Why changing your diet is always the first step in treating Hashimoto’s

August 11, 2010 in Food & Nutrition, Thyroid Disorders | 19 comments

lowcarbDr. Kharrazian has written an excellent post over at his blog about the importance of proper diet in the treatment of Hashimoto’s. He covers all the bases: the importance of going gluten-free, why gluten-free isn’t enough for most people, how to identify and address food sensitivities, how to balance blood sugar, and how to deal with the psychological and emotional resistance that may arise when making significant dietary changes.

The main obstacle most Americans face in implementing dietary changes, as Dr. K points out, is their addiction to the idea of a “quick fix”:

Americans are infatuated with pills, thanks to decades of conditioning from the pharmaceutical industry. It doesn’t matter whether they come from the pharmacy or the health food store, we have a cultural fixation with finding that magic bullet. It’s no wonder—making genuine, lasting changes to your health takes hard work and discipline, the two last things you’ll see advertised on commercials during your favorite television show.

As long as this mentality prevails, we’ll continue to suffer from increasing rates of disease and morbidity, and our “disease-care” system will continue to buckle and, eventually, collapse.

Dietary and lifestyle changes aren’t easy, but they’re the key to promoting health and preventing disease. And that’s just as true with Hashimoto’s as it is with type 2 diabetes and heart disease.


Daniel August 11, 2010 at 10:14 am

Thanks for sharing the link. The post by Dr. Kharrazian is a treasure trove of good information on Hashimoto’s and how to repair the gut. I agree that we should avoid gluten and sweets if we have an auto immune disease.
Quote:”This immune response to gluten can last up to six months each time it’s ingested.” I am surprised about this fact. Does this mean we should be 100% free all the time? I sometimes cook with soy sauce (with flour in it) so i am wandering if a small amount is also bad.

Chris Kresser August 11, 2010 at 10:17 am

As Dr. K said, 90% gluten-free is like 90% pregnant.  Even a small amount can provoke an immune response.  You can use gluten-free tamari instead of soy if you want that flavor.

Vic Shayne, PhD August 11, 2010 at 11:52 am

My field is whole food supplementation, which isn’t the same thing as vitamin pills or herbs, BUT my contention has always been that to combat any disease or symptom, the first place to begin is with the diet. There is no substitute for the nutrients one needs from nature’s foods in order to address any health problem. Over the past twenty years I have seen “miracles” happen only by adopting a rational, whole foods, natural diet.

Vic Shayne, PhD August 11, 2010 at 11:56 am

Regarding Chris’ statement about gluten, I couldn’t agree more. I’ve known a number of people who have said they have reduced the amount of gluten in their diets, or that they try to eat a mostly gluten-free diet. But when an individual is gluten intolerant, it seems to be an all-or-nothing solution because just a small amount of gluten is enough to begin flattening the villi of the small intestine. Further, complete abstinence allows yesterday’s gluten effects to resolve tomorrow. If you eat it now and then, you are only continuing a cycle of negative effects without allowing your body to heal.

Denise August 11, 2010 at 1:01 pm

Chris, I’m a 46-yr-old female, recently diagnosed with multi-nodular goiter but have “normal” blood results (including autoimmune); needle biopsy of a large nodule which I was told revealed “nothing abnormal” (although my mom, who is a physician, said didn’t look like a very good sample as it was “mostly blood with a few follicular cells”). I have what I feel are hyperthyroid symptoms upon waking (racing thoughts, OCD, fast heartbeat, palpitations) and hypothyroid-related symptoms throughout the day (lethargy, constipation, depression, low Vitamin D, unexplained high cholesterol, long periods, hot flashes). The tightness in my neck from the goiter is very uncomfortable. My question is this — After reading your articles I’m going to try to address leaky gut, gluten intolerance etc. — Is there a chance that will help me with the NODULES, or are are those only going to go away with thyroid hormone and/or surgery?

Chris Kresser August 11, 2010 at 1:19 pm

Denise: I don’t know the answer to that question.  If I had to guess, I’d say addressing the underlying imbalances may stop the growth of the nodules and prevent new ones from occurring, but not dissolve the existing nodules.

Mary August 11, 2010 at 7:24 pm

I have Hashi’s and am very overweight but I don’t have any digestive complaints – no gas, reflux, constipation, diarrhea…and when I did a saliva test for cortisol levels had no issue with the anti-gliadin antibodies.  Is it still likely that gluten is causing or exacerbating my auto-immune thyroid issues?  Also – I’ve heard that some well-fermented wheat may be OK for celiacs – would this also apply for those gluten-sensitive in other ways?

