Updated: Oct 10
16 Tips If You Have Hashimoto’s
What is Hashimoto's Thyroiditis?
Hashimoto’s thyroiditis is an autoimmune condition that can result in the destruction of the thyroid gland. It develops when an imbalanced immune system leads an attack on the thyroid gland, and can eventually lead to inadequate thyroid hormone production and hypothyroidism. Because it is an autoimmune condition, it is important to support the immune system as well as thyroid health as these are paramount in healing from Hashimoto’s thyroiditis and in maintaining proper function within the body.
Advances in autoimmunity research have indicated that the following three factors need to be present for an autoimmune condition to develop:
Environmental trigger or triggers that affect the way our genes are expressed
Intestinal permeability, or “leaky gut”
Intestinal permeability occurs when your gut, namely the small intestines, becomes hyper-permeable, which then allows particles such as toxins, microbes, and partially digested foods to leak from your gut and travel freely through your bloodstream. This then causes your immune system to be on high alert due to potential threats. Leaky gut combined with an environmental trigger causes imbalance in the immune system resulting in the body no longer recognizing itself from a foreign invader. In the case of Hashimoto’s, thyroid cells are damaged by a trigger, then the dying thyroid cells send out a stress signal where the immune cells come in to save the thyroid from attackers but instead attack the thyroid. Over time, more thyroid damage occurs, and the body can no longer compensate to regenerate thyroid cells, resulting in the inability to produce thyroid hormone.
In Hashimoto’s and any other autoimmune condition, becoming a detective to figure out your root cause(s) is vital so that you know which types of changes you need to implement to recover. Here are 16 tips to become empowered to take control of your Hashimoto’s and regain your health.
1. Eliminate environmental triggers. The most common types of triggers that can be at the root of the Hashimoto’s condition include food sensitivities and/or allergies, nutrient depletions, stress, farming chemicals (pesticides, herbicides, fungicides), household chemicals (cleaning products, cosmetics, skincare), impaired ability to detoxify toxins, digestive issues, infections, and inflammation. It is important to remove any trigger that causes a stress signal to your immune system and thyroid. Remember, a trigger for one person may not be a trigger for another. Read on to find out more on how you can uncover some of your triggers.
2. Remove reactive foods. Eliminating reactive foods such as food sensitivities, food intolerances, and food allergies help reduce inflammation that could be perpetuating an inflammatory immune response.
Removing gluten from the diet is a great starting place for someone with an autoimmune thyroid condition. Gluten can contribute to leaky gut, and people with Hashimoto's already have leaky gut so gluten can continue to cause an inflammatory response from the leaky gut. Additionally, when we eat gluten, the protein in it called gliadin, looks similar in chemical structure to that of the thyroid tissue. For this reason, when someone with Hashimoto's eats gluten, it passes through the leaky gut and escapes into the bloodstream, and the immune system sees it as a foreign invader tagging it for destruction along with tagging its look-alike thyroid tissue for destruction, too. The immune system can then attack the thyroid for up to 6 months after consumption of gluten. This process is called molecular mimicry. The same process can occur with the casein protein that is present in dairy.
Dairy has a protein in it called casein. Casein can look similar to gluten, so the immune system can potentially confuse dairy for gluten and cross-react in a similar way as the molecular mimicry that occurs with gluten and the thyroid. Removing dairy could also be a tremendous help to someone with Hashimoto's.
Avoiding processed, packaged foods, refined vegetable oils, refined sugar, conventionally raised animal products, and limiting or avoiding caffeine and alcohol can also be a great way to improve Hashimoto’s.
Consider doing an elimination diet of the foods most commonly found to cause inflammation in the body, coupled with foods to which you know you react negatively. Common food sensitivity culprits include gluten, dairy, soy, eggs, corn, nuts, shellfish, alcohol, and preservatives. Ideally, you eliminate these foods for 4-6 weeks, sometimes longer, then slowly reintroduce each food back in one at a time, waiting 3-4 days between each food reintroduction. During this reintroduction phase, your body's reaction to those foods will be more pronounced if your body doesn't like it, so you want to take notice if you experience any negative symptoms to that food. If you do react to the reintroduced food, then it is a good indication that you could benefit from avoiding that food for even longer such as 6 months before reintroducing that food while you do some deeper gut healing, or sometimes permanently such as with gluten.
