces the thyroid's ability to produce hormones. Hashimoto's is the leading cause of hypothyroidism in the United States, accounting for the majority of cases.

Hypothyroidism means the thyroid gland produces insufficient thyroid hormone (T4 and T3). It can be caused by Hashimoto's (most commonly), thyroid removal or damage from radioactive iodine treatment, certain medications, iodine deficiency, or, rarely, a problem with the pituitary gland. Both conditions result in the same experience: too little thyroid hormone, and the wide-ranging symptoms that follow.

What hypothyroidism actually does

Thyroid hormones regulate metabolism - how fast your cells work, how much energy they use, how warm you stay, how quickly your heart beats and digestion moves. Too little thyroid hormone slows everything down. This is why hypothyroidism affects so many systems simultaneously and why the symptom list is so varied.

Common symptoms
  • →Persistent fatigue, even after sleep
  • →Brain fog and difficulty concentrating
  • →Weight gain or difficulty losing weight
  • →Cold sensitivity
  • →Hair thinning or loss
  • →Low mood, depression, or anxiety
  • →Constipation and slow digestion
  • →Puffy face, hands, and feet
Hashimoto's-specific
  • →Elevated TPO or TgAb antibodies on labs
  • →Neck tenderness or goitre in some cases
  • →Fluctuating symptoms — flares and remissions
  • →Joint pain and muscle aches
  • →Possible gluten sensitivity connection
  • →Higher risk of other autoimmune conditions

Managing thyroid conditions day to day

  • →Medication adherence and timing — the most impactful daily habit; consistency of timing matters as much as consistency of dose
  • →Regular lab monitoring — TSH, Free T4, Free T3 every 6–12 months when stable, more often when adjusting dosage
  • →Symptom tracking — because TSH doesn't tell the whole story; daily logs give you and your provider data between blood draws
  • →Sleep and stress management — both directly affect cortisol, which suppresses T3 conversion and worsens symptoms
  • →Nutrition — selenium, timing, and food-drug interactions — evidence-based dietary support for thyroid function and antibody reduction
How Ziva supports thyroid patients
Isabella monitors your symptoms, medication timing, lab trends, nutrition, sleep, and stress - connecting everything so you understand not just what your TSH is, but why you feel the way you do and what to do about it. And so your provider sees a complete picture before every appointment.
On this page
Key daily habits
Medication before everything · 30-min food gap · Selenium in your diet · Sleep 7–9h · Stress check-in · Morning symptom log - these five habits, tracked daily, change your TSH and how you feel.
Common questions

What people ask.

Ziva Health is a wellness and health-coaching app. It is not a medical device and does not diagnose, treat, or prescribe. All content is for informational purposes only. Always consult a qualified healthcare professional - including your endocrinologist or GP - for medical decisions about your thyroid condition and medication.

Isabella AI

Track your thyroid.
Isabella connects your symptoms,
labs, and daily habits.

Daily wellness check-ins, medication timing, lab tracking, nutrition, and sleep - all connected. Isabella shows you why you feel the way you do, and what to do about it.

Free to start · HIPAA compliant · For Hashimoto's and hypothyroidism

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