Chris Kresser August 11, 2010 at 8:22 pm

Gluten intolerance can manifest in many different ways, depending on the specific subtype of transglutaminase being attacked by the body. The saliva test is inadequate for testing gluten intolerance. Fecal IgA is a more accurate marker, which is why I recommend enterolab.com. That said, the prevalence of gluten intolerance is so high in Hashimoto’s patients that I tell any patients with that condition to avoid gluten. Even the best testing methods aren’t completely accurate, and the risk of exacerbating the autoimmune attack on the thyroid is just not worth it. Fermented wheat is not okay – in the studies I’ve seen, there is still gluten in it even after significant fermentation.

Lovelyn August 12, 2010 at 12:34 pm

My family has been gluten free for two years now and it’s made such a big difference in my husband and my stepson’s health. I haven’t really noticed any difference for me, though. I’m just sticking with it because it’s easier if we’re all gluten free.

julianne August 19, 2010 at 11:58 pm

I also have Hashis with no symptoms though – just sky high anti-bodies. I have been on a lowish carb diet for 14 years – low gluten and grains, maybe 1 serve day if that.
It wasn’t until I went Paleo that my niggling issues cleared up.
Now – no more joint inflammation, no more PMS or bad Menstrual cramps. Ganglion cyst went away. Weight more stable. No more mild constipation. No more dishydrotic eczema.
Hashis is an auto immune issue – I’m sure meany other people like me have other auto-immune issues brewing even if not diagnosed.
Paleo is awesome – I have just started switching my clients that direction – it is so much more effective than a diet with grains and legumes.
If you have Hashis – go strictly paleo for 30 days – then see how you are

Barbara August 21, 2010 at 8:12 pm

I have Hashimoto’s, and I’m a mess.  I don’t feel my synthroid/cytomel is working, although the docs, even endocrinologists, say my TSH is low/normal.
What’s Paleo?

julianne August 23, 2010 at 5:47 pm

Paleo is short for Paleolithic, eating like a hunter gatherer, pre-agricultural.
No grains, no legumes (including soy and peanuts) no dairy, no sugar, no artificial sugar, no additives, no chemically altered fats, no refined foods.
I eat fresh seafood, poultry and grass fed meat and organ meat, lots of vegetables especially the colourful non starch ones, (but not potatoes), some fruit especially berries, natural fats like raw nuts, olive oil, avocado, coconut, and sometimes a little grass fed cream or butter, natural flavours – herbs and spices.
If you can hunt it, or if you can gather or pick it – you can eat it.
This diet changed my life

gabriela August 29, 2010 at 11:06 pm

Gluten stays in your system for 6 months??? I thnk you may be right about the gluten. I avoid it mostly but notice the symptoms after I consume it and the horrible roller coaster begins again. I have hashis and am on bio-identical dessicated porcine extract but I think the fillers include gluten. Looks like I’ll have to cut gluten out altogether and request gluten free medication, which is double the price.
The paleo diet sounds great. may have no choice but to try it.

Jen September 20, 2010 at 5:14 pm

I just found your blog and I’m scouring it to the best of my ability to get a feel for all that it offers.  I have to ask one question:
What reason is there for not considering removal (or killing) of the thyroid altogether?
Don’t get me wrong, I wouldn’t really consider that, but I just have to ask.
Jen- Concord, CA (diagnosed w/Hashi’s in 2008)

Chris Kresser September 20, 2010 at 5:19 pm

Lots of reasons, Jen, although it is appropriate in some uncontrolled cases of Graves’ disease. Management with supplemental hormone isn’t a perfect science. The body is complex and utilizes mechanisms for hormone regulation we’re only beginning to understand. Replacing the function of sophisticated, living tissue with a pill is much easier said than done. By the way, I will be starting to see clients in early October in Berkeley, CA if you need some additional help figuring this stuff out. You can contact me through the blog.

Kristin September 23, 2010 at 4:17 pm

What percent of Hasimoto’s patients are also gluten intolerant?  I thought I read it was only like 3%.  Thanks!

Chris Kresser September 23, 2010 at 4:57 pm

There are varying statistics, but they’re based on inaccurate tests. Clinically the correlation is very high. I suggest all HASHI’s patients be off gluten.

momon February 23, 2011 at 6:18 pm

i am suffering from diabetes since 6 years but recently also found having hashimotos disease.i suffering from fatiqueness since its hard to choose diets. please advice me foods what to eat and what not to eat for these 2 disease.

Gluten Intolerance April 7, 2011 at 2:24 am

How does it feel being gluten free over a month? I have some friends, who are diabetic, and all I know for preventing this is eating gluten – free foods. Is Hashimoto the same with Celiac Disease?

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