You can also consider getting tested for food sensitivities to formulate a dietary plan that is personalized to you. Just know that there are many food sensitivity tests available, and none of them are perfect as some can present with false positives and others false negatives. It is a good option if you cannot pinpoint your food sensitivities and need the objective data to support your decision on removing reactive foods.
Multiple therapeutic diets have been reported to be beneficial to reverse Hashimoto’s, and while there is not a one size fits all diet there are versions of a paleo style diet that have worked well in those with Hashimoto's, as this style of eating eliminates many potentially problematic foods that could be setting off an inflammatory immune response. With that said, some people will need to take their diet a step further in which the Autoimmune Protocol diet (AIP, or sometimes called the Autoimmune Paleo diet) could be beneficial. An AIP diet is designed to include lean, grass-fed animal protein, an abundance of leafy greens, vegetables, healthy fats, fermented foods, low glycemic fruits, and it removes gluten, dairy, soy, eggs, corn, added sugars, legumes, beans, alcohol, canned foods, processed foods, coffee, all grains, nut, and seeds. It is restrictive but it can help you heal your gut, reduce inflammation, and help in the autoimmune spectrum of conditions. The AIP is something you can try as an elimination diet, or continue it for 3-6 months strictly, and reintroduce certain foods while monitoring your body's response to each one. Some find it best to continue the AIP for longer than 6 months, while others find they can add back in certain foods every so often. Oftentimes, it is a matter of trial and error to find what works best for you combined with your own needs, motivations, and challenges.
Are you having trouble figuring out which foods are reactive for you? Book a complimentary consult with me to find out how I can help you.
3. Optimize your Nutrition. Many people with Hashimoto’s have nutrient deficiencies that contribute to the development of Hashimoto’s and its negative symptoms. Adjusting the diet to include nutrient-dense foods that support the immune system and the thyroid is one of the quickest ways to regaining your health. For optimal thyroid function, there are several nutrients that are essential for thyroid health.
Iron is needed to convert iodide to iodine to form thyroid hormones, and it helps to convert T4 thyroid hormone to the more active T3 thyroid hormone.
Selenium also helps convert T4 to T3, and studies have shown that it helps reduce Hashimoto's antibodies.
Zinc is needed to make thyroid stimulating hormone (TSH) and it also helps in the conversion of T4 to T3. Zinc supports immune function as well.
Iodine is needed to make thyroid hormones, T4 and T3. Note that its use in Hashimoto's is controversial as too little or too much can cause problems with thyroid health.
Tyrosine is an amino acid that combines with iodine to form thyroid hormone.
B vitamins help with energy production, and many people with Hashimoto's feel fatigued and exhausted.
Vitamin C helps facilitate a healthy immune system and also helps absorb iron, a key nutrient for thyroid health.
Magnesium is involved in over 300 biochemical processes in the body, and it supports the immune system and heart health, maintains nerve and muscle function, and plays a role in energy production, just to name a few.
Below are some healing foods that you may want to consider adding to your diet, unless of course you have a food sensitivity to it or another reason that prevents you from consuming them. Also opting for organic as much as possible will help minimize chemical-laden foods that can have detrimental effects in the body.
Healthy sources of animal protein such as grass-fed beef, pasture-raised poultry, and wild-caught salmon or other low mercury fish are complete proteins which help to rebuild and repair the body. Animal protein also contains nutrients that support thyroid function, including selenium, iron, zinc, and tyrosine.
Dark leafy greens such as spinach, kale, arugula, bok choy, collards, and swiss chard contain B vitamins that are important for the immune system and thyroid to operate efficiently.
Bone broth is a rich source of collagen and nutrients that can help support the gut lining and repair leaky gut.
Fermented foods such as sauerkraut, kimchi, or kefir to help promote healthy intestinal flora and good bacteria.
Cooked cruciferous vegetables such as cauliflower, broccoli, cabbage, kale, radish, brussels sprouts, and turnips. These contain glucosinolates that help the body in detoxification. Lightly cooking crucifers minimizes goitrogenic properties.
Avocados are a great source of healthy fat, have anti-inflammatory properties, and are filled with vitamins and minerals.
Berries are rich in antioxidants and high in fiber, as well as myoinositol that can improve thyroid function and blood sugar.
Brazil nuts are rich in selenium, a nutrient that is needed to convert inactive T4 hormone to active T3 hormone.
And many more quality, whole foods!
