What is the right diet to heal Hashimoto’s?
I hear this question a lot. Unfortunately, the answer isn’t always straight forward, as nutrition is the only science where multiple answers can be both correct and wrong. One (wo)man’s medicine can be another (wo)man’s poison.
We are all different, and although we may have the same condition, different interventions may be required for each of us to heal. That said, I have learned a lot, through trial and error, on my journey to heal my own body, and have worked with and surveyed thousands of other people with Hashimoto’s who have been able to feel better through dietary changes.
In this article, I’d like to share some of what I’ve learned, including:
- My personal diet journey
- How to balance blood sugar by limiting carbs
- The top six dietary changes I recommend
- Nutrient-dense healing foods to incorporate in your diet
- Three Root Cause diet templates to consider
My Personal Diet Journey
I have tried a variety of diets on my Hashimoto’s healing journey. I started by going gluten and dairy free after having food sensitivity tests that showed I reacted to both. My stomach was extremely grateful. My acid reflux disappeared in just 3 days! I no longer had a chronic cough, diarrhea, or bloating, either. Having learned about the connection between food and autoimmune disease, I excitedly re-tested my TPO antibodies. Unfortunately, they had increased. I also became more tired, and my anxiety worsened.
At first, I was surprised, but came to learn that I made the same rookie mistake that people who go gluten free usually do. I replaced my previous junk food with “GFJF” (gluten free junk food), like soy and rice-based gluten free bread, pretzels, dairy free milk, and cookies.
Soy has been linked with autoimmune thyroid disorders, and gluten free junk foods, bread, cereals and soy milk have an incredibly high glycemic index. The blood sugar imbalances from gluten free junk foods promote adrenal dysfunction, which can affect thyroid function.
Eventually, I made a point to remove soy, and I balanced my blood sugar by eating lower glycemic index foods. I felt better, and my thyroid antibodies decreased. But soon, healing plateaued, and I started becoming bloated again.
So I went back to the drawing board and began researching alternative diets. I resonated with the theory behind the GAPS diet, which was comprised of nutrient-dense foods like meats, vegetables, fruit, eggs, and nuts, so I took the plunge. I felt better at first. Almost immediately, I noticed increased muscle tone and energy levels.
But even after several months, I continued to have digestive issues. I had been trying so hard to find the right diet!
Instead of giving up, I decided to follow another diet that removes gluten and dairy, and limits fruit. I started to immediately have positive results. I felt happier. My skin cleared up, my hair became bouncy and shiny again, and I was glowing! Three months after, my TPO antibodies had dropped to the 200 range.
So what wasn’t working for me?
Some of the fruits were causing blood sugar imbalances. I also did additional testing and figured out that I was not digesting protein correctly (especially eggs). I cut them out, added green smoothies to the mix, and started eating raw (but puréed) veggies.
The test showed that I was reactive to some “healthy” foods I occasionally ate: chard, apples, garlic, and strawberries. I decided to “test” the validity of the test and ate a whole bunch of these foods all at once. I noticed more joint pain when I consumed the foods I had tested as sensitive toward.
My takeaway is that it’s important to listen to your own body, instead of relying solely on any one dietary theory. Dietary theories are meant to be a starting point. Your own body will give you further direction.
Which Diet Should You Start With?
If you’ve been eating a Standard American Diet (S.A.D.), consisting of a large quantity of grains, dairy, soy and processed foods, you may be wondering where to start your own dietary journey.
Multiple diets have been reported to reverse Hashimoto’s and other autoimmune conditions, including the Specific Carbohydrate diet, Paleo diet, Autoimmune Paleo diet, low-FODMAPs diet, and Body Ecology diet, as well as gluten, soy, dairy, and iodine free diets.
The connecting thread behind these diverse diets is that they all remove various reactive foods. Most of the diets also include animal proteins, are more nutrient dense than the SAD, and remove processed foods.
What About Vegan and Vegetarian Diets?
While vegan and vegetarian diets have been reported to be extremely helpful with autoimmune and chronic conditions, I have not been able to find reports of people recovering from Hashimoto’s by following a vegan diet. Even devout vegans who are nutritionally conscious still struggle with low body temperatures, hypothyroidism and Hashimoto’s.
Some of the reasons that such diets may be problematic in Hashimoto’s are that they can:
- Exacerbate blood sugar issues
- Prevent the gut from healing
- Contribute to nutrient deficiencies that may exacerbate Hashimoto’s
I consider myself to be diet-agnostic. I try not to form too many attachments to any dogmas, be it diets, herbs, medications or other treatment modalities. My goal is to simply try to find the most successful protocols, and to show my readers what works.
