In this post we will be looking at some of the research on which foods to include and why on the Hashimoto’s diet.
Now, in our earlier article, we went into a lot of detail about what foods NOT to eat on the Hashimoto diet.
In brief, here are the main six food groups to avoid, but please do read the full post:-
- Lactose and Dairy Products
- Canola Oil and other Seed Oils (Vegetable Oils)
- Raw Cruciferous Vegetables
- Soy Products
- High Sugar and Processed Foods
What is Hashimoto Thyroiditis?
Hashimoto Thyroiditis is basically an inflammation of the thyroid gland. Hence, ‘itis‘ means inflammation and obviously, ‘thyroid’ refers to the thyroid gland.
In this case, however, the thyroid becomes underactive, not due to the gland underfunctioning, but because of an autoimmune disease response.
An autoimmune response refers to any disease process whereby the body’s own antibodies, mistake an organ or tissue as alien, and attack it.
Thus in Hashimoto Thyroiditis, the thyroid gland does not produce enough thyroxine due to inflammation. Hence, a medical picture of hypothyroidism occurs.
This post will be looking at which foods to include in your new eating plan if you have Hashimoto Thyroiditis.
Our two posts on the Hashimoto Diet are a variation, based on specific research for thyroiditis, of the Autoimmune Protocol (AIP).
The Autoimmune Protocol is sometimes called the Paleo Autoimmune Diet. This eating plan aims to reduce inflammation in the body and, hence, stop the autoimmune response.
The main underlying principles of the Hashimoto’s diet are to:-
- Heal the gut and digestive system
- Eliminate foods that cause inflammation, such as those that cause allergies, intolerance or are difficult to digest
- Promote nutrient rich, organic ‘clean’ eating
- Include more food types that promote healing of the thyroid gland
NOTE: This post does NOT advocate avoiding seeing your physician if you have any symptoms of hypothyroidism. It is very important that you have the specific blood screening and tests to diagnose hypothyroidism and the underlying cause.
In the case of hypothyroidism, depending on your thyroxine levels, the traditional treatment is Levothyroxine (a synthetic hormone replacement).
This article, encourages a conventional approach to treatment for Hashimoto’s in combination with dietary and lifestyle changes.
Foods to Include on the Hashimoto’s Diet
Indeed, recent research into the brain-gut connection suggests the use of probiotics for anxiety.
So, we find a wealth of information out there on the health benefits of probiotics and fermented foods.
What are Probiotics?
Basically, your gut should have a balance of good bacteria and bad bacteria. In general, probiotics are the live ‘good’ bacteria, yeast and microorganisms that reside in, and maintain the health of, your gut.
One of the major roles of the gut flora is to help digest and metabolise foods. In addition, the gut microbiota plays an important role in immunity and inflammation.
Therefore, it stands to reason that probiotics have become an area of research for autoimmune diseases.
Interestingly a small, 2018 study showed that patients with Hashimoto Thyroiditis have an altered gut microbiota. Furthermore, there was a correlation between the level of bacterial imbalance in the gut and clinical symptoms.
Another medical study found that Small Intestine Bacterial Overgrowth (SIBO) basically an excess of bacteria in the small intestine was present in over 50% of hypothyroidism patients.
Finally, according to research, the phenomenon of increased intestinal permeability (or ‘leaky gut‘) may play a role in inflammation and thus many chronic diseases, including autoimmune conditions.
Mu (et al.) in a 2017 research article for ‘Frontiers in Immunology‘ states:
” … reversing gut leakiness appears to be an attractive therapeutic strategy. Prebiotics and probiotics, for example, can be used to reduce intestinal permeability.”
How to introduce Probiotics into your Diet
The two families of good bacterias that are often found lacking in people with autoimmune disorders are Lactobacillus and Bifidus.
You can initially take ‘live’ bacteria probiotics in a supplement form to boost your gut health. However, always speak with your physician or pharmacist before taking any health supplements.
Many natural foods contain probiotics, particularly fermented foods, so a healthier way to introduce these good bacteria is to naturally consume them.
Probiotics in Foods
So, what foods to eat that are rich in probiotics?
