Dr. Izabella Wentz, PharmD

Thyroid Pharmacist

Is This Diet Helpful for Hashimoto's?

New Study Shows That This Type of Diet Is Helpful for Hashimotos!

Medically reviewed and written by Izabella Wentz, PharmD, FASCP

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Can diet reduce your thyroid antibodies? A group of Italian researchers has recently published a study about the effects of nutrition on Hashimoto’s, and they say “Yes!”

Over the course of 3 weeks, 180 people with Hashimoto’s were randomized to receive the study diet vs. a standard low-calorie diet. 108 patients ate the study diet, while 72 patients served as the control group and followed a low-calorie diet without any food restrictions or guidelines. Thyroid antibodies (Thyroid Peroxidase antibodies (TPO antibodies), Thyroglobulin antibodies (TG antibodies) and anti-microsomal antibodies), TSH, free T3, free T4 as well as body weight, mass, and composition was measured before the start of the study and after the study ended 3 weeks later in both the study group and the control group.

Thyroid antibodies (Thyroid Peroxidase antibodies (TPO antibodies), Thyroglobulin antibodies (TG antibodies) and anti-microsomal antibodies), TSH, free T3, free T4 as well as body weight, mass, and composition was measured before the start of the study and after the study ended 3 weeks later in both the study group and the control group.

Here Are the Results of the Study

Get this… after just 21 days, all the patients in the study group showed a significant decrease in the levels of thyroid antibodies, which are known to indicate how aggressive the attack is on the thyroid gland!! (The higher the antibodies, the more aggressive the attack, and I consider a drop of 10% or more an improvement!) This means that their condition was getting better!!

  • Thyroglobulin (TG) antibodies dropped by 40% (−40%, P<−0.013)
  • Thyroid Peroxidase (TPO) antibodies dropped by 44% (−44%, P< 0.029)  Anti-microsomal antibodies dropped by 57%!! (−57%, P< 0.000)
figure 4
 

In contrast, the people following the “normal diet” saw an increase in thyroid antibody markers!! This means that their condition was worsening…

  • Thyroglobulin (TG) antibodies increased by 9% (+9%, P<0.017)
  • Thyroid Peroxidase (TPO) antibodies increased by 16% (+16%, P<0.004) Anti-microsomal antibodies increased by 30%!!  (+30%, P<0.028)
figure 3

After 21 days, the study patients showed a slight decrease in body weight, body mass index and lost fat mass! “With regard to the body parameters measured in patients who followed this diet, reduction in body weight (-5%, P<0.000) and body mass index (-4%, P<0.000) were observed.”

Do You Want to Know More About the Diet??

Here are the specifics of the study diet:

Low carbohydrate – The study diet program was based on the following guidelines: 12-15% carbohydrates, *50-60% proteins, and *25-30% fats (the standard Western diet contains 50% carbohydrates, 15% proteins, and 35% fats.

Veggie rich – Patients were told to eat vegetables, including large leafy greens (but to exclude goitrogens, see below).

Meats – Patients were told to eat only lean parts of red and white meat and were also allowed to eat fish.

Excluded goitrogens – The authors quoted the following foods as goitrogenic: “cruciferous [vegetables] (Brassicaceae) family (rapeseed or canola, cabbage, turnip, watercress, arugula, radish, horseradish), milk, soy, spinach, millet, tapioca, and lettuce. Even certain food additives, i.e., nitrates used for fish and meat preservation [were considered goitrogens].”

Also excluded – eggs, legumes, dairy products, bread, pasta, fruit, and rice.

*I usually recommend a higher fat and lower protein ratio for people with Hashimoto’s and have reached out to the authors of the study to clarify the ratios as well as some other info but have not heard back. One of my readers, Anasuya Basil, a certified nutrition consultant mentioned that she believed the protein and fat ratios may have been accidentally switched by the authors of the paper. Per Anasuya “When I try to create a meal plan with the macronutrient %s that is recommended I find that this would effectively cut out nuts and seeds because that easily boosts the fat % well over 25-30%. Given that this diet already excludes grains and legumes, it would be harder to get adequate fiber without nuts and seeds. Vegetables are not high in fiber relative to grains/legumes/nuts and seeds. I suppose you could include berries and figs to get that fiber, but this is very limiting.”

The Root Cause Approach

I was really excited to see that a diet very similar to what I’ve been recommending since 2012 now has research to back it up!!

