Which Diet is Best for Hashimoto’s? 6 Diets Use & 3 To Avoid

Which Diet is Best for Hashimoto’s? 6 Diets Use & 3 To Avoid

If you’ve ever been confused about what to eat because of your Hashimoto’s then this is the article for you. 

I’m going to take away the guessing game that is your diet…

Reduce your stress about what foods you should be eating and what foods you should be avoiding…

So that you can get back to what’s important:

Healing your autoimmune disease.

This article is going to go over how you should be approaching your diet after your diagnosis of Hashimoto’s.

And here’s the thing:

There is no one-size-fits-all diet that you should be following!

Everyone is completely different and that means the diet you need is not the same as your friends or someone in your support group. 

This article will teach you everything you need to know to get started and feel confident you are on the right track…

So let’s jump in:

The Secret to Finding the Right Diet for Your Body

If you want to find the best diet for your body you will need to follow a few rules:

  • Don’t be afraid of trial and error (you most likely will not get it right on the first try).
  • Pick your diet based on your symptoms and other medical problems (blindly picking a diet to follow is NOT the best approach).
  • Don’t base your results on your antibody levels alone (It is possible for your antibody levels to stay the same but for your symptoms to improve).
  • Your diet should NOT be a huge source of stress in your life, if it is then it will be counterproductive to healing (1)!

By following these guidelines you will improve your chances drastically of finding the diet that works for you. 

And remember: 

Use this outline as a GUIDE, it is not a replacement for medical advice.

Will These Diets Help me Lose Weight?

You’ve been conditioned to think that Diet and Exercise are the keys to weight loss.

But in Hashimoto’s and Hypothyroidism that couldn’t be farther from the truth.

Changing your diet will HELP you lose weight, but in the majority of patients, it’s really just one step.

You may lose 5-20 pounds by changing your diet (depending on how much you have to lose) but changing your diet will NOT get you back to your normal weight if your thyroid is underdosed. 

I’ve written extensively about how to lose weight with Hashimoto’s and hypothyroidism: 

As you can see from the case studies above that you can lose weight with each of the diets listed below. 

The most important part is picking the diet best for YOUR body.

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Why Diet is the Most Important Part of Treating Hashimoto’s Thyroiditis

As you know…

Hashimoto’s disease is an autoimmune disease which means your body is literally attacking and killing itself.

In the case of Hashimoto’s, this attack occurs on the thyroid gland itself!

If left untreated over long periods of time this will ultimately result in the destruction of your thyroid gland tissue

That means your thyroid won’t be able to produce thyroid hormone anymore and you will be left with supplementing with thyroid hormone in the form of thyroid medication for life.

It doesn’t sound pretty, but here’s the deal:

You can reduce and even prevent the attack on your own thyroid by making some targeted changes.

While diet is a critical component of reducing the inflammation in Hashimoto’s, it isn’t the end all be all treatment. 

In order to treat Hashimoto’s, you must reduce inflammation

That means you have to address ALL causes of inflammation including:

  • Dietary allergies and antigens
  • Gut Imbalance (dysbiosis, SIBO, gut infections, leaky gut, etc.) 
  • Physical, Emotional, and Physiological stressors
  • Chemical Toxins and Endocrine Disruptors
  • Nutrient Deficiencies
  • Lifestyle changes including improved sleep, exercise, and stress reduction techniques

Doing just one of these is a recipe for failure… 

There is almost no question that your diet may increase inflammation in your body, but it’s certainly not the only culprit.

And in order to reduce all inflammation, each area must be addressed.

So diet (while probably the MOST important aspect of reducing inflammation) is really just the beginning…

Which Diet is the Best for Reducing Antibody Levels?

There are MANY different diets you can choose from to help reduce inflammation and autoimmunity, but the important part is finding the right one for you. 

I’ve successfully used all of these diets in my patients to help them feel better, lose weight and reduce antibody levels.

