The Best Diet for Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis is an autoimmune condition where the body attacks its own thyroid tissues and that results in hypothyroidism. Treatment for Hashimoto’s should be lifestyle based to include: identifying and treating the root cause, taking medications and supplements as advised, and managing symptoms through lifestyle changes – especially nutrition! Picking the best diet for Hashimoto’s can seem confusing to people, so this post is meant to help you determine what would work best for you.

There is no single best diet for Hashimoto’s disease.

For best results, if you are diagnosed with Hashimoto’s you should work with a registered dietitian to find the right diet for you!

Popular Diets for Hashimoto’s Thyroiditis

There are four popular “Hashimoto’s diets” you may come across in your research. These are:

• Whole30
• Specific Carbohydrate Diet
• Gut and Psychology Syndrome Diet
• Paleo/Autoimmune Paleo 

The commonalities of these diets are that they include:

• Elimination of grains
• Promotion of micronutrients
• Reduction of inflammatory foods

Each one of these thyroid diets has pros and cons. Here’s what you need to know about each one…

Whole30, a “30 day guide to total and health and food freedom.”

The Whole30 diet is based on the premise of a month-long challenge where the dieter focuses on foods deemed whole and health-promoting to improve overall health- both mentally and physically.

Guidelines for Whole 30:

Eat whole, health-promoting foods are meat and poultry, fish and seafood, eggs, fruits, vegetables, and nuts and seeds.

This list comes with a few caveats:

• All of these foods must be unprocessed.
• None of these foods may be used to recreate recipes that mimic baked goods, junk foods, or sweet treats.
• Foods considered whole but not health-promoting are eliminated during this protocol.
• Off-limit foods include alcohol, sugar, grains, legumes, dairy, and food additives commonly used in processing. These additives are artificial sweeteners, carrageenan, MSG, and sulfites.
• No weighing yourself at any time during the 30 days.

Benefits vs. Risks of Whole 30 for Hashimoto’s

Benefits:

Food Group Elimination

Whole30 is skillful at identifying and choosing to eliminate food groups that may worsen inflammation and damage the thyroid, like gluten. As for dairy and soy, these are tolerated on a case-by-case basis. Eliminating both will prevent guessing which one is the trigger for you specifically, but special care will need to be taken during reintroduction of foods.

Lower Inflammation

Although it is not explicitly stated, the no grains and no legumes rule does apply to oils. Grain and legume oils are corn, bran, soybean, and peanut oil. However, it is a recommendation to also avoid sunflower, safflower, canola, grapeseed, and sesame oil, too. Avoiding the grains and these oils will help to reduce inflammation, the presence of which can affect proper thyroid function.

Increase Micronutrients

Diversifying your diet through lifestyle modifications that reduce processed foods and increase plant foods promote micronutrient intake.

Risks:

30 Days

The length of this protocol is 30 days, while Hashimoto’s is an autoimmune disease that will not end when this program does.

Food Morality

Foods are viewed as good or bad and allowed or not-allowed. Many of the foods on the off-limit list might not be inherently bad for your individualized body. It is up to you and your healthcare practitioner to decide which foods do and do not work for you. Proceed with caution if you do  have a history of disordered eating.

Cure-All Marketing

Diet, alone, will not completely eliminate your symptoms of Hashimoto’s, but it can help. Thyroid disease is a complex illness that requires addressing the root cause whether that be nutrient deficiency, exposure to toxins, infections, or adrenal dysfunction.

Specific Carbohydrate Diet (SCD) for Hashimoto’s Thyroiditis

The SCD is “a treatment to induce remission of active inflammation.”

The SCD was originally created as a form of medical nutrition therapy for children with Crohn’s disease, a chronic inflammatory bowel disease. While it has restrictions on sugar, lactose, and all grains, it is still a complete, nutritionally adequate diet.

The diet is supposed to starve “bad” bacteria in the gut to improve the composition of the gut microbiome.