If you’re new to my work, here are my dietary guidelines in a nutshell that align with the study

I always advocate for a diet that is gluten free (due to sensitivity in up to 88% of people with Hashimoto’s), free of soy, canola, and rapeseed, due to potential goitrogenic properties that have been found to be an issue in Hashimoto’s.

I also recommend avoiding dairy products (not due to goitrogen content, but rather due to dairy protein sensitivity that is present in up to 80% of people with Hashimoto’s). It’s best to eat nitrate free meats when possible and limit processed foods and meats in general.

In many cases, I suggest an Autoimmune Paleo diet (excludes grains like rice and corn, excludes legumes and eggs in addition to nuts and seeds). I will often recommend staying off millet for advanced cases of Hashimoto’s, as it is a seed which can be reactive in some, with tapioca/cassava I urge moderation due to starchy content. In some cases, I may also recommend a restriction of fruit.

Differences Between the Study and My Recommendations

I previously wrote a post about goitrogens—a goitrogen is any substance that interferes with thyroid function—the tricky part is that not all of them are created equally, and not all of them work in the same way. Overall, my position on goitrogens in the crucifer family like broccoli, cabbage, turnip and the like has been that they are healthy for most people with Hashimoto’s and that they help the body detoxify, especially when cooked, fermented or lightly steamed, but even in their raw state. I have not seen issues with cruciferous vegetables in most clients, with the exception of those with small intestinal bacterial overgrowth (SIBO) (because crucifers are high in FODMAPs, which aggravate SIBO), and in those with the CBS genetic mutation (due to the high sulfur content of crucifers).

Lettuce is hardly ever something I recommend avoiding, with the exception of some cases of irritable bowel syndrome, as any raw veggies can aggravate IBS and we know that lettuce is not exactly a cookable thing 😉

Fat vs. protein vs. carb ratios – I often have people play around with their fat to protein to carb ratios to eat what fits them best. Some people (especially if they’re more active) will benefit from more proteins. Others benefit from more fats, such as those with brain fog, pain, and depression. Some may even benefit from ketosis. Personally, for me, lower carbs, higher fats, and ketosis made me feel amazing for a couple of years until I hit a plateau and then needed to add back more carbs to feel my best. The bottom line is that you have to adjust the diet to your needs and your needs may change!

Critique of the Study

It’s difficult to tell whether the carb restriction, goitrogen restriction, avoiding highly reactive foods (gluten, dairy, soy, eggs), or all of the above, played a role in improving patient outcomes.

I personally have seen similar results with thyroid antibodies reducing—and sometimes going away—and symptoms like fatigue, brain fog, anxiety, IBS and pain virtually disappearing and weight and hair loss beginning to decline in as little as three weeks with carb restriction and avoiding reactive foods! I am not sure what role goitrogens play at this point… If you are already eating low carb and avoid reactive foods and are interested in being a “guinea pig” for three weeks and also remove goitrogens, I’d love for you to report back to me on what results you found!

I would love to see a study that isolated goitrogens vs. low carb diet vs. allergen avoidance. Until then, I’m happy with the interest in this direction and will look forward to hearing from my fellow root cause rebels who decide to take on the guinea pig challenge.

I wish that the control group was an actual control group (the control group should have kept eating their “normal” diet), and I also wish that low-calorie was defined. How low are we talking? 800 Calories? 1200 Calories? 1500 Calories?? Obviously, there’s a big difference between 800 and 1500 Calories!

There was very little talk about adherence. Were the study participants actually following the diet they were told to follow? Was the control group actually eating low calorie? (adherence is a challenge for many studies of this sort).

Another critique of this study is that I wish the study had been done for at least 3 months, as that is the time needed to see the full effect on thyroid antibody markers!

**In reading the introduction and conclusion, it seems that the patients following the low-carb, low-goitrogenic diet saw a reduction in thyroid antibodies and weight markers. However, in reading the results, it looks as though the low-calorie group lost the weight? In my experience, losing weight in either scenario is going to happen, at least within three weeks (those in the low-calorie group are more likely to gain it back, while the ones in low-carb group won’t gain the weight back but may eventually plateau if their adrenals are still out of balance -> 90% of people with Hashimoto’s have some degree of adrenal dysfunction in my practice -> Here’s a post about adrenals). I’ve reached out to the researchers for clarification.

Additionally, it would have been great to track patient symptoms in addition to weight because, after all, we all want not just to look better but also feel better!!

