If you have read some of the posted comments from thyroid and autoimmune thyroid forums and Facebook groups, chances are you’ll come across people with Graves’ disease and Hashimoto’s who experienced dramatic improvements in their health just by changing their diet. Some people do nothing but eliminate gluten from their diet, and yet feel significantly better. Others need to be more strict with their diet in order to receive great results. However, one question you might have is whether or not eating well simply helped to improve the health of these people, or did making these dietary changes reverse the autoimmune component of their condition? I’m going to discuss this in this blog post.
Although the focus of this blog post is on whether changing one’s diet alone can reverse Graves’ disease and Hashimoto’s, I’d like to briefly review the triad of autoimmunity [1] and discuss the four main categories of autoimmune triggers. According to the triad of autoimmunity, in order for autoimmunity to develop you need 1) a genetic predisposition, 2) an environmental trigger, and 3) an increase in intestinal permeability (a leaky gut). As you know, we can’t change your genes, but we can reverse autoimmunity by removing the trigger and healing the gut.
Focusing on the environmental triggers, there are four main categories of these triggers:
1. Food
2. Stress
3. Chemicals
4. Infections
As you can see, one of the main categories is food. So it is possible that food can be a trigger, and if a specific food is the sole trigger, then eliminating this food from one’s diet can reverse the autoimmune component. If this is the case, then why do some people who eliminate gluten [2], or perhaps even follow a strict autoimmune Paleo diet [3] for a few months, not get into remission? There are a few obvious answers, with one being that food isn’t a trigger in everyone. In many people the main trigger is stress, chemicals, and/or infections. If this is the case, then eating well alone won’t reverse one’s condition.
Another reason why a person who follows a strict AIP diet might not get into remission is because they have multiple triggers. In other words, certain foods might be a trigger, but they might have one or more triggers from the other categories I listed above. I see this quite frequently, as a person might feel significantly better when eliminating certain foods, but they are still symptomatic, their thyroid antibodies [4] are still high, etc. This usually means that not all of the triggers have been removed.
It’s also worth mentioning that a person might clean up their diet and not feel better, and then prematurely decide that food wasn’t the main trigger, when the real problem is that they weren’t strict enough with their overall diet. For example, someone might completely go gluten and dairy free, but they might react to another food (i.e. corn). Or perhaps cross contamination is an issue, as a person might think they’re completely avoiding a certain food, but somehow they’re getting exposed to it. This is especially a concern when eating out. These are just a few things to consider when evaluating your diet.
Which Foods Can Be Triggers?
The truth is that you can have an immune system reaction to any food. However, this doesn’t mean that all foods are potential autoimmune triggers. For example, while I don’t do a lot of IgG food sensitivity testing [5], I have done such testing on some of my patients, and I’ve seen people test positive for healthy foods such as broccoli and asparagus. While one can argue that eating these foods might cause inflammation (if one is sensitive to them), and perhaps even prevent the gut from healing in this situation, they aren’t autoimmune triggers.
On the other hand, gluten, dairy, and corn are potential triggers of autoimmunity. This is why most natural healthcare practitioners will advise their autoimmune patients to avoid these foods. This is especially true when trying to restore one’s health, but a strong argument can be made to continue avoiding these common allergens even after achieving a state of remission.
How Can Food Trigger Autoimmunity?
Something called molecular mimicry may explain why certain foods can trigger autoimmunity. I’ve discussed molecular mimicry in past articles and blog posts, as it seems that certain foods contain antigenic substances that have amino acid sequences similar to those of human proteins (1) [6]. When someone eats these foods, this can result in the production of antibodies that not only react against the food antigens, but the body’s own tissues. An example of this is gluten, as there is some evidence that gluten has a similar amino acid sequence to the thyroid gland, which can cause the body to develop antibodies not only against gluten, but the thyroid gland as well.
Removing Your “Leaky Gut Triggers”
In addition to environmental triggers playing an important role in thyroid autoimmunity, it’s also important to mention that different factors can cause a leaky gut. In the past I’ve mentioned how gluten causes a leaky gut in everyone, and so if gluten is the only autoimmune trigger and is also the only “leaky gut” trigger, then avoiding gluten alone might be the solution to reversing the autoimmune component of Graves’ disease or Hashimoto’s. I say “might” be the solution because even after removing the trigger and healing the gut, you might need to do things to reduce proinflammatory cytokines [7] and increase regulatory T cells, [8]which is also necessary to suppress the autoimmune component.
