Hashimoto’s is the most common autoimmune disease in the United States. It is a thyroid disorder and an autoimmune disease. The autoimmune part of the equation makes virtually everything a challenge and this is particularly true when it comes to trying to figure out what to eat.
One of the absolute truths about Hashimoto’s is that no 2 people have the same version of the disease. There are too many variables, people are at different stages of progression, and they have other autoimmune, endocrine, digestive or systemic problems.
So, generalizing about what kind of diet is the best is kind of like asking, “Where do I build my house on this minefield?”
You build it where it won’t set off the mines. Some people estimate that 70 – 80% of the immune system is found in the gut.
Whatever the actual percentage, there is no doubt that what goes through your digestive system has a huge impact on your immune system. Huge.
This concept is just common sense, but many doctors and health care practitioners ignore it. Why? One doctor friend of mine put it to me this way.
He said, “I don’t bother trying to change people’s diets. It’s easier to get an alcoholic to stop drinking than to get people to change the way they eat.”
People are attached to food. It has cultural, emotional and psychological roots that run deep. However, if you have Hashimoto’s and you want to learn to manage it properly, you need to abandon all of that. It will not serve you.
Many people with Hashimoto’s also have intestinal permeability, also known as leaky gut. A healthy GI tract is one that one has a lush forrest of villi, all held tightly together.
This keeps the bad guys, like bacteria, chemicals, environmental toxins and undigested food out of the blood stream. Unfortunately, chronic inflammation turns this lush forrest into a desert and poor diet, blood sugar imbalances and chronic stress open up wide chasms that a molecular 18 wheeler could drive through.
Many people believe that this actually sets the stage for the onset of autoimmune disease when the immune system shorts circuits and starts confusing other stuff with our own tissue. The one food that is most often implicated in this is gluten.
Many people also believe that the best way to heal autoimmune disease is by healing the gut. ( I am one of those people. ) So this begs the question, what heals the gut?
The first step to healing the GI tract is to remove all the foods that are creating chronic immune responses. Eventually, you can add them back in one at a time (hopefully). When you do you will begin to discover your own unique set of land mines.
And instead of rummaging around in the dark there are now also diagnostic tests available to help determine which foods cause an autoimmune response in you (More on this in a moment). This can save you a lot of trial and error and can help you identify the really bad ones.
The foods that tend to be the worst are those that you, invariably, love the most. Like ice cream, cheese, bread, and pasta. And there is a biological reason for this. Both foods made from gluten and milk have proteins that are very similar in structure to morphine.
They are called casomorphin in milk and gluteomorphin or gliadorphin in wheat products. Now wonder we love them, we’re freakin’ addicted to them!
There are a few different camps out there for autoimmune disease diets. Most of them involve elimination and provocation. In other words, you take foods out and put foods back. The biggest differences seem to be which foods you put back.
Once again, the reality is that some people can put some foods back and others can’t. Remember, your Hashimoto’s is not your brother’s or sister’s Hashimoto’s. You have to find your own way. There are some foods that some people will have to eliminate from their diets forever. FOREVER.
And this is the real challenge. Because some people will suffer more from cheating than others. But, even if you feel like the damage wasn’t so bad and you can live with it, it may be destroying valuable tissue like your brain or something that you might want to use later in life.
Cheating can have serious and, sometimes, silent consequences, like the destruction of important tissue.
Here’s a quick overview of the most popular diets currently being used.
The Paleo diet or Paleolithic diet, also called the Cave man diet or Hunter-Gatherer diet, is one in which you are told to eat like our nomadic ancestors. Centered around common modern foods, this diet consists mainly of fish, grass-fed pasture raised meats, eggs, vegetables, fruit, fungi, roots, and nuts, and excludes grains, legumes, dairy products, potatoes, refined salt, refined sugar, and processed oils.
Critics argue that this diet is essentially just the Atkins diet with a few updates, but it has a loyal following. And if you really ate like our Paleolithic brethren, that is, you hunted around the African plains with a spear and a few rocks, you would eat a diet that was largely plant based with a few lucky days of meat binging thrown in.
And you would spend a lot of time running and doing old school cross fit maneuvers as you escaped hungry lions and hyenas. Definitely a formula for good health – if you didn’t get eaten.
The autoimmune version of this diet removes grains, eggs, beans, legumes, dairy, soy, refined sugar and salt, all processed oils and nut based oils, and night shades (tomatoes, eggplants, peppers and potatoes) and, sometimes, nuts.
Its really restrictive, but can be quite effective. The real issue seems to be – can you come up with a diet plan that isn’t basically all meat all the time? And you definitely can. You need to make a conscious effort to have plenty of fruit and vegetables.
Some people with Hashimoto’s do very well on this diet and it can dramatically improve the health of your gut on its own. Add some supplements that heal the intestines, as well, and you could have a winning formula. (More on that in an upcoming post)
The flip side of Paleo is the Vegan autoimmune diet. It is, essentially a gluten and, in some cases, grain free vegan diet. No meat, no dairy, no eggs, no animals, and no fish. And in some cases, no grains or beans.