Busting Common Hashimoto’s Diet Myths…

I’m really excited that this diet is busting common Hashimoto’s diet myths.
Some people think that going gluten free is only beneficial in people who have both Hashimoto’s and Celiac disease, but none of the patients in this study were found to have Celiac disease! All of them did have Hashimoto’s, and all of the patients who followed the study diet had a reduction in thyroid antibodies!

Many people with Hashimoto’s are also dairy sensitivity (up to 80% felt better in my survey). Interestingly, the study reported that 83% of people with thyroid antibodies had a deficiency in lactase, which is an enzyme that digests lactose in milk. In my experience, the casein in milk is more of a problem than the lactose, however.

Have you heard the myth that a low carbohydrate diet is “bad” for Hashimoto’s? Again, this is a common myth, but this study has shown that this is not the case and that low-carb is actually beneficial. Furthermore, I’m excited to see evidence that supports eating proteins and fats 🙂

So what about the goitrogen myth? I still hold my original stance but am willing to re-evaluate this position given more evidence. If you are already eating low carb and avoid reactive foods and are interested in being a “guinea pig” for three weeks and also remove goitrogens, I’d love for you to report back to me on what results you found… because after all, how you feel is most important!!

Conclusion

If you would like to reduce your TPO antibodies, reduce your TG antibodies and feel better (and potentially lose up to 5% of your weight), try the following plan for three weeks!

  • Free of highly reactive foods (gluten, grains, eggs, soy, dairy, legumes)
  • Low carbohydrate diet (low in fruit too!)
  • Rich in veggies (maybe even limit goitrogens?)

To help get you started, download your free 2-Week AIP Recipe Plan below!

I hope this helps you on your journey!!

References
  1. https://www.dovepress.com/effects-of-low-carbohydrate-diet-therapy-in-overweight-subject-with-au-peer-reviewed-fulltext-article-DDDT
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Disclaimer: The information contained herein is for informational purposes only and should not be construed as medical advice. Please consult your physician for any health problems and before making any medical or lifestyle changes.

Lifestyle changes can result in improved thyroid function and/or an increased absorption of thyroid hormone medications, leading to a lower required dose and possible symptoms of hyperthyroidism at a dose that was previously stable. Please discuss lifestyle changes with your physician and ensure that your thyroid function is monitored every 6-8 weeks while making lifestyle changes. Symptoms of overmedication include, but are not limited to: rapid or irregular heartbeat, nervousness, irritability or mood swings, muscle weakness or tremors, diarrhea, menstrual irregularities, hair loss, weight loss, insomnia, chest pain, and excessive sweating. Do not start, change, increase, decrease or discontinue your medications without consulting with your physician.

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Comments

  1. Hi Isabella,
    I loved reading your story an found it so inspiring.
    I am 72 and was diagosed last April with Hashimotos. Then I knew why I was feeling the way I was.
    I was wondering what your thoughts are on organic swiss water decaff coffee are ?

    Reply

    • Kathy- Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! In some,
      removal of gluten will lead to intestinal healing within three months,
      in others, it may take up to two years.Other foods may cross-react with gluten and cause a similar immune response as well as intestinal permeability, and include: dairy products, chocolate, yeast, oats, and coffee. Also, Tannins in tea and coffee
      can inhibit iron absorption and should be spaced out by an hour
      from iron-containing meals. Here are a couple of articles you may find to be helpful!! 🙂

      FOOD SENSITIVITIES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply

  2. Hi Izabella, Thanks for this article, indeed all of your articles on Hashimoto’s Thyroiditis. Sometimes I would like to print one of your articles so that I can have it on hand. Is it possible to have a print button? Also, my teeth have suffered since I’ve had Hashimoto’s and I have had a dry mouth for about 6 years now. Last time I was at the dentist she told me to rinse my mouth twice a day with a teaspoon of bicarb in a glass of water to make my mouth more alkaline. An acidic mouth destroys the enamel on your teeth.

    Reply

      • Thank you for helping Marcia know how to print the articles. I think she may be referring to an option to “print” which would exclude all the blue hyperlinked article titles in the right margin, all the comments here, and maybe even the full-color photo at the top of the article. Many websites offering helpful and practical articles like these will offer a “print” button which reduces the printable portion to just the article. It saves on ink and makes it so much more practical for printing. Thanks for listening!

        Reply

  3. Hi Dr. Wentz,
    I’m really grateful for your website and resources.
    I have been a vegetarian for nearly two decades and would never consider changing that. I have been reading your suggestions about avoiding egg, dairy and soy but these are primarily ingredients in my diet, along with fruits and vegetables.
    Do you have suggestions for a vegetarian form of this diet?

