What is the Best Diet for Hashimoto?

Last modified on October 28th, 2022

The question of whether or not there is a best diet for Hashimoto can be a bit tricky. Everyone is unique, as are their dietary needs. With that in mind, making dietary changes can help your symptoms. There are certain components of diet that many people with Hashimoto’s find helpful.

Below we’re going to cover what you should know about a healthy diet for Hashimoto and hypothyroid patients. We’ll also cover other lifestyle tips relating to this condition.

What Is Hashimoto’s?

Before going into the best diet for Hashimoto, what is it? 

Hashimoto’s disease is an autoimmune disorder leading to hypothyroidism. Hypothyroidism is an underactive thyroid. Much less often, it can cause hyperthyroidism. Hyperthyroidism is an overactive thyroid.

Your thyroid is a small gland in the front of your neck.

If you have Hashimoto’s, the immune system makes antibodies that attack your thyroid gland. You may experience the buildup of large numbers of white blood cells, part of your immune system, in your thyroid. As a result of the attack, your thyroid can’t make enough of the necessary hormones to function properly.

Thyroid hormones affect how you use energy and affect almost every part of your body.

Other names for Hashimoto’s include:

• Hashimoto’s thyroiditis
• Chronic lymphocytic thyroiditis
• Autoimmune thyroiditis

The condition is the most common cause of hypothyroidism, affecting an estimated 5% of Americans.

• Women are 4 to 10 times more likely to have Hashimoto’s than men.
• Typically, women develop it in their 30s through their 50s, although it can develop in younger women.
• Having other autoimmune disorders puts you at greater risk of developing autoimmune thyroiditis. For example, celiac disease, lupus, and rheumatoid arthritis can all be associated with autoimmune thyroiditis.

Complications of hypothyroidism from this disorder include high blood pressure, heart disease, heart failure, and high cholesterol, similar to primary hypothyroidism.

What are the Symptoms?

Potential symptoms of Hashimoto’s include:

• Swelling on the front of your throat (goiter)
• Fatigue
• Low energy levels and sluggishness
• Pale, dry skin
• A puffy face
• Brittle nails
• Unexplained weight gain
• Constipation
• Muscle aches and stiffness
• Prolonged or excessive menstrual bleeding
• Depression
• Memory lapses
• Increased cold sensitivity
• Dry, thinning hair is a common symptom, as is hair loss
• General problems with metabolic functions

It’s unlikely you’ll initially notice the symptoms. Then, over time they can get more significant and apparent. If you’re experiencing the above symptoms of autoimmune thyroid disorders, your doctor can make a diagnosis based on a blood test.

A hormone blood test can determine the amount of hormones your pituitary glands and thyroid are producing. If you have an underactive thyroid, you’ll have a low level of thyroid hormone. You’ll have a high level of thyroid-stimulating hormone (TSH) because your pituitary gland will try to stimulate more thyroid hormone production.

An antibody test can also be part of a diagnosis since this is an autoimmune disorder. An antibody test will examine whether your body is producing abnormal antibodies against the thyroid and let you know if you have elevated thyroid antibodies.

Conventional Treatments

If you receive a diagnosis of Hashimoto’s, you may need to take a synthetic thyroid hormone. That typically means you’ll take the synthetic hormone levothyroxine daily.

• Synthetic levothyroxine is the same as thyroxine, which is the natural version of the hormone your thyroid makes.
• The goal of taking thyroid medication is to restore normal thyroid hormone levels and reverse your symptoms of autoimmune disease.
• Your healthcare provider will check your TSH levels after six to eight weeks of treatment and adjust the dosage if necessary.
• Once your dose normalizes your thyroid levels, your doctor will probably check your TSH every year to ensure no changes are needed.

How Does Your Lifestyle Affect Hashimoto’s?

Diet and lifestyle can play essential roles in managing your thyroid disorder, particularly if you still have symptoms even when taking medication.

One reason for this is due to the role of inflammation. Inflammation leads to many of the symptoms, as is the case with other autoimmune disorders. If you can reduce your inflammation, it may help your symptoms and your quality of life.

