Hashimoto’s Thyroiditis Part 2:
Which style of eating is best for you?
By Rebecca Jaspan, MPH, RD, CDN, CDCES
Have you been recently diagnosed with Hashimoto’s thyroiditis? If you’ve gone to “Dr. Google,” you might be overwhelmed with mountains of information; everything from different foods to avoid to the dozens of supplements you should take. Some of this information might even be contradicting itself. I would assume you’re not even sure where to begin. To start, close “Dr. Google” and talk to your registered dietitian, who can help you make an individualized plan that works for your symptoms and lifestyle.
There are a number of diets recommended for Hashimoto’s. While research is limited in telling us the best go-to intervention, it is known that diet and lifestyle modifications are a key way to reduce symptoms along with medication prescribed by your endocrinologist. These changes help reduce inflammation, slow or prevent further thyroid damage, and manage blood sugar and cholesterol levels1.
So, what diet is best for Hashimoto’s? Some research recommends cutting out gluten or dairy. Others find symptom relief from a plant-based, anti-inflammatory diet. And some individuals follow the Autoimmune Protocol Diet, which is a strict elimination diet followed by phased reintroduction of foods. Everyone responds differently based on their symptoms, so it’s best to talk with your doctor and registered dietitian to figure out what might be best for you. Let’s take a deeper dive into some of these eating patterns.
Many individuals find symptom relief when they eliminate dairy and gluten from their diet. There is a high prevalence of lactose intolerance and sensitivity to milk protein in individuals with Hashimoto’s2. When dairy is consumed, the immune system activates and leads to increased inflammation. One study showed decreased TSH levels in patients who avoided lactose2. Studies show symptoms relief from following a gluten-free diet as well. Due to an increased risk of celiac disease with Hashimoto’s, it is advised that all patients with Hashimoto’s are screened for celiac disease3. This association may be explained by low selenium and vitamin D due to malabsorption3. A study investigating the efficacy of a gluten-free diet in 34 women with Hashimoto’s found that a gluten-free diet reduced thyroid antibodies and increased vitamin D and concluded that a gluten-free diet may show clinical benefits for patients with Hashimoto’s3.
As inflammation is a driving force of Hashimoto’s, increasing intake of anti-inflammatory foods may be helpful to relieve symptoms. A study with 218 women with Hashimoto’s showed decreased oxidative stress in those who ate fruits and vegetables more frequently4. Additionally, a significant positive association was shown between anti-inflammatory plant oil consumption and T3 levels in patients with Hashimoto’s5. Another study showed decreased serum thyroid autoantibodies with increased consumption fatty fish intake6.
Finally, the Autoimmune Protocol Diet was designed for people with autoimmune diseases. It involves phased elimination and reintroduction of foods such as grains, dairy, nightshade vegetables, added sugar, coffee, legumes, eggs, alcohol, nuts, and seeds. In a study with 16 women with Hashimoto’s disease, the AIP diet showed decreased levels of C-reactive protein, an inflammatory marker, and increased quality of life7.
The diet for Hashimoto’s is extremely individualized and may involve a series of trial and error. Be sure to work with your registered dietitian to find what style of eating works best for your body and symptoms.