In analyzing the diets that have worked for my clients and readers, I’ve found the following three diets to be especially helpful:
- The gluten, dairy and soy free diet
- The Paleo diet
- The Autoimmune Paleo diet
I’ve further refined these diets to Hashimoto’s by making some adjustments based on clinical experience of what works for most people with Hashimoto’s, including:
- Balancing blood sugar and limiting the intake of carbohydrates
- Limiting fish high in mercury levels
- Limiting foods high in iodine
- Increasing the intake of protein and good fats
- Adding nutrient dense foods found to benefit the thyroid
- Removing personally reactive foods
Balancing Blood Sugar By Limiting the Intake of Carbohydrates
You might be surprised to learn that, while protein, fat and micronutrients are all required by the human body, carbohydrates are not a required nutrient. While (good) fat is required for normal cell function, we can actually survive on little to no carbohydrates in our diets.
Not only are carbs not required, they’re also the greatest contributor to blood sugar imbalances — which up to 50 percent of those with Hashimoto’s may have! These imbalances can contribute to anxiety, weight gain, hair loss, irritability, weakened adrenals, fatigue, and increased thyroid antibodies. Limiting one’s carbohydrate intake and consuming plenty of good fats and proteins instead can help balance blood sugar.
I recommend staying away from processed carbohydrates, as those will cause the greatest blood sugar swings. Stick to natural carbohydrates, such as sweet potatoes and berries, but not too many at first. For best results, you may want to limit yourself to 1-2 servings of carbohydrates a day if you’re still in the early stages of your healing journey and are struggling with blood sugar swings. For some of my clients, even too much fruit can throw them off. You will be able to improve your tolerance of carbohydrates as you heal.
Limiting the Intake of Fish High in Mercury Levels
Seafood is rich in omega-3 fatty acids, which can help restore immune balance and reduce inflammation. However, frequently eating fish that is high in mercury can lead to elevated levels of mercury in the body, which can disrupt thyroid function and contribute to our toxicity load.
Some fish, like swordfish and tuna, are higher in mercury than others — so I recommend looking for lower-mercury species like salmon and trout. (Check out the Environmental Working Group’s complete seafood guide.)
You can also get omega-3s from supplements, and you can read more about the fish oil supplements that I recommend.
Limiting Foods High in Iodine
While iodine is essential for thyroid function, excessive amounts can exacerbate Hashimoto’s. Today, with iodized salt being prevalent in most countries, iodine excess is recognized as a risk factor for developing Hashimoto’s! (Read more about the iodine and Hashimoto’s controversy and foods high in iodine.)
In my experience, iodine needs to be dosed appropriately to provide benefit and prevent harm. Some research has shown that a low-iodine diet has been helpful in reducing the autoimmune attack on the thyroid gland and in normalizing thyroid function in people with iodine-induced Hashimoto’s. I’ve found that for most people with Hashimoto’s, a small intake of iodine (150-220 mcg daily) is usually safe and potentially helpful.
Increasing the Intake of Good Fats and Protein
Although we’re finally coming out of the decades we spent fearing fat, there’s still a lingering mindset that keeps us from eating enough of this energy-rich macronutrient. I encourage you not to fear fat; it’s essential for brain function, healthy skin, shiny hair, and cell membrane formation.
The key is to eat good fats found in fish, olive and coconut oil, and avocados; and avoid bad (trans) fats, found in baked or fried goods, packaged cookies, certain cereals, and hydrogenated oils. When you eliminate processed foods from your diet, you will essentially have eliminated almost all forms of trans fats. As a bonus, you’ll naturally be getting a more balanced omega-3 to omega-6 fatty acid ratio. (You can read more about omega-3 fatty acids here.)
Increasing your intake of good fats with fish will likely also boost your protein intake. People with chronic illnesses actually need more protein in their diet to help support greater cell and tissue repair demands. Protein also acts as the raw fuel to create thyroid hormones and reverse intestinal permeability.
I recommend eating about 1-1.2 grams of protein, per kilogram of body weight, per day (roughly 0.5 grams per pound of body weight).
In addition to getting protein from foods, it may also be helpful to obtain protein from protein powder, such as Rootcology AI Paleo Protein, as people with Hashimoto’s may have trouble extracting protein from the foods they eat. Since it has already been broken down into fine form and separated from other ingredients, protein from powder is generally easier to digest than protein from foods.
Adding Nutrient Dense Healing Foods
Besides removing potentially reactive foods, adding in nutrient-dense foods is key to healing your gut.
Here are some of the foods I have found to be especially beneficial for the thyroid:
- Green smoothies – These are a really great way to increase our intake of nutritious food without the digestive stress. As they’re chopped up, the food becomes easier to digest, and the nutrients are more readily absorbed. Additionally, they’re a wonderful source of chlorophyll, which has been shown to help support the process of detoxification in the liver, reduce inflammation and oxidative stress, raise iron levels, and even work as a natural deodorant by neutralizing odors.