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Natural Remedies and Diet for Hashimoto

The standard treatment, as indicated, is thyroid hormone replacement medication. Some people may not prefer to use this option for various reasons, such as side effects or concern they’ll forget to take it. That leads them to explore natural remedies.

We are starting to learn more about some of the underlying components that can lead to thyroid issues, including stress, poor diet, and not having enough of certain nutrients in your diet.

Some of these underlying issues can be remedied if you find the best diet for Hashimoto that works for you. It’s important to note that when we talk about a diet for Hashimoto, we aren’t talking about something to lose weight or a crash diet. We’re talking about sustainable, long-term changes you can make to improve your overall, underlying health and reduce or reverse your symptoms.

Below we explore some research-backed ways you might be able to help yourself if you have hypothyroidism symptoms and diet plans for thyroiditis patients.

Selenium

When you’re researching the best diet for Hashimoto, you might see a lot of talk about selenium.

• This is a big one to understand. Selenium is a trace element. Selenium plays a role in thyroid hormone metabolism.
• Foods with selenium include Brazil nuts, grass-fed beef, turkey, and tuna.
• If you follow a vegan diet, you may be at especially high risk of selenium deficiency.
• Hashimoto’s thyroiditis often reduces your body’s supply of selenium. For some people, supplementing with it can help balance thyroxine or T4 levels. You can get too much selenium, so you must be careful about the dosage.

In general, selenium intake is thought to be linked to many autoimmune disorders. Supplementing with selenium if you have not only Hashimoto but other thyroid issues like Grave’s has been shown to improve quality of life.

Researchers believe selenium supplementation can be clinically beneficial if you have certain autoimmune and thyroid-related disorders.

Selenium with vitamin E can reduce oxidative damage and inflammation in the body.

Zinc

Zinc is a mineral needed for thyroid hormone production. You need optimal levels of zinc to have healthy levels of T3, T4, and TSH.

• There are some key ways zinc deficiency may be influencing your thyroid problems. One in four people in the general population may be zinc deficient.
• Zinc is vital for immune function, gut health, the conversion of T4 to 3, and the production of TSH.
• Zinc tightens intestinal junctions associated with leaky gut.
• Zinc helps prevent oxidative stress. Oxidative stress is associated with inflammation and DNA damage.
• Zinc is also critical to immune function. When you have optimal levels, your immune system response will be more balanced. Along with helping autoimmune systems, this can help you better fight infections.
• When you don’t have adequate levels, it can prevent the T4 hormone from being converted into active T3. When you take zinc along with selenium, you may notice even more benefits and improvements in thyroid function and thyroid health.

In 2015 a study looked at 68 overweight or obese female patients with hypothyroidism. Patients were given either a zinc or selenium supplement, a placebo, or they were given zinc and selenium simultaneously. Three months later, the participants taking the combination of zinc and selenium, as well as those just taking zinc saw significant increases in free T3 levels.

Study participants taking both zinc and selenium experienced a significant decrease in TSH and increases in T4, promoting healthy thyroid function and reducing thyroid symptoms.

B Vitamins

B vitamins and especially vitamin B12 are important to make sure you’re getting enough of either in your diet or through supplementation.

• Vitamin B12 is a water-soluble vitamin.
• Animal proteins like meat, fish, and eggs often have B12. We all need B12 for cell reproduction, normal cell growth, protein synthesis, and cognitive function.
• B12 is a cofactor for energy production. The vitamin plays a role in the function of the immune system.
• Optimal B12 levels help promote the healthy metabolism of homocysteine. Homocysteine is a naturally occurring amino acid. High blood levels may increase the risk of Alzheimer’s, osteoporosis, heart disease, and stroke.
• Low B12 symptoms include fatigue, low mood, and irritability. Deficiency symptoms may also include headaches, lethargy, feelings of pins and needs, depression, weakness, and problems with your memory.
• If you’re a vegan or vegetarian, you’re at an especially high risk of B12 deficiency since it’s primarily in meat and animal foods.