The 7 diets that I want to go over in detail include:

  • #1. The Elimination Diet
  • #2. Autoimmune protocol diet
  • #3. Gluten-free diet
  • #4. Paleo diet
  • #5. Low FODMAP diet
  • #6. The carnivore diet

If you’ve never heard of any of these diets don’t worry, I’m going to go over what factors may lead you to choose one over the other and how to pick the best diet for you. 

When it comes to following a diet the truth is you really will get 90% of the benefit as long as you can remain consistent with whichever diet you pick. 

So don’t get caught up in all the nuances, instead just focus on sticking to the plan. 

#1. Food Sensitivity Diet (Elimination Diet)

The Elimination diet is based on the idea that certain foods may cause negative reactions in certain people. 

In the most basic sense, you simply remove these foods from your diet and then monitor how you feel. 

Pretty simple, right? 

There are two ways to do this diet:

The first is with blood testing for food sensitivities: Find specific foods that you are sensitive to using delayed IgG food sensitivity testing. Testing for IgG antibodies will find food *sensitivities* that you may be reacting to, but may not be allergic to. You can find more information in the video below: 

When most people think of food allergies they think of allergies to foods like shellfish and tree nuts which may cause swelling of the face airways leading to potentially life-threatening situations. 

We aren’t talking about food allergies like these.

Instead, we are talking about sensitivities to certain foods that may make you react with low-grade inflammation, changes in colonic bacteria, depression, anxiety, mood disorders, acne, postnasal drip, and so on.  

This type of food “allergy” is mediated by a different type of immunoglobulin known as IgG.

And the foods that trigger this reaction are more difficult to spot compared to those that cause anaphylaxis.  

Why?

Because your reaction to the food might be delayed by up to 48 hours AFTER eating the food you are sensitive to.

This delayed reaction makes it difficult to put your finger on which foods may be causing you problems and can get really frustrating.

Delayed IgG food sensitivity testing can be very helpful for patients who don’t respond to the traditional elimination diet that simply removes the most common food allergies from the diet. 

The second is to eliminate foods systematically: Instead of getting the delayed IgG blood test, you can simply remove the major food groups that most people are sensitive to for 30-90 days.

This allows enough time for the inflammation to cool down, your GI tract to begin healing, and most of the other symptoms you may be experiencing to resolve. 

Once you’ve eliminated your symptoms (and only if you have eliminated your symptoms) you can then begin to slowly reintroduce these food groups back into your body while monitoring how you react.

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If you find that you feel poorly after reintroducing certain foods back into your diet then you have some great information: 

Stop eating the food that makes you feel terrible! 

I’ve found that this type of diet can be difficult for patients who like things to be black and white.

Sometimes people just don’t want to give up their favorite foods even if they react poorly to them, so if you fall into this category it may be a good idea to just get the food sensitivity test to see which foods you need to avoid.

The most common food groups removed from this diet include gluten, dairy, soy, sugar, artificial sweeteners, corn, peanuts, eggs, and shellfish. 

If you elect to go this route (without the blood testing), then it’s best to remove at least the top 5-7 most common food allergens. 

You don’t want to remove too many foods initially because that can make dietary choices very difficult and doesn’t always lead to long-term success. 

You can find an example below of the various phases of the elimination diet:

Does it work?

Yes! 

The combination of going gluten, dairy, and soy-free, plus removing any foods you may be sensitive to by checking your delayed IgG antibodies, is one of the most effective methods for determining which diet your body needs.

In order for this diet to be effective just remember that you need to stick to it for at least 2-3 months.

According to a group study using this diet, 62% of people reported that they felt better, 4.2% said they felt worse, and 43% had a reduction in Hashimoto’s antibodies.

