Dr. Kharrazian has written an excellent post over at his blog about the importance of proper diet in the treatment of Hashimoto’s. He covers all the bases: the importance of going gluten-free, why gluten-free isn’t enough for most people, how to identify and address food sensitivities, how to balance blood sugar, and how to deal with the psychological and emotional resistance that may arise when making significant dietary changes.
The main obstacle most Americans face in implementing dietary changes, as Dr. K points out, is their addiction to the idea of a “quick fix”:
Americans are infatuated with pills, thanks to decades of conditioning from the pharmaceutical industry. It doesn’t matter whether they come from the pharmacy or the health food store, we have a cultural fixation with finding that magic bullet. It’s no wonder—making genuine, lasting changes to your health takes hard work and discipline, the two last things you’ll see advertised on commercials during your favorite television show.
As long as this mentality prevails, we’ll continue to suffer from increasing rates of disease and morbidity, and our “disease-care” system will continue to buckle and, eventually, collapse.
Dietary and lifestyle changes aren’t easy, but they’re the key to promoting health and preventing disease. And that’s just as true with Hashimoto’s as it is with type 2 diabetes and heart disease.
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{ 53 comments… read them below or add one }
Thanks for sharing the link. The post by Dr. Kharrazian is a treasure trove of good information on Hashimoto’s and how to repair the gut. I agree that we should avoid gluten and sweets if we have an auto immune disease.
Quote:”This immune response to gluten can last up to six months each time it’s ingested.” I am surprised about this fact. Does this mean we should be 100% free all the time? I sometimes cook with soy sauce (with flour in it) so i am wandering if a small amount is also bad.
As Dr. K said, 90% gluten-free is like 90% pregnant. Even a small amount can provoke an immune response. You can use gluten-free tamari instead of soy if you want that flavor.
My field is whole food supplementation, which isn’t the same thing as vitamin pills or herbs, BUT my contention has always been that to combat any disease or symptom, the first place to begin is with the diet. There is no substitute for the nutrients one needs from nature’s foods in order to address any health problem. Over the past twenty years I have seen “miracles” happen only by adopting a rational, whole foods, natural diet.
Regarding Chris’ statement about gluten, I couldn’t agree more. I’ve known a number of people who have said they have reduced the amount of gluten in their diets, or that they try to eat a mostly gluten-free diet. But when an individual is gluten intolerant, it seems to be an all-or-nothing solution because just a small amount of gluten is enough to begin flattening the villi of the small intestine. Further, complete abstinence allows yesterday’s gluten effects to resolve tomorrow. If you eat it now and then, you are only continuing a cycle of negative effects without allowing your body to heal.
Chris, I’m a 46-yr-old female, recently diagnosed with multi-nodular goiter but have “normal” blood results (including autoimmune); needle biopsy of a large nodule which I was told revealed “nothing abnormal” (although my mom, who is a physician, said didn’t look like a very good sample as it was “mostly blood with a few follicular cells”). I have what I feel are hyperthyroid symptoms upon waking (racing thoughts, OCD, fast heartbeat, palpitations) and hypothyroid-related symptoms throughout the day (lethargy, constipation, depression, low Vitamin D, unexplained high cholesterol, long periods, hot flashes). The tightness in my neck from the goiter is very uncomfortable. My question is this — After reading your articles I’m going to try to address leaky gut, gluten intolerance etc. — Is there a chance that will help me with the NODULES, or are are those only going to go away with thyroid hormone and/or surgery?
Denise: I don’t know the answer to that question. If I had to guess, I’d say addressing the underlying imbalances may stop the growth of the nodules and prevent new ones from occurring, but not dissolve the existing nodules.
I have Hashi’s and am very overweight but I don’t have any digestive complaints – no gas, reflux, constipation, diarrhea…and when I did a saliva test for cortisol levels had no issue with the anti-gliadin antibodies. Is it still likely that gluten is causing or exacerbating my auto-immune thyroid issues? Also – I’ve heard that some well-fermented wheat may be OK for celiacs – would this also apply for those gluten-sensitive in other ways?
