Throughout my journey to heal from Hashimoto’s, I’ve been able to eliminate all of my symptoms and get my condition into remission, using a variety of interventions. The most profound of these strategies were those that were centered around food and nutrition.
I have come to believe so strongly in the healing power of nutrition, that I’ve focused a large part of my work around teaching people which foods are most beneficial for gut healing, which nutrients are required for proper thyroid function, and which foods are commonly problematic for those with Hashimoto’s. I’ve even written my own cookbook to share my favorite recipes and strategies for using food as medicine with my readers — that’s how passionate I am about the healing potential of food!
However, eating all the organic and nutrient-dense foods in the world won’t do us any good if our bodies aren’t able to extract the nutrition we need from them. The truth is that nutrient depletions are almost always a factor in Hashimoto’s thyroiditis. In fact, I would argue that due to our current farming practices and Western diet, most healthy people have nutrient depletions, too!
Eating conventionally grown foods, taking medications and having food sensitivities can affect nutrient extraction. Gut inflammation, poor digestion, malabsorption issues, gut infections, and even hypothyroidism itself, can also influence it. For many people with Hashimoto’s, a crucial step towards healing will be addressing digestive challenges that may be preventing them from absorbing the nutrients they need.
In this article, I will explore the role nutrients play in thyroid health, including:
- The types of nutrients our bodies need
- How nutrients are extracted from the food we eat
- The many causes that affect the extraction of nutrients from food
- The most common nutrient depletions in Hashimoto’s
- How having nutrient deficiencies could be a sign of being in “survival mode”
What Are Nutrients?
Nutrients are molecules of food that the human body uses to create energy and grow, and can be broken down into two main categories: macro- and micronutrients. While macronutrients — fats, carbohydrates and proteins — are eaten in large quantities and provide the primary energy source for our bodies, micronutrients (vitamins and minerals) are eaten in relatively small quantities. However, they provide essential nourishment and keep all of our bodily systems (like our metabolism, blood pressure, and thyroid function) functioning as they should. When we talk about nutrient deficiencies, we are usually referring to a lack of these important micronutrients.
While all micronutrients serve a purpose within our bodily functions, the vitamins A, C, D, E, K, as well as the B vitamins thiamine (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folate (B9), and cobalamin (B12), are all considered essential. (This means that they are required for normal bodily functions, but the body cannot produce them in sufficient quantities to meet its needs.)
Our body’s essential minerals consist of phosphorus, potassium, sulfur, sodium, chloride, magnesium, iron, zinc, copper, manganese, iodine, and selenium, molybdenum, chromium, and fluoride.
How Does the Body Extract Nutrients?
When we eat food, our bodies break down the macro and micronutrients into smaller pieces until they can be absorbed by the body. This process is referred to as “nutrient extraction.” Depending on how well the process of breaking down food is working in your body, you could be extracting and absorbing less than 10 percent, or more than 90 percent, of the foods you consume!
The digestive process, responsible for nutrient extraction, begins in our mouths, with enzymes (amylase, lysozyme, and lipase) that are released via the salivary glands to break down the foods we chew. It continues in our stomachs, where hydrochloric acid (stomach acid) and gastric enzymes further break down the food particles before they move into the small intestine.
Here, the pancreas releases enzymes, and the liver produces bile, to break down the nutrients. This is done so that the villi (tiny finger-like bristles) on the intestinal lining can grab onto any usable nutrients and drop them into the bloodstream and lymphatic system, where they can be used by the rest of the body.
If any part of this chain is not functioning well, nutrient depletions can result.
What Causes Nutrient Depletions?
Breakdowns in digestive system function are just one of several factors that can affect nutrient extraction. The way in which our food is grown, the medications we take, the foods that we’ve developed intolerances to, stress, and even hypothyroidism itself, can all inhibit our bodies’ ability to extract and absorb the nutrients it needs to function properly. Let’s discuss a few factors that can significantly affect our ability to obtain nutrients from the foods we eat.
Due to modern farming practices, the commercially-grown vegetables, fruits, and grains that we are eating today have significantly lower nutritional content than they had 100 years ago. For example, nutrient data from the U.S. Department of Agriculture (USDA) shows that the calcium content of broccoli averaged 12.9 milligrams per gram of dry weight in 1950, but only 4.4 mg/g of dry weight in 2003.