More information: 

PROS

  • The elimination diet had the highest reduction in antibodies of the diets in the survey.
  • Easy implementation (it’s not hard to start and there are plenty of free resources to help guide you).
  • You don’t necessarily need to see a nutritionist to start (though you can if you’d like extra help).
  • A moderate percentage of people felt better on this diet.
  • It can be cost-effective if you do not get delayed IgG food allergy testing (in other words, you don’t need to spend a lot of money on testing).

CONS

  • The highest percentage of people felt WORSE on this diet.
  • Testing can be expensive and, at times, inaccurate.
  • Requires a lot of time to reintroduce food groups and you must stick to a schedule if you want it to work.
  • May take weeks to months to feel better as you figure out which foods you should avoid.

Who Should Consider the Elimination Diet?

  • People who react with itching, swelling, hives, runny nose, or post nasal drip after eating certain foods
  • People who also have a personal history of Asthma or Eczema
  • People who have failed other more basic diets like Gluten-free, soy-free, or grain-free and are still symptomatic or still have high levels of antibodies
  • Quick Tip: You don’t necessarily need to have delayed IgG sensitivity testing to get started. It may be necessary for some people but you can get started right away by eliminating the 7 most common reactive foods (listed above). 

#2. Autoimmune Paleo Diet (AIP)

Also referred to as the autoimmune protocol or autoimmune diet, this diet is very similar to the paleo diet except it also excludes nuts, seeds, eggs, legumes, and nightshades.

The AIP diet is felt to be one of the best diets to reduce antibody levels in Hashimoto’s (and other autoimmune diseases) but it is also one of the most restrictive diets out there making it difficult to sustain for long periods of time. 

To see a case study of one of my patients using AIP to lose weight and feel better please see this post.

Since this is really just a modified version (which is already fairly restrictive), you may be wondering what is left to eat if you further restrict the foods that you can eat.

You can see the list of the allowed foods below:

  • Vegetables (Except Nightshades)
  • Fruits
  • Coconut Products
  • Fats: Olive oil, Coconut oil, Lard
  • Fermented Foods
  • Bone Broth
  • Grass Fed Meats, Poultry, and Seafood
  • Non-seed Herbal Teas and Green Tea
  • Vinegar (Including Balsamic without added sugar)
  • 1 Tsp of Maple Syrup and Honey used as sweeteners
  • All fresh non-seed Herbs
  • Grass Fed Gelatin and Arrowroot Starch

Does it work?

As long as you can sustain this diet it has the highest potential to help reduce antibody levels and improve symptoms.

One of the problems with the AIP diet is how restrictive it is which can lead to a lack of compliance in many patients. 

In other words, many thyroid patients start this diet with good intentions but fail to continue using it long enough to see results.

According to group data, 75% of people felt better, 4% of people felt worse, and 43% had a reduction in antibodies while following the auto-Immune paleo diet. 

More information: 

PROS

  • A moderate percentage of people felt better on this diet.
  • Many patients report feeling better very quickly.
  • Includes gut-healing foods like bone broths.
  • Good support community online.
  • Easy access to recipes online.

CONS

  • A high percentage of people felt WORSE on this diet.
  • Lots of restrictions initially, making compliance difficult.
  • Requires a lot of time to reintroduce food groups after phase 1.
  • Patients may start reacting to foods they didn’t react to previously which may lead you down a path of ever restricting your food choices.

Who should consider the Autoimmune Paleo Diet?

  • People who have multiple autoimmune conditions (in addition to Hashimoto’s), multiple food sensitivities, and multiple medical problems
  • People who have failed other less restrictive diets (gluten-free, paleo, dairy free, etc.)
  • People who want to jump to the “best diet” and are willing to make drastic changes to their diet
  • Quick Tip: I don’t typically recommend that all Hashimoto’s patients start with this diet because for many patients less restrictive diets are enough to lower antibody levels and improve symptoms, if you fit into the categories above I would strongly consider AIP to start. 