    Heartfelt thanks!

    Reply

  4. Hi Dr. Wentz,
    I was diagnosed with hypothyroidism when I was 19, I’m now 42. I never thought I had any symptoms (although looking back, I can see there were some) and have always been thin. My dose of levothyroxine went up during and after pregnancy and recently it went up again. I’ve definitely been more tired over the past 10 years since having kids and joke about my “mom brain.” However, when my doctor recently said we need to up the dose even more, I got concerned, what is going on? At first I thought maybe it was too many kale smoothies, but I don’t usually have raw kale more than twice a week. I’ve also had some other symptoms, such as increased fatigue, brain fog, and joint pain. I’ve also always had a touch of IBS. (I was tested for celiac 3 years ago and had a colonoscopy and biopsy, all which came back normal.) As a dietitian, I eat a very healthy, balanced diet, but definitely have the “all foods can in moderation approach.” After reading up on functional and integrative nutrition, reading your articles, and a book by dietitian Kathie Swift, I decided to eliminate gluten and dairy from my diet last month. I’m also trying to avoid soy and limit corn. But I feel like there are so many other foods to be aware of too. Honestly, it’s all a little overwhelming, even for a food-versed dietitian, and I’m wondering if I should seek out a functional medicine doctor. Also, is it even possible to improve thyroid function in someone like me who has had it for 20+ years? Thank you!

    Reply

  5. Isabella,
    I have read over and over about the diets for hashimotos. I’m really struggling with the low carb no grain and legumes idea. I was a vegetarian for 27 years and during some of those years I was a vegan. I started eating chicken, turkey, tuna and salmon about 3 years ago. Unfortunelty I’m not a fan of meat eating and want to become a vegan again. But how can I do that without getting my protein from grains, legumes and nuts and seeds? I do notice I feel better with less grains and no nuts or seeds. Plus I believe I have leaky gut. Isn’t protein one of the things that leak into my blood stream? I have been gluten and soy free for about a year now and am dairy free for 4 whole days. I feel very concerned that eliminating all these trigger foods wil leave me in a state of poor nutrition.

    Reply

    • Paulette- Recovering from adrenal fatigue and hypothyroidism when following a vegetarian diet is very challenging, as vegetarian diets are often carbohydrate heavy.
      Vegetarian sources of protein such as legumes (beans), dairy, grains, soy and some seeds may be incompatible with trying to heal a leaky gut, which is almost always present with Hashimoto’s. Pea protein is an alternative that may be easier to digest and is less likely to cause food sensitivities (I use NOW Foods brand).

      Eggs, some seeds, and nuts would be the preferred sources of protein for vegetarians, however, some people with Hashimoto’s may be intolerant to those as well, especially in the early stages of starting a healing diet.

      Being a vegan is even more challenging, and nuts and seeds would be the go-to source of protein, which are usually too difficult to digest for many in the beginning of their thyroid healing journeys.

      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.

      Additionally, many former vegans have reported improved symptoms of Hashimoto’s following transitioning to a Paleo diet. Based on this, I believe that animal proteins must play an important role in building back the health of people with Hashimoto’s.

      That said, while meats and fats are important for healing, eating them exclusively will produce an acidic environment in the body; hindering healing, and thus the diet should be balanced with plenty of nutrient rich vegetables (suggested ratio may be 20% meat/80% veggie).

      Additionally, vegan and raw vegan diets can be extremely helpful for cleansing and detoxifying, especially for those with persistent protein digestion issues. A vegan diet can be followed for a few days to a few weeks and may help the body detoxify. B12 and iron or ferritin supplements should be utilized at this time to prevent deficiency.

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply

      • Izabella, thank you very much for this clarity!! I’m plugging a way little by little as my fatigue levels are very high. Post Exertional Malaise is one of my common symptoms and it doesn’t take that much to get me there. I am gluten free for a year now, soy free for several months and now 6 days dairy free. I raised my vit. D levels from 16 to 36. I found my body wasn’t utilized vit. D supplements or prescription that did not have the k1 and k2. Ive also had very little nuts but I see my major mistake is that I eat legumes just about every day. Out the door they shall go!! or at least out of my diet. I am taking selenium and Vit. E, and trying to locate a 30mg supplement of zinc that also has 2 mg of copper. Again, thank you!