Well, because fermented foods are prepared by adding bacteria, these are the way forward. Here are a few to introduce into your diet:-
Natural live yogurt: The most common bacteria in live yogurt is Lactobacillus. However, be aware that many store-bought yogurts contain large amounts of sugar which do NOT help the balance of microorganisms in your gut. The best and easiest way to introduce delicious fresh fruit yogurts into your diet is to make your own. It is easy, cheap and fun.
Kefir: Is similar to yogurt, but is a fermented milk drink. Although you can make kefir with milk substitutes, such as coconut milk, due to the fermenting process it is usually safe for those who are lactose intolerant. So, kefir actually contains more strains of live bacteria and yeast than yogurt.
Sauerkraut: All the way from Germany this fermented cabbage is super rich in probiotics, fiber, vitamins and minerals.
Kimchi: Korea’s answer to Sauerkraut. A fermented vegetable and spice dish.
Kombucha: Swap that standard cuppa for a fermented cup of green tea (or traditional brown tea).
Pickles: Sometimes known as ‘gherkins’ these are simply probiotic-rich fermented cucumbers. Note: pickles in vinegar destroy the probiotic quality
Summary on Probiotics for the Hashimoto Diet
- Increased intestinal permeability (leaky gut) is thought to be a factor in gut health and autoimmune diseases
- Medical research shows that gut microbiota plays an important role in immunity and inflammation
- Small research studies have shown that altered gut microbiota and Small Intestine Bacterial Overgrowth (SIBO) are more likely in Hashimoto Thyroiditis patients
- Following medical advice you can take a probiotic supplement
- Increase your intake of naturally fermented foods
- Get creative and proactive – make your own yogurts and Kombucha
- For Hahimoto’s diet avoid soy based fermented products such as Miso and Tempeh
2) The Debate around Iodine
The research on iodine on the Hashimoto’s diet can be a little confusing and contradictory, to say the least. So let’s try and unravel some of the information.
Iodine (together with Selenium) is necessary for the manufacture and function of the hormone, thyroxine.
Iodine Deficiency and Hypothyroidism
So, according to medical studies, an iodine deficiency causes thyroid disorders such as goitre, hypothyroidism and delayed growth and intellectual development.
In the early 2000’s iodine deficiency affected around 2 billion people worldwide. However, in many countries iodine has been added to the salt (iodized salt) to help solve the problem.
However, recent research in the US suggests that iodine deficiency is reemerging.
Likewise in Europe, Lazarus in a 2014 study on ‘Iodine Status in Europe‘ states:-
A significant part of the population in Europe is mildly deficient in iodine; an increase in dietary iodine consumption by 50-100 μg/day would be beneficial, with minimal or no adverse consequences.
Iodine and Autoimmune Hypothyroidism
This is where it all becomes VERY confusing!!
In the early 2000s, medical research suggests that it is an increase in iodine in the diet that causes,
‘… a significant increase in the incidence and intensity of autoimmune thyroid disease‘.
However, more recent research disputes the above claim. In a 2016 research article published in the British Medical Journal (BMJ) claims again, that it is an iodine deficiency that causes autoimmune thyroid problems.
Furthermore, in areas and countries, such as Japan, where an excess of iodine in the diet occurs, the association between iodine and autoimmune thyroiditis has NOT been found.
So … Hashimoto’s Diet and Iodine What to do?
We do NOT suggest taking any iodine supplements with Hashimoto thyroiditis WITHOUT the advice of your physician.
According to the National Institutes of Health (NIH) the recommended daily allowance (rda) of iodine for adults is 150 micrograms per day.
If the iodine issue has confused you – there are four types of tests that you can ask your physician to take.
This way, you can personalize your care and know if iodine deficiency (or excess) is an underlying problem for you.
Foods Rich in Iodine
Salt: Many salts in the Western world have iodine added so always check your salt label. If iodine is added it will be labelled ‘iodized‘. If this is the case you are probably getting more than enough.
Other foods that are a good source of iodine include:-
- Seaweed: Seaweeds are the richest food source of iodine. Kelp, for example, has over four times the daily minimum recommended amount.
- Milk products: Particularly milk and yogurt are good sources of iodine.
