How Diet and Nutrition Can Help Thyroid Issues

Fatigue that no amount of caffeine can shake, uncomfortable constipation, and wait… is that a bald spot???

These are just some of the key symptoms of Hashimoto’s Disease, the most common cause of underactive thyroid (hypothyroid) in the United States.

But sadly, despite being so common, Hashimoto’s is poorly understood by many doctors and likely under-diagnosed. And that’s a huge bummer, because there is SO much we can do to manage and control Hashimoto’s - you don’t just have to accept it!

So today, let’s dig into what Hashimoto’s is, how it affects the body, and most importantly, what we can do to treat it holistically, including how diet and nutrition can help thyroid issues. 

What is Hashimoto’s Disease?

Hashimoto’s is an autoimmune disease where the immune system attacks the thyroid gland, causing tissue damage and preventing it from producing adequate thyroid hormones. Low thyroid hormones cause the symptoms of Hashimoto’s including:

• Fatigue 
• Depression 
• Constipation
• Hair loss
• Pale and dry skin
• Loss of fertility
• Intolerance to cold
• Heavy or irregular periods

While Hashimoto’s can occur in both men and women, it (and all autoimmune disease) is more common in women. 

How Do I Get Tested for Hashimoto’s?

Hashimoto’s is diagnosed via blood test for thyroid stimulating hormone (TSH) and thyroid peroxidase (TPO) antibodies. High TSH levels and the presence of antibodies are both indicative of Hashimoto’s. However, even if TSH levels are normal (or even low!)high TPO levels are still indicative of Hashimoto’s. High TSH levels occur when available active thyroid hormone (T3/T4) levels are low, or receptivity to these hormones is low, tricking the body to think they aren't around. All this is to say that it’s important to test both TSH and TPO for an accurate diagnosis. 

There are three stages of Hashimoto’s:

Silent Autoimmune - This occurs when antibodies are elevated, but there are no symptoms of hypothyroid or tissue destruction. If not addressed, this will progress to the next stage. 

Autoimmune Reactivity - Elevated TPO antibodies, with symptoms of hypothyroidism (fatigue, thinning hair, etc.), but no clinically noticeable loss of thyroid tissue.

Autoimmune Disease - Occurs when antibodies are elevated, hypothyroidism symptoms are present, and there is measurable tissue destruction. 

Ideally, we would catch Hashimoto’s at the silent autoimmune phase, but the reality is that most people are not tested until symptoms are present, and are therefore in the reactivity or disease stage when they begin treatment. This is one reason why I advocate for routine thyroid screening, ideally annually. At the very least thyroid levels should be screened at the time of the first period (menses), postpartum, and during menopause, because these are the three periods of life when women are most likely to express and autoimmune condition. 

Hashimoto’s and thyroid disease are not always synonymous. If TSH levels are high, but no antibodies are detected, it could be hypothyroidism from another cause. 

Can Hashimoto’s Disease Be Cured?

Getting a Hashimoto’s diagnosis is scary, and it’s only normal to wonder “Can I fix this?”

The answer isn’t black and white. Technically, Hashimoto's is considered incurable (as are most autoimmune diseases). However, that does not mean you’re doomed. In functional medicine, the goal is to get autoimmune disease into remission. 

I promise, you absolutely can be healthy and have an autoimmune disease in remission! My job is to help you do just that. 

So how do we do that? As a functional medicine practitioner, I treat disease by addressing the root cause. That means understanding why you got sick is incredibly important. The “why” will inform how to best treat your disease. Before we get into treatment, let’s talk about why disease occurs. 

What Causes Hashimoto’s?

Like all autoimmune diseases, hashimoto’s doesn’t have one cause. Instead, it develops due to a complex interplay of predisposing factors and a triggering event. Predisposing factors “set the stage” so that when a trigger occurs, disease develops. If you’re not sure what risk factors or triggers could be present for you, we can work together to test and establish your root cause. 

Here are some established risk factors for Hashimoto’s:

• Genetic (having a family member who also has Hashimoto’s)
• Other autoimmune disorders (vitiligo, Grave’s disease, type 1 diabetes, lupus, Rheumatoid arthritis, etc.)
• Polycystic ovarian syndrome (PCOS)
• History of Traumatic Brain Injury
• Maternal autoimmune disease, especially if inflammation was present during gestation
• Chronic infections (bacterial, viral)
• Multiple adverse reactions to foods, chemicals, etc. (loss of tolerance)

Let’s go over some of the more common triggers I see with my own patients:

1. Toxin Exposure

For some people toxin exposure is not a serious issue, but for others, toxin exposure can trigger autoimmunity. (The difference is likely due to differences in detox capabilities, including the ability to biotransform heavy metals). In those who do struggle with toxin exposure, common chemicals like BPA have been shown to trigger autoimmunity. The issue can be with both total toxin exposure, as well as chemical immune reactivity. In chemical immune reactivity, even very small exposures can create an immune reaction. 