Critics of this diet argue that you don’t get enough amino acids from plants alone and many Hashimoto’s folks are also iron, B12 and Vitamin D deficient and its hard to virtually impossible to effectively keep those levels up without animal products or supplementation.
It also takes a lot of things, pardon the pun, off the table. So it doesn’t leave you a lot left to eat.
But this diet also has its loyal fans and can be very effective in reducing the inflammation that drives the autoimmune process and destruction of the gut. If supplements are added here, and you eat enough, you can also have a winning formula with this approach.
Some people think that one way to figure out which version of the autoimmune diet is best for you might be to use blood typing. Those with blood types that need meat (Type O) might do better on Paleo, those who are not big meat eaters (Type A) may do better with the Vegan version.
The remaining blood types (B and AB) might need some hybrid of the two. Which ever you chose it is vitally important to eat as much variety as you can within all these restrictions and to supplement with iron, Vitamin B12 and Vitamin D as it becomes necessary.
All of these autoimmune diets remove lectins. Lectins are nature’s answer to insects long before Monsanto began its evil march towards domination of our food supply.
They are, basically, natural pesticides that live in plants to help them survive the ravages of fungi, bacteria and viruses. They are kind of like natural toxins.
Lectins are carb binding proteins that protect plants and have other functions like protein synthesis and delivery in animals. They’re pretty sticky molecules, which makes them cause problems in our intestines because they get stuck there and start eating away at the walls.
It is believed that lectins leave leaky gut in their wake, in a trail of savaged villi. Once they have wrought their carnage, they breach the walls of the intestines and leak into the bloodstream with lots of other unwanted particles. And the immune system goes nuts trying to deal with it all.
Foods with the highest amounts of lectins are: grains of all kinds (wheat being the worst), legumes (soy being the worst), nightshades (mentioned earlier), and oils made from seeds. GMO foods also have lots of lectins because they are used in genetic modification to enhance pest and fungal resistance.
Salt: Recent studies have indicated that that high salt levels may push the initiation of autoimmunity by driving the TH-17 pathways. Basically, its an on switch.
Problem. Lots of Hashimoto’s people have low blood pressure and desperately need salt. Iodine can also be bad for some Hashimoto’s people. Answer: Moderate salt without iodine (unless you are iodine deficient – there’s always a caveat).
Sugar Issues: Many Hashimoto’s people have blood sugar issues and if their blood sugar goes too high or too low it can really impede their progress. Some of these diets are so restrictive that people’s blood sugars end up dropping and spiking and they wind up defeating the very program that they are on.
Answer: Find the foods you like, eat them often. Start the day with a protein. Don’t ever skip meals.
Anemia: Many Hashimoto’s patients develop anemia for a host of reasons. This can completely undermine any dietary changes you are trying to make. Test for iron deficiency and red blood cell counts and make sure you are supplementing with iron if necessary (especially if you are choosing the vegan route). Vitamin C can also enhance iron absorption.
Cross Reactors: These are foods that have a similar protein structure to gluten and our own tissue. Like gluten, they may have to permanently avoided because they drive the autoimmune attack and disease progression.
Parasites, Candida and Other Critters: Some people with Hashimoto’s may also also require additional treatment of the ecosystem of their intestines. These can further complicate dietary restrictions and supplementation.
Adrenal Issues: The adrenals play a critical role in intestinal permeability and with insulin resistance. Cortisol causes the intestinal walls to open further and it makes insulin not work a well. So stress management and adrenal love are also really important.
Other Autoimmune Diseases: Many Hashimoto’s people have other autoimmune diseases in various stages of progression and some of these can have a huge impact on the digestive system, such as Type I diabetes, adrenal autoimmunity, liver autoimmune, Crohn’s disease and more. If these factors are present, adjustments must be made accordingly.
And this is just an overview to give you a sense of the complexity, difficulty and variability of what you are dealing with. There are many more issues that can come into play and undermine your progress. These include, the gall bladder, neurotransmitters and the brain, low stomach acid and more!
There is some terrific diagnostic testing available today that can help to decipher some of these puzzles. We can test for intestinal permeability, cross reactors, additional autoimmune issues, etc. These tests are not that expensive if your doctor won’t order them or doesn’t know that they exist.
Diet is critically important in the successful treatment of Hashimoto’s, but a diet that works for someone else may not work for you. You need a program that is tailor made for your unique set of circumstances and related issues.
Need help? I offer a free 30 minute Hashimoto’s Healing Strategy Session. In it you can share where you are, where you want to be and I can give you some recommendations that will help right away.
Book your session now: https://hashimotoshealing.as.me/strategy
Prevalence of celiac disease in autoimmune thyroiditis. Minerva Endocrinol 2007 Dec;32(4):239-43
Celiac disease and autoimmune thyroid disease. Clin Med Res 2007 Oct;5(3):184-92. Review