Graves' Disease Diet Guide: How to Eat When You Have Hyperthyroidism
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Graves’ Disease Diet Guide: How to Eat When You Have Hyperthyroidism

Can your diet change the course of Graves' disease?

Do certain foods make hyperthyroidism worse? Do certain foods make it better?

Can you lose weight by eating certain foods if you have this disease?

The truth is that changing your diet can certainly impact the progression of Graves' BUT you must be doing it the right way.

In this Graves' disease diet guide you will learn the answer to all of these questions and more: 

More...

Can you Cure Graves' Disease? 

One question I get asked all the time is this:

Is Graves' disease curable?

And the answer is, maybe (at least in some situations).

In order to dive into how it might be possible to cure Graves' disease, we need to really discuss what this condition is. 

While it is true that Graves' disease is a type of Hyperthyroidism, that isn't the underlying cause of Graves'.

Graves' disease is an autoimmune disease.

Causes of graves and hyperthyroidism

By definition, this means that your immune system has malfunctioned to the type that it is accidentally attacking your own tissues and causing problems.

In the case of Graves', this attack comes from antibodies (that your body produces) that look very similar to the natural hormone TSH (which stands for thyroid stimulating hormone).

These antibodies that your body creates sit on the receptors in your thyroid and cause your own body to accidentally pump out lots of thyroid hormone into the bloodstream. 

This causes all of the symptoms of hyperthyroidism and Graves' such as:

  • Anxiety or mood changes
  • Heart palpitations and rapid heart rate
  • Weight loss (initially) but usually followed by rapid weight gain (following treatment -> more on this below)
  • Hot flashes or heat intolerance
  • Reduction in energy levels or fatigue
  • Insomnia or difficulty sleeping

We know that Graves' disease results from too much thyroid hormone but the real cause of this stems from the immune system. 

So the real question becomes this:

Can we calm down the immune system that is causing the attack on your thyroid gland?

And the answer is not clear for everyone, but in certain individuals it most certainly is.

And that's where dietary intervention comes into play when treating Graves' disease.

For many people, it might just be one of the most important aspects of treatment.

​Before we dive into the specifics of changing your diet let's talk about certain scientifically proven facts surrounding Graves' disease and autoimmune disease. 

​The Gluten and Graves' Connection

The first thing you need to realize and accept is that there is a proven and scientific link between Celiac' disease and Graves' disease.

Many studies have shown that patients with Celiac' disease (1) are significantly more likely to present with Hashimoto's thyroiditis and or Graves' disease - both of which are autoimmune diseases of the thyroid.

This connection stems from the link between intestinal inflammation, gluten and the initiation of autoimmune disease through molecular mimicry and inflammation. 

Some patients may have "silent" Celiac disease meaning that they have NO intestinal symptoms related to the disease.

This is particularly concerning if you are a patient and you hope that your Doctor knows this information.

Most of the symptoms of Celiac' disease tend to be extra intestinal - meaning that they do NOT exist in the GI tract.

Non-specific symptoms like depression, anxiety, migraines

Graves disease and intestinal permeability

Why is treating and finding Celiac disease in hyperthyroid patients important?

Removing gluten from your diet may improve the following areas:

  • Increase the absorption of nutrients
  • Increased absorption of medications (like thyroid hormone)
  • Reduced levels of inflammation
  • Improvement in intestinal permeability
  • Reduction in autoantibodies in certain people and conditions

​While all of these areas are important one VERY important aspect is the last one. 

Some studies have shown that adopting a gluten-free diet (2) in those with Celiac' disease may result in a REDUCTION of thyroid antibodies.

This makes testing for and treating Celiac' disease your number 1 priority if you have hyperthyroidism.

Please note, however, that if you don't have a thyroid anymore (due to it being removed or ablated) then your treatment will likely be different - we will go over this below. 

So what does this mean for you if you have Graves'?

At the very least you should be TESTED for Celiac' disease through serum and I recommend taking it a step further by removing gluten from your diet for at minimum 90 days.

