Featured Recipe: Crispy Oven-Fried Fish Tacos
The relationship between food and health is crystal clear: a balanced diet may protect you from a number of chronic conditions. Likewise, a diet tailored to your individual needs when you’re diagnosed with a health issue may go a long way to helping you feel your best, despite the illness.
That’s the case with Hashimoto’s disease, an autoimmune disorder that attacks the thyroid gland. Here, learn more about the disease, its symptoms, possible treatments and what you can eat (and what foods you should avoid) to best manage the condition.
Try These: Healthy Dinner Recipes
What Is Hashimoto’s Disease?
Featured Recipe: Taco Spaghetti Squash Boats
Hashimoto’s disease, also called Hashimoto thyroiditis or chronic lymphocytic thyroiditis, is a condition that causes the immune system to attack the thyroid gland, resulting in chronic inflammation. Over time the thyroid gland is damaged, causing hypothyroidism, a condition where the thyroid is underactive and incapable of producing the hormones necessary for several bodily functions. Hashimoto’s is the most common cause of hypothyroidism in the United States.
Symptoms of Hashimoto’s disease include fatigue, unexplained weight gain, constipation, sensitivity to cold, and dry skin. The disease tends to progress slowly, which means symptoms tend to get over many years. Hashimoto’s is most common in middle-aged women, but also affects men and children and women of all ages.
Hashimoto’s disease can be controlled with a prescription synthetic hormone medication called levothyroxine, plus a balanced diet. While a nutritious eating plan cannot cure any autoimmune condition, it helps reduce the ongoing inflammation associated with Hashimoto’s, which may help you feel better and support your overall health.
Read More: The Surprising Link Between Chronic Inflammation & Obesity—Plus What You Can Do About It
Diet and Hashimoto’s Disease
Featured Recipe: Simple Grilled Salmon & Vegetables
There is not a single prescribed diet for Hashimoto’s, and no diet has been proven to treat the condition. Though thyroid hormone replacement medications help manage the symptoms, experts say that the drugs don’t treat the underlying problem (the autoimmune process that causes the body to attack the thyroid).
It’s unclear what kickstarts the autoimmune response that harms thyroid function, but increased intestinal permeability, also known as “leaky gut,” may play a role. Julie Stefanski, RDN, spokesperson for the Academy of Nutrition & Dietetics, says, “Despite the fact that there aren’t standard recommendations for everyone with autoimmune disease, many people are investigating the influence of gluten on their personal health. Emerging research has linked gluten, found in wheat, barley and rye, with the production of a protein called zonulin in the intestine. Zonulin is thought to affect the tightness of the connections between cells in the intestine, allowing increased absorption of substances that may trigger an immune response.”
People with Hashimoto’s disease may also have celiac disease, which damages the small intestine. Celiac disease is another autoimmune condition. There is no cure for celiac disease but it can be managed with a gluten-free diet. When starting a gluten-free diet, it’s important to work with an experienced healthcare professional, like a registered dietitian nutritionist, for an individualized nutrition plan. Poorly planned gluten-free diets are linked to a higher risk for nutrient deficiencies, particularly B vitamins, vitamin D, calcium and iron.
Those with Hashimoto’s may find that avoiding gluten eases symptoms. In a survey of over 2,000 people with Hashimoto’s conducted by Izabella Wentz, Pharm.D., FASCP, 88% felt better after following a gluten-free diet. However, a 2022 review of gluten-free diets and Hashimoto’s published in Nutrients found no evidence that going gluten-free is beneficial. It concluded that only people with celiac disease or gluten sensitivity should eliminate gluten.
Best Foods for Hashimoto’s Disease
People with Hashimoto’s often try different diets, such as vegan, paleo, grain-free and dairy-free, but none of these diets have been proven to treat, cure or reverse the condition. The most beneficial way of eating for Hashimoto’s helps tame inflammation while providing nutrients that support overall health. Foods that are rich in antioxidants, such as whole and lightly processed fruit, vegetables and whole grains, contribute to less inflammation. Unsaturated fats and sources of lean protein also play key roles in an anti-inflammatory eating plan.
