Hey people! I’m always astonished when people share with me that their doctor said, “Diet doesn’t matter, there’s nothing you can do except take thyroid hormone.”
I have literally heard variations of that one sentence over 500 times. I really don’t understand it because in my (and many of my colleagues) clinical experience this is the single most important factor in achieving long term success.
In today’s post I want to share a new research study that suggests otherwise. This was published in the Drug Design, Development and Therapy Journal, Volume 10, 2016.
This study, entitled, Effects of low-carbohydrate diet therapy in overweight subject with autoimmune thyroiditis: possible synergism with ChREBP , looked at “…a total of 180 patients, 84 males and 96 females, aged 30–45 years. All the subjects did not present celiac disease, but Hashimoto’s disease was detected. Moreover, each patient showed others autoimmune symptoms, they are typical Hashimoto’s disease.”
(This isn’t huge cohort, but it’s certainly enough people to give us some decent data.)
All patients had elevated antibodies.
TSH, free T3, free T4 and levels of anti-microsomal, anti-thyroglobulin, and anti-peroxidase Abs were measured. (Which is interesting since anti-microsomal and anti-TPO antibodies are essentially the same ).
They were put on the following: a diet program based on the following proportions: carbohydrates 12%–15%, proteins 50%–60%, and lipids 25%–30%. These patients were instructed to eat large leafy and other types of vegetables and only lean parts of red and white meat, avoiding goitrogenic food. The following items were also excluded from the diet: eggs, legumes, dairy products, bread, pasta, fruits, and rice.
This protein-rich diet plan was implemented for 3 weeks, at the end of which bioimpedance tests, bodyweight measurements, and blood tests (TPO Ab, anti-microsomal Ab, thyroglobulin [TG] Ab, and thyroid hormones) were performed.
There was also a control group that didn’t make any dietary changes and were also tested.
Initial (pre-diet) levels of FT3, FT4, and TSH were not significantly different between the two groups.
In just 3 weeks, these were the results: patients treated as above showed a significant reduction of antithyroid (-40%,P<0.013), anti-microsomal (-57%, P<0.003), and anti-peroxidase (-44%, P<0,029) Abs. Untreated patients had a significant increase in antithyroid (+9%, P<0.017) and anti-microsomal (+30%,P<0.028) Abs. Even the level of anti-peroxidase Abs increased without reaching statistical significance (+16%, P>0064).
In other words, there was a 40% reduction in anti-thyroid, a 57% anti-microsomal and a 44% ant-TPO antibodies. While people in the control group who made no changes showed an in crease of 9% anti-thyroid, 30% anti-microsomal and 16% increase in anti-TPO antibodies.
There was also some weight loss noted about a 5% reduction and a 4% reduction in BMI.
Those antibody reduction numbers are HUGE differences. If they were develop a drug that could do that, it would be a multi-billion dollar discovery.
So, I think it’s safe to say that this type of diet is, at least, worth trying.
I also think there are few things that came up in this study that interesting and worth pointing out. These researchers had the dieters remove goitrogenic vegetables. I have looked into the research on this and I don’t think they have the impact that we have been led to believe.
In my opinion, as long as you steam or blanch or cook them in some way, most of those properties are not an issue. Here’s a good discussion on this.
Basically, with the exception of soy, these vegetables have far more health benefits than problems.
The other thing I thought was fascinating about this study was the discussion of why this may be (I’m a geek when it comes to this and I’m forever curious to learn WHY?)
First thing the researchers note is that “… the aim of this type of diet is to reduce the overall inflammatory state and consequently inflammation of the thyroid gland.” This is an anti-inflammatory diet and test results confirm that.
Also, they note that these results may be “related to the role of the thyroid hormone receptor-α (TRα), found mainly in the liver and white adipose tissues.”
This receptor is involved in fat metabolism and balance. It causes certain genes to be expressed ( such as ChREBP or Carbohydrate-responsive element-binding protein which interacts with carbohydrate expression in DNA.)
In addition, they note “It has also been suggested that TRα could be involved in the transcriptional regulation of lipogenesis in the liver. Activation of these genes determines an increase in the expression of anti-microsomal Abs, which occurs mainly in the REL of hepatocytes, and it has a fundamental role in inflammatory processes.”
In other words, this receptor is involved in fat production in the liver (which is the result of sugar and carbohydrate consumption) AND it increases anti-microsomal antibodies AND it is is important in inflammation.
I have often noted how important blood sugar regulation is for Hashimoto’s patients and I frequently express this to my patients and we work diligently to balance their blood sugar. And this is why it is so important!
They also note” that 83% of patients with a high level of autoantibodies are breath test positive to lactase with a lactase deficit higher than 50%…” This is one of the reasons dairy can be problematic for Hashimoto’s patients as well.
And one final point that was really interesting and which emphasizes the importance of making sure your liver is functioning properly is that “Chronic inflammation of the thyroid gland can also be due to the presence of environmental contaminants that are suspected to disturb activity against the endocrine system, known as endocrine disrupting chemicals.”
These chemicals like PCBs are known endocrine disruptors and have been shown to disrupt thyroid function. These researchers suggest that a rise in anti-microsomal antibodies may be a way for our bodies to defend the thyroid and prevent it from being further destroyed.
What these chemicals do is to disrupt the thyroid receptor that we looked at earlier. And this all happens in the liver. What this study makes us more curious about is how the thyroid gland is involved in lipid metabolism (yes, those of you who know me may see the light going off in my brain- more blog posts to come!).
Bottom Line? A diet based on the reduction of carbohydrate content leads not only to a weight loss, but also a decrease in fat mass and a significant drop of autoantibodies in Hashimoto’s thyroiditis.
So, dear doctor, DIET DOES MATTER!!!!!
Try it people.
Have a great day, unless you have other plans!
I recently conducted an informal survey on my Facebook page (http://facebook.com/hashimotoshealing)
I asked people about what worked for them the most in treating their Hashimoto’s symptoms.
The results were rather telling and, I feel, are relevant to this post. Many of them talked about dietary changes being one of the most significant factors in helping to alleviate their symptom.
Here’s a graph of the results:
So now, not only is it my profession, it’s my passion, and it’s personal. I’ve been joking with people lately saying it’s a blessing and a curse. A blessing because I really get it, and a curse because I really got it! ?