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What Diet Should People With Hypothyroidism and Hashimoto’s Thyroiditis Follow?

In the last blog post I discussed a diet for hyperthyroidism and Graves’ Disease, and so it’s only fair that I take some time to discuss the ideal type of diet for those with hypothyroidism and Hashimoto’s Thyroiditis.  Although many people with Hashimoto’s Thyroiditis do great when following an autoimmune paleo diet, others need to make certain modifications.  If you read last week’s blog post you’ll notice that in this post there is a good amount of overlap in the dietary recommendations, although just keep in mind that everyone is different, and not everyone will respond well to the same exact diet.

Just like I did in last week’s post, I’ll attempt to make this easier to understand, as what I’ll do is go through each category of food, and discuss some of the main foods within each category which can commonly be consumed, and which ones should usually be avoided.

Vegetables.  Most people with hypothyroidism and Hashimoto’s Thyroiditis should eat a wide variety of vegetables each day.  I would try to eat at least five servings of vegetables per day, and more than this would be even better.  This includes vegetables such as artichoke, asparagus, broccoli, carrots, celery, kale, lettuce, onions, spinach, squash, sweet potatoes, and zucchini.  Some people reading this probably are wondering if it is a good idea to eat cruciferous vegetables, such as broccoli, cabbage, and kale. A number of years ago I did recommend for anyone with a hypothyroid condition to completely avoid these foods, but the more research I have done, the more I have realized that all of the research studies on goitrogenic vegetables involve giving large amounts of these foods to rodents.  I’m not suggesting that people with hypothyroid conditions should eat large amounts of raw cruciferous veggies, but these are very healthy foods, and in most cases, eating a few servings per day won’t cause any issues in those people with hypothyroidism and Hashimoto’s Thyroiditis.

Those people with Hashimoto’s Thyroiditis will want to be cautious about eating the nightshades, which include tomatoes, eggplant, white potatoes, and peppers.  And the reason for this is because these foods contain compounds which can have a negative effect on the health of the gut.  I discussed this in greater detail in my article entitled “Nightshades and Thyroid Health“.

You might wonder if it is essential to eat all organic vegetables.  Of course this is ideal, although I realize that in some areas it can be difficult to purchase organic food, and it is also more expensive than non-organic food.  However, you really do want to minimize your exposure to pesticides, and while rinsing your vegetables can help, eating organic is best.  If you don’t have access to organic food, or if you can’t afford to purchase organic food, then I would recommend to obtain the Dirty Dozen list from the Environmental Working Group and avoid those non-organic foods which are on the “Dirty Dozen list”, and try to eat vegetables which are on the “Clean Fifteen” list.

Sea Vegetables.  Kelp and other sea vegetables have some health benefits, although they are also very high in iodine.  Although eating foods rich in iodine is different than taking high dose iodine supplements, some people with Hashimoto’s Thyroiditis don’t do well even when eating iodine-rich foods.  This sometimes can be related to a selenium deficiency, as antioxidants such as glutathione are selenium dependent, and these antioxidants are necessary to offset the oxidation reaction caused by iodine.  And so unless if someone with Hashimoto’s Thyroiditis is certain that they have sufficient levels of glutathione and other antioxidants (i.e. vitamin C) I would recommend for those people with this condition to minimize their consumption of these foods.

Fruit.  Most people with hypothyroidism and Hashimoto’s can have a few servings of low glycemic fruits per day, which include apples, avocados, blueberries, raspberries, blackberries, cherries, grapes, peaches, pears, etc.  But how about other fruits such as bananas, watermelon, and cantaloupe?  It really does depend on the person, as while these definitely have some health benefits, bananas have a high sugar content, and melons have a higher glycemic index.  As a result, if someone has blood sugar imbalances it is best to minimize their consumption of these fruits.

I would also recommend to eat at least twice as many vegetables than fruit.  I bring this up because I commonly see the opposite pattern, as it is common for people to eat four or five servings of fruit per day, and sometimes more than this, yet only eat a couple of servings of vegetables on a daily basis.