Though the reasons for this may be numerous, evidence points to two primary factors for the drop in nutrient content of most conventionally-farmed foods. The first is what is called the “dilution effect.” Today, the use of fertilization, irrigation and other means to produce greater yields in industrial farming, tends to decrease the concentration of vitamins and minerals in crops. Essentially, as tomatoes get bigger, they also get more watery and less nutritious.
The other factor is a genetic change in farmed foods, where nutrients are bred out of food at the genetic level, in favor of higher-yield varieties. Greater yields lead to greater profits. However, they also result in crops with higher levels of carbohydrates that tend to favor caloric density over nutritional quality.
To ensure you’re getting the most nutritious food possible, it’s important to opt for organically-grown, non genetically-modified fruits and veggies whenever possible. (You can read more about how to shop for produce in my Health Food on a Budget article.) Existing studies show that organic fertilization practices produce crops with higher levels of ascorbic acid (vitamin C), lower levels of nitrates, and improved protein quality compared with conventionally grown crops.
While eating organically farmed fruits and vegetables offers a higher nutrient content, it is also important to address digestive issues to ensure that those nutrients are properly broken down and absorbed, so that the body can optimally utilize them.
Eating a diet rich in a diversity of whole foods is the best way to ensure that we are taking in a healthy array of nutrients. However, many people with Hashimoto’s may be on a restrictive diet and find that they are not consuming all of the nutrients their body needs.
One example would be the gluten free and Paleo diets, which work wonders for most people with thyroid conditions, as they eliminate gluten, and other foods that tend to be problematic for most people. However, eliminating grains, as these diets do, can lead to a deficiency in thiamine, which is crucial for energy production and often deficient in those with Hashimoto’s. Selenium, zinc, and iron are also commonly deficient in those on grain free diets, and often need to be supplemented.
Vegan and vegetarian diets that eliminate animal foods will usually cause depletions in vitamin B12 as well as in calcium, chromium, copper, iodine, iron, magnesium, manganese, zinc, and Omega-3. Low-fat diets put us at risk for deficiencies in fat-soluble vitamins such as A, D, E, and K, as well as Omega-3 fatty acids. High protein diets can cause depletions of vitamin B6. Lactose free diets deplete vitamin B1, vitamin D, and calcium. Low carbohydrate diets cause depletions in vitamins B2, B6, B9, calcium, magnesium, potassium, and iron.
The Standard American Diet (SAD) itself causes depletions in fat-soluble vitamins, calcium, iodine, magnesium, potassium, zinc, and omega-3. Therefore, it’s important to take a look at your diet and supplement where necessary, so that you are not missing out on any of the important nutrients that your body needs to function properly.
Many medications, used for a variety of conditions, can deplete vital nutrients from the body. For example, birth control pills can deplete selenium, zinc and the amino acid tyrosine, which are all necessary for proper thyroid function.
While short-term use of medications generally won’t cause nutrient deficiencies, long-term use can. In some cases, drugs can even reduce your body’s ability to absorb nutrients from food sources themselves.
This is the case with proton-pump inhibitors (PPIs), used to reduce acid reflux and heartburn, which can interfere with the body’s ability to absorb vitamin B12, calcium, and magnesium (which are often depleted in those with Hashimoto’s). While these drugs are often prescribed to reduce acid, it is actually a lack of stomach acid that is the problem for most people, particularly those with Hashimoto’s. Many people will be misdiagnosed and put on these acid blocking medications long term, leading to a further reduction in stomach acid, and in turn, a depletion of important vitamins and minerals.
Low Stomach Acid
Studies have found that people with Hashimoto’s and hypothyroidism often have hypochlorhydria (low stomach acid) or achlorhydria (lack of stomach acid). Inadequate stomach acid levels can limit our absorption of amino acids, iron, zinc, and other nutrients.
Symptoms of low stomach acid include: acid reflux, low B12, ferritin or iron levels, fatigue despite thyroid medications, and constipation/diarrhea.
To counteract symptoms, several supplements can be used to help digest protein-rich meals. One such supplement that I routinely recommend is Betaine HCl and Pepsin. In fact, of the readers with Hashimoto’s who took my survey, over 59 percent said they felt better taking betaine with pepsin! Betaine and pepsin are naturally occurring components of gastric juice that make nutrients and amino acids from our protein-containing foods more bioavailable (by breaking down protein bonds). Thus, boosting stomach acid levels with betaine and pepsin may allow nutrients (including protein, calcium, B12, and iron) to be fully absorbed.