Guidelines for the SCD Diet:

Foods to consume:

• All unprocessed meats and eggs
• All natural cheeses (except ricotta, mozzarella, cottage cheese, cream cheese, processed, or spreadable cheeses)
• Homemade yogurt cultured over 24 hrs
• Most legumes
• Most nuts and nut flours
• All-natural peanut butter
• Most non-starchy vegetables (not canned)
• All fruits and 100% juices with no additives
• Honey
• Saccharin

Foods to avoid:

• All processed/added sugar except honey
• All grains
• Canned vegetables
• Starchy vegetables
• Some beans
• Seaweed
• Canola oil
• Commercial mayonnaise
• High lactose dairy products
• Candy
• Sweet chocolate

The focus is on low-sugar, low lactose, and the elimination of all additives and grains.

Unlike Whole30, corn oil is allowed even though it is a grain derivative.

Illegal beans include soybeans, chickpeas, bean sprouts, mung beans, fava beans, and shelled peanuts. 

Benefits vs. Risks of the SCD for Hashimoto’s Thyroiditis

Benefits:

Heals the microbiome

By eliminating complex carbohydrates this reduces bacterial overgrowth caused by fermentation. Simple carbohydrates are easily absorbed, so the bacteria in the intestines are not given time to feed on it.

Lowers inflammation

Similar to the Whole30 diet, elimination of gluten itself will reduce the incidence of autoimmune attacks and protect the thyroid. The dairy allowed on this diet is supposed to be organic and lactose-free, which are usually better tolerated. The fermented yogurt is also full of probiotics, which provide digestive support. I would advise to reduce saturated and seed oils and focus on healthy fats instead, although it is not specified.

Risks:

Might be too difficult to follow

The ins and outs of this diet are a lot to remember in the beginning but can be made manageable through referring to a chart or written down list of accepted foods. Some of the guidelines are not as black-and-white as others, namely, sugar, dairy, and beans. It may also at times feel unfamiliar and restrictive.

Time commitment

Unlike Whole30, the average length of time recommended for followers of the SCD diet is around 1 full year. Results seen after 1 year are significant changes in microbial stool composition and decreases in disease activity and inflammatory markers.

Gut and Psychology Syndrome Diet (GAPS) for Hashimoto’s Thyroiditis

GAPS is “designed to heal and seal the gut lining, rebalance the immune system, and restore the optimal bacterial ecosystem within the GI tract.”

The GAPS Diet was created to treat the unique needs of patients afflicted by intestinal and neurological conditions, which are thought to result  from an imbalanced microbiome ecosystem. It aims to heal leaky gut and prevent toxins from accessing the bloodstream, which would impede brain function. GAPS protocol is an adaptation of the SCD, and it restricts difficult-to-digest foods while emphasizing nutrients that directly provide digestive support.

Guidelines for the GAPS Diet

This diet works in two phases, the introductory phase and maintenance phase.

In general, here are the guidelines for the overall GAPS diet.

Foods to include

• Broth with every meal
• Fresh eggs (if tolerated)
• Fresh meats, fish, and shellfish
• Canned fish in oil or water
• All natural cheese, homemade yogurt, ghee
• Anti-inflammatory oils
• Nuts
• Mostly cooked non-starchy vegetables
• Beets
• Winter squash
• Lima beans
• Peas
• All fruit
• Honey
• Cellulose
• Fermented foods

Foods to eliminate:

• Grains
• Pasteurized dairy
• Starchy vegetables
• Simple carbohydrates

Phases of the GAPS Diet

Each phase will also include food from the previous phases.