Cure vs. Remission vs. Improvement
In some of my webinars and articles I’ve discussed the difference between “cure” and “remission”, and how Graves’ disease and Hashimoto’s can’t be permanently cured since they involve a genetic component. While “getting into remission” doesn’t sound as good as “being cured”, this still involves the elimination of one’s symptoms, normalization of thyroid markers (include thyroid antibodies), and correcting other imbalances related to the autoimmune thyroid condition. And it is possible to stay in remission for a prolonged period of time, as I’ve been in remission from Graves’ disease since 2009, although I’ve dealt with some other health issues over the years, most notably Lyme disease, which I discussed in a previous blog post [9].
On the other hand, many people experience an improvement in their symptoms and/or labs upon changing their diet, but they don’t go into remission. For example, they might have a reduction of their symptoms, but they don’t completely go away. Or their blood tests might improve, but they’re still not in balance. Keep in mind that in some cases of Hashimoto’s the thyroid panel can’t be normalized, which is why you also want to monitor the thyroid antibodies, along with other tests that were out of range. If you experience some positive changes after modifying your diet but don’t get into remission, please don’t become discouraged, as this is very common. When this is the case, in most cases there are other triggers/imbalances that need to be addressed.
How Do You Know If Food Is Your Only Trigger?
As for how to know if food is your only trigger, in my opinion, the best way to find out is through an elimination and reintroduction diet. If you avoid all of the allergenic foods (gluten, dairy, corn, etc.) and your symptoms resolve and your thyroid panel and antibodies normalize, then you know that food was the main culprit. On the other hand, if your symptoms don’t improve and/or your blood tests don’t normalize, then there are most likely other triggers present. As I briefly mentioned earlier, sometimes removing the trigger alone isn’t sufficient, as you might need to do other things to reduce the inflammation.
I mentioned IgG food sensitivity testing earlier, and you might wonder if this is something you should consider doing. In some cases this can detect food triggers, although false results are common, which is why I don’t recommend such testing to all of my patients. Earlier I also mentioned that not every food that tests positive on an IgG food sensitivity panel is an autoimmune trigger. I realize that many people don’t want to stop eating foods that have gluten and dairy, but this is the best way to find out of these are triggers. Plus, even if gluten isn’t a trigger it’s best to be avoided, especially while healing your gut.
Is It Necessary To Eat A Strict Diet If Food Isn’t The Main Trigger?
If you’re pretty sure that certain allergens aren’t a trigger in your case, you might wonder if it necessary to continue avoiding these. For example, if you followed an elimination diet for at least 30 days and didn’t experience any improvement in your symptoms or thyroid markers, is it okay to reintroduce gluten, dairy, and other common allergens? I get this question asked a lot, and I usually recommend to continue avoiding the “allergenic foods” at least until one’s health has been restored…even if they aren’t responsible for triggering autoimmunity.
This is especially true with gluten, as I reminded you earlier how the research shows that gluten causes a leaky gut in everyone. And since dairy and corn cross react with gluten (eating these foods can produce gluten antibodies), one can argue that it’s best to avoid these foods as well. In fact, some natural healthcare practitioners recommend for people with autoimmune conditions of all types to permanently avoid gluten, dairy, and corn. I’d be lying if I told you that I’ve avoided all of these 100% since I’ve been in remission. But I’ll also admit that anytime myself or anyone else with an autoimmune condition is exposed to these food allergens they’re taking a risk.
What’s Your Experience With Avoiding “Food Triggers”?
Please feel free to share your experience with eliminating some of the allergenic foods discussed in this blog post. If you received good results when avoiding gluten, dairy, corn, etc., and perhaps even achieved a normalization of your thyroid antibodies after doing this, please feel free to share your experience in the comments section below. On the other hand, if you strictly avoided these common allergens and didn’t see any positive changes, I’d like to hear from you as well. Perhaps you didn’t notice a difference in your health when avoiding gluten, dairy, or corn, but noticed a significant improvement when avoiding another food or allergen (i.e. soy, eggs, nightshades, etc.)