Our gut lining is the largest barrier between our bodies and the outside world. It fills the vital role of letting nutrients into the body while keeping bacteria, viruses, parasites, and toxins out. When the integrity of the gut barrier is impaired, these harmful organisms and substances can “leak” into the body through “holes” in the intestines, hence the term leaky gut. (This is also known as “intestinal permeability.”)
Low stomach acid, enzyme and nutritional deficiencies, bacterial imbalances, stress, certain medications, and infections can all lead to a leaky gut. Boosting stomach acid to help the body break down food for absorption (as mentioned above) will help prevent undigested food particles from damaging the gut lining.
Furthermore, drinking bone broth, which contains collagen, gelatin and amino acids to heal the gut lining, as well as following gut healing protocols such as the one in my book, Hashimoto’s Protocol, will also help to repair damages to the gut barrier and reverse leaky gut.
When the “holes” in the intestinal walls are repaired, the body will be better able to absorb nutrients from the foods it consumes!
Food sensitivities are known as type IV delayed hypersensitivity reactions, governed by the IgG branch of the immune system. As the name implies, they do not occur right away, unlike food allergies (think peanut allergies), which occur immediately. In fact, it can take up to four days for them to manifest, and this is one of the reasons why it’s so hard for most people to correlate food sensitivities with symptoms.
The most common food sensitivities found in people with Hashimoto’s are gluten, dairy, soy, grains, nightshades (potatoes, tomatoes, and peppers), nuts, and seeds. However, a person can become intolerant to any food!
In surveying my readers and clients, I’ve found that about 93 percent have felt better on a gluten free diet. Another 75 percent reported feeling better on a dairy free diet, 73 percent felt better grain free, and another 60 percent said they felt better soy free. Egg and nightshade free diets were helpful 40 percent and 35 percent of the time, respectively.
People with Hashimoto’s are also five times more likely to be diagnosed with celiac disease, wherein they experience an autoimmune attack on their intestines with every bite of gluten. This attack destroys the villi, which are delicate, hair-like projections that cover the intestines. The villi are important, as they help the body digest and absorb nutrients from food. Recently, gluten intolerance has been described as a spectrum, with only the most severe cases being diagnosed as celiac disease.
When people continue to eat the foods they are sensitive to, it can damage their intestines, and in turn, rob them of vital nutrients. Elimination diets and food sensitivity testing can help identify the food culprits. Eliminating them (for a time, or indefinitely) will allow the gut a chance to heal.
Lack of Digestive Enzymes
Many people with Hashimoto’s have a deficiency of digestive enzymes that prevents them from breaking down the foods they eat for proper absorption. This can contribute to food sensitivities and nutrient depletions when the body is unable to break down food into small enough pieces for nutrient extraction.
Around a third of people with Hashimoto’s may have deficiencies in bile and/or pancreatic enzymes, which can lead to issues with fat absorption. Additionally, up to 80 percent of people
with Hashimoto’s may have difficulty digesting plant fibers. The digestive process demands a lot of energy, so when it requires more metabolic work than normal, it can be taxing on the body.
Utilizing easy-to-digest foods and targeted digestive enzyme supplementation can restore proper digestion and eliminate symptoms like fatigue, virtually overnight. Many people are amazed by how much more energy they have after they start taking digestive enzymes, such as Rootcology Pancreatic Enzymes Plus, with their meals. You can read more about digestive enzymes here.
Gut Bacteria Imbalance
Our bodies depend on a vast army of microbes that perform a variety of crucial functions, including protecting us against germs, breaking down food to release energy, and producing vitamins.
People with autoimmunity have been found to have lower amounts of the probiotic bacteria Lactobacillus and Bifidus, as well as higher amounts of the opportunistic E. coli and Proteus bacteria. E. coli and Proteus bacterial species are often referred to as “opportunistic pathogens” because they only become pathogenic when the opportunity is just right. If they are outnumbered by good probiotic bacteria, they behave like good citizens of the gut and may add value to one’s gut health; but in times where they outnumber the probiotics, they may start to damage the gut wall, leading to intestinal permeability. This will, in turn, lead to food sensitivities and nutrient malabsorption.