It’s very important that people with autoimmune disease aggressively detox toxins, but it's essential to do it in the right order! If detox is begun before the autoimmunity is under control, the detox can actually flare autoimmune symptoms and make them worse.

2. Viruses 

Viruses are known to trigger autoimmune disease. Hepatitis C, human Parvo b12, Coxsackie, and herpes viruses, in particular Epstein Barr Virus (EBV - the virus that causes mononucleosis), are all known to trigger Hashimoto’s.

3. Bacteria

Bacteria and the biofilms they create can both trigger autoimmune disease. Bacteria can closely resemble human tissues well as decorate the extracellular matrix (ECM) of their biofilms with molecules that resemble human tissues. These molecules are recognized by the immune system, causing activation of autoimmune pathways.

These bacteria have all been implicated in the development of Hashimoto's: H. Pylori (which can actually be protective in IBD, but, can be a trigger for other autoimmune conditions like psoriasis, vitiligo, and RA), Borrelia Burgdorferi (Lyme), Yersinia Enterocolitica, Staph, and Strep. 

4. Gluten

Gluten induces leaky gut, even if a person doesn’t have Celiac disease. It is immunogenic, cytotoxic, and proinflammatory. In those with autoimmune disease, gluten can flare symptoms and prevent remission. It can have a negative effect on the microbiome and boost oxidative stress. 

However, gluten isn’t the only problem food! In many people, other common trigger foods include grains, eggs, dairy, soy, chocolate, coffee, and legumes. 

5. Mold

Mold is a silent epidemic that can trigger and exacerbate autoimmune conditions. Both the individual and the home need to be tested and treated for mold. In individuals, mold can be tested using urinary mycotoxins, CIRS markers, and VCS testing. An IEP (indoor environment professional) should assess the home for mold with an ERMI test. In general, humidity over 50% in any room is a problem. Test this with a hydrometer.

How to Treat Hashimoto’s Naturally

Now that we’ve covered some of the more common causes I see in Hashimoto’s, we can get into the good stuff: what you can do to put the disease in remission!

1. Test to Find the Root Cause

There’s a lot to cover here, but the first thing I do with any new patient is testing to help determine what their root cause is. Some key things I’m looking for are gut pathogens, bacteria, fungii, viruses, and chemical compounds that can trigger the immune system. 

With that information in hand, I move down the line of treatments, starting at the mouth!

2. Optimize the Microbiome & Gut Health

The microbiome begins in the mouth, so that’s where I start treatment as well. We need to optimize the oral flora and change out any products that could be damaging the mouth’s microbiome for healthier picks. Next up, I’ll start a protocol to heal leaky gut. Healing leaky gut is essential, but it’s not the only step, so don’t stop here!

We’ll also optimize digestive secretions and microbiome resilience in this step to help prevent any future gut infections. A lack of adequate stomach acid prevents proteins from being fully broken down. Those larger, more intact proteins then enter the bloodstream and are more likely to trigger immune activity. For anyone with autoimmune issues, or who is having immune reactions to specific foods, supplemental HCL to boost stomach acid levels is a must.

3. Balance Your Blood Sugar

No matter what dietary changes you do or don’t make (more on that below), the most important is eating in a way that supports balanced blood sugar. When blood sugar is high, the pancreas produces a surge of insulin. That insulin surge has an inflammatory effect on the body, causing autoimmune conditions to flare. This connection is so strong, I have seen clients put their autoimmune condition into remission just by balancing their blood sugar. It’s really that important. If diet changes alone aren’t enough, we can use key supplements to help bring blood sugar back into balance.

4. Optimize HPA-Axis Hormones

The hypothalamic-adrenal-pituitary (HPA) axis hormones include cortisol, the “stress” hormone. Optimizing this system often requires active stress management - more on that below.

5. Measure & Adjust Key Nutrient Levels

Key nutrients for Hashimoto’s health include omega fatty acids, selenium, zinc, and vitamins A,C, and D. Before supplementing, I always test. 

6. Detox Safely

If testing has revealed the presence of compounds like heavy metals, it’s very important that detox is done safely. Aggressive detox strategies can backfire for people with autoimmune disease, as the detox process can flare the autoimmune condition if the person has an immune reaction to the chemicals being detoxed. I recommend testing for what chemicals a person has reactivity to, then working to calm the reactivity, and finally detoxing with herbs and supplements like glutathione, as well as exercise and sweating.