Gluten intolerance can manifest in many different ways, depending on the specific subtype of transglutaminase being attacked by the body. The saliva test is inadequate for testing gluten intolerance. Fecal IgA is a more accurate marker, which is why I recommend enterolab.com. That said, the prevalence of gluten intolerance is so high in Hashimoto’s patients that I tell any patients with that condition to avoid gluten. Even the best testing methods aren’t completely accurate, and the risk of exacerbating the autoimmune attack on the thyroid is just not worth it. Fermented wheat is not okay – in the studies I’ve seen, there is still gluten in it even after significant fermentation.
My family has been gluten free for two years now and it’s made such a big difference in my husband and my stepson’s health. I haven’t really noticed any difference for me, though. I’m just sticking with it because it’s easier if we’re all gluten free.
I also have Hashis with no symptoms though – just sky high anti-bodies. I have been on a lowish carb diet for 14 years – low gluten and grains, maybe 1 serve day if that.
It wasn’t until I went Paleo that my niggling issues cleared up.
Now – no more joint inflammation, no more PMS or bad Menstrual cramps. Ganglion cyst went away. Weight more stable. No more mild constipation. No more dishydrotic eczema.
Hashis is an auto immune issue – I’m sure meany other people like me have other auto-immune issues brewing even if not diagnosed.
Paleo is awesome – I have just started switching my clients that direction – it is so much more effective than a diet with grains and legumes.
If you have Hashis – go strictly paleo for 30 days – then see how you are
Julianne
I have Hashis too and I did the Paleo experience for 30 days. I noticed a huge difference with my level of energy. My stomach feels better too. I am sticking with it!
I am replacing milk with Goat’s milk, Is that ok? I don’t want to have calcium deficiency.
Is riz ok in this diet? I thought all grains were out but I saw yesterday on a blog (in France) that they included rice. Is this right?
I have Hashimoto’s, and I’m a mess. I don’t feel my synthroid/cytomel is working, although the docs, even endocrinologists, say my TSH is low/normal.
What’s Paleo?
Paleo is short for Paleolithic, eating like a hunter gatherer, pre-agricultural.
No grains, no legumes (including soy and peanuts) no dairy, no sugar, no artificial sugar, no additives, no chemically altered fats, no refined foods.
I eat fresh seafood, poultry and grass fed meat and organ meat, lots of vegetables especially the colourful non starch ones, (but not potatoes), some fruit especially berries, natural fats like raw nuts, olive oil, avocado, coconut, and sometimes a little grass fed cream or butter, natural flavours – herbs and spices.
If you can hunt it, or if you can gather or pick it – you can eat it.
This diet changed my life
http://www.thepaleodiet.com
Gluten stays in your system for 6 months??? I thnk you may be right about the gluten. I avoid it mostly but notice the symptoms after I consume it and the horrible roller coaster begins again. I have hashis and am on bio-identical dessicated porcine extract but I think the fillers include gluten. Looks like I’ll have to cut gluten out altogether and request gluten free medication, which is double the price.
The paleo diet sounds great. may have no choice but to try it.
I just found your blog and I’m scouring it to the best of my ability to get a feel for all that it offers. I have to ask one question:
What reason is there for not considering removal (or killing) of the thyroid altogether?
Don’t get me wrong, I wouldn’t really consider that, but I just have to ask.
Jen- Concord, CA (diagnosed w/Hashi’s in 2008)
Lots of reasons, Jen, although it is appropriate in some uncontrolled cases of Graves’ disease. Management with supplemental hormone isn’t a perfect science. The body is complex and utilizes mechanisms for hormone regulation we’re only beginning to understand. Replacing the function of sophisticated, living tissue with a pill is much easier said than done. By the way, I will be starting to see clients in early October in Berkeley, CA if you need some additional help figuring this stuff out. You can contact me through the blog.
Did not feel jen’s question was answered. Why is removal or killing the thyroid not a wise idea? Please give more facts and details for those of us being told to consider it. Also, what are the dangers of having thyroid cysts removed?