4. Consider testing for nutrient depletions or insufficiencies. While it is always best to eat nutrient-dense foods to get as many nutrients as possible, sometimes nutrient-rich food is not always enough and targeted supplementation may be warranted for additional support. If you aren't sure what nutrients you are deficient in, there are testing options you can do to look at micronutrient insufficiencies. Talk to your doctor or functional medicine provider to ask about the best testing options for each one. One note on iron, ask your healthcare provider to test a full iron panel that includes ferritin, which is the main storage from of iron.
5. Restore the function of your gut. All autoimmune conditions have some degree of leaky gut. Additionally, there could be dysbiosis present within your gastrointestinal tract resulting in an imbalance in your gut flora, a loss of beneficial bacteria, an overgrowth of bacteria, fungus, or parasites, and/or a loss of overall diversity of your gut microbial flora. This matters because more than 2/3 of our immune system lies within the gut, so it is prudent to begin with repairing and restoring the health of the gut as an integral part of the healing journey. Optimizing digestion is also key for breaking down food, digesting it, and absorbing it – proper eating hygiene by slowing down while we eat, being mindful and grateful of what you are eating, and chewing your food are three things you can do to help optimize this. In functional medicine, there is a 5 R framework for gut health, which stands for remove, replace, reinoculate, repair, and rebalance. Here is a brief outline of this framework:
Remove anything posing a negative response to the body such as inflammatory foods, infections, toxins, and stress. Comprehensive stool testing can reveal gut microbial imbalances, chronic infections, parasites, and digestive function markers.
Replace enzymes and digestive secretions that may be lacking such as digestive enzymes, acids, and bile.
Reinoculate means you are rebuilding your gut flora. This can be done by consuming pre- and probiotic foods and supplements such as fiber-dense foods and fermented foods. Supplementing with a high-quality probiotic can also be beneficial.
Repair the gut lining. Foods that naturally soothe the gut lining include okra, chia seed, ground flaxseed, artichoke, legumes, gelatin, collagen powder, and bone broth. Mucilagenous nutrients such as l-glutamine, quercetin, slippery elm, aloe vera, zinc carnosine, antioxidants, marshmallow, and DLG can help heal and seal the gut lining as well. Ensuring vitamin D sufficiency helps prevent future permeability.
Rebalance is all about lifestyle. You want to focus on quality sleep, exercising in the right amounts, stress reduction, balancing work and play, having healthy relationships, getting outside nature, and more as these all influence our gut microbiome and our gut-brain connection.
Working with a functional medicine practitioner can be helpful in formulating a customized plan for you as well. Book a complimentary consult here if you're interested in learning more about how I can help you.
6. Heal any infections. Sometimes infections can be sneaky, chronic, simmering infections. Bacterial and viral infections can trigger autoimmune thyroid conditions. There are certain infections that are linked to autoimmune thyroid disease and you can read about them here from Dr. Amy Myers article that is referenced with studies. If you find you aren't improving with your Hashimoto's, it could be worth getting tested for a chronic, hidden infection and seeking appropriate treatment from a qualified healthcare provider if you do have an infection.
7. Minimize toxin exposure and support detoxification pathways. Toxins are ubiquitous in the environment and many people with Hashimoto’s may not be able to detoxify their bodies appropriately, so it is important to become a conscious consumer and choose household and personal care products that do not contain hormone-disrupting chemicals in them. Supporting your liver, the organ responsible for much of the body’s detoxification, is also a good way to ensure you eliminate the toxins from your body. Making sure you are having a formed, easy to pass stool one to three times daily is key, as this is one of the ways your body eliminates toxins. Staying hydrated with clean, filtered water is a great way to support your detox pathways. Sweating is another way we naturally detox our bodies, so getting in daily movement and even relaxing in a sauna can assist our detox pathways.
8. Maintain stable blood sugar. Learning to eat foods that promote stable blood sugar is important in protecting your adrenals and in improving mood, energy, brain function, and weight. Including a healthy fat, fiber and clean protein with each meal is helpful for stabilizing your blood sugar.
9. Manage stress. Stress can be and is a common trigger for Hashimoto’s, so learning ways to cope with stress that resonate with you will be highly beneficial in rebalancing your adrenals, where cortisol, our main stress hormone, is produced. Spending ample time outside in nature and in the sun, meditation, breathwork, yoga, exercise, and getting a daily dose of joy can help ease into a relaxed and healing parasympathetic state and away from the fight-or-flight sympathetic mode that increases stress within the body.