7. Helminth Therapy

OK, this does sound crazy at first, but the research backs it up. Helminths are a specific type of worm, and the larval form (not the whole worm) is a common infection in much of the world. In countries with the highest infection rate of helminths, autoimmune disease rates are lowest. Helminths release tuftsin-phosphorylcholine (TPC), which turns on T- and B-regulatory cells. A prescription version of TPC has been shown to cure autoimmune conditions in animals, and clinical trials are underway. In the meantime, helminth therapy can be life-changing. I’ve been studying helminth therapy for years - read my blog post about it here.

How Diet and Nutrition Can Help Thyroid Issues

There’s no one perfect diet for Hashimoto’s (sorry!). Instead, I start with the Autoimmune Paleo (AIP) diet and customize based on the individual. No one should blindly follow a highly restrictive diet like AIP long term. Diversity is the key to a strong and healthy microbiome, so don’t eat the same thing day in and day out.

That being said, restricting certain foods can be helpful. At a minimum, I recommend avoiding gluten and dairy. For many people with Hashimoto’s, removing nightshades can also be beneficial. And if testing shows the presence of antinuclear antibodies (ANA) or rheumatoid factor (RF), I suggest cutting lectins as well. Also consider reducing sodium intake (or supplementing with potassium at salty meals) since high sodium activates the pro-inflammatory immune pathway TH-17, which pours gas on the Hashimoto’s fire. 

In some cases, intermittent fasting, a lower calorie or starch diet, and exercise (but not all 3 at once!) can be used to increase autophagy (clearance of proteins). Poor autophagy can increase immune reactivity. But please note, this is not me telling you to starve yourself. These are advanced techniques that should only be used in certain people under the care of a highly trained practitioner. 

Lifestyle Changes for Hashimoto’s Remission

While they aren’t “sexy,” lifestyle changes to better manage stress, get adequate sleep, and exercise are probably the most important part of any plan to treat Hashimoto’s. 

1. Why Sleep Matters

We know that sleep disorders (in those without sleep apnea) increase the risk of developing autoimmune conditions. The body primes and develops immune cells while we are sleeping, and a lack of sleep also induces an inflammatory response. Lack of sleep also leads to dysfunctional natural killer (NK) cells, a key part of the immune system, especially important for fighting viruses. 

If you take away one thing from this blog post, let it be this: unless you’re getting proper sleep, you have very little chance of autoimmune recovery. It’s that important! In fact, I consider sleep and blood sugar (see above) to be the two “cornerstones” of healing autoimmunity. The easiest way to get started on a better sleep pattern is to develop a routine pattern of sleep, rising and going to bed at roughly the same time every day - and bonus points if your bedtime can be before 10 PM. 

2. Managing Stress

Stress activates interleukin-17, creating a cascade that affects the immune system. But, it’s important to differentiate between good stress, which does not affect IL-17, and negative stress, which does. Positive stressors include things like exercise you enjoy, while negative stress might be an unsupportive partner or an unfulfilling job. I suggest active practices to reduce stress like GUPTA, Inaura, EMDR, therapy with a trained professional (especially Somatic therapy), Synctuition, Hypnotherapy, Ziva meditation, and MBSR training. 

3. Exercise

Sedentary behaviors can heighten inflammatory responses in the body. Any increase in movement is a good thing and better than none - so simple changes liking parking further away or taking the stairs instead of the elevator really can help. That being said, more intense workouts do have more anti-inflammatory actions, and are a great tool for those who are able to do them. However, going too hard is a real risk. A good rule of thumb is that you should be able to recover from the workout within one day. If you’re laid out on the couch for days after a workout, it was too hard. 

Will I Need Medication, Too?

I believe in mixing the best of both Western and alternative medicine… which means sometimes, yes, medication is a tool we need to use. Using medication isn't “failing” and it doesn’t mean taking other steps to heal your Hashimoto's - like the ones I’ve described in this article - aren’t worth the effort. 

No matter where you’re starting or what your goals are, we can work together to find an effective, sustainable path toward remission.

Need Help With Hashimoto’s?

Helping women overcome health challenges like Hashimoto’s is my (gluten free) bread and butter. There’s nothing I love more than meeting a new client, hearing their story, and helping them create a customized plan to achieve their health goals.

If you have Hashimoto’s and you want support finding the root cause, creating a customized treatment plan, and recovering your health, I would be honored to support you. The first step is to book a free, no-obligation consultation with my team. 

Let’s tackle your health goals together!

>>> Book a free consult today

by Kyle Leahy