You can get tested for Celiac' disease with these serum markers:

  • Tissue transglutaminase antibody
  • Gliadin peptide antibody
gluten antibodies case study

The presence of these antibodies indicates that you do indeed have Celiac' disease and should remain gluten-free indefinitely. 

But even if you test negative for these antibodies I do think you should seriously consider going gluten-free for 90 days.

Going gluten-free helps reduce intestinal inflammation and promotes (if done correctly) healthier food choices. 

You can read more about the gluten and Hashimoto's connection including recommendations on how to eliminate it from your diet in this post. ​

The ​connection between your diet and Graves' goes even further than just gluten, however: 

Download my Free Resources:

Foods to Avoid if you have Thyroid Problems: 

I've found that these 10 foods cause the most problems for thyroid patients. Learn which foods you should absolutely be avoiding if you have thyroid disease of any type. 

The Complete List of Thyroid Lab Tests:

This list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose thyroid hypothyroidism correctly!

Download more free resources on this page

​Food Sensitivities and Intestinal Inflammation

Another important consideration for your diet is whether or not you have food sensitivities. 

Why?

Because food sensitivities promote intestinal inflammation which promotes increased intestinal permeability.

​Don't let this confuse you because it's actually quite simple:

If you eat food that your GI tract (stomach) reacts to it will respond with local inflammation.

This inflammation damages the protective layer that your GI tract is supposed to provide and turns this protective barrier from a solid wall to a "leaky" net.

dysbiosis with a poor diet

Then, instead of blocking the absorption of harmful bacteria or proteins, these complexes are absorbed into your bloodstream and cause issues. 

I've simplified the process in explaining it but that doesn't change how you approach treatment for the problem.

What is it?

You get rid of the inflammation causing the problem!

​What does this mean for you?

It means that if you have Graves' disease there is a high chance that you are reacting to certain foods or food groups that may be worsening your immune function and intestinal tract.

The good news is that you can treat this problem by simply testing for these ​sensitivities and then avoiding whatever foods are causing your problems. 

If you want to get testing make sure you get evaluated using a delayed IgG food sensitivity test.

This is more accurate in diagnosing "chronic" food sensitivities that you may be silently reacting to with inflammation. 

​You will want to get this test over the more conventional food "allergy" testing that most physicians are aware of. 

You can read more about this type of testing here.

The combination of food sensitivity testing if coupled with a gluten-free diet is VERY powerful for patients with Graves'. 

Does Graves' cause Weight Loss or Weight Gain? 

When we talk about changing your diet if you have Graves' disease we need to talk about which problem you are struggling with. 

Why?

Because it matters whether you have ACTIVE Graves' disease or whether you suffer from hypothyroidism related to Graves' disease treatment. 

Many people are confused about whether or not Graves' disease should cause weight loss or weight gain. 

If your body creates too much thyroid hormone shouldn't that lead to weight loss, not weight gain?

Well, you are correct. 

UNTREATED Graves' disease leads to weight loss, but if you know you have Graves' changes are high that you are being treated and THAT is most likely causing weight gain. 

The treatment for hyperthyroidism is to slow down the thyroid and all of the treatments related to Graves' and hyperthyroidism have been shown to cause weight gain (3) (not weight loss). 

So it matters whether or not you've been treated (and how you've been treated) when we talk about your diet. 

weight gain in hyperthyroid patients after thyroidectomy

Eating for those with Active HYPERthyroidism

For those with ACTIVE hyperthyroidism, meaning that they have NOT undergone thyroidectomy or RAI, these patients need to be very aggressive about their diet. 

I've come up with guidelines below that you should follow if you want to reduce inflammation and try to REVERSE your antibody level and disease state. 

These recommendations should be adopted ASAP and aggressively, but realize that it may not be sufficient in every person to slow down or halt your disease state. 

In most instances, you will need to include supplements and other treatments as well. 

It's also very important to be aggressive about your dietary changes at this point because if your disease state progresses then the next step is thyroidectomy or radioactive iodine ablation. 

These therapies leave you hypothyroid and almost always lead to weight gain long term. 

So the best treatment option is to halt the disease state BEFORE these therapies become necessary. 