Dairy products and eggs.  If someone has Hashimoto’s Thyroiditis and is following a strict autoimmune paleo diet, then they will want to avoid all dairy products and eggs.  And there are a few reasons for this.  With regards to dairy, many people are sensitive to the proteins of dairy, especially casein.  Some people do fine when consuming raw dairy, but not everyone.  And the same is true with regards to milk from a goat or sheep.  However, if someone has a casein sensitivity then they might react to all types of dairy, regardless of whether it is raw or pasteurized, or if it comes from a cow, goat, or sheep.  I discussed dairy in detail in a past blog post entitled “Should People With Graves’ Disease and Hashimoto’s Thyroiditis Avoid Dairy?“.  As for eggs, although eggs are very nutrient dense, egg allergies are common, and egg whites include compounds which can have a negative effect on gut health.  With that being said, many people do fine consuming egg yolks.  My current approach is to have people with Hashimoto’s Thyroiditis avoid these foods for one month, and if they are struggling with the diet then they can try to reintroduce egg yolks.

Fermented foods.  Most people with hypothyroidism and Hashimoto’s Thyroiditis can benefit from eating some non-dairy fermented foods on a regular basis.  This includes kimchi, kombucha tea, sauerkraut, and unsweetened coconut yogurt.  Although fermented dairy products such as kefir and yogurt can also benefit one’s health, since I typically have my patients avoid dairy I recommend for them to avoided fermented dairy products.  If someone has a condition such as small intestinal bacterial overgrowth (SIBO) then they probably won’t be able to tolerate fermented foods until this problem is addressed.

Coconut products.  Most people with hypothyroidism and Hashimoto’s Thyroiditis do fine when consuming coconut products, which include coconut butter, coconut milk, coconut oil, coconut flakes, and coconut yogurt.  Plus, there is some evidence that coconut can help to increase the metabolism, which might offer yet another benefit to those with an underactive thyroid.  With regards to coconut milk and coconut yogurt, although you can purchase these at most health food stores, you need to be careful about other ingredients which might be included that you shouldn’t consume, and as a result it might be best to make your own coconut milk and yogurt.  As is the case with fermented foods, if someone has SIBO then they might not tolerate coconut products.

Meat.  Most types of meat are fine to eat, including beef, chicken, turkey, lamb, and pork, although the quality of the meat is of course important. For example, if someone is going to eat beef then ideally they will want to choose 100% grass fed beef.  If someone is eating poultry then organic pasture raised is preferred, although this admittedly is challenging to find in some areas.

Organ meats are very nutrient dense, and so if you like organ meats such as liver and heart then feel free to eat these.  Of course you want to make sure the organ meats are from a good quality source.

Seafood.  There is a lot of controversy over eating fish.  First of all, fish are high in mercury, as well as other toxins.  This is especially true with larger fish, but toxins affect the smaller fish as well, although to a lesser extent.  While some natural healthcare professionals claim that fish which are high in selenium help to offset any adverse effects of mercury, I still recommend to limit one’s consumption of fish to three times per week, and to try to eat fish with a low mercury content.  I’ve discussed this in greater detail in an article I wrote entitled “Seafood and Thyroid Health“.

Nuts and Seeds.  Although nuts and seeds are nutrient dense, they also have lectins and phytic acid, which can have a negative effect on gut health.  As a result, if someone has a leaky gut or another gastrointestinal issue then it probably is best to avoid nuts and seeds.  This is the main reason why nuts and seeds aren’t part of an autoimmune paleo diet, as a leaky gut is common in autoimmune conditions such as Hashimoto’s Thyroiditis, and some feel that a leaky gut is a necessary prerequisite to develop autoimmunity.  If someone is pretty certain they don’t have a leaky gut or other digestive issues, I would still make sure not to eat too many nuts and seeds, although having one or two servings per day is probably fine for most people.  Soaking nuts and seeds will help to reduce the antinutrients and make them easier to digest, although someone with a leaky gut still should be cautious about eating soaked nuts and seeds.  I’m sure some people who add chia seeds and or flax seeds to their smoothies will wonder if this is okay, but if you are dealing with a leaky gut then these should also be avoided, as these also have compounds which can affect the permeability of the gut.

Gluten-Free Grains.  Although some people seem to do fine eating a small amount of gluten-free grains such as brown rice, buckwheat, and the psuedograin quinoa, these also include compounds which can affect the health of the gut.  As a result, anyone dealing with a leaky gut should ideally go grain-free, at least until the gut has been healed.

Legumes.  These should ideally be avoided while trying to restore one’s health since they also have compounds which can affect intestinal permeability.  This includes black beans, lentils, peanuts, pinto beans, and soybeans.

