The short answer. Stem cells (MSCs) and exosomes are being studied for their potential to modulate the immune processes involved in autoimmune thyroid disease. Animal and laboratory studies, including one on Hashimoto’s patients’ own immune cells, are encouraging, but controlled clinical evidence in patients remains limited: no controlled trials in patients have yet been published. They have not been shown to restore functioning thyroid tissue once it has been lost, and they do not replace your thyroid medication. For the right patient, they can be considered as an addition to standard care, with blood tests to measure whether they helped.
What are Hashimoto’s and Graves’ disease?
Both are autoimmune thyroid diseases: the immune system turns against the thyroid gland. They simply push it in opposite directions.
In Hashimoto’s thyroiditis, immune cells gradually infiltrate and damage the thyroid, and antibodies against thyroid peroxidase (TPO) and thyroglobulin appear in the blood. Over time the gland produces less hormone. It is the most common autoimmune disease and the leading cause of an underactive thyroid where iodine intake is adequate.1
In Graves’ disease, antibodies switch on the TSH receptor, so the gland overproduces hormone. Some patients also develop thyroid eye disease, where tissue behind the eyes becomes inflamed and expands.2
Standard treatment manages the hormone level: levothyroxine for an underactive thyroid; antithyroid drugs, radioactive iodine or surgery for Graves’.1,2 Those treatments work well for hormone levels. What they do not do is change the autoimmune process itself. That gap is why so many patients ask about stem cells.
Stem-cell and exosome treatment for autoimmune thyroid disease remains investigational and should be considered only as an adjunct to established endocrinology care, not a replacement for it.
Can stem cells help Hashimoto’s thyroiditis?
The most direct evidence comes from animal work. In a 2020 study, rats with experimentally induced Hashimoto’s were given mesenchymal stem cells (MSCs). Compared with untreated animals, they had lower thyroid antibody levels, less damage and less immune-cell infiltration in the gland, and a shift in the immune balance: fewer inflammatory Th17 cells and more regulatory T cells (Tregs), the cells that keep the immune system in check.3
That balance between Th17 cells and Tregs is a central part of the problem in Hashimoto’s, which is why the finding matters. Reviews of the field describe MSCs as a promising option for thyroid autoimmunity for the same reason.4
What we do not yet have is published controlled trials in patients. Until those exist, nobody can honestly tell you what proportion of people improve, by how much, or for how long. The clinics that quote you a figure are not quoting a trial.
What stem cells cannot do in Hashimoto’s
- They have not been shown to restore clinically meaningful functioning thyroid tissue in patients once significant thyroid tissue has been lost. If you have established hypothyroidism, you will still need levothyroxine.
- They are not a cure. The aim is to calm the autoimmune activity, not to switch the disease off permanently.
- Regrowing a working thyroid from stem cells has been achieved in mice using a different cell type (pluripotent stem cells). It is not a treatment available to patients anywhere.5
Bring your results. If you have Hashimoto’s and are considering regenerative treatment, bring your last TSH, free T4, TPO antibody results and any thyroid ultrasound to your consultation. I will tell you honestly whether you are a reasonable candidate. WhatsApp +971 52 328 6185.
Can stem cells help Graves’ disease or thyroid eye disease?
The research here is earlier still. In mice with a Graves’-like eye disease, human placenta-derived MSCs reduced the fat expansion behind the eye and lowered inflammatory markers, with effects comparable to steroids. The same cells reduced fat formation in orbital tissue from patients when tested in the laboratory.6
Graves’ disease already has effective treatments, and uncontrolled hyperthyroidism needs to be managed first, not delayed while you explore other options. Regenerative treatment can only be considered once thyroid levels are controlled, and never as a replacement for antithyroid medication.
How would stem cells calm an autoimmune thyroid?
Stem cells do not travel to the thyroid and take over. When given by drip, most of the cells are held first in the lungs.7 Their effect comes mainly from what they release: signalling molecules that tell immune cells to calm down and damaged tissue to repair. This is called a paracrine effect, and it is why MSCs have been described as an “injury drugstore.”8
In autoimmune thyroid disease, the signal that matters most is the one that moves the immune system away from attack (Th17) and back towards tolerance (Tregs).3 That takes time. The cells need to settle and keep producing those signals, which is why changes are measured over months, not days.