        Reply

  6. I have been on this diet now for 10 days. I have had a goitre for nearly thirty years. I will let you know how it goes. Feeling better already!

    Reply

  7. I have mostly been following your dietary guidelines – no dairy, eggs, soy, gluten, processed food or coffee. But I am vegetarian and no matter how hard I try, I can’t tolerate meat. I don’t want to have to try to, even. Beans and legumes give me protein and rice a few times a week makes me feel like I’ve had actual food. I’ve been doing this very diligently for a little over 2 weeks and I’ve lost 7lbs and I do feel better now that the initial detox from caffeine is over. Is it safe to say that rice and legumes aren’t a problem for me? I haven’t had my antibodies checked since I was diagnosed many many years ago. Perhaps I should get a starting value?

    Reply

    • Candance – thank you for following this page. Please, understand that due to liability issues, I am unable to answer specific medical questions.

      Recovering from adrenal fatigue and hypothyroidism when following a vegetarian diet is very challenging, as vegetarian diets are often carbohydrate heavy.

      Vegetarian sources of protein such as legumes (beans), dairy, grains, soy and some seeds may be incompatible with trying to heal a leaky gut, which is almost always present with Hashimoto’s. Pea protein is an alternative that may be easier to digest and is less likely to cause food sensitivities (I use NOW Foods brand).

      Eggs, some seeds, and nuts would be the preferred sources of protein for vegetarians. However, some people with Hashimoto’s may be intolerant to those as well, especially in the early stages of starting a healing diet.

      Being a vegan is even more challenging, and nuts and seeds would be the go-to source of protein, which are usually too difficult to digest for many in the beginning of their thyroid healing journeys.

      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.

      Additionally, many former vegans have reported improved symptoms of Hashimoto’s following transitioning to a Paleo diet. Based on this, I believe that animal proteins must play an important role in building back the health of people with Hashimoto’s.

      That said, while meats and fats are important for healing, eating them exclusively will produce an acidic environment in the body; hindering healing, and thus the diet should be balanced with plenty of nutrient rich vegetables (suggested ratio may be 20% meat/80% veggie).

      Additionally, vegan and raw vegan diets can be extremely helpful for cleansing and detoxifying, especially for those with persistent protein digestion issues. A vegan diet can be followed for a few days to a few weeks and may help the body detoxify. B12 and iron or ferritin supplements should be utilized at this time to prevent deficiency.

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply

  8. I find all of the information very interesting. Would you have any diet advice for someone with hyperthyroid and glouters?

    Reply

    • Cindy – thank you for following this page. Please, understand that due to liability issues, I am unable to answer specific medical questions.

      Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually, people with Graves have hyperthyroidism, and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own, and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.

      We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Hashimoto’s Protocol
      thyroidpharmacist.com/protocol

      Reply

  9. I find it really hard to have a diet “rich in veggies” when there are hardly any veggies left to eat. “Plenty of green leafy vegetables…” except spinach and kale and, according to this Italian study, maybe not even lettuce. What’s really left here? Swiss chard and arugula? Also, once you remove tomatoes, peppers, eggplant and potatoes (all nightshades), you’re left with a swiss chard and arugula salad, celery and carrots. Not very nutritious. Even most green olives have a pepper in them (pimiento), so you have to make sure to get the ones without pimientos.

    So, since salads are hardly very nutritious anymore, I start steaming vegetables to make up for it, but even these choices we can’t be 100% sure about. I steam “Normandy vegetables” from Costco which is broccoli, cauliflower, carrots and yellow peppers (I throw out the yellow peppers since they’re a nightshade). If I didn’t eat these, I’m not sure what other veggies my diet could be “rich” in. Cucumbers and beets? Yeah, okay.

    I also eat a lot of sweet potatoes and green plantains. But, I wouldn’t say my diet is “rich” in veggies. I barely feel the need to eat anymore, actually. I guess removing sugar and empty carbs from my diet really changed my appetite. I eat a breast of chicken and a burger every day, a lame salad of greens I’m not supposed to eat, steamed veggies I’m not really supposed to eat either, a sweet potato and a plantain. That’s about it. Every day. Some days I’ll have a piece of salmon or have a cucumber, some beet or a piece of fruit.

    I feel better but don’t think I’m eating a very nutrient-dense diet. I try to make up for that with organic moringa powder, which supposedly has enough vitamins to live on (starving people in 3rd world cultures live off it, basically).