Soy.  This is yet another controversial topic in the world of thyroid health.  Although a small amount of fermented non-GMO soy might be okay depending on the person, one’s overall consumption of soy should be minimized.  I would definitely look to avoid processed soy products such as soy protein powder, soy burgers and chicken nuggets, soy milk, etc.  I’m not too concerned about a small amount of soy lecithin being consumed, as long as it’s from a non-GMO source.  With that being said, some people react negatively to all types of soy, even soy lecithin.

Sugars.  Having a very small amount of natural sweeteners such as honey, pure maple syrup, molasses, or stevia is usually fine, although there are exceptions.  On the other hand, other sweeteners such as agave, corn syrup, high fructose corn syrup, and sucrose should be avoided.  The sugar alcohols are controversial, as while many people seem to do fine with them, they might have a negative effect on gut health, and they usually lead to bloating and gas in those with small intestinal bacterial overgrowth.  For more information on this I’d check out my blog post entitled “Natural Sugars, Sweeteners, and Thyroid Health“:

Herbs and spices.  Some herbs and spices are usually fine to consume, such as cilantro, garlic, cinnamon, ginger, oregano leaves, and rosemary.  Sarah Ballantyne (author of the wonderful book The Paleo Approach) has done a lot of research in this area, and she has put together a comprehensive list of what herbs and spices are fine to eat, which ones you should be cautious about, and which ones should be avoided.

Oils.  With regards to cooking, consider using coconut oil, although if someone has problems with coconut oil then they can use lard or duck fat as alternatives.  Olive oil shouldn’t be used for cooking, but it makes an excellent salad dressing (I personally use an olive oil/garlic combination on my salads).  Although there is some controversy over flax oil, I think adding some organic flax oil (not flax seeds) to your salad or smoothie is fine in most cases.

Processed Foods.  Obviously these should be avoided while trying to restore one’s health back to normal.  While some people are able to get away with eating processed foods, for others it will have a negative effect on their recovery.  After someone has restored their health back to normal they of course should still to eat mostly whole foods, although if someone has a healthy gut then eating some processed foods on an occasional basis probably won’t be a big deal.

Remember That There Is No Specific Hypothyroid Diet For Everyone

Although these are some general guidelines, just keep in mind that everyone is different.  As a result, there might be some people who are unable to eat the “allowed” foods due to food sensitivities, a yeast or bacterial overgrowth, etc.  On the other hand, some people eat some of the “forbidden” foods yet still receive good results.  The problem is that it is impossible to predict who will do fine when straying from the diet, and who won’t show a significant improvement in their health.  And so while I realize the diet is strict, especially for someone who has gut issues, I would recommend to try to be strict in order to achieve optimal benefits.

So if you have hypothyroidism/Hashimoto’s, then hopefully you have a better idea as to what you can eat, and which foods you should avoid while trying to restore your health.  While the overall goal should be to eat whole foods while avoiding the refined foods and sugars, the type of whole foods you eat can be an important factor in your recovery.

As I mentioned, you ideally want to eat at least twice as many vegetables as fruits, and if at all possible try to buy meats, fruits, and vegetables that are organic.  If this isn’t possible then at least try to buy healthier meats while trying to avoid fruits and vegetables that are on the Dirty Dozen List.  Although following these dietary recommendations alone probably won’t be enough to restore the health of most people, making these changes can lead to a huge improvement in your health, and when combined with other factors will greatly increase your chances of restoring your health back to normal.


 

25 Comments

  1. AURELIA OANA says:

    Some doctors (not many) recommend Thytrophin PMG to be swallowed and thus “confuse” the antibodies which would attack the natural thyroid in this Thytrophin PMG and not the thyroid ANYMORE!!!! how much truth lies in this? I wonder! and I have Hashimoto’s: could I take Thytrophin PMG along with the synthetic Synthroid? in fact I feel NO BETTER after years of synthetic hormone! why not try this??? does anyone here know?

    • Dr. Eric says:

      Hi Aurelia,

      Thytrophin PMG does seem to be effective in neutralizing the negative effects of the antibodies, although keep in mind that this doesn’t do anything to address the cause of the autoimmune response. And as I’m sure you know, thyroid hormone medication doesn’t do anything for the cause either, and if someone has other imbalances (i.e. weak adrenals, a leaky gut, etc.) then it’s common for people with hypothyroidism not to feel better, even when taking thyroid hormone.