Stem cells or exosomes: which is better for thyroid autoimmunity?
Exosomes are the small packets cells use to send those same signals, without the cells themselves. In the wider immune research, MSC exosomes also increase regulatory T cells and reduce Th17 cells.9 Research on them in thyroid disease specifically is at an early stage.9
The closest evidence to patients so far is a 2025 Italian laboratory (ex vivo) study. Researchers took immune cells from patients with Hashimoto’s, activated them in the laboratory, and treated them with exosomes from mesenchymal stem cells. The exosomes slowed the overactive T cells, and the higher dose roughly halved the proportion that were dividing. Regulatory T cells rose from about 4% to between 12% and 15%. Inflammatory signals, including IL-17, were switched down.10
Two limits matter. This happened in a dish, not in patients, so it does not show that exosome treatment helps people with Hashimoto’s. And the authors point out that there is still no standard way to isolate and store exosomes, which changes what they carry and how active they are.10 That is why the source and preparation of an exosome product matter as much as the word on the label.
In my clinical experience, some patients report earlier changes following exosome treatment, whereas responses following MSC treatment may develop more gradually. However, no head-to-head trial in autoimmune thyroid disease has established that exosomes act faster or that MSC effects last longer. This is therefore clinical observation rather than trial evidence.
Exosomes are a cell-free option for patients who prefer not to receive living cells. Patients who, after a full discussion, prefer cell-based treatment can consider MSCs.
Should I stop my thyroid medication?
No. Continue levothyroxine, antithyroid drugs or any other prescribed treatment exactly as before. Regenerative treatment is given alongside standard care, never instead of it. Any change to your medication is made by your endocrinologist, based on your blood tests, not on how you feel after a drip. I am happy to write to your endocrinologist so they know what you are having.
How would we know whether it helped?
Before treatment, we record a baseline. We then repeat the same tests at about three and six months:
- Thyroid function: TSH, free T4 and free T3.
- Antibodies: TPO and thyroglobulin antibodies for Hashimoto’s; TSH receptor antibodies (TRAb) for Graves’.
- Your medication dose, and whether it has needed to change.
- Symptoms such as fatigue, brain fog and cold intolerance, recorded the same way each time.
If nothing has moved by six months, I will tell you that rather than recommend another session.
Is it safe?
The largest safety review of MSCs given by drip pooled 55 randomised trials and 2,696 adult patients. The only side effect clearly more common than in control groups was a short-lived fever. The pooled analysis did not detect an increased rate of infection, thrombotic events or malignancy during the available follow-up.11 Those trials were in other conditions, not thyroid disease, but they are the best evidence available on the safety of the drip itself.
Safety also depends on the product. At our clinic, cells and exosomes are prepared by two established, regulated laboratories: one Italian, operating since 2009 and in Dubai since 2013, and one British, in Dubai since 2017. Every patient is screened and assessed before treatment.
Who should not have it
- Anyone with active cancer or a recent cancer history.
- Pregnancy, or actively trying to conceive.
- Active infection.
- Uncontrolled hyperthyroidism; Graves’ needs to be stabilised first.
Travelling from elsewhere in the Gulf? Send your recent thyroid results before you book and we can review them in advance, so your visit to Dubai is planned around a clear recommendation. WhatsApp +971 52 328 6185.
Frequently asked questions
Can stem cells cure Hashimoto’s?
No. They are being studied for their potential to calm the autoimmune activity, but they do not cure the disease, and they have not been shown to restore functioning thyroid tissue that has already been lost.
Can stem cells lower my TPO antibodies?
In animal studies, MSCs lowered thyroid antibody levels.3 Whether the same happens in patients has not yet been shown in controlled trials, which is why we measure your antibodies before and after.
Will I be able to stop levothyroxine?