What percent of Hasimoto’s patients are also gluten intolerant? I thought I read it was only like 3%. Thanks!
There are varying statistics, but they’re based on inaccurate tests. Clinically the correlation is very high. I suggest all HASHI’s patients be off gluten.
I agree with Kris, I have hashimotos and a blood test and biopsy came back negative for celiac desease. But since I stopped consuming glutin, my goiter shrunk, and I feel better.
What is the difference between a thyroid goiter and a thyroid cyst? I have been diagnosed with a cyst that has gone from 10mm to over 20mm in five years and is getting larger now. Doctors want to remove it. Is diet a safer, better alternative?
i am suffering from diabetes since 6 years but recently also found having hashimotos disease.i suffering from fatiqueness since its hard to choose diets. please advice me foods what to eat and what not to eat for these 2 disease.
How does it feel being gluten free over a month? I have some friends, who are diabetic, and all I know for preventing this is eating gluten – free foods. Is Hashimoto the same with Celiac Disease?
Thanks for the information. I have been taking synthroid for about 4 years and cymotel for about 1. I feel so awful and I want to go off the meds and try to cure myself by changing diet. My doctor says dangerous to do that and she’s had patients who have got very sick going off them. I have been on a mostly gluten free, organic diet for about a year now and need to get off dairy. Can’t buy grass fed butter and milk here but do buy organic and don’t have much. Can I ask what the worst thing that can happen if I go off the meds do you know? Any help is appreciated.
Going off your meds is not the right answer. Your body cannot function without T3 and T4. Changing your diet isn’t going to magically make your thyroid produce more hormones especially if it has already mostly stopped functioning. What it will do is decrease the immune load that you are laboring under. You end up with more energy and a clearer mind because your immune system isn’t battling everything that is sneaking in through your gut. Over time it is possible that you may be able to reduce your medications but you should be feeling much better before you even think about that step. My experience says that cutting out the possible inflammatory foods 100% is way more important than buying organic. Try a 30 day trial with NO wheat, dairy, grains, or sugar and see how you feel then make more in depth decisions.
Kelli, Thanks so much for taking the time to answer and for your advice. I’m not having grains, sugar or wheat and will stop the dairy and hopefully see if that helps.
cheers
Yes! Kelli thank you. I won’t go off my levoxyl but will do a gluten free sugar free diet for 30 dAys straight and see how I do. Even if my nodules are still there I know I’ll feel better.
But what about my nightly red wine??? Where does this fall on the gluten free scale?
Diagnosed with Hashimoto 3 years ago. All Gluten tests negative but I dont believe them it makes me sick. My problem is that I’m allergic to ALL fruits and ALL vegetables plus add in Dairy, tree nuts and eggs. I cant even be in a room while they are cooking or steamed or touch them or I have to use an epi pen. No allergist, health & wellness or endicr has an answer. We have our own organic garden and just walking through the garden causes shock. I dont have a “go to” food like fruit. I cant get my carbs from gluten or fruits and veggies. Very depressing situation, battling each day. So I just eat minimal items and feel miserable or get sick. Immune system is getting worse…HELP
Hey when I first found out a year ago about having hashis and having to take levoxyl and cytomil everyday for the rest of my life I was upset….i would suggest staying on the medication, give it a chance to work. If you still, dont feel good maybe your dose isnt right. Ask doc to check free t3 and free t4. Being gluten free has helped me so much. Email me if u need more info
Thanks Cynthia. I have been on my meds for 3 years and they check every 3 months a full thyroid panel and its always normal. I have went Gluten free before but I cant stick with it because the only other foods to substitute Im allergic too. So I have a hard time getting carbs then my blood sugar drops.
Hi! Jodi, I am in the same boat as you and really struggling. I have intolerances to phenols — which are natural chemicals in most foods — and in almost all fruits and vegetables. I’m not allergic to them per se, but for some reason (maybe the hashimotos) my liver can’t process phenols right now at all and so I get very sick and have gallbladder attacks from eating most vegetables and fruits and lots of other foods like chicken, tea, chocolate. I find that I do much better with cruciferous vegetables than any other type — that includes broccoli, kale, brussel sprouts, and cauliflower. These are usually the only ones I can eat without a reaction, but sometimes they give me a slight reaction too. Otherwise, my safe-food is brown-rice. I never have an attack from brown rice, so I eat rice cakes, cooked rice, brown rice protein, rice porridge, etc.