    Reply

  10. I have Graves’ disease and this was Such a helpful article. Thyroid storm beginnings in 2016 and a university study on Chris kresser’s website had me obsessing over reverse T3, which sounded like me in every part of the description (chronic fatigue and hypo thyroid symptoms in a hyper
    Thyroid patient) and matched my thyroid numbers (my RT3 was 34). The university study said a high carb diet conclusively helped. I started it. 2 months later I began having emotional meltdowns. I started crying and screaming a lot. My body started feeling like it was made of electricity. For 8 months I loaded my body up with carbs until every day I was balled up and writing with sobs and during these episodes, self harming on a regular basis. One day I realized it was the carbs. The next day I went on a ketogenic diet. I am still recovering but I have fewer and fewer episodes, I feel less and less electric, I suddenly have energy that is approximately normal, and I feel calm more often and for longer. I already knew diet could affect your thyroid health (eliminating gluten healed all the tumors on my thyroid over 2 years), but this change is really improving the way I feel physically and mentally and I am so grateful others are talking about it. I am very hopeful for the future.

    Reply

    • Cherie – Thank you for following this page and for sharing. It is good to hear that you are doing so much better! <3

      Graves and Hashimoto's are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto's, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto's results in hypothyroidism and is usually treated with Synthroid and replacement hormone.

      The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually, people with Graves have hyperthyroidism, and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own, and these people end up on Synthroid as well.

      Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.

      We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Hashimoto’s Protocol
      thyroidpharmacist.com/protocol

      Reply

  11. Hi Izabella,
    Thank you for all the wonderful work you are doing to give people this information. I have had Hashimotos for 10 years and was taking Levothyroxine this whole time. I still had many symptoms even with the medication. I first saw you in the Betrayal documentary and then my doctor recommended your book. When the thyroid secret series came out my mom sent me the link and I watched it. I began following the Autoimmune Protocol almost two weeks ago. Within a few days I had seen such dramatic results that I was starting to see symptoms of overactive thyroid. Working with my doctor, I reduced my thyroid dose by half. I have not felt this good in years!!! I have energy, I am losing weight (finally), and I feel like for the first time in my life, I am in control of my health. Thank you! And you can count me as one of you success stories ?

    Reply

  12. Hello Dr. Wentz,

    I tried the paleo diet without milk and grains for about 7 weeks.
    I lost 7 kg and looked very bad and sick. I came into the range of underweight. I also became very weak and had no more energy. Significantly less than before. Everything was getting worse and worse. I felt extremely malnourished even though I ate a lot.

    Now I eat dairy products and gluten-free grains. I look better and my weight is rising. But I have a lot mucus in the throat and have some more digestive problems.

    I have been trying to find the right diet for me for many years. It’s really hard, because Paleo probably has a very negative effect on me. Probably due to the high liquid content. The more liquid I take, the worse my symptoms become. I have CFS, MCS and a pain syndrome.

    I have ordered your new book, and I hope that they will also have helpful tips for the people who do not get along so well with Paleo.

    Thank you for your great videos and your books

    P.S. If you have any tips for me would be great 😉

    Reply

    • Alan – thank you for following this page. Did you know that reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients (gluten sensitivity, in particular, has been implicated in causing a Selenium deficiency, a well-known risk factor for Hashimoto’s), and can also produce intestinal permeability whenever they are eaten?

      Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts, and pain by eliminating the foods they are sensitive to. Some will also see a significant in thyroid antibodies! An additional subset of people will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.

      FOOD SENSITIVITIES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

      TAILORING YOUR THYROID DIET
      https://thyroidpharmacist.com/articles/tailoring-your-thyroid-diet-to-your-needs

      Reply

  13. I have been eating a strict diet for the last seven years. I only ate proteins, fats and low carbs, no fruit at all. A year ago, I tried to start eating a Paleo diet. I added berries, almond and coconut flour, almond butter, and nuts. I didn’t notice a big change until I started experimenting with smoothies and juicing. I was only having one green juice per day for one month. In that month, my cycle never started, I was always regular and never skipped a month. I was using kale in my juice everyday. After a month, I really saw a change in my energy and had more depression, so I discontinued juicing. My cycle started about 5 days later. The next month, I ended up in the hospital because my hormone levels had dropped so low, and had extreme amount of blood loss and passing large blood clots. I had not felt well after doing smoothies a few months earlier using spinach. But I only did those for a couple of weeks. After researching, I assume that it was from the raw cruciferous vegetables. I have just started reading your book, Hashimoto’s Protocol. I am going to try and follow it as close as I can. On your green smoothie and green juice, do you recommend that I leave off the baby greens and kale or just not have them often?