      • AURELIA OANA says:

        Thank you so much, Dr. Eric! I did stop taking thyroid hormone medication as I’ve read in many places and I try to address my immune system, I don’t know where to start, as I’m doing this on my own, say “leaky gut”… i don’t know the symptoms; however, as I said before, I don’t believe in doctors because I was put on thyroid medication by doctors, endocrinologists…GOD FORBID!

        • Dr. Eric says:

          Hi Aurelia,

          Keep in mind that while the primary goal with Hashimoto’s Thyroiditis is to address the autoimmune component, some people do need to take thyroid hormone medication. Even though the medication doesn’t do anything for the cause, thyroid hormone is very important to one’s overall health, and so we don’t want the levels to be too low. The problem is that many people take the medication but don’t do anything to address the cause of their condition.

  2. AURELIA OANA says:

    would any dessicated thyroid in Armour, for instance, (pig or bovine) have the same effect??? I wonder! in fact I’m extremely curious! or only Thytrophin PMG would serve? thank you!

    • Dr. Eric says:

      Hi Aurelia,

      Unfortunately taking a desiccated form of thyroid hormone such as Armour or Nature-Throid won’t have the same effect as Thytrophin PMG.

      • AURELIA OANA says:

        Thank you, doctor, thank you so much for taking time to answer my questions! it’s difficult for me to get Thytrophin PMG and it’s good to know those mentioned by you would do no good; however, I’m so curious: did YOU have Hashimoto’s? did YOU get rid of it? how lucky! was it difficult to find the ROOT of your Hashi’s? my illness (can I say that?) was discovered 3 years ago, now I’m 61, do you think it’s too late to solve the problem?I wish I could find such a doctor like you, but I’m in Europe; what a pity!
        PS How old were you when you discovered it?
        Aurelia Oana

  3. AURELIA OANA says:

    I see, the questions are too personal; and yes, I HAVE read that small amounts of thyroid hormone would do in Hashimoto cases; I’ve also read that doctors recommend a combination of T3 and T4, which sounds quite reasonable; my tests (Nov 2014) were FT3:3.04, FT4: 0.91, TSH: 17.60; what do you think? I live on the border with another country and had to go to THAT country to check my blood, here,all was messed up! what if I have my thyroid gland removed? would my problems have an end? However, I’m lucky to speak English,otherwise….
    Aurelia Oana

    • Dr. Eric says:

      Hi Aurelia,

      Your TSH is extremely high, and so I can’t tell you what to do, but based on your numbers you probably can benefit from taking thyroid hormone while trying to address the cause of your condition. If you were to have your thyroid gland surgically removed then you definitely will need to take thyroid hormone medication on a permanent basis, and the surgery of course wouldn’t do anything to address the cause of the problem.

      • AURELIA OANA says:

        Hi Dr. Eric,
        I’ve read this is inherited, my mom had it!so… but what perplexes me, stuns me, have no words…how come I have FT3 half the amount of the normal and FT4 at the inferior limit, I’ve read T4 is turned into T3 by the body – where from such an amount of FT3 if FT4 is so little or not enough? or I’m wrong? moreover, my symptoms are not those “a la carte”, I’m never cold, my hair is not thinning, etc, why? it’s true that my pulse goes up to the sky even if I’m sitting, not to talk about when I walk…my heart is pounding seriously…cannot lose weight; so I think I’m a “special” case.
        And thank you for your reply!
        Aurelia Oana

  4. AURELIA OANA says:

    However, I decided to self-medicate so every morning I take 25 mg of Euthyrox (T4) or should I take Novothyral which contains T3, too? I don’t HAVE where to go, who to ask…If I don’t feel better, I’ll take 50 and so on…I’ll go back with the amount of hormone depending on how I feel. I also might have problems with the gut, maybe candida, whatever. We used to have a very good naturopath here, but now I understand he has gone… well he has problems.

  5. AURELIA OANA says:

    I am never hungry, am I normal?

  6. AURELIA OANA says:

    Hi, Dr. Eric,
    I’ve been in a very unpleasant period, feeling bad, depressed, have just quit smoking (April 12), my TSH went up to 26 and my T3 decreased a bit;
    but I received (yesterday) Thytrophin PMG so I took one pill last night before bed and the first result: no more sweat during the night!hope for the better!