1. Homemade bone broth, soft tissues from bones used in making broth, juices from fermented vegetables, and ginger tea with honey between meals.
2. Raw organic egg yolks, meat & vegetable stews, fermented fish, homemade ghee, and increased daily amount of homemade yogurt and juices from fermented vegetables.
3. Ripe avocado, nut butter/egg pancakes, eggs made with animal fat, and sauerkraut/fermented vegetable solids.
4. Meats (non-barbecued or charred), cold pressed olive oil, fresh pressed vegetables juices, and nut-flour based breads.
5. Cooked apple puree, raw vegetables, and fresh pressed juices with fruits and vegetables.
6. Raw fruit, honey, and diet-adhering cakes/sweet treats.

Supplements for the GAPS Diet

• Probiotics
• Essential fatty acids
• Cod liver oil
• Digestive enzymes

Benefits vs. Risks of the GAPS Diet for Hashimoto’s

Benefits:

Elimination

Like other “Hashimoto’s Diets,” GAPS eliminates known “trigger” foods such as gluten and pasteurized dairy.

Reduces Some GI Symptoms

Anecdotally, the GAPS diet has been shown to reduce bouts of GI upset resulting in bloating, indigestion, and general digestive irritation.

Risks:

Lack of Neurological Research

Absence of research is not lack of efficacy, but it does help in establishing legitimacy of a diet. The lack of research present is regarding the claims of healing autism, Tourette’s, and other neurological disorders. For those able to last through the introductory phase, it is recommended to give the diet a try.

Poor Adherence

This diet can last anywhere from 1-2 years and is slightly less restrictive than the SCD diet overall. The problem of adherence lies in the beginning phases where intake is strictly controlled, but it is definitely doable.

Paleo & Autoimmune Paleo Diet (AIP) for Hashimoto’s Thyroiditis

The AIP diet “addresses underlying inflammation stemming from the gut and brings the microbiota back into balance while optimizing nutrient intake.”

Autoimmune paleo takes the original paleo diet, which is marketed as being based on the diets of our ancestors, and furthers the food restrictions while increasing nutrient consumption.

Guidelines for the Paleo/AIP diet

Paleo

Foods you can eat on the Paleo diet:

• Meat and fish
• Eggs
• Fruits
• Vegetables
• Nuts & seeds
• Anti-inflammatory fats & oils

Foods to avoid on the Paleo diet:

• Grains
• Dairy
• Legumes
• Added sugars
• Artificial sweeteners
• Inflammatory oils
• Trans fats

AIP

Foods to include with AIP:

• Lean meats, liver
• Vegetables, excluding nightshades (tomatoes, potatoes, peppers, and eggplant)
• Restricted amounts of fruit,
• Fermented foods
• Omega-3 abundant seafood
• Anti-inflammatory oils

Foods to avoid with AIP:

• Everything not allowed on a traditional paleo diet
• Coffee
• Eggs
• Nuts & seeds
• Nightshades (tomatoes, potatoes, peppers, and eggplant)

Benefits vs. Risks of the Paleo/AIP diet

Benefits:

Physical & Emotional Health

In addition to a lifestyle intervention, AIP lowers inflammation and supports the immune system. Following a restrictive diet such as this may add to additional stress, but working with an NTP or RD can alleviate this problem.

Improves Bowel Diseases

6-week adherence to the AIP improved Mayo clinic scores, which correspond to measures of ulcerative colitis/ bowel inflammation. These symptoms include bowel movement frequency, rectal bleeding, presence of mucus, and disease activity.

Risks:

Not Shown to Improve Thyroid Function

Alone, this diet will not cure Hashimoto’s disease, but none of these diets will do that alone. What it will do is address preventable autoimmune attacks related to inflammatory food consumption.

Takeaways about the Best Diet for Hashimoto’s

Ideally, people with Hashimoto’s should work with a trained practitioner who is familiar with providing treatment for thyroid disease. An overly restrictive diet can set you up for other health problems and may not improve the health of your thyroid. 

These diets are all similar but have varying levels of restriction and duration. It is up to you and your healthcare practitioner to decide which one of these diets is for you. These should not be diets you randomly embark upon, as they require careful planning to promote your healing.

The best diet for Hashimoto’s is the diet that works best for you.