#3. Gluten-Free Diet

If you don’t already know about gluten here is a quick primer:

Gluten is a name used to define multiple proteins found in wheat, rye, and barley. There are two varieties of problems that people can experience from exposure to gluten, both of which cause problems for the immune system and the gut: 

The first is Celiac disease:

People with this condition have an autoimmune response when introduced to the gluten protein which results in damage to the intestines, inflammation, and many other extra-intestinal signs and symptoms.

Diagnosing Celiac disease is not very difficult because patients with this condition typically have elevated blood levels of gliadin, transglutaminase-2, and endomysium which you can find on testing. 

When present, Celiac disease results in damage to the intestinal wall as your immune system attacks the gluten protein as if it’s a foreign invader.

This damage leads to increased intestinal permeability (“leaky gut”) and a variety of symptoms including an increased risk of developing autoimmune diseases (2) like Hashimoto’s thyroiditis.

This process happens through several mechanisms including molecular mimicry (3).

In essence, as your intestinal wall gets damaged it lets in portions of undigested proteins, food particles, and bacteria to which your body creates antibodies.

These antibodies can then cross-react with other tissues resulting in damage and autoimmune disease.

Obviously, this is not something you want going on in your body which is why treating Celiac disease by going gluten-free is so important.

Even if you don’t have Celiac disease you can still experience problems with gluten.

When this happens, it’s called gluten sensitivity (the official name is non-Celiac gluten sensitivity or NCGS for short).

Originally, many providers didn’t think this condition existed but it turns out it does and its existence is supported by plenty of data(4)

Non-celiac gluten sensitivity:

People with this condition react negatively to gluten, much like those with Celiac disease, but the symptoms and pathophysiology are slightly different between the two.

For starters, traditional blood tests for gluten antibodies are all negative (5) which means it’s more difficult to diagnose.

These negative blood tests can also lull some patients into falsely believing that gluten isn’t a problem for them when it still is.

Just because you have negative antibodies to gluten doesn’t mean gluten isn’t a problem for you.

For those people with gluten intolerance, non-celiac gluten sensitivity still causes plenty of problems both in the intestinal tract and outside of the intestinal tract and that’s one of the ways that some experts recommend diagnosing the condition:

  • Intestinal symptoms: Bloating, abdominal pain, diarrhea, epigastric pain, nausea, gas, acid reflux, IBS-like symptoms, and constipation
  • Extraintestinal symptoms: Fatigue, headaches, anxiety and other mood changes, brain fog, numbness/tingling, joint and muscle pain, and skin changes including rashes or random outbreaks

Do you have any of these symptoms but negative blood tests for Celiac disease? 

Or have you removed gluten in the past and felt better when you did? Only to find out that your symptoms return when you start eating it again?

If so then you might have non-celiac gluten sensitivity (6).

In addition to the symptoms listed above, NCGS can also cause increased inflammation and increased intestinal permeability, just like Celiac disease, leading to much of the same increased risk of developing autoimmune diseases. 

For this reason, (and many others) it may be smart to avoid gluten altogether if you have Hashimoto’s whether you have been officially diagnosed with either Celiac disease or non-Celiac gluten sensitivity. 

Sometimes it’s better to err on the side of caution and probability.

Does it work?

Going gluten-free will usually result in SOME improvement in symptoms (7) for most patients with Hashimoto’s. In my experience, up to 80% of patients with Hashimoto’s have some improvement (as defined by a reduction in thyroid symptoms, thyroid antibodies, or some combination of the two) when going gluten-free.

In order to see success with the gluten-free diet, you must avoid all sources of gluten.

This is trickier than it seems as gluten is often hiding in all sorts of foods, sauces, condiments, and even some cosmetics.

I’ve been gluten-free for 9 years but when I first went started I continued to find small sources of contamination in food products and condiments months down the road.

According to group data 88% of people felt better on this diet, ~1% of people felt worse, and 33% of people had a reduction in antibodies. 