Thanks Nicole. You are the first person who has come up with a possibility of the cause. Can we exchange emails and try to figure this out together? Your email gave me hope!
I need help, please. I have suffered from Hashimoto’s, untreated, for over ten years. Was finally diagnosed this year, but due to the fact that I live in a domestic violence women’s shelter, have no insurance and am currently (though not usually) unemployed, I cannot get a prescription (have tried) and have some but not total control over what I am eating. I am really suffering. My anxiety and depression are getting to me – what can I do to lessen my suffering? Thanks for any help, Melissa
Hi Melissa – have you tried applying for Medicaid for yourself if you are currently living in a shelter and have no form of income? Often you can qualify for this assistance in the interim. If you go to a hospital for help in this area, they can often find resources too. Additionally, have you talked to a social worker or case worker at your shelter? They should also be able to locate low cost or free medical care (they may even have someone who comes to the shelter!) to help you. Hashimoto’s is nothing to mess around with – I can’t believe you have managed this long without treatment. I wish you much luck and strength ~
Kristina
Hi Kristina, Thanks for replying- yes, I have struggled and suffered awhile. I have been to two clinics- and yes, a Dr. recently came to the shelter and he is one of the ones who said I have to have an endocrinologist for treatment. There is free medical /dental care for the homeless – bu tis is ver very generic and basix. They have insurance called Access here – and I was told I could not apply because I have no children. Budget cuts and new restrictions. Yes, I have talked to a case worker and also a therapist about my frustrations. I think, my best hope is to finally get a job and get real insurance.
Hi they say you shouldn’t have soy or corn with hashis
Mostly everything gf has soy and some stuff is made with corn flower. Is this bad? What can we eat?? Thanks Im so depressed and lost on this new diet!
I think it’s easier to manage this by just avoiding “Gluten-Free” foods- those that are manufactured to resemble a product typically made with wheat. When I went GF, I started suddenly eating GF cookies, cakes, etc.- items I wasn’t eating much of in their gluten form. That wasn’t the healthiest option! When I switched to Paleo, where I am avoiding grains altogether, I seem to have an easier time. I am limiting my GF treats to those I can make myself, for special occasions, which gives me a lot more control over the ingredients.
I have Hashimotos, I’m sure I have celiac, I’ve thought about this a lot I’ve read a lot, I’ve seen standard doctors, I’ve seen alternative doctors. I think we autoimmune suffers are the yellow canary in the mine. My opinion is we should take the best vitamin supplements available. And avoid any genetically modified foods like there the plague. Can anyone say enough about organic, or clean water that’s not poisoned by our friendly government with fluoride. Use fluoride and glutin free toothpaste. And if you have any amalgam mercury dental fillings be very careful and have them replaced by a dentist who knows what their doing so you don’t swallow any. And also very important is probiotics I believe gut health must be healed, You have to take medication so you don’t die, but you don’t have to feel alone, sadly theirs a lot more of us out their. P.S. Wikipedia Monsanto. And as far as what to eat try meat , potato, and vegetables, especially grass feed meat, and organic vegetables, and fruit. Everyone wants to eat birthday cake try Betty Crocker glutin free cake mixes, they have recipes on their web sites that are better than any thing with flour, because they won’t make you sick. It takes a while to get used to never eating glutin but I got used to it, I tell myself nothing tastes as good as feeling good feels. I google glutin free recipes all the time, and my whole family loves them. And my meringue cookies are so good my adult friends want them for Christmas gifts. They were my grandmothers recipe, Meringue Chocolate Chip Cookies, Preheat oven to 350* beat 2 room temp egg whites till stiff, add 2/3 cup sugar gradually one tablespoon at a time till glossy add 1/2 tsp glutin free real vanilla extract, and 1 package chocolate chips. Fold in gently. Drop on lightly greased cookie sheet. Place in oven and turn off oven, leave over nite.