- Fermented foods – Fermentation is a process of food preservation that produces probiotics, or “good bacteria,” that can balance intestinal flora. I recommend that you buy fermented foods, like sauerkraut, that require refrigeration, as probiotic bacteria can only survive a couple of weeks at room temperature.
- Bone broth – Bone broth provides healing collagen and nutrients to support our gut lining and skin. Seventy percent of readers in my 2015 survey found that bone broth helped them feel better.
- Hot lemon water – Lemon juice can help support the liver’s detoxification pathways; and, thanks to its acidity, it can also increase the absorption of thyroid hormone medications. Most people who start drinking hot lemon water on an empty stomach in the morning in place of caffeinated beverages are surprised by not just how much energy they have, but also how much better they feel overall.
- Beets – Beets are a good source of phytonutrients, which perform anti-inflammatory and antioxidant duties in the body. Beets are especially good for those with MTHFR gene mutations and elevated homocysteine levels, as their betaine content can help break down homocysteine. I recommend eating 1 to 2 servings of beets a week. However, because they are naturally high in sugar, you’ll want to combine them with a healthy fat or protein source.
- Cruciferous veggies – Crucifers are healthy for most people with Hashimoto’s, and their glucosinolates help increase detoxification in the liver.
- Cilantro – Fresh cilantro is a natural chelator, which means it will bind to certain toxins and help excrete them from the body. You can add cilantro to salads, avocados and green juices, and use it as a fresh condiment topper on soups.
- Fiber – Fiber acts like a sponge as it moves through the digestive process and helps absorb toxins and excess hormones, ultimately supporting their path to excretion. It’s best to get fiber from fruits and vegetables versus supplemental forms, as fiber supplements have been known to aggravate intestinal permeability and SIBO. I suggest gradually adding fibrous foods into your diet if you don’t normally eat a lot of them.
- Turmeric – The curcumin content in turmeric helps support the gut, liver, and inflammatory pathways, and can be especially helpful if you are experiencing pain.
- Berries – Berries are an incredible source of phytonutrients that act as antioxidants in the body. Because they are high in fiber, they don’t cause a spike in your blood sugar, as some types of fruit do. Blueberries are a rich source of myo-inositol, a nutrient that has been shown to improve thyroid function and blood sugar. Aim for 1-2 servings of berries daily. It’s best to spread these servings out throughout the day, as I’ve found that too much fruit at one time can cause a spike in blood sugar that may lead to tiredness.
Remove Personally Reactive Foods
It’s important to reiterate that each person needs to assess their individual dietary needs and find the diet that works best for them. For many people, that will involve some level of food sensitivity testing to identify the foods that are reactive for them.
Food sensitivities are governed by the IgA, IgM and IgG branches of the immune system. Reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients, and can also produce intestinal permeability whenever they are eaten.
Reactions after consuming them may take as long as hours or even a few days to manifest, and may include acid reflux, bloating, irritable bowel syndrome, palpitations, joint pain, anxiety, nerve tingling or headaches.
Most people will see a dramatic reduction in symptoms by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies. An additional subset of people will be able to get their Hashimoto’s into complete remission just by getting off the foods they react to.
Most Helpful Diet Templates for Hashimoto’s
After making these adjustments, these diets have evolved to become…
- The Root Cause Intro Diet
- The Root Cause Paleo Diet
- The Root Cause Autoimmune Diet
I hope that these diet templates will be a helpful place for you to start. That said, no matter what, it’s important to remember that these dietary protocols don’t need to control your life. They are approaches to healing your body from the effects of Hashimoto’s, but they should be seen as fluid and not fixed; you can try them as they are designed, and then you can let them morph into what works best for your unique body.
The Root Cause Intro Diet
For those wishing to overcome their Hashimoto’s symptoms, I always suggest that going gluten, dairy and soy free is the best place to start. Those three foods tend to be the most problematic for people with thyroid conditions, and removing them can often lead to a significant reduction in symptoms.
To those starting their health journey, I recommend the Root Cause Intro Diet, which focuses on removing the six most commonly reactive substances in those with Hashimoto’s:
These dietary irritants, when combined with the environmental toxins we are exposed to on an everyday basis, can overburden the body. In people with Hashimoto’s, who may already have impaired detox abilities, this buildup of toxins can impede healing. By following this diet, you will create an internal environment focused on healing and help calm the immune system.
The Root Cause Paleo Diet
To dive a little further, I have found a Paleo-style diet to be the most effective for the majority of people with Hashimoto’s. In fact, 81 percent of my readers said a Paleo-style diet made them feel better!
The historical theory behind the health benefits of a Paleo diet is that the digestive systems of humans have not had sufficient time to adapt to today’s farming practices or to the ingredients and chemicals in modern processed foods. The theory blames the rise in chronic diseases, obesity, and allergies on the agricultural revolution, which added grains and processed foods — as well as toxins — into our diet.