- White fish: Especially haddock and cod which contain around 230 to 390 mcg per 120g portion. A 170g portion of scampi provides around 160 mcg of iodine
- Fruit and vegetables: Contain small amounts of iodine
Be aware that an excess of iodine may cause issues for those with thyroid problems. Aim for 150 mcg per day the RDA.
Summary on Iodine for the Hashimoto’s Diet
- Iodine deficiency appears to play a role in hypothyroidism
- There is a lot of debate between medical specialists regarding iodine
- Latest research suggests that there is not a risk in taking iodine naturally in the diet for autoimmune thyroiditis
- The RDA of iodine for adults is 150 microgramms per day
- If you are unsure ask your physician for a test
- Include foods rich in iodine but be aware if the salt you use is iodized
So don’t be fake, fast, easy or cheap!
Selenium is a mineral and a micronutrient that is present in soil, water and some foods.
The thyroid gland is an organ that has the highest amount of selenium, hence, the importance of discussing the role of selenium on the Hashimoto’s diet.
Indeed, selenium is necessary to the thyroid, both for antioxidant function and the metabolism of the thyroid hormones.
There is a complex relationship between selenium, iodine and thyroid function and the two need to work in balance to maintain optimal thyroid function.
There are several recent medical studies (1, 2, 3) that suggest that a selenium supplement may reduce the autoimmune antibody count in Autoimmune Thyroiditis.
However, it is VERY important that you do not supplement with selenium if you are iodine deficient as this can also suppress thyroid function.
For this reason, do NOT take selenium (or any other) supplements without medical supervision and the appropriate tests if you have Hashimoto’s thyroiditis. You can discuss the role of iodine and selenium with your endocrinologist.
Foods Rich in Selenium
The recommended daily amount of selenium for adults is 55 to 75 mcg per day.
However, an excessive amount of selenium (around 330 mcg per day) can potentially be toxic so BE careful.
The following foods are good sources of selenium, although the amount does vary depending on soil quality.
- Brazil Nuts: are the best source of selenium and contain between 2 to 253 mcg per nut. So before you go and indulge in a whole packet be VERY careful of excessive selenium intake
- Meat: Beef, turkey, chicken and pork all contain selenium from around 18 to 33 mcg per 3 ounces serving
- Tuna yellowfin: is another excellent source of selenium at around 92 mcg per 3 ounces serving
- Shrimps, sardines and halibut with a selenium content of 40, 45 and 47 mcg per 3 ounces serving respectively
- Dairy foods and eggs also contain selenium in smaller quantities
- Brown Rice and Lentils
- Baked Beans
- Fruits and vegetables: In lesser quantities are Spinach, green peas, bananas, peaches and potatoes
Summary on Selenium for the Hashimoto’s Diet
- Although more research is necessary, several medical studies suggest that a selenium supplement reduces antibodies and improves symptoms in Hashimoto’s Thyroiditis
- The relationship between iodine, selenium and thyroid function is complex
- Do NOT take a selenium supplement if your iodine status is unknown OR if you are iodine deficient
- NEVER take any supplements with Hashimoto’s Thyroiditis without medical supervision
- There are many food sources that contain selenium.
- Aim for the daily recommended allowance of between 55 and 75 mcg per day
- Do NOT overdose on brazil nuts that are very high in selenium
- Although unusual, selenium toxicity may occur and it is possible, although unusual without supplements, to overdose
Again, zinc is an important trace element for thyroid health.
Indeed, zinc is necessary for the synthesis of thyroid hormones. Interestingly, this is a two-way system whereby low levels of thyroxine, in turn, affect the absorption of zinc.
Furthermore, pertinent to cases of Hashimoto Thyroiditis, zinc plays a role in regulating the immune system.
Indeed, a 2018 meta-analysis found a consistent link between a zinc deficiency and patients with autoimmune disorders.
Zinc and Hashimoto’s diet
So, in the case of Hashimoto Thyroiditis, we do not recommend a zinc supplement. Again, as in the case of selenium, you can overdose on zinc.
If you have any symptoms of a zinc deficiency discuss tests with your physician.