There’s also a connection between B12 deficiency and autoimmune thyroid disease, with one theory for that being that hypothyroidism can make it harder for your body to extract needed minerals and vitamins from your food sources. You may also have problems with your digestive functioning, H. pylori infections, or pernicious anemia, which affects B12 levels.

If you have a thyroid condition or risk factors for B12 deficiency, you may not be properly absorbing it, even if you eat animal proteins. If you do have low B12 levels, taking a supplement can help.

The best option is a sublingual vitamin B12 supplement, a liquid you hold under your tongue. Sublingual supplements are very absorbable by your body.

Vitamin D

Vitamin D levels are thought to play a pivotal role in autoimmune and immune modulation.

• Vitamin D is responsible for signaling and biological processes that regulate your immune system.
• In people with autoimmune diseases, including Hashimoto’s, low levels of vitamin D are also discovered.
• The impact of vitamin D is that it acts like a hormone in the body and it activates thousands of genes in our bodies.
• Metabolic syndrome, diabetes, and Alzheimer’s may even be associated with low vitamin D, and many cancer patients are also found to have very low vitamin D status.

Specifically, vitamin D treatment in patients with Hashimoto’s thyroiditis may decrease the progression of hypothyroidism.

Studies link low levels of vitamin D and vitamin D deficiency not only with the presence of Hashimoto’s but also disease severity.

Magnesium

Recent studies have indicated a link between adding more magnesium to your diet or taking supplements and reducing autoimmune symptoms.

• Magnesium can be low if you experience chronic stress or have a diet high in sugar.
• Magnesium deficiency can raise your body’s production of inflammatory chemicals, contributing to immune dysfunction.
• Food sources with magnesium include almonds, bananas, spinach, and avocado. Black beans are another food source of magnesium.
• One of the initial signs of magnesium deficiency is often fatigue. Muscle weakness, stiffness, and spasms can also indicate deficiency early on.

Probiotics

If you have thyroid or autoimmune issues, eating foods with probiotics or taking supplements might help. There are links between hypothyroidism and problems in the small intestine.

For example, problems with GI motility can cause small intestinal bacterial overgrowth (SIBO). Hypothyroidism is often linked with changes in GI motility. SIBO can then lead to chronic diarrhea and other GI symptoms.

When you take a probiotic supplement or have foods like yogurt or kefir, it can help improve your intestinal health and perhaps reduce symptoms of autoimmune disease.

Iron

If you have low thyroid function, you may be more at risk for iron deficiency. Iron deficiency can worsen hypothyroid symptoms like fatigue.

• When you have hypothyroidism, since you have a reduced supply of thyroid hormones, it can suppress bone marrow activity.
• This can reduce your production of red blood cells, leading to anemia.
• It can also go the other way—iron deficiency can lead to hypothyroidism.
• Iron is needed to produce red blood cells and TSH.

If your doctor does a blood test and you have low iron levels, they may recommend a dietary supplement. 

• Taking an iron supplement with vitamin C tends to be best, especially for vegetarians.
• Many plant foods have phytates. Phytates bind to iron.
• That binding prevents them from being absorbed in your intestines.
• Iron has an affinity for binding to vitamin C.
• When you take them together, iron can be absorbed more easily, making it more bioavailable in your blood.

Foods high in iron include organ meat like liver and red meat.

Caffeine can impair your absorption of iron, so be careful about it if you’re anemic or you have thyroid autoimmunity.

Curcumin

If you have any autoimmune disorder, curcumin can be a powerful part of your arsenal to combat it. Curcumin can protect the thyroid against oxidative damage. Curcumin can also help reduce the size of thyroid nodules, which are common in patients with Hashimoto’s disease.

Is There Any Type of Diet for Hashimoto That’s Best?

So, above we talked about some of the common deficiencies people with Hashimoto experience and how these can play an underlying role in thyroid dysfunction. A good starting point if you’re looking for a diet for Hashimoto is to start with those, but beyond that, a few special diet options are beneficial for helping with hypothyroidism and related symptoms.

We’ll go over not only the particular options for a diet for Hashimoto that may work for you but also some general foods to eat and not eat if you have this condition.