Foods to Eat

While changing your diet for Graves' you should focus on eating certain foods and avoiding others.

The exact foods YOU need to avoid will depend on your IgG food sensitivity testing, but you can adopt these changes almost immediately: 

Vegetables:

(Organic whenever possible)

  • Broccoli
  • Arugula
  • Cabbage
  • Cauliflower
  • Collard Greens
  • Sweet potato/Yams
  • Asparagus
  • Bok Choy
  • Brussels Sprouts
  • Kale
  • Zucchini
Fruits:

(Organic whenever possible)

  • Apples
  • Apricots
  • Bananas
  • Blackberries
  • Blueberries
  • Cherries
  • Strawberries
  • Raspberries
Protein:

(Organic or grass-fed whenever possible)

  • Wild caught fish
  • 100% grass-fed + organic beef
  • Pastured + organic eggs
  • Pastured + organic chicken
  • Pastured + organic pork
  • 100% grass-fed + organic processed meats
Fats:

(Cold Pressed)


  • Animal fats (pastured or 100% grass-fed)
  • Coconut oil
  • Extra virgin olive oil
  • Almonds/Almond butter
  • Avocado
  • Cashews
  • Coconut butter
  • Macadamia nuts
  • Brazil nuts

While the type and kind of food matters so do the amount and macromolecule ratio of each food group. 

If your goal is to reduce autoimmune function and inflammation then sticking to these foods (and avoiding those below) will serve you well. 

If your goal is weight loss I recommend that you look deeper into managing your macromolecule ratios and take further steps in my weight loss guide.

*Please note that this is NOT a complete eating guide, but does include recommendations to help you get started. 

Foods to Avoid

  • Gluten (we've discussed this above)
  • Dairy products (especially low fat dairy products)
  • Refined carbohydrates like breads 
  • Inflammatory fats and industrial seed oils (sunflower oil, safflower oil, canola oil, corn oil, etc.) 
  • Processed foods with preservatives (avoid food with ingredients you can't pronounce)
  • Alcohol
  • Sugar

Even more important than eating the RIGHT food groups is avoiding the WRONG food groups. 

You need to make sure you are simultaneously doing both.

Eating for those post thyroidectomy or RAI​ (and now HYPOthyroidism)

It's worth talking about patients who fall into this category. 

Why?

Because once your thyroid is ablated or removed you go from having hyperthyroidism to hypothyroidism. 

This shouldn't be surprising, but this point is missed by many patients. 

Many people still focus on how they have hyperthyroidism once their thyroid has been removed which can confuse them when they search for information. 

thyroid metabolism reset poster for side bar

If your thyroid has been removed or ablated then you are by definition hypothyroid and you are reliant upon thyroid medication indefinitely. 

This also means that your treatment is DIFFERENT! 

Hypothyroid patients are treated differently than HYPERthyroid patients. 

And, by the way, once you have your thyroid removed (or ablated as the case may be) you are not only hypothyroid but the chances are very high that you are going to gain weight. 

​You can learn more about eating and changing your diet if you have hypothyroidism secondary to thyroidectomy or radioactive iodine ablation in this post

Using Supplements with Dietary Changes for Better Results

​While making dietary changes (as indicated above) is a great idea and your first step, it certainly shouldn't be your only step or last step. 

To augment the benefits of changing your diet you can get even more benefit by adding specific and targeted supplements to your regimen.

Remember:

Our goal here is to reduce inflammation, improve GI function, reduce intestinal permeability and ​naturally normalize your immune function. 

Changing your diet does this to some degree, but you have to realize if there is existing damage to your GI tract then it may take more than just food to improve the situation.

Likewise, especially as it relates to nutrient deficiencies, often times patients are deficient in certain nutrients (especially Vitamin D, Zinc and Selenium) which ​NEED to be replaced in order to improve immune function. 

With this in mind, I recommend that you strongly consider adding some of the following supplements to your new dietary changes. 