I have another comment, glutin free treats full of sugar and grains, are shouldn’t be a main part of your diet. If home made you can better control the quality of ingredients, if your healthy only eat them occasionally and in small amounts. Make your diet as healthy as possible. Such as organic fruits and vegetables grass fed meat, organic milk, at the very least no bgh ect, clean water, herbal teas, and if your immune system can’t handle glutin be careful with other grains, when grains are ground they become inflamitory, if you have murcury fillings, have them safely replaced. And take quality probiotics and vitamin mineral supplements. Remove as many toxins from your environment as possible. Especially anything you put in or on your body. Take care of yourself and care for yourself.
Simple Truths organic products are wonderful! Also eggs have Soy if there not Organic shop at a health food section or store..get the right vitamins and protein powders! Vitamin D3 is crucial I take 2000 d3 and it’s also in my supplement 2600 is average. Detox and get on Paleo diet! Distilled water helps but do not drink for months as it can remove good minerals u need. Do not eat foods like fish with Mercury or shower without a filter!
I have Hashimotos also along with celiac disease and pernicious anemia.just wondering what kind do protein powder is good for us?
Meant to say what kind of protein powder?
Hi,
I hope you can answer a fairly simple question. I went on an elimination/low acid/anti-inflammatory diet of no soy, grains (except brown rice), dairy, nightshades, citrus, refined sugars to try to address my fatigue and to lose weight. I did it perfectly for two weeks, then had some imperfect days during the holidays, but basically stuck with it for 6 weeks and have noticed no improvement in anything. In fact, my mood has been terrible, my fatigue is worse, an my mental clarity has suffered such that I’m burning half the meals I cook now and dropping things. Is there any explanation for this sort of diet not working? I thought it was supposed to help anyone.
Thanks!
I went through a similar experience. I’ve since discovered that I do much better if I try to eat a fairly well-rounded diet with an emphasis on optimizing thyroid metabolism. Make sure you get enough iodine and selenium. Gluten-free didn’t help me at all. (I ended up with low t3.) In fact, whole grain breads and pasta, paired with a source of protein, have helped my mood and energy levels. I also eat lots of fruits and veggies, a small amount of dairy, and a handful of nuts now and then. I’m almost 50 and I’m in perimenopause, but I feel much better than I did for the years I tried to go gluten-free. I truly believe we’re all different and what works for some may not work for others. I do try to stay away from junk food and think that’s a good idea for everyone. Good luck!
Hi Amy
Just to say that you have taken the words right out of my mouth!
I have read Dr Mark Hymans great book Ultramind and was quite excited that it would help my Hashimtotos. I followed the diet eliminating sugars, gluten and dairy only to find my weight crashed by half a stone (I’m not a big person) and my energy has been in the basement ever since! I have all the hyothyroid symptoms like you and am soooo disappointed as I really thought this diet would help and the reverse seems to be true! I wonder what the reason is?
I have hashimotos I had a large goiter. My endo said only treatment thyroid removal. I asked her about diet she said she’s never seen it help. I quit glutin in all it many forms. My thyroid shrunk to normal my neck is beautiful I feel happy I feel healthy I’m still on levothyroxine. Saw my endo she was rude and mean to me. I won’t see her again. Please educate yourself your family and friends any one who will listen about the dangers of genetically modified foods. There in all processed foods. And they have never been safety tested. Thank your politicians for taking bribes and endangering everyone’s health with this gm garbage. Obama and his family only eat non gm foods and organic vegetables.
I have Hashimotos I had a large goiter. I asked my endo if a diet change would help she said she has never seen it help. My goiter got larger I couldn’t fall asleep at nite so uncomfortable. Endo told me the only treatment is thyroid removal surgery, consult with a surgeon. Boy was he eager to cut my throat. I decided to try something different. I changed my diet, and that changed my life! I quit glutin in all its many forms. My thyroid is its normal size. My neck is small again and beautiful. I feel healthy and happy. I saw my endo she was mean and rude to me she never even asked what I did. I won’t see her again. Be your own advocate. I hope I can help others recover the most beautiful gift in life. Health and Freedom!