According to the National Institutes of Health (NIH) the recommended dietary allowance (RDA) of zinc for adults is 11 mg per day for males and 8 mg per day for females.
In the meantime, zinc occurs naturally in many foods including:-
- Oysters: May not be kind on the wallet but oysters are a superb source of zinc boasting around 74 mg per 3 oz serving
- Beef, Pork and Chicken: A 3 oz serving will provide 7 mg, 2.9 mg and 2.4 mg respectively
- Cooked crab: Another excellent source of zinc at around 6.5 mg per 3 oz serving
- Lobster: Again, not bad at 3.4 mg per 3oz serving
- Baked beans
- Yogurt: 1.7 mg per 8 ozs
- Nuts: Almonds and Cashews both contain small amounts of zinc
- Milk and cheese
- Green peas
- Chickpeas and kidney beans
Summary on Zinc for the Hashimoto Diet
- Zinc is an important trace element necessary for the normal functioning of the thyroid gland and plays a role in the immune system
- Medical studies show that people with Hashimoto’s thyroiditis may have a correlating link deficiency
- It is possible to take TOO much zinc in your diet
- ALWAYS discuss any food supplements and tests for zinc deficiency with your physician
- The RDA for zinc is 8 mg per day for females and 11 mg per day for males. Aim for this amount in your Hashimoto’s diet plan
- Incorporate zinc rich foods into your diet, without going over the RDA
5) Vitamin D
The main role of Vitamin D in the body is to help absorb calcium and phosphorous and regulate the building of bones. Hence, a Vitamin D deficiency can result in rickets.
However, more recent research is beginning to explore the role of Vitamin D in heart disease, cancer and autoimmune conditions such as Hashimoto Thyroiditis.
Research for Vitamin D and Hashimoto Thyroiditis
The relationship between Vitamin D deficiency and Hashimoto’s thyroiditis has been shown in several medical studies over the years.
One 2016 study concludes that,
Vitamin D deficiency is frequent in Hashimoto’s thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism …
However, as you may have guessed by now, it is never that simple in the world of research.
Indeed a 2017 medical study completely refutes this claim, stating that,
Vitamin D treatment in Vitamin D deficient patients with Hashimoto’s thyroiditis could not have significant effect on thyroid function and autoimmunity.
Vitamin D and Hashimoto’s Diet
Unfortunately, it is very difficult to get an adequate amount of Vitamin D from foods..
Indeed, the main way of topping up your Vitamin D levels is to get out with bare skin in the natural sunlight.
Also, you could incorporate this daily dose of fresh air and sunlight with some exercise which also may prove helpful for those with Hashimoto Thyroiditis.
However, in the winter months, in some climates, it may be difficult to get the recommended amount of Vitamin D.
Your personal Vitamin D levels can be tested with a simple blood test. Again, ALWAYS speak with your treating physician about a Vitamin D supplement.
According to the National Institutes of Health (NIH) the new RDA for Vitamin D in adults is 600 iu per day.
Foods Rich in Vitamin D
- Swordfish and Salmon: Both good sources of Vitamin D containing 566 iu and 457 iu respectively per 3 oz serving
- Tuna: Contains around 154 iu per 3 oz serving
- Fortified (Vitamin D added) fruit juices
- 1 cup of fortified milk has 115 to 124 iu
- Beef liver
- Fortified cereal
- Swiss Cheese
Summary on Vitamin D for the Hashimoto Diet
- Medical studies regarding the role of Vitamin D and Hashimoto Thyroditis are conflicting
- Ensure that you get plenty of natural sunlight on bare skin whenever possible
- Before taking a Vitamin D supplement ALWAYS discuss with your treating physician
- You can ask your physician for a Vitamin D test
- The RDA of Vitamin D for adults is 600 iu
- Some food sources do contain Vitamin D
Although we have discussed above some of the main nutrients and foods to include in Hashimoto’s diet, the key is an all-round healthy, organic diet.
By this, we mean:-
- Plenty of lean meat and fish
- Lots of fresh, organic fruit and vegetables: (See notes on cruciferous vegetables)
- Plenty of fluids – avoid sugar and soda drinks
- Healthy seeds and nuts
- Include gluten alternatives such as quinoa and corn noodles
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