Written by: Bonnie Feldman, DDS, MBA, Anna Simon, Ellen M. Martin
As our knowledge of nutrition and of food-as-medicine expands, using food as health enhancers and therapy agents has become increasingly popular. Many patients are following dietary guidelines to help mitigate symptoms, based on a growing understanding that diet and nutrition can either exacerbate or reduce symptom severity. But with this popularity has come the usual wave of wacky fad diets and dubious advice. Let us help you wade through the ocean of information to start experimenting with your diet for better health.
What is Hashimoto’s?
Hashimoto’s Disease is an autoimmune disorder of the thyroid (a gland in your neck that controls your metabolism, how your body uses energy). When the thyroid is damaged by a misdirected immune response, it makes too little thyroid hormone, leading to the impairment of many bodily functions.
Symptoms include swollen neck and feelings of fullness in the throat due to an enlarged thyroid (aka goiter), in addition to fatigue, weight gain, joint and muscle pain, constipation, thinning hair, changes in menstruation, depression, slowed heart rate, and more. As with many autoimmune and chronic conditions, no two cases are exactly alike.
Hypothyroidism, or an underactive thyroid gland, is common in Hashimoto’s patients. Standard treatment for hypothyroidism includes thyroid hormone replacement therapy. This treatment can cause unwanted systemic side effects such as weight gain, bloating, acne, and others. An emerging understanding of alternative medicine and the realization of the potential importance of lifestyle modifications has highlighted modified diet, supplements, and exercise as important factors that may moderate or even reverse these side effects, symptoms, prevent or moderate flares, and complement or reduce reliance on pharmaceuticals.
The Best Foods For Hashimoto’s
Certain foods and food components may help manage Hashimoto’s symptoms. The Internet offers an overwhelming amount of diet ideas, including the Autoimmune Protocol (AIP) and Gut and Psychology Syndrome (GAPS) diets for inflammatory diseases. Check out our post on autoimmune diet comparisons to learn more about these different diets. While we do believe that following a diet that emphasizes anti-inflammatory and antioxidant-rich foods should help people with Hashimoto’s, we don’t believe in a one-diet-for-all approach, because Hashimoto’s affects people differently and symptoms vary among patients.
This table can offer a good starting point for any Hashimoto’s patient. Combining our own experimental knowledge with scientific research (1), we’ve crafted our best food recommendations for Hashimoto’s patients.
In general, following a generic autoimmune diet, which broadly focuses on eliminating processed foods, dairy, and added sugar, while increasing consumption of vegetables, fruits, fish and other whole foods may help Hashimoto’s patients.
Common nutrient deficiencies in Hashimoto’s patients include Vitamin D, iron, selenium, B12, melatonin, thiamine, and magnesium (2). Supplements can be taken if needed. Although it can be costly, eating organic produce and meats could be a better option because they lack the added chemicals found in conventional products (3)
Drinking plenty of fluids is always important in keeping your body functioning as best as it can. If you experience gastrointestinal issues, we suggest eating smaller meals and only eating when you’re hungry to minimize stomach pain. We also recommend keeping a food diary to track foods that trigger your symptoms, as well as foods that mitigate symptoms.
The Worst Foods for Hashimoto’s
In contrast to anti-inflammatory foods, there are pro-inflammatory foods that should be avoided. These include processed meats, sodas and sugary beverages, salty snacks, packaged sweets, and refined carbohydrates. Unfortunately, these foods are also easy to reach for when stress eating or snacking. If you suffer from Hashimoto’s, these types of foods are likely to intensify any symptoms you’re already experiencing.
In addition to the generic proinflammatory foods listed in the table below, there are some more specific foods that might be harmful to Hashimoto’s patients. A low-carbohydrate or gluten-free diet may reduce autoimmune thyroid antibodies and possibly thyroid inflammation. Try reducing carbs or cutting out gluten to see if that helps reduce your symptoms. Additionally, avoiding goitrogens (iodine uptake inhibitors primarily found in soybeans and Brassica vegetables such as broccoli, cauliflower, Brussels sprouts, and cabbage) is advised, as they cause thyroid inflammation (4). Tobacco smoke also contains goitrogens.
Research suggests that iodine is an environmental trigger of thyroiditis (5). However, you shouldn’t necessarily avoid iodine. According to Dr. Izabella Wentz, “If you have iodine-deficiency induced hypothyroidism (the leading cause of an underactive thyroid), then take iodine.” Talk to your doctor about taking or avoiding iodine.