It is estimated that contemporary Western populations get as much as 70 percent of their daily energy intake from foods that were never or rarely consumed by our hunter-gatherer Paleolithic ancestors. These non-Paleo foods include grains, refined sugars, dairy, and highly processed fats.
After eliminating grains and processed foods, a Paleo diet replaces these with nutrient-dense foods: nuts and seeds, vegetables, fruit, and eggs. Meat and fish are also allowed.
I have put my own twist on the Paleo diet, with what I call the Root Cause Paleo Diet. It specifically eliminates the foods that tend to cause the most problems for those with Hashimoto’s, while adding in the nutrients that help the body heal.
The Root Cause Paleo Diet eliminates:
- Legumes (except green beans and pea protein)
- High iodine foods
- Capsaicin-containing peppers (chili pepper, red chilli flakes, cayenne pepper)
Foods included on the diet are:
- All meats
- All vegetables
- All fruit
- Nightshades (except cayenne and chili peppers)
- Black pepper (piper nigrum)
- Bell peppers
- Smoothies made with hydrolyzed beef protein, such as Rootcology Paleo Protein and Rootcology AI Paleo Protein
- Smoothies with added pea protein, like Rootcology Pea Protein Powder
The Root Cause Autoimmune Diet
If you are still experiencing symptoms, especially gut-related symptoms, after following the two diets above, my recommendation is to step up to the Root Cause Autoimmune Diet. This diet adds eggs, nightshades, nuts, and seeds, to the list of excluded foods.
Eggs can be a reactive food for some people with Hashimoto’s, including 48 percent of readers that I surveyed in 2015. Eggs contain the enzyme lysozyme, which has the ability to bond with bacteria and proteins as it moves through the digestive process, collectively forming what’s referred to as a “lysozyme complex”, which can irritate those with leaky gut.
Nightshades contain alkaloids, which are chemical compounds that can be reactive substances in some people. Forty-seven percent of readers found removing nightshades relieved their joint aches, pain, swelling, tingling, and numbness.
While nuts are a highly nutritious source of protein and healthy fats, they can be tough to digest. Additionally, they contain oxalates and phytates, both “anti-nutrients” that can interfere with mineral absorption. In the Root Cause Autoimmune Diet, nuts are excluded, but even if you don’t react to them now and you add them back in later, I recommend rotating them with other foods, eating them every three to four days.
Finally, seeds have the potential to aggravate an already irritated gut, as they tend to resist digestion, and might contribute to symptoms if you have trouble digesting proteins.
To recap, the Root Cause Autoimmune Diet excludes:
- Dairy (including butter and ghee, which are allowed in traditional Paleo)
- Hot peppers
Foods allowed on this diet include:
- Fish and shellfish
- Fruits (all, especially coconut)
- Meats (all)
- Oils: avocado, coconut, and olive
- Vegetables (except nightshades)
The list of included foods may seem short, but in practice it translates to countless options for delicious eating, and you’ll find some of my favorite recipes in my new cookbook!
Beyond Food: Where Do I Go From Here?
If, after removing problematic foods, you still experience symptoms, it may be a sign to start digging for potential other root causes behind your thyroid condition.
You may consider removing toxins, reversing nutrient depletions, addressing gut-related issues with digestive enzymes, treating infections like Candida, Blasto or H. pylori, testing for SIBO, and balancing the adrenals. (I’ll go into further detail about possible root causes of Hashimoto’s in my new cookbook!)
Limiting one’s intake of carbohydrates, fish high in mercury levels and foods high in iodine — while increasing one’s intake of protein and good fats, adding nutrient dense foods found to benefit Hashimoto’s, and removing personally reactive foods — can make an enormous impact on your health!
While I hope these suggestions help you on your journey to find the right diet for you, know that your journey is YOURS and you need to keep digging until you find what works for you.
If you’re looking for strategies and recipes to help you get started on thyroid-friendly dietary interventions, consider getting a copy of my new cookbook, Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health. This is a cookbook and nutrition guide that reveals how food can be used as medicine in the same manner that pharmaceuticals are used to impact our biology, and it’s designed with healing recipes and protocols specifically for people with Hashimoto’s or autoimmune conditions.
The first few chapters will teach you how to support yourself through optimal diet, digestive enzymes and proper nutrients. You’ll also find tools and strategies for success and 125 delicious recipes that will help your body heal.
I hope you find this wealth of information helpful on your health journey!
PS. You can also download a free Thyroid Diet Guide, 10 thyroid-friendly recipes, and the Nutrient Depletions and Digestion chapter of my Root Cause book for free by signing up for my weekly newsletter. You will also receive occasional updates about new research, resources, giveaways and helpful information.
Note: Originally published in February 2015, this article has been revised and updated for accuracy and thoroughness.