Hashimotos (or Hashimoto) thyroiditis also called Hashimotos disease is one of the most common thyroid disorders in the United States and other developed countries (1).
Even when treated with medication, its symptoms may significantly affect quality of life (2).
Research shows that diet and lifestyle modifications may drastically improve symptoms, in addition to standard medication. Every person with Hashimotos disease responds differently to treatment, which is why an individualized approach for this condition is so important (2).
This article explains the diet and lifestyle modifications most likely to benefit those with Hashimotos disease.
Hashimotos thyroiditis is an autoimmune disease that gradually destroys thyroid tissue via lymphocytes, which are white blood cells that are part of your immune system (1).
The thyroid is a butterfly-shaped endocrine gland that sits at the base of your neck. It secretes hormones that affect nearly every organ system, including your heart, lungs, skeleton, and digestive and central nervous systems. It also controls metabolism and growth (3, 4).
The main hormones secreted by the thyroid are thyroxine (T4) and triiodothyronine (T3) (4).
Eventually, damage to this gland leads to insufficient thyroid hormone production.
Hashimotos disease is an autoimmune condition that affects your thyroid, eventually causing inadequate hormone production.
Diet and lifestyle play vital roles in managing Hashimotos, as numerous individuals find that their symptoms persist even with medication. Plus, many people who exhibit symptoms arent given medication unless they have altered hormone levels (2, 5, 6).
Whats more, research suggests that inflammation may be a driving factor behind the wide range of Hashimotos symptoms. Inflammation is often tied to diet (7, 8, 9).
Diet and lifestyle modifications are likewise key to reducing your risk of other ailments, as people with Hashimotos disease have a higher risk of developing autoimmune conditions, high cholesterol, obesity, and diabetes (10, 11, 12, 13).
Research shows that cutting out certain foods, taking supplements, and making lifestyle changes may significantly improve symptoms and quality of life.
Plus, these changes may help reduce inflammation, slow or prevent thyroid damage caused by elevated thyroid antibodies, and manage body weight, blood sugar, and cholesterol levels.
Diet and lifestyle changes may significantly decrease antibody levels, improve thyroid function, and reduce symptoms caused by Hashimotos disease.
Here are some evidence-based dietary tips to help treat Hashimotos disease.
Many studies indicate that those with Hashimotos are more likely to have celiac disease than the general population. As such, experts recommend that everyone diagnosed with Hashimotos be screened for celiac disease (14).
Whats more, some evidence suggests that gluten- and grain-free diets may benefit people with Hashimotos disease.
In a 6-month study in 34 women with Hashimotos disease, a gluten-free diet reduced thyroid antibody levels while improving thyroid function and vitamin D levels, compared with a control group (15).
Many other studies note that people with Hashimotos disease or autoimmune diseases in general likely benefit from a gluten-free diet even if they dont have celiac disease (16, 17).
When following a gluten-free diet, you must avoid all wheat, barley, and rye products. For example, most pastas, breads, and soy sauces contain gluten though gluten-free alternatives exist.
A grain-free diet is more restrictive than a gluten-free diet, as it bans all grains. Although this dietary change may also offer benefits, research supporting it is limited.
The Autoimmune Protocol (AIP) Diet is designed for people with autoimmune diseases. It removes potentially harmful foods like grains, dairy, nightshades, added sugar, coffee, legumes, eggs, alcohol, nuts, seeds, refined sugars, oils, and food additives (2).
In a 10-week study in 16 women with Hashimotos disease, the AIP Diet led to significant improvements in quality of life scores and significantly decreased levels of the inflammatory marker C-reactive protein (CRP) (2).
Although these results are promising, larger longer duration studies are needed.
Keep in mind that the AIP Diet is a phased elimination diet and should be prescribed and monitored by an experienced healthcare provider.
Lactose intolerance is very common among people with Hashimotos disease (18).
In a study in 83 women with Hashimotos disease, 75.9% were diagnosed with lactose intolerance (18).
If you suspect lactose intolerance, cutting out dairy may aid digestive issues, as well as thyroid function and medication absorption. Keep in mind that this strategy may not work for everyone, as some people with Hashimotos tolerate dairy perfectly well.
Inflammation may be a driving force behind Hashimotos disease. As such, an anti-inflammatory diet rich in fruits and vegetables may significantly improve symptoms.
A study in 218 women with Hashimotos disease found that markers of oxidative stress a condition that causes chronic inflammation were lower in those who ate fruits and vegetables more frequently (19).
Vegetables, fruits, spices, and fatty fish are just some examples of foods with powerful anti-inflammatory properties.
Following a diet low in added sugar and highly processed foods but rich in whole, nutrient-dense foods may help improve your health, manage your weight, and reduce Hashimotos-related symptoms (2).
Whenever possible, prepare your meals at home using nutritious foods like vegetables, fruits, proteins, healthy fats, and fiber-rich carbs.
These foods offer powerful antioxidant and anti-inflammatory benefits.
Some research indicates that certain low carb diets may help reduce body weight and thyroid antibodies in people with Hashimotos disease (20).
These particular diets provide 1215% of daily calories from carbs and restrict goitrogenic foods. Goitrogens are substances found in cruciferous vegetables and soy products that may interfere with thyroid hormone production.
Yet, cruciferous vegetables are highly nutritious, and cooking them diminishes their goitrogenic activity. Thus, its unlikely that they interfere with thyroid function unless eaten in extremely large amounts (21).