Gluten or Grain-Free Diet for Hashimoto

One of the most popular diets for Hashimoto’s and people with thyroid disorders is gluten or grain-free. Many people who have autoimmune disorders like Hashimoto’s also tend to have food sensitivities. You don’t necessarily need to have Celiac to get benefits from grain or gluten-free diet.

• In a survey of more than 2,200 people with Hashimoto’s, 76% believed they were sensitive to gluten.
• Some of the symptoms they described as gluten reactions include headaches, fatigue, brain fog, diarrhea, cramping, and nausea.
• Eighty-eight percent of respondents in that survey said they felt better when they followed a gluten-free diet.
• Specific benefits they cited included improvements in energy, mood, digestion, and weight reduction.
• Gluten is a protein found in grains like wheat, barley, and rye.
• A grain-free diet is similar to gluten-free but more restrictive because it eliminates grains like oats, buckwheat, and quinoa.

There’s not a lot of evidence a grain-free diet is good for Hashimoto’s. Gluten-free seems to have more benefits without eliminating the essential nutrients, including selenium, that you get from certain foods with grains.

Paleo Diet for Hashimoto

The paleo diet is built on the concept of what our ancestors would eat. Specifically, its basis is on what people during the Paleolithic era might have eaten.

• A paleo diet for Hashimoto can be a good option because it includes whole foods, many of which are anti-inflammatory.
• Types of foods you can eat on a paleo diet include lean meat, fish, vegetables, fruits, nuts, and seeds.
• The idea behind the paleo diet is that our bodies aren’t well-matched to the way we eat in modern life.
• Farming changed and people began to eat dairy, grains, and legumes, but that, based on some theories, contributed to the prevalence of obesity and chronic disease.
• On a paleo diet, you avoid not only grains and legumes but also refined sugar, dairy, salt, potatoes, and processed foods.

Autoimmune Paleo Diet for Hashimoto

The autoimmune paleo diet is also called AIP or the autoimmune protocol. It’s a specific variation of the paleo diet that can help heal the digestive tract lining and the immune system.

The goal is to initially eliminate dietary triggers that cause inflammation and contribute to autoimmunity.

The AIP diet is relatively restrictive. You go for at least 30 days eliminating:

• Grains
• Dairy
• Gluten
• Pseudo-grains
• Legumes
• Nuts
• Seeds
• Nightshade vegetables
• Eggs
• Vegetable oils
• Alcohol
• Sugar and sweeteners
• NSAIDs
• Food additives

After you go through the entire elimination period, you gradually introduce eliminated foods to determine if you react poorly to them. If you react, the AIP diet indicates you should re-eliminate the items and then retest later on.

There are also lifestyle components that are part of this diet for Hashimoto. For example, it encourages regular physical movement, getting plenty of sleep, and stress reduction.

There have been research studies over the past years looking at the effectiveness of AIP, particularly for inflammatory bowel disease. Researchers found that more than 70% of participants in multiple studies achieved remission after six weeks of AIP.

Anti-Inflammatory Diet for Hashimoto

Chronic inflammation associates with so many chronic illnesses, and perhaps this includes autoimmune thyroiditis. That’s why some people find success with the use of an anti-inflammatory diet for Hashimoto.

• An anti-inflammatory diet is one focusing on fruits and vegetables, as well as omega-3 fatty acids.
• Other items to include in an anti-inflammatory diet are lean protein, healthy fats, whole grains, and spices.
• Foods to limit in an anti-inflammatory diet include processed food, alcohol, and excessive red meat.
• The anti-inflammatory diet isn’t on its own one specific regimen of eating.
• Instead, there are different types of diets falling into the category of anti-inflammatory. One of the most well-known is the Mediterranean diet.
• When you have an anti-inflammatory diet as part of your routine, it should help combat free radicals that cause inflammation and damage your thyroid.

You might want to choose oily fish like salmon and tuna, a variety of fruit such as blueberries, and vegetables like kale and spinach, as well as cruciferous vegetables if you want to have an anti-inflammatory diet. Cooking with olive oil can be part of a balanced diet focusing on combatting inflammation.

One of the easiest ways to incorporate this eating style into your life is to go with simple unprocessed foods with fresh ingredients.