The solution? Eating fermented foods and taking a high dose probiotic can populate the intestines with enough “good bacteria” to outnumber the opportunistic ones and help restore balance to the microbiome. Addressing underlying infections like Candida overgrowth and SIBO can also lead to a healthy balance of gut bacteria that will help heal a leaky gut and allow for nutrient absorption.
Reduced Liver Function
The liver is an important organ that is responsible for a multitude of processes: it filters the blood, stores glucose for energy, produces and secretes bile for fat digestion, and is necessary for converting T4 to the active T3 hormone. It’s also our primary detoxification organ.
An accumulation of toxic buildup in the liver (caused by toxins in our environment and the foods we eat) will reduce its ability to secrete bile and digest food, leading to nutrient deficiencies, along with bile and gallstone issues that tend to be more common in Hashimoto’s.
Additionally, a liver that is overburdened may cause extreme sensitivities to foods that it cannot process, which will lead to intestinal damage and a further depletion of nutrients.
Supporting the liver by removing toxins in our food and environment, eating foods that support liver health, and adding liver support supplements, such as the Rootcology Liver Support Kit, will help the liver produce adequate bile to boost digestion and increase nutrient extraction.
Hypothyroidism, in itself, will lead to poor extraction of minerals and vitamins from our food sources. It can be a bit of a “chicken or the egg” scenario — which came first, hypothyroidism or nutrient depletions? The answer is… either! A lack of essential nutrients can be a triggering event for Hashimoto’s, but having a thyroid disorder can, itself, also cause a depletion of nutrients.
Thyroid hormones determine our metabolism throughout the entire body, regulating everything from temperature, to hair growth and skin turnover. As such, the digestive tract is also impacted by thyroid hormones. A lack of sufficient thyroid hormones inhibits every aspect of digestion, from enzyme production to liver function, making nutrient extraction more difficult and less efficient.
One study conducted on rats observed that the rats who were hypothyroid showed an increase in intestinal transit time (diarrhea), while the rats who were hyperthyroid showed a decrease in bowel motility (constipation). A direct correlation was found between levels of T4 (thyroid hormone) and intestinal motility, highlighting one of the ways that thyroid hormones themselves affect gut health.
It’s important to note that a bowel that is impacted (as seen with constipation) may create a physical barrier in the small intestine, blocking the absorption of nutrients. This can also disrupt healthy gut flora and cause toxins to be reabsorbed into the body, instead of eliminated. On the other hand, food that moves too quickly (as seen with diarrhea) through the digestive tract may not be fully absorbed, resulting in a loss of macro and micronutrients.
Thus, optimizing thyroid hormones may promote healthier bowel functions, which in turn will help us better absorb nutrients.
Common Nutrient Depletions in Hashimoto’s
Now that we’ve covered the top eight causes of nutrient depletions, let’s talk about the seven nutrient depletions that are most likely to affect those with Hashimoto’s. Given that the thyroid relies on these highly-specific nutrients to perform optimally, and each nutrient has its own important role, addressing such depletions is vital to reversing Hashimoto’s! Some nutrients can be supplemented safely without specific testing, while others require testing to ensure proper dosage and use.
The four thyroid supplements that are safe and helpful for most, without lab testing, are:
- Thiamine – Also known as B1, thiamine is responsible for converting carbohydrates into energy and also helps with the digestion of proteins and fats.
- Selenium – Selenium is an important trace element and antioxidant required for healthy thyroid hormone synthesis and metabolism.
- Magnesium – Magnesium is necessary for more than 300 biochemical reactions in the body: it supports the immune system, maintains normal nerve and muscle function, regulates the heartbeat, strengthens bones, keeps blood glucose levels steady, and plays a role in the production of energy.
- Zinc – Zinc is involved as a catalyst in many different pathways in the body. It’s also very important for gut health, immune function, tissue healing, the conversion of T4 to T3, and the production of TSH. It can help tighten the intestinal junctions of those with intestinal permeability, as well.
Other nutrient deficiencies require lab testing prior to supplementation. This is the case with certain minerals and fat soluble vitamins that may accumulate in the body, leading to excess. Lab results can help determine the specific dosing and supplement duration that are right for you.
The three most important nutrient tests I always recommend for people with Hashimoto’s are:
- Vitamin D – Vitamin D is necessary for helping your body to absorb calcium and strengthen your bones, but it also plays an important role in your immune system health.
- B12 – Vitamin B12 is an essential water-soluble vitamin that is commonly found in animal proteins and is required for protein synthesis, cell reproduction, and normal growth.