Some evidence suggests that soy harms thyroid function as well, so many people with Hashimotos choose to avoid soy products. Nonetheless, more research is needed (22, 23).
Going gluten-free, avoiding dairy, and following a nutrient-dense, anti-inflammatory diet are just a few tips that may improve symptoms of Hashimotos disease.
Several supplements may help lower inflammation and thyroid antibodies in people with Hashimotos disease. Plus, those with this condition are more likely to be deficient in certain nutrients, so supplementing may be necessary (24).
Beneficial supplements include:
Other supplements like fish oil, alpha-lipoic acid, and N-acetyl cysteine may also help people with Hashimotos disease (37, 38, 39).
Note that supplementing with high doses of iodine in the absence of an iodine deficiency may lead to adverse effects in those with Hashimotos. You shouldnt take high dose iodine supplements unless your healthcare provider has directed you to do so (40, 41).
Many vitamin and mineral supplements, including zinc, vitamin D, and magnesium, may benefit those with Hashimotos disease.
If you have Hashimotos disease, a nutrient-dense diet may help reduce the severity of your symptoms and improve your overall health. Focus on the following foods (42):
Keep in mind that some people with Hashimotos disease avoid a few of the foods mentioned above, such as grains and dairy. Its important to experiment with your diet to find out what foods work best for you.
Whole, nutrient-dense foods should make up the majority of any healthy diet and may be especially helpful if you have Hashimotos disease.
Eliminating or restricting the following foods may help reduce Hashimotos symptoms and improve your overall health (43):
Some healthcare providers suggest that people with Hashimotos disease avoid soy and dairy as well and sometimes even nightshades and all grains.
However, although these recommendations may help many individuals, its important to experiment with your diet to find the best method for you.
Working with a dietitian who specializes in autoimmune diseases like Hashimotos disease can help you narrow down potentially problematic foods and set up an eating pattern thatll help you feel your best.
Steering clear of added sugar, highly processed foods, and gluten-containing grains may help reduce Hashimotos symptoms and improve your overall health.
Getting plenty of sleep, reducing stress, and practicing self-care are extremely important for those with Hashimotos disease.
In fact, research shows that engaging in stress reduction practices helps reduce depression and anxiety, improve overall quality of life, and lower thyroid antibodies in women with Hashimotos disease (44).
Letting your body rest when youre feeling fatigued is important as well.
Additionally, you should take thyroid medication on an empty stomach at least 3060 minutes before breakfast or at least 34 hours after dinner for maximum absorption (45).
Even coffee and dietary supplements interfere with thyroid medication absorption, so its best to consume nothing but water for at least 30 minutes after taking your medicine (46, 47).
Your healthcare provider can answer any questions about how to ensure maximum absorption.
Keep in mind that when youre first starting medication, it may take a few weeks or longer to start feeling better. If your symptoms arent improving, speak to your healthcare provider about other options.
As Hashimotos symptoms may significantly affect your quality of life and mental health, be sure to find a healthcare team that you trust. This may take some time, but its essential to getting the right treatment.
Reducing stress, getting plenty of rest, and practicing self-care are essential for those with Hashimotos disease. Finding a healthcare provider whom you trust is also key.
Its thought that Hashimotos disease develops from an immune defect coupled with environmental factors, though these factors arent fully understood (48, 49).
Diagnosis depends on symptoms and laboratory results.
Lab results indicating Hashimotos disease include elevated thyroid-stimulating hormone (TSH), low levels of free thyroxine (FT4), and increased anti-thyroid peroxidase (anti-TPO) antibodies.
Some people with Hashimotos disease also have elevated TSH receptor-blocking antibodies (TBII) and antithyroglobulin (anti-Tg) antibodies. These antibodies attack the thyroid gland (1).
The diseases destruction of the thyroid is intermittent. During its early stages, people may present with symptoms and lab results that indicate hyperthyroidism or even have normal lab values.
As such, Hashimotos disease is often difficult to detect, and individuals may go for months without the proper diagnosis. Up to one-third of people treated for hypothyroidism dont receive adequate or proper treatment (50, 51).
Hashimotos disease affects both women and men, but women are 510 times more likely to be diagnosed. Your risk increases with age, and most women are diagnosed between the ages of 30 and 50 (1, 50).
This condition is usually treated with synthetic or natural thyroid hormones. Synthetic ones include levothyroxine (Synthroid) and liothyronine (Cytomel), while natural ones include Armour Thyroid and Naturethroid.
Because Hashimotos disease affects nearly every organ system in your body, its associated with a variety of symptoms. These include (1, 51):
Untreated or improperly treated Hashimotos disease may lead to serious side effects, such as an increased risk of heart disease, cognitive disorders, and even death (52, 53).
Hashimotos symptoms vary widely and include weight gain, fatigue, cold intolerance, and constipation. The disease is diagnosed based on symptoms and lab results.
Hashimotos disease is a common autoimmune condition that affects the thyroid. It causes numerous symptoms that may persist even if you take thyroid medication.
Research shows that dietary and lifestyle changes can significantly improve your symptoms and boost your overall health. However, every person with Hashimotos disease is different, so its fundamental to find a dietary pattern that suits your needs.
A dietitian or other healthcare provider who specializes in autoimmune diseases may be able to help you find an eating pattern that works for you.
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Hashimoto Diet: Overview, Foods, Supplements, and Tips - Healthline