Focus on supplements which promote normal intestinal health: 

  • Probiotics (high dose): Taking high dose probiotics can help normalize intestinal microflora, reduce inflammation and may even promote normal caloric absorption. Taking probiotics has been shown to reduce to improve a variety of symptoms ranging from depression to diarrhea through these mechanisms. In order to get these benefits, you MUST be taking high enough dosages of high-quality probiotics. In active Graves' disease, you will want to use 50-100 billion CFU's per day (with meals and in between meals). 
  • L-glutamine + DGL: L-glutamine is a critical building block in the repairing of your intestinal tract. Taking high doses of l-glutamine can restore proper function to your GI tract and improve immune function in the process. It also may reduce sugar cravings (added bonus). You need to use at least 5 grams per day to get these benefits. I also recommend that you take it with other GI enhancing supplements like DGL, aloe and slippery elm which can further enhance GI benefits and cool down inflammation. 
  • Pepsin + HCL: Low stomach acid may lead to a reduction in nutrients (iron, B12, etc.) and may promote decreased immune function. While taking other GI supplements (and especially if you have a thyroid disorder) taking HCL with pepsin can help improve GI function dramatically. Normal stomach acid is also required for thyroid hormone absorption (which is important if you are taking thyroid hormone replacement medication). 

Supplements to cool down inflammation: 

  • Fish oil: Fish oil has been shown to reduce inflammation and can help treat depression and chronic pain. These benefits come from the balancing of the omega 3 & 6 fatty acids that occur when taking fish oil. An imbalance in this ratio promotes inflammatory pathways in the body. When taken properly fish oil can help with weight loss, reduce fat mass directly, increase skeletal muscle mass and reduce inflammation. To get these benefits you will need to take 2-5 grams per day (that's 2-5 capsules per day assuming each soft gel is 1,000mg). 
  • Alpha lipoic acid: ALA is a VERY potent anti-inflammatory agent which has been shown to help reduce blood sugar levels, reduce inflammatory markers and help with weight loss. This supplement should be taken in doses up to 1,200mg-1,800mg per day for best results for at least 3 months. 
  • Quercetin (with bromelain): Quercetin is another powerful anti-inflammatory agent and is especially powerful when coupled with bromelain. Bromelain and quercetin can also help improve immune function and improve the GI tract as well. Take 1-2 caps each day for best results. 

Supplements to ease immune function: 

  • Zinc picolinate: Zinc is a mineral that many people are deficient in (especially thyroid patients). Zinc plays a very important role in immune regulation, it's also a potent anti-inflammatory and anti-oxidant. Taking zinc can actually help normalize thyroid function as well. When using zinc make sure you get zinc bound to picolinic acid which increases absorption. You will want to use 30-60mg per day. 
  • Selenium: Zinc should almost always be taken in combination with selenium due to how they interact with one another. In clinical studies, selenium has been shown to reduce thyroid antibodies and also has many of the same benefits that zinc has. Take 200-400mcg per day for best results (couple it with zinc). 
  • Vitamin D3 + K2: Unless you are getting 20-30 minutes of uninterrupted sun EACH and EVERY day during noon to 2pm chances are VERY high that you are deficient in Vitamin D. Studies have shown that people with low Vitamin D levels are much more likely to develop autoimmune disease due to how Vitamin D interplays with your immune system. Take 2,000 to 5,000 IU's daily until your serum Vitamin D levels get to the 40-50ng/ml range. You want to supplement with Vitamin D3 ONLY, avoid Vitamin D2 formulations. Also, take Vitamin K2 with Vitamin D3 for best results. 

Back to you

​So what's the takeaway here?

Your diet is a critical component to managing and treating Graves' or hyperthyroidism but it must be done correctly.

You need to alter your diet based on what type of treatment you are undergoing for Graves' and add in additional therapies such as supplements for best results.

I recommend going gluten-free and removing the food groups listed above if you aren't sure where to start.

Now I want to hear from you:

Do you have Graves' disease?

Has diet helped you reduce your disease?

Has it helped with weight loss? 

Why or why not?

Leave your comment below! ​

References (Click to Expand)

Westin Childs
 

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders. He is trained in Internal Medicine, Functional Medicine and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances. You can read more about his own personal journey here.

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