A variety of fruits and vegetables: Include an array of fruits and vegetables every day to ensure you’re getting enough essential vitamins and minerals, and phytonutrients, which are protective plant compounds. Many phytonutrients are also antioxidants.
High-fiber foods: Foods rich in fiber, such as whole grains, beans and legumes and vegetables, help to manage blood sugar which results in less inflammation. Fiber feeds the beneficial microbes in the colon that produce substances that help manage inflammation. A balanced eating plan with adequate fiber is also helpful for weight control and heart health.
Lean proteins: Lean beef, poultry, seafood, eggs, tofu, and beans and legumes deliver protein with little or no saturated fat. Protein is necessary to make immune system cells.
Healthful fats: Salmon, albacore tuna, nuts, flaxseed, chia seeds and avocados have monounsaturated and polyunsaturated fats, including omega-3s, which decrease inflammation in the body.
Try These: Healthy Fish & Seafood Recipes
Key Nutrients for Hashimoto’s Disease
Featured Recipe: Tuna Poke
Selenium: Selenium is a mineral that plays a role in thyroid hormone metabolism. A 2021 study published in Clinical and Translational Science showed that supplementing with selenium could help reduce the antibodies caused by Hashimoto’s, but more studies are needed to confirm this effect. Until experts are certain about selenium supplements, include selenium-rich foods such as Brazil nuts, turkey, tuna and shrimp in your balanced eating plan.
Vitamin D: “While the relationship between vitamin D and autoimmune disease remains unclear, we do know that vitamin D is an important part of a functioning immune system,” says Stefanski. Studies have found people with Hashimoto’s to have low vitamin D levels. Stefanski says, “For those with Hashimoto’s disease it’s important to have your vitamin D level checked. Unfortunately, since there are limited food sources of vitamin D, supplementation with vitamin D3 may be necessary to maintain a consistent level of vitamin D in the body.” Salmon, tuna, fortified dairy foods and egg yolks contain vitamin D, but the best source is the sun.
Read More: What Happens to Your Body When You Take Vitamin D Every Day
Dietary patterns high in refined carbohydrates, such as sugar, corn syrup, maple syrup, white bread, pasta and rice, are associated with more inflammation. The same goes for saturated fats (found in fatty meats), processed meats (such as salami, full-fat dairy foods and palm and coconut oils) and trans fat (found in French fries, donuts and other pastries). Some highly-processed foods, including fast food, take-out items, and restaurant fare are loaded with refined carbohydrates, saturated fat and trans fat, so eat them sparingly as part of a diet to reduce the symptoms of Hashimoto’s.
Read More: Is Canola Oil Healthy? Here’s What Dietitians Have to Say
Questionable Foods and Diets for Hashimoto’s Disease
Featured Recipe: Instant-Pot Potato Soup
In people with Hashimoto’s disease, certain foods are bothersome to some but not others, which is why it’s important to work with a licensed nutrition professional, such as an RDN, who is familiar with autoimmune disorders to develop a nutrition plan that’s right for you.
Wheat and other grains: Avoid gluten if you have been diagnosed with celiac disease. If you don’t have celiac disease but think you are sensitive to this protein found in wheat and some other grains, and in some processed foods, you can try following a gluten-free diet.
Goitrogens: “There are some foods called goitrogens that may interfere with iodine metabolism and thyroid function,” says Stefanski. Iodine is essential to thyroid function. “While these are extremely healthy foods, overconsumption of some foods including cruciferous vegetables (such as Brussels sprouts, broccoli, cauliflower, cabbage, bok choy, collards and kale), soy products and some types of millet may affect thyroid function in some individuals.” In a 2020 review of studies published in Nutrients, the authors concluded that in those with thyroid disease, long-term daily intake of goitrogens may decrease the body’s ability to absorb iodine.
The Bottom Line
If you have Hashimoto’s, your doctor should prescribe medication to manage your symptoms. Follow a diet high in fiber, healthy fats and lean proteins from whole and lightly processed foods, and limit refined carbohydrates, highly-processed foods and saturated and trans fats. In addition, you may choose to work with an RDN to determine if you have any food sensitivities and possibly experiment with different dietary approaches, including a gluten-free diet.