- Ferritin – Ferritin is our iron storage protein. Low levels are commonly associated with Hashimoto’s and may lead to fatigue, difficulty breathing, and hair loss.
For detailed information about these nutrients, including dosage and testing, please see my article on the seven most common nutrient deficiencies in Hashimoto’s.
How Starving the Body of Vital Nutrients Perpetuates Hashimoto’s
I do think the reason why Hashimoto’s is so prevalent these days is almost always linked to issues with nutrient absorption, in addition to constantly being in “survival mode.”
My theory is that when the body believes that the world is not a safe place, (due to various factors such as external stressors, threats, and pathogens), it goes into energy-conservation mode, which can slow down the thyroid. Over the years, I have called this theory “The Safety Theory of Hashimoto’s.” In essence, this theory is about survival.
Interestingly, research has shown that the thyroid gland works with our immune system to sense our environment and to help us survive. In fact, a 2013 study found that the thyroid gland can sense danger and initiate an inflammatory autoimmune response against itself, through molecules known as danger associated molecular patterns (DAMPs).
Our bodies have evolved to achieve two main goals: to help us survive, and to help us reproduce and perpetuate our species. So, to ensure the best chances for survival, our bodies are constantly sensing our environment and adapting to it.
A concept referred to as “adaptive physiology” suggests that our bodies develop chronic illnesses in response to our environment. In other words, adaptive physiology suggests that chronic illness serves a protective role when our bodies feel threatened in our environment, be it by a predator, or another cause of external stress.
One of the main threats to survival for early humans was food scarcity, and an effective survival technique was to reduce one’s metabolism so fewer calories would be required. The body accomplishes this by slowing down the thyroid gland, which regulates metabolism. I believe that early humans developed the propensity toward thyroid conditions because this helped us survive in times of famine.
Although famines are rare in today’s developed world, we may send the same signal to our bodies when we aren’t getting adequate nutrients — if we can’t extract them from the foods we’re eating, or by eating processed and factory-farmed foods that are lacking in nutrients, being on a calorie-restricted diet, eating foods that we are intolerant to and cause inflammation or digestive difficulties, and even eating when stressed. All of these signal to the body that food (and nutrients) are scarce, and that we are in a famine.
In other words, starving our bodies of vital nutrients can send signals that our environment is not safe, and that we need to go into survival mode. This slows down our metabolism and perpetuates hypothyroidism, as well as allows nutrient deficiencies to go unaddressed.
That is why improving one’s extraction of nutrients from food is so important!
Many factors, including modern farming practices, a lack of enzymes and stomach acid, suboptimal gut health, and an overburdened liver, can affect the amount of nutrients that we can extract from our diet. Furthermore, making our bodies believe we are depriving ourselves of vital nutrients can exacerbate the autoimmune attack on the thyroid. So how do we address underlying issues related to nutrient extraction and autoimmune thyroiditis? Fill our plates with organic, whole foods. Work to heal digestive issues, with probiotics, digestive enzymes, and betaine and pepsin. Remove food tiggers, to heal intestinal damage. Eliminate toxins that burden the liver. And slow down, to enjoy a nutrient-dense, home-cooked meal! Once we do that, our bodies will think we are safe again, and Hashimoto’s symptoms can be reversed.
To make getting the most nutrition out of your food as easy for you as possible, I created my very own cookbook, Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health, which has just been released!
The goal of my cookbook is to make eating a nutrient-dense, gut-healing diet easy for you to achieve. In it, you’ll find 125 recipes that are full of all of the foods your body needs to heal your thyroid and thrive.
Additionally, you’ll discover the best tools and resources for making diet changes an easy part of your life, including customized dietary modifications for specific food sensitivities, strategies for optimizing digestion and gut health, and a guide on how to use supplements to provide your body with the nutrients it’s craving.
I am certain that you will find my new cookbook to be a helpful resource for healing your gut and getting the most nutrition from your meals. I can’t wait to hear what your favorite recipes are! In the meantime, as always, I wish you well on your healing journey!
You can also download a Thyroid Diet Guide, 10 thyroid-friendly recipes, and the Nutrient Depletions and Digestion chapter of my first book for free! You will also receive occasional updates about new research, resources, giveaways and helpful information.
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Note: Originally published in February 2015, this article has been revised and updated for accuracy and thoroughness.