I too have Hashimoto’s and I’m just starting my journey to trying to recapture my life through a healthy diet. Your recommendations and encouragements were very helpful to me. Your comments about your endo doctor bear out a statement my supportive husband uses. “A patient cured is a customer lost”. Sounds like this doctor is more concerned with her pocketbook than your health. Sadly, her kind is all too prevelant!
I have just been told this week by a physicians assistant that I have Hashimoto’s. She wants me gluten free for 6 weeks, repeat labs, and then return to see her in 8. I was diagnosed around 7 years ago with hypothyroidsim and have been taking Levoxyl (75mg). My family physician has checked my thyroid yearly and said it was doing fine even as recent as 4 months ago. His lab work showed that I had a very low vitamin D level that concerned him; however. Could this latest lab work be skewed due to a high volume intake of dairy, raw broccoli, raw carrots, peanuts, peanut butter? All of the things I have been eating prior to seeing physician’s assistant are so called “no-no’s”. Four weeks ago, I had a hysterectomy and actually was seeing this p.a. for hormone replacement when she found this new diagnosis. Or could my lab work be inaccurate due to a recent hysterectomy? Guess I do not want to accept this. Is there any chance people with Hashimotos can ever return to eating normal? In the last two days, I have found myself eating “nothing” as to eating “gluten free”. Are there any good websites that show diet suggestions, foods, etc? Any help appreciated…thanks!
Hi, I’d like to make a comment to Lisa. The normal standard American diet is crap. Our food is not natural, it’s genetically modified. Thank your corrupt politicians during the next election. If your child was sick you wouldn’t treat them like you do yourself. Be kind to yourself, take the time to educate yourself. The Internet is the greatest change to mankind since the printing press. Try Dr Mercola, or the book wheat belly. Their is a lot of great info out there. Did you know most people end up with some horrible disease. You have a great opportunity to go into your kitchen, and heal yourself with a healthy diet. Take up some meditation, watch some funny movies. Reduce your stress, teach yourself to cook and eat really healthy. Your life will never be the same you have a serious challenge! It’s not fair, well life’s not fair. Life is hard. be good to yourself, become a health nut, it’s a lot more fun to be a nut than always feeling icky.
Hi Kim, you are so right!
I’ve had Hashis diagnosed for 12 years now. Taking Synthroid helped feel normal after two years. I’ve had Different doctors, endocrinologists but no one had ever addressed my diet. Recently I saw a Naturopath for frozen shoulder, when he found out about my Hashimotos he forgot about my shoulder and began to address my gut. After 13 blood sample tubes for testing, he said I have a Leaky Gut Syndrome and wants to put me on a strict cleansing for a month. That means Colonics, diet, herbal supplements and PT of some sort. He wants me to take a month off work, drink more water, go to bed by 10pm. Reduce stress is what the goal is. I think he wants to jump start my gut. We tested for Celiac and I’m negative for that. But I’ve been reading a lot in the Internet and I’m blown away with all the info. Like Kim says, educate yourself and take care. There is hope.
I just found out that I have hasitmotos. It started with nodules on my throat which were removed. I am in my 60s and had some removed when I was 17. Both times, no signs of cancer. The doctor removed my left thyroid because of a large number of cysts. Both of my adult children have celiac spruce. I was tested and told that I did not have it. I have read about so many people going gluten free, so I went on a gluten free diet. I can’t see any difference. I don’t feel bad and am not tired all the time. I was only told to cut back on my carbs. I walk two miles a day, at least six days a week and go to the gym three times a week. So, my question is….. Does everyone with Hashi’s disease need to go gluten free?
A recent xray discovered two internal hernias at the top of my stomach! Could this be termed leaky gut? I have been taking medication for hashimoto disease for four years and also require a vitamin D supplement. Should a person take iodine supplements to assist?
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