Not if your thyroid has already lost the ability to make enough hormone. Any change in dose is made by your endocrinologist, based on your blood tests.
Exosomes or stem cells: which should I start with?
Exosomes are a cell-free option if you prefer not to receive living cells; MSCs are a cell-based option. In my clinical observation, some patients notice changes sooner after exosomes, while responses to MSCs may develop more gradually. This has not been demonstrated in comparative thyroid trials.
How soon would I notice a difference?
It varies. In my clinical observation, some patients report changes sooner after exosomes than after MSCs, but this has not been shown in comparative trials. For either, blood test changes are judged at three and six months, not within the first weeks.
Can I have it if I have Graves’ eye disease?
Research in thyroid eye disease is still in animal and laboratory studies.6 Active eye disease needs your ophthalmologist and endocrinologist first. Regenerative treatment can only be discussed once things are stable.
Is it covered by insurance?
Generally not. Regenerative treatment for thyroid disease is self-funded.
Book a regenerative consultation. An honest assessment of whether stem cells or exosomes make sense for your thyroid, with your blood tests reviewed first. WhatsApp +971 52 328 6185.
About the author Dr Shiva Faramarzi, MD, is an aesthetic, regenerative and longevity physician at Apogee Clinic, JBR, Dubai (DHA licence 43705219). She offers autologous and donor stem cell therapy and exosome IV treatment. This article is patient education and does not replace a consultation with your own doctor.
References
- Ragusa F, et al. Hashimotos’ thyroiditis: epidemiology, pathogenesis, clinic and therapy. Best Pract Res Clin Endocrinol Metab. 2019;33(6):101367. doi:10.1016/j.beem.2019.101367
- Smith TJ, Hegedüs L. Graves’ disease. N Engl J Med. 2016;375(16):1552–1565. doi:10.1056/NEJMra1510030
- Cao Y, Jin X, Sun Y, Wen W. Therapeutic effect of mesenchymal stem cell on Hashimoto’s thyroiditis in a rat model by modulating Th17/Treg cell balance. Autoimmunity. 2020;53(1):35–45. doi:10.1080/08916934.2019.1697689
- Ye S, Zhu ZL. Stem cell therapy for thyroid diseases: progress and challenges. Curr Ther Res Clin Exp. 2022. PMC8968462
- Kurmann AA, et al. Regeneration of thyroid function by transplantation of differentiated pluripotent stem cells. Cell Stem Cell. 2015;17(5):527–542. doi:10.1016/j.stem.2015.09.004
- Park M, et al. Human placenta-derived mesenchymal stem cells ameliorate orbital adipogenesis in female mice models of Graves’ ophthalmopathy. Stem Cell Res Ther. 2019;10:246. doi:10.1186/s13287-019-1348-0
- Fischer UM, et al. Pulmonary passage is a major obstacle for intravenous stem cell delivery: the pulmonary first-pass effect. Stem Cells Dev. 2009;18(5):683–692. doi:10.1089/scd.2008.0253
- Caplan AI, Correa D. The MSC: an injury drugstore. Cell Stem Cell. 2011;9(1):11–15. doi:10.1016/j.stem.2011.06.008
- Zou J, Peng H, Liu Y. The roles of exosomes in immunoregulation and autoimmune thyroid diseases. Front Immunol. 2021;12:757674. doi:10.3389/fimmu.2021.757674
- Tomasello L, Guarnotta V, Siragusa G, Biondo M, Arnaldi G, Giordano C, Pizzolanti G. Th-1 cytokine-primed small extracellular vesicles from limbal mesenchymal stem cells modulate immune and inflammatory responses in Hashimoto’s thyroiditis: an ex vivo proof-of-concept study. Mol Biomed. 2025;6:139. (The authors declare patent applications on this cell source.) doi:10.1186/s43556-025-00388-y
- Thompson M, et al. Cell therapy with intravascular administration of mesenchymal stromal cells continues to appear safe: an updated systematic review and meta-analysis. EClinicalMedicine. 2020;19:100249. doi:10.1016/j.eclinm.2019.100249