10. Exercise by choosing physical activity you enjoy. Tuning in to the kind of movement your body craves is key – you want to feel refreshed and energized afterwards, not exhausted and stressed. Over-exercising can be just as detrimental to your adrenals as lack of exercise, and if you are over-exercising it puts an additional stress on your body and therefore creates a poor healing environment in those with Hashimoto's. We all start at different points of how much or how little we exercise, but yoga, strength training, and walking outside in nature can be a good way to get in your movement while not overstimulating the adrenals. Find what works best for you by listening to your body.
11. Prioritize sleep. Quality and ample sleep should be prioritized as our bodies heal, repair, and detox while we sleep. Aim to get 7 to 9 hours (ideally 8-9) of sleep by establishing a bedtime routine with good sleep hygiene to ensure a night of restorative sleep.
12. Get your most up-to-date thyroid labs checked. Checking a full thyroid panel regularly even after knowing you have Hashimoto’s can be helpful to stay in check with how your body is responding to the nutritional and lifestyle changes you are making, as well as thyroid hormone medication, if you are taking one. A full thyroid panel would include: TSH, free T3, free T4, Reverse T3, thyroid peroxidase antibodies (TPOAb), and thyroglobulin antibodies (TgAb). Some providers may think that rechecking the TPO and Tg antibodies is not necessary, but it can be helpful to check them periodically to ensure they are trending down indicating a positive response.
13. Check your vitamin D level. Numerous studies have shown a correlation between low vitamin D levels and autoimmune conditions, including various thyroid conditions such as Hashimoto’s and Graves’ disease. Here a few ways to get your vitamin D:
Many of us do not spend enough time outdoors. Allowing for safe sun exposure with your skin exposed without sunscreen, ideally mid-day (the timeframe does depend on the lightness or darkness of the skin), but if you are out for long periods then certainly opt for a mineral-based sunscreen keeping in mind that sunscreen does block vitamin D.
While our main source of vitamin D comes from the sun, there are some foods that contain some vitamin D such as salmon, sardines, egg yolks, and mushrooms. Just remember that human diets do not provide sufficient vitamin D.
If your vitamin D level is low, work with your healthcare provider regarding supplementing with vitamin D3 (or a D3/K2 formula), which is a more biologically active form. Talk with your healthcare provider about your dose as this is a fat-soluble vitamin and can accumulate if you take too much.
14. Thyroid hormone medication. If you are on thyroid hormone medication, take it on an empty stomach and wait a minimum of 60 minutes before eating or drinking coffee. Additionally, the most commonly prescribed thyroid medication, levothyroxine, contains T4 thyroid hormone; however, T3 is the active form of thyroid hormone. This is important to think about as T4 must be converted into T3, and if you have trouble with this conversion, you may not be getting the proper amount of T3 your body needs to function its best (another reason to check a full thyroid panel that includes free T3!). Also, remember, Hashimoto's is not just a thyroid issue, it is also an immune system imbalance creating an autoimmune dynamic in your body. Thus, while taking a thyroid hormone medication can certainly be helpful and life-saving, it should not be the only avenue you take in taking control of your Hashimoto's. Your immune system health should also be addressed for you to truly feel better and calm the autoimmune response.
15. Create a resilient belief system. Adjusting your mindset to believe in your body’s innate ability to heal and be well truly makes a positive difference in your journey to recovery.
16. Find a practitioner who is well-versed in nutrition and functional medicine. Consider working with a functional or integrative practitioner who takes a whole-body approach to wellness. You can work together to investigate and uncover your root causes and develop a customized plan with tools, support, and guidance.
I hope these tips have been helpful in inspiring you to take control of your health with Hashimoto’s thyroiditis. If interested, book a complimentary consult to find out more about how I can help you.
Disclaimer: All information is generalized and presented for information purposes only. These statements have not been evaluated by the Food and Drug Administration. Any recommendations or considerations in this article or on this website are never to be construed as medical advice, and it is not intended to diagnose, treat, cure or prevent any disease.
Dr. Melissa De Brito
Melissa is a functional medicine health coach and pharmacist. She gravitated towards a functional approach using food as medicine coupled with sustainable lifestyle changes after struggling with her own autoimmune thyroid condition of Graves’ disease and Hashimoto’s. She has turned her passion of culinary nutrition and functional medicine to helping others regain their health naturally. If you are interested in her health coaching services as part of your wellness journey to uncover your root causes, rebalance the body, and transform your health, please reach out to her via email at firstname.lastname@example.org or book a discovery call here.
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