  7. AURELIA OANA says:

    Disappointed, in a way: I have no candida, so no leaky gut and I wonder: what IS the cause of my Hashi’s? more digging is the next step…

  8. AURELIA OANA says:

    Hi Dr. Eric
    Are you a chiropractor doctor? I’m very curious. And thank you!

  9. Holley Whiteman says:

    I have been going through your writings on the Hashimoto Hypothyroidism I suffer from this and have been on Synthriod for 6 years have been after my doctors for a diet and never got a straight answer so was really glad to have run onto your site.
    The question I have is about the white potatoes we use a yellow meat potato called German butterball and fingerling salad potato also yellow meat are these considered to be in the night shade family as well.we grow as much of our own vegetables as possible and are getting ready for this year so if you would give my an answer as soon as possible I would appreciate it very much.
    With repsect Holley Whiteman

    • Dr. Eric says:

      Hi Holley,

      Although I’m not an expert on German butterball potatoes, I’m pretty certain that they are considered to be part of the nightshade family.

  10. jasper says:

    i have also test my thyroid and my t3 and t4 where to low.
    but i had taked armour but no better feelings..
    how to find your cause of your problem?
    Sometimes I think I’m intolerant to any food. Now lately I have extremely dry skin and acne and extremely swollen eyelids and I ‘m only 22 pfff.

    I have tried so many supplements but nothing really works. and been to several doctors. One person also said that I have adrenal exhaustion. Now I ‘m going to take natural thyroid and adrenal caps caps. because I take all probiotics and glutamine and gelatin with collagen

    • Dr. Eric says:

      Hi Jasper,

      It can be a challenge to find the cause of your condition, but in addition to taking supplements you of course want to make sure you are eating a healthy diet, improve your stress handling skills, get enough sleep, etc. It also might be a good idea to work with a natural healthcare professional who can do the necessary testing to help determine what the underlying cause of your condition is.

      • Barb says:

        Dr Eric,
        Do you recommend seeing an endocrinologist to find the underlying cause of Thyroiditis or Hashimoto’s? Or is there another type of specialist you would recommend? Vitiligo has started on my body in March and now it is everywhere. First appearing on my forehead, it has worked its way down to my feet. Is that what you consider to be an autoimmune response? We found a low T4 but TSH was fine. Thank you!

  11. mariana says:

    Hi DR.Eric!I am 62 and test results T4fee 12,Free T3 4,TSH 6.8 and TPO antibodies 285.Do I need Synthroid?I feel crappy,anxious,insomnia.I sometimes crave salt,but my cortizol is o’k and the endo said my thyroid function is preserved.I worry about the anxiety and insomnia.Is it correct that if I do not start synthroid hashimoto may progress to anothe autoimmune disease and brain deteriotion.What is your advice?
    Mariana

  12. mariana says:

    Hi Dr.Eric!Would i benefit from 200mcg on an empty stomach combo Se methionine and vit E 200i.u or just SE to reduce the TPO antibodies
    Thanking you again a lot.I am stopping dairy and grains but for how long?I am gluten free.
    Thanks a lot
    Mariana

  13. Rose says:

    I don’t have a thyroid gain so much weight what do you recoment

  14. Mary Gregory says:

    I am a 51 year old female that has had Hypothyroidism since I was 30 (when Diagnosed) I also had a Goiter. I am now being told I have Hashimoto’s. six years ago I had a Lap Band put in. Originally I lost almost 90 pounds…but most of it has come back. I am sufffering from fatigue, weight gain, menopause symptoms, numbness in feet and hands. I still work out at least three times a week, but it does not provide any extra energy for me. I am currently taking Nature throid, selenium, and magnesium. I am on a gluten free, no added sugar diet. I am a LVN and have some knowledge in regards to the bodies systems. I am desperate for a “normal Life”.

  15. Paula says:

    I stoped taking my Levothyroxine 8 weeks ago
    I feel better off the medications and am taking kelp
    I feel that my GP/ MD hadnt been monitoring my symptoms properly
    Especially when im having a hyper
    Im not saying this is the correct thing to do for everyone however for me its working so far
    Yes i still get fatiguefd etc but at least i have some energy to do short sharp bursts of exercise now where before i couldnt do any
    And for me thats bad as exercise keeps my brain alert

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Natural Treatment Methods:
Graves Disease Treatment
Hypothyroidism Treatment
Hyperthyroidism Treatment
Natural Thyroid treatment


Conventional Treatment
Methods:
Radioactive Iodine
Thyroid Hormone