    Reply

  14. Thank you for this post. I was diagnosed with hypothyroidism about 9 years ago. At the time, my doctor did not indicate that it was Hashimoto’s. She put me on Levothyroxine and that was it. A year or two later, I trained for a marathon. My TSH levels went crazy (worse). I asked the doc if my training had anything to do with it. She said absolutely not. She did not ask about diet or anything else. Besides the adrenal issues that were probably occurring during that training, I was also carb loading often eating large bowls of glutinous pasta before long runs. During my next annual physical while no longer training, I was tested again and we had to reduce my levothyroxine dose. Since then my doctor has joined a functional medicine practice. My test results are posted in a portal. I have had elevated TPO Ab (in the low 100’s) for the past 4 years. She has never mentioned that as an issue. I had an episode of elevated heart rate and panic attacks about 3 years ago. I went to the doctor and saw the nurse practioner. The rn told me to avoid gluten and prescribed magnesium. That combination dramatically improved my condition or at least how I feel. Since then I have been researching the effect of diet on Hashimoto’s. I’ve now also eliminated dairy and follow a mostly paleo diet, with the exception of occasional rice and corn. I have tried very low carb but exhaustion begins to set in if I keep it up too long (over 1 month or so). Maybe a T4 – T3 conversion issue? I have great respect for the medical profession but I think it fails us in two ways: 1) rarely do doctors seek to get to the root of a medical issue, instead focusing on naming the problem, i.e. Diagnosis, and eliminating symptoms and 2) they do not acknowledge that diet is a huge factor in preventing illness. So thank you for your work, for citing the reasearch and noting your observations/problems in the research.

    Reply

  15. Going vegan high carb (Raw Till 4) improved my condition, I was getting most of my calories from bananas, dates, apples, mangoes, papaya, pineapples, persimmons, melons, etc. Eating 3000+ calories per day and lost lots of weight whilst also gaining lots of energy. Only when I started adding in cooked foods containing gluten / wheat and or refined oils did my condition worsen again. I believe the wheat relapsed the condition, and the refined oils don’t help either. Apparently Polyunsaturated Fats (PUFAs) are well connected with lowered metabolic rates, Ray Peat, PhD has some very well researched information in this area. Omega 3 and 6 PUFAs can combine with iodine to create anti-thyroid molecules.

    Reply

  16. Hi Dr. Izabelle,

    I did subscription to your series, but I am so busy did not have time to take a look. My tyriod fuction is a little bit slowed, T3 decreased (not much). Got advice to take Lugols 50mg daily, and I take it for the last 3 months. Feeling better, but would like to get your opinion about iodine for thyroid. Thanks a lot, greetings from Croatia.
    Marko

    Reply

    • Mirko – thank you for following this page.

      I’m very hesitant in recommending iodine in Hashimoto’s. Although iodine serves as fuel for our thyroid and is very important in iodine deficiency hypothyroidism, Hashimoto’s is a different mechanism. It’s like pouring gas into an engine that’s on fire… that’s essentially what’s happening in Hashi’s, thyroid inflammation, and adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, animal and human studies. I have spent 4 years researching this and have seen too many people suffering the consequences of adding iodine too soon. My approach is, let’s fix the engine first (usually a gut issue), and then add the fuel once we know that the engine is no longer on fire. Hope that you will check out my book. I have an entire chapter on the iodine controversy that references numerous studies as well as the work of Abraham and Brownstein.

      AMAZON
      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Hashimoto’s Protocol
      thyroidpharmacist.com/protocol

      Reply

      • Thx for your answer. So you basically claim that Dr. Brownstein protocol is false? You know that he claim that he has healed tousands of hypothyroidism (many of them with Hashimoto) patients with iodine… withoute any side effect. Thx.

        Reply

  17. Interesting article. I was diagnosed with hypothyroidism about 7 years ago and took Levothyroxine for about 5 years. My symptoms subsided and I stopped the Levothyroxine on my own (hate taking pills). I moved and my new doctor ran blood work which showed a still elevated TSH and he also ran TPO antibodies and TG antibodies which were also elevated. At that point I found out I had Hashimotos and was referred to my endocrinologist. I still had no symptoms (blood pressure normalized also and was off blood pressure medication), but with his persuasion I restarted Levothyroxine. At the time of recheck I asked him if I could recheck the TPO antibodies and he told me it would not make a difference. He told me with Hashimotos the thyroid is under constant attack and continues to lose its ability to function. With less ability to function, less antibodies are produced against it so you could not distinguish whether the thyroid showed improvement or more damage. In either case he would not run it. What is your opinion? He also does not believe diet can help reverse it but I do. I have been a whole foods vegan for 5 years and I take D3 and B12 supplements (pescovegetarian before that). I feel it has helped with my symptoms, however, my TSH is still slightly elevated (still working with my endocrinologist to get to a therapeutic dose). Could this diet be modified for a vegan?