Conventional products may contain more synthetic chemicals (3), which may have greater effects on those with autoimmune diseases or related conditions.
Other Tools for Managing Hashimoto’s
Engage in Mindful Eating
Other aspects of eating are important besides being aware of the best and worst foods for your body. Eating smaller, nutritionally-balanced meals could help ease digestion and help fight flare-ups. Chewing your food slowly and engaging your jaw can help activate your oral microbiome and promote better oral health. A key aspect of mindfulness is paying attention to your body’s short and long-term response to a food – if it stings or produces cramping, or diarrhea the next day, consider it a likely bad actor in your diet.
What you drink matters too! Water normalizes the pH of your mouth – healthy human saliva has a pH of 7.4. When we consume acidic foods and beverages, such as fruit juice and soda, our oral pH is thrown out of balance (not to mention the additional sugar and calorie intake). When the pH within our mouths falls below 5.5, demineralization occurs, making us more susceptible to oral diseases, such as dental caries and periodontal disease. Drinking plenty of water daily can help maintain a healthy mouth pH, in addition to keeping you hydrated. When drinking tea, coffee, juice, alcohol, or kombucha, we recommend pairing with a glass of water as well for optimal oral health.
Exercise, Exercise, Exercise
Staying active is incredibly important to maintaining healthy living. It is even more important for those who suffer from Hashimoto’s and other autoimmune diseases because exercise can help reduce inflammation and alleviate symptoms. Exercise can take on many forms, from higher-intensity training like running or playing sports to lower-intensity exercises like walking, yoga, Pilates or other movement therapies. Hypothyroidism makes it especially difficult to get started, so start with any increase in activity and build up from there. Get our free ebook on movement therapy to explore more options!
Relax and Reduce Your Stress
Constant stress is one of the negative by-products of modern life. While our stress responses were beneficial in helping our ancestors avoid predation and other life-threatening situations, constant but not life-and-death stressors brought about by modern society can be extremely harmful to our bodies. While helpful in short bursts (we still may need to catch that bus!), our flight-or-fight responses, part of our sympathetic nervous system, can have harmful consequences when constantly activated by non-life-threatening stress. These consequences include triggering or exacerbating flare-ups. It is therefore important for those with Hashimoto’s to reduce overall stress.
One of the easiest ways to do this is to make sure you are getting enough sleep. Most people do not get the recommended 7-9 hours of sleep daily. Whether taking an afternoon nap, going to bed earlier, or (if scheduling permits) sleeping later, emphasis should be on consistent restful sleep. Regular sleep habits are helpful in reducing insomnia and encouraging deep, restful sleep. Relaxation throughout the day is also important. This could mean an early morning workout, an afternoon yoga class, or even taking 15 minutes in the middle of the day just to focus on your breathing. Figure out what works best for you and do it. Take the time to be the best version of yourself: your stress will go down, your body will feel better, and your productivity may even increase!
Hashimoto’s Disease is a condition that can affect each patient differently. Following some sort of anti-inflammatory diet and lifestyle habits may help mitigate your symptoms. What worked for your friends, family, or spouse might not work for you. Everyone is unique and experimenting with food therapy may not be an easy fix. Try not to be overwhelmed by all of the recommendations and information out there, go slowly and trust yourself. At the end of the day, you are your greatest advocate and you know your body best. Fearlessly experiment with your dietary options and be mindful of your reactions. Our free food therapy e-book can help guide you through this process of experimentation.
Have you tried any autoimmune diets? What foods work/don’t work for your body? Let us know in the comments.
- Burek, L. C., & Rose, N. R. “Autoimmune thyroiditis and ROS” Autoimmunity Reviews. Vol 7(7). 2008. 530-537. https://www.sciencedirect.com/science/article/abs/pii/S1568997208000505
- Wentz, I. (2018). Resources – Dr. Izabella Wentz. https://thyroidpharmacist.com/resources/
- Smith-Spangler, C et al. “Are organic foods safer or healthier than conventional alternatives?: a systematic review” Annals of Internal Medicine. Vol 157(5). 2012. 348-366. https://www.ncbi.nlm.nih.gov/pubmed/22944875
- Hunter, W. (2019, January 18). Hashimoto’s Thyroiditis: Symptoms, Causes, & Treatment. https://selfhacked.com/blog/hashimotos/
- Rose, N.R. et al. “Iodine: an environmental trigger of thyroiditis” Autoimmunity Reviews. Vol 1(1-2). 2002. 97-103. https://www.sciencedirect.com/science/article/abs/pii/S1568997201000167