The Best Diet for Hashimoto's Disease

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The relationship between food and health is crystal clear: a healthy diet may protect you from a number of illnesses and ailments. Likewise, a diet tailored to your individual needs when you're diagnosed with a health condition may go a long way to helping you feel well, 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 foods you should avoid-to feel your best.

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Hashimoto's disease, also called Hashimoto thyroiditis or chronic lymphocytic thyroiditis, is a condition that causes the immune system to attack the thyroid gland. Over time these attacks damage the thyroid gland, rendering it no longer able to produce the hormones necessary for several bodily functions. This leads to hypothyroidism, or an underactive thyroid gland. 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 is progressive, which means symptoms will get worse over time.

Hashimoto's disease can be controlled with a prescription synthetic hormone medication called levothyroxine, plus a balanced diet. While your diet cannot cure the autoimmune condition, it can help you prevent weight gain and reduce inflammation.

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There is not a single prescribed diet for Hashimoto's, and no diet has been proven to treat Hashimoto's. Thyroid hormone replacement medications treat the symptoms, but functional doctors, dietitians and nutritionists argue that this doesn't treat the underlying problem (the autoimmune process that causes the body to attack the thyroid).

It's unclear what causes the autoimmune response, but intestinal permeability, also known as "leaky gut," may play a role. Julie Stefanski, R.D.N., 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."

Anecdotally, people with Hashimoto's often say avoiding gluten may ease symptoms. In a survey of over 2,000 people with Hashimoto's conducted by Izabella Wentz, Pharm.D., FASCP, 88 percent felt better after following a gluten-free diet. This doesn't mean that everyone with Hashimoto's should go gluten-free though. It's important to work with an experienced health care professional, like a registered dietitian, for an individualized nutrition plan. Others have experimented with vegan diets, paleo, grain-free and dairy-free, but none of these diets has been proven to treat, cure or reverse Hashimoto's.

The best diet for Hashimoto's is one that is high in whole, unprocessed foods, including high-fiber fruits, vegetables and whole grains; healthy fats; and lean proteins. People with Hashimoto's often end up experimenting with different diets until they find one that makes them feel best. A common theme in all of them is whole, unprocessed foods.

• A variety of fruits and vegetables: Assuming you aren't sensitive, reach for an array of colorful fruits and vegetables at every meal to ensure you're getting enough essential vitamins and minerals.

• High-fiber carbohydrates: Fiber is key for weight management, a healthy heart and blood sugar control. Fruits, vegetables, whole grains, beans and legumes are high in fiber.

• Lean proteins: Chicken, fish, turkey, eggs, tofu, beans and nuts deliver healthy proteins with minimal or no saturated fat.

• Healthful fats: Salmon, albacore tuna, nuts, flaxseed, chia seeds and avocados are full of monounsaturated and polyunsaturated fats, including omega-3s, which decrease inflammation in the body.

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• Selenium: One study showed that supplementing with selenium could help reduce the antibodies caused by Hashimoto's, but more studies are needed to confirm this effect. Eggs, tuna, chicken, beef and Brazil nuts are high in selenium.

• 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, fortified dairy and egg yolks are high in vitamin D, but the best source is the sun.

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• Refined sugars and refined grains
• Processed foods
• Saturated and trans fats

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In people with Hashimoto's disease, these foods bother some people and not others, which is why it's important to work with a professional to develop an individualized nutrition plan.

• Gluten: Avoid gluten if you have celiac disease. If you don't have celiac disease but think you are sensitive to this protein found in wheat and some other grains, 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. "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." Other nutritional experts don't think that goitrogens are a problem in Hashimoto's.

Bottom line: If you have Hashimoto's, your doctor will prescribe medication to manage your symptoms. Follow a diet high in fiber, healthy fats and lean proteins from whole foods, and limit refined sugars, processed foods and saturated and trans fats. In addition, you may choose to work with a dietitian to determine if you have any food sensitivities and possibly experiment with different diets, such as paleo, vegan, vegetarian or gluten-free.

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