    Reply

  18. Many sources show that being on a low carb/keto diet results in a reduction in the conversion of T4 to T3 as insulin is required for this conversion to occur. I need to lose weight (& have Hashimotos) so want to get on a low carb/keto diet, but concerned about potential harmful effect on T4-T3 conversion. What are your thoughts on the low carb thyroid hormone production conundrum? Any scientific evidence out there in regards to this?
    Thanks!

    Reply

    • Helen – thank you for following this page. The most common triggers in Hashimoto’s are nutrient deficiencies, food sensitivities, intestinal permeability (leaky gut), stress, an impaired ability to get rid of toxins and in some cases, infections. Optimizing your health starts with food. Figuring out which foods nourish you, and which ones cause you harm is the single most important thing you can learn in your health journey.

      I’ve found that recognizing and eliminating reactive foods can be a life-changer for most people with Hashimoto’s.

      Reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients (gluten sensitivity in particular has been implicated in causing a Selenium deficiency, a well known risk factor for Hashimoto’s), and can also produce intestinal permeability whenever they are eaten.

      Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods that they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function!

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      TAILORING YOUR THYROID DIET
      https://thyroidpharmacist.com/articles/tailoring-your-thyroid-diet-to-your-needs

      DAIRY AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/got-hashimotos-you-may-want-to-reconsider-dairy

      Reply

  20. I search the internet, been to a couple functional health doctors, spent $1000’s on supplements and tried every diet possible. I wish that I could say I have found something that works. I have never been on medication for my Hashimoto’s and have really tried to control this thing naturally. My biggest issue with having Hashimoto’s is what it is doing to my stomach. I deal with gas and bloating daily and it usually starts in the afternoon and continues until I wake the next morning. I have been gluten-free for 3yrs, tried Paleo, Keto, you name it and nothing seems to work. My husband and children have to put up with a cranky mom/wife because frankly I’m just sick of being sick after trying everything I know to do. The only thing I haven’t tried is the elimination of all the reactive foods at once. If I’m trying to eat Keto and cut out all reactive foods, what in the world am I going to eat and would I be able to sustain that long term?? I’m a fitness professional so exercise and staying active is not an issue. I am at my optimal weight I just feel like crud most of the time. Should I bite the bullet and go see an endocrinologist? My fear is that they’ll want to do a bunch of invasive testing and put me on meds immediately…. any helpful advise would be greatly appreciated as I am very discouraged.

    Reply

  21. Hello Dr. Wentz,
    I came across this article by searching for “Tapioca” I have found a delicious coconut based joghurt (if I am not mistaken you have been mentioning joghurt and kefir on a coconut basis). The product I bought contains coconut milk, Tapioca flour and joghurt cultures. No other ingredients. In the study it is said Tapioca should be excluded. Do you have any opinion about this one?

    I was so happy to have found something which is really delicious but not sure whether or not Tapioca is sth I should better exclude.

    Best, Tina

    Reply

  22. At the end of the article it mentions that the study may have switched the fat and protein percentages. Was this confirmed? I am trying to play with my macros a bit to see if it’ll help jumpstart weight loss and was curious. While I know the ideal macro for every individual may be different, is there a particular ratio that is recommended for those with hashis? Would that ratio be different for those suffering from hashi’s and adrenal fatigue? I know carbs should be limited (especially early in the day).

    Reply

  23. I would be interested if the ‘study groups’ diet was significantly changed in the Keto diet. If the study group wasn’t concerned about eating gluten and simple carbs before the Keto diet, the diet would have drastically altered their diet and their tpo test showed that. Would it have changed that much if they were gluten free and avoiding simple carbs (sugar). Sounds like they need another study. ?

    Reply

  24. Thanks! What brought my TSH down to a .975 and feeling great is a truckload of grass fed dairy, high protein, salt, high carbs from fruit mostly, some saturated fat and no unsaturated fats as well as avoiding all goitrogens.

    Reply

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