The Role of Diet & Nutrition in Managing your Hashimoto’s Symptoms

There is no one-size-fits all diet approach for Hashimoto’s—some patients feel great just going gluten free, others do well without gluten and dairy, and others do better on an autoimmune or Paleo style diet. The best way to find out what diet is best for you is to do a thorough elimination diet to find out if any food allergies or sensitivities are contributing to symptoms. That being said, the best place for anyone who is newly diagnosed to start is with a gluten-free approach. Anyone with autoimmune disease should avoid gluten for life, and this is a necessary first step.

Elimination Diet

While gluten-free helps a lot of those with Hashimoto’s feel better, some people have sensitivities to other foods—most commonly soy and dairy, but frequently sensitivities to eggs, nightshade vegetables, nuts, seeds, and other grains are found. The best way to determine food allergies and sensitivities is by doing a thorough elimination diet (otherwise known as the autoimmune protocol), where all potentially problematic foods are removed for a period of at least 30 days, and then reintroduced one at a time to assess tolerance.

Food Allergy Testing

There are food allergy tests that your doctor can perform, but they are notoriously inaccurate and expensive. A thorough elimination diet (removing foods from the diet for a period of time and then adding them back in) is still the gold standard for food allergy testing.

The Importance of a Nutrient-Dense Diet

In addition to finding out which foods a person may be sensitive to, focusing on whole, nutrient-dense foods will give their body the best chance to heal. Here are some nutrients those with Hashimoto’s may need more of:

  • Iodine—while supplemental or excess iodine may be problematic, iodine is still
  • Vitamin D—while it is found in small amounts in meats and mushrooms, vitamin D is produced by our skin when we exercise smart sun exposure.
  • Vitamin A—found in organ meats, seafood, meats, and its precursor beta-carotene is found in colorful fruits and vegetables.
  • Selenium—necessary for the conversion of thyroid hormones in the liver, this mineral is found in high amounts in seafood and brazil nuts.
  • Omega-3 Fats—necessary for managing inflammation, this essential fat can be found in fish, shellfish, and grass-fed animal meats.
  • Zinc—necessary for the conversion of thyroid hormones in the liver, this mineral is abundant in shellfish, meats, and pumpkin seeds.

Supporting Gut Flora with Probiotics

Research has shown that all autoimmune diseases are positively impacted by the beneficial flora found in our digestive tracts. We can support these bacteria by taking probiotics, as well as eating probiotic foods—those that have been fermented, like sauerkraut, kombucha, kefir, kvass, etc.

Gluten Sensitivity

Gluten-Free Diet plus Foods to Avoid

Common Foods that Contain Gluten:

  • Bread—sandwich bread, French bread, bagels, baguette, flatbread, pita bread, naan, brioche, white bread, ciabatta, matzo, pancake, pizza crust, tortillas, croissants, cornbread, bread crumbs, hamburger and hotdog buns, waffles, crepes, croutons
  • Baked Goods—muffins, cakes, cookies, pies, cobbler, brownies, scones, biscuitss and mushrooms, vitamin D is produced by our skin when we exercise smart sun exposure.
  • Crackers—pretzels, cheese crackers, graham crackers, saltine crackers, bagel chips, water biscuits, chips
  • Pasta and Noodles—all shapes made out of wheat, semolina, or farina; gnocchi, ravioli, tortellini, dumplings, ramen, udon noodles, soba noodles, chow mein, egg noodles
  • Cereals and Granola—those made with wheat, barley, and rye; in addition, those made from oats, corn, and rice are often contaminated during manufacturing
  • Breading—bread crumbs, panko, breaded foods
  • Sauces—soy sauce, sweet and sour sauce, hoisin, pancake syrup, salad dressings, BBQ sauce, teriyaki
  • Gravies—thickened with flour
  • Malt and Malt Beverages—extracted from barley
  • Brewer’s Yeast
  • Beer—unless labeled gluten-free

Less-common foods and household items to double-check labels:

  • Spice Mixes
  • Brown Rice Syrup
  • Bulk Foods
  • Candy
  • Food Coloring
  • Roasted Nuts
  • Veggie Burgers
  • Energy Bars
  • French Fries
  • Potato Chips
  • Lunch Meats
  • Meat Substitutes
  • Supplements
  • Play Dough
  • Tea
  • Tomato Paste
  • Trail Mix
  • Condiments
  • Household Products
  • Personal Care Products
  • Medications
  • Envelopes, Stamps, Stickers
  • Mouthwash
  • Toothpaste

How to avoid cross-contamination:

  • Otherwise gluten-free flours processed non gluten-free facility (rice flour, buckwheat flour, sorghum flour, and soy flour)
  • Otherwise gluten-free grains processed in a non gluten-free facility
  • Cutting boards, knives, pots, pans, countertops, utensils, and other cooking tools used to prepare gluten-containing foods
  • Condiments that are used to spread on to gluten-containing foods (peanut butter, jelly, mayonnaise, mustard, etc.)
  • Foods that have been fried in a fryer with gluten-containing foods
  • Airborne wheat flour (such as in a bakery)
  • Baked goods from facilities that are not certified gluten-free
  • Bulk bins at grocery stores

Other Food Allergies

Soy, Iodine & Goitrogen Issues

In addition to gluten, there are other foods that those with thyroid conditions find problematic. Soy (and foods made from soy, like soy sauce, tempeh, soymilk, soy protein isolate, tofu) contain isoflavones which act like estrogen in the body. Their consumption can lead to hormonal imbalance and worsen hypothyroidism. Iodine can increase autoimmune attacks on the thyroid, due to its ability to reduce activity of an enzyme called thyroid peroxidase (TPO). Although some people have reported feeling better with iodine supplementation, caution is warranted as it can cause some people to go into a flare (especially in the presence of selenium deficiency). A moderate intake of iodine in foods should not be problematic except in the most sensitive cases. Goitrogens are compounds in foods that can inhibit thyroid function. They are found in foods like:

  • Broccoli
  • Brussels sprouts
  • Cabbage
  • Cauliflower
  • Kale
  • Flaxseed
  • Mustard greens
  • Pears
  • Peaches
  • Sweet potatoes
  • Peanuts
  • Pine nuts
  • Radishes
  • Rutabaga
  • Soy
  • Spinach
  • Strawberries
  • Turnips

Avoid eating them in large quantities raw (such as in green smoothies or juice), as cooking decreases goitrogen content by 30%. Most people are fine eating these foods in moderation and not excessively.

Check out HA’s Menu Planning, Recipe & Nutrition Resources

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