Keto Diet for Hashimoto

Some find success using the keto diet for Hashimoto, but it’s not for everyone.

A keto diet, when followed well, can reduce inflammation and therefore reduce Hashimoto’s symptoms.

• A ketogenic or keto diet is one where you focus on consuming high amounts of fat and low carbohydrates.
• The diet helps lose weight, but it also has benefits for other conditions, such as epilepsy and even cancer.
• The idea of a keto diet is that you’re putting your body into ketosis.
• When you’re in the state of ketosis, you’re burning fat for fuel. Fat replaces glucose from carbohydrates and sugar as your primary fuel.

You typically when following a keto diet have fewer than 15 grams of carbs a day.

• A keto diet can help with balancing blood sugar, reducing pain and inflammation, and it may even help with migraines.
• There’s research showing this way of eating can help regulate moods and improve brain function.
• The fat you consume in a keto diet is not what you might think of traditionally—it’s about healthy fats like avocados. Fat quality is essential.
• Other sources of fat you might eat a lot of on a keto diet include meats, eggs, fish, nuts, seeds, cheese, and butter.

The downside of a keto diet for Hashimoto is that some of the foods you eat when following it can cause reactions if you have autoimmune thyroid conditions, such as dairy. Everyone is different, and a keto diet for Hashimoto can be ideal for some people and not work for others.

Low Sugar Diet for Hashimoto

A low sugar diet, as you might guess from the name, involve the reduction of added sugars and other types of sweeteners and even foods with natural sugars.

• A low-sugar diet can help with weight loss and it’s suitable for managing chronic diseases.
• If you have issues with blood sugar control, a low-sugar diet is a great way to maintain healthy glucose levels.
• Things not to eat on a low-sugar diet include sugary drinks, packaged snacks, excessive alcohol, refined sugar, and fruits high on the glycemic index scale.
• You should also avoid white bread and flower.
• Instead, eat green leafy vegetables, berries and citrus fruits, lean proteins, fatty fish and nuts, and seeds.

Benefits of the low sugar diet include promoting heart health and a lower risk of type 2 diabetes. It’s also not incredibly restrictive or hard to follow, and you have a lot of flexibility in what you end up eating.

What Are the Worst Foods for Hashimoto’s?

While everyone is different, some of the foods that people with hypothyroidism and Hashimoto’s tend to find worsen their symptoms include:

• Gluten
• Soy
• Dairy
• Alcohol
• Sugar
• Grains

The above are the foods and drinks that most often trigger an immune response, and they cause a decline in gut health.

We often hear about food allergies but less about food sensitivities. Your immune system has multiple branches causing delayed food reactions. These delayed reactions are food sensitivities. They may occur up to three days after having a particular food.

Symptoms of food sensitivities include:

• Headaches
• Achy muscles and joints
• Fatigue
• Brain fog
• Depression
• Irritability
• Anxiety
• Gastrointestinal symptoms like bloating and gas

Best Foods to Eat for Hashimoto’s

Even if you don’t follow a specific diet, some of the best foods you can eat in your diet for Hashimoto include:

• Chicken
• Lean red meat
• Dark chocolate
• Kefir
• Spinach
• Eggs
• Pumpkin
• Avocado
• Fish like tuna and salmon

The Best Diet for Hashimoto—Final Thoughts

Hashimoto’s is a complex thyroid disorder to live with, and it’s frequently linked to the development of hypothyroidism. You can try different diets for Hashimoto, such as gluten-free, anti-inflammatory, and the autoimmune paleo protocol, and see what works for you.

Many of these diets are actually very similar to one another, and they focus on eating nutritious, whole foods that combat inflammation and give you the nutrients you need. Many people with Hashimoto’s are deficient in nutrients like iron and selenium, so focusing on getting these through nutritious foods can help reduce or even reverse your symptoms.

Ashley Sutphin Watkins

Ashley Sutphin Watkins is a graduate of the University of North Carolina at Chapel Hill. She's a medical content writer, journalist and an avid researcher of all things related to health and wellness. Ashley lives near the Smoky Mountains in East Tennessee with her family.

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