More information: 

PROS

  • The highest percentage of people felt better when going gluten-free.
  • There’s lots of free information, how-to guides, recipes, and meal plans available online.
  • It’s easy to get started right away (just go into your pantry and start throwing away foods that contain gluten).
  • There’s a great support community online including Facebook groups, bloggers, health coaches, and more.

CONS

  • It can be difficult to remove ALL sources of gluten from your diet.
  • There is lots of gluten-free junk food available (it’s easy to eat an unhealthy gluten-free diet).
  • Going gluten-free can help but often you may need more restrictive diets to see the improvement you are looking for.

Who should consider the Gluten-Free diet? 

  • All patients with Hashimoto’s (going gluten-free for 3 months should be standard for any newly diagnosed Hashimoto’s patient).
  • Patients with a family history of Celiac disease, Hashimoto’s, or other thyroid problems.
  • People who have chronic migraines, chronic headaches, acne, or multiple gastrointestinal symptoms.
  • Quick Tip: Most people benefit from going gluten-free (even if you decide on a different diet you should still ALSO be gluten-free for 3 months). Don’t fall into the trap of thinking that if you have negative antibodies to gluten you are fine to eat it. Most patients with Hashimoto’s do much better cutting out gluten. 

#4. Paleo Diet

The paleo diet is another very popular diet, and for good reason.

It consists of real whole food that attempts to mimic the diet of the paleolithic man/woman which automatically removes inflammatory industrial seed oils, GMO food products, refined grains, added sugar, and generally most foods you shouldn’t put into your body.

Here’s a brief graphic outlining what you can and can’t eat on the paleo diet:

From a macromolecule perspective, the paleo diet tends to be higher in healthy fats with moderate amounts of protein and generally small amounts of carbohydrates. 

One of the dangers of going paleo is actually reducing your carbohydrates too much because the most common sources of carbs are generally forbidden.

While reducing the number of carbohydrates can be good in certain medical conditions (leptin and insulin resistance, for instance), reducing all sources of carbohydrates can result in worsening fatigue in some patients with Hashimoto’s.

Another potential pitfall of eating a paleo-based diet is consuming too much protein. 

High levels of protein can activate the mTOR pathway (8) and influence leptin levels leading to worsening leptin resistance and inflammation (9).

As long as healthy fats, proteins, and carbs are balanced the diet is excellent, but it does require some manipulation and personalization on your part to get there.

Does it work?

I’m a big fan of pretty much any whole food-based diet and would routinely start my patients on modified versions of the paleo diet and then further manipulate and refine their macromolecules based on their symptoms and lab tests. 

The paleo diet is a great starting point because there is plenty of information including recipes and diet guides available on the internet to help you get started.

And because this diet automatically removes most unhealthy foods, even if it’s not perfect for you, you should see some improvement.

In addition to these benefits, according to group data 81% of people felt better, 3.2% of people felt worse, and 27% of people had a reduction in antibodies after adopting the paleo diet. 

More information: 

PROS

  • A large percentage of people felt better on this diet.
  • There’s lots of free information, guides, recipes, and meal plans available online to help beginners.
  • There’s a great paleo community online that can offer help, advice, and personal experience.
  • There is lots of research backing the health claims.

CONS

  • The standard paleo diet is low in carbohydrates which may lead some people to experience fatigue and may exacerbate existing conditions such as adrenal fatigue.
  • Some people can have problems maintaining body weight due to a lower amount of carbs.
  • It may be too restrictive for certain individuals which mean compliance may be an issue.

Who should consider the Paleo Diet?

  • People who have tried going gluten-free but still have room for improvement in their symptoms.
  • People with any of the following: acne, depression, anxiety, fatigue, eczema, environmental/seasonal allergies, post nasal drip, IBS/IBD, GERD, chronic constipation.
  • For people who are unsure of what diet is best for them, this is a GREAT place to start.
  • Quick Tip: The Paleo diet is great to start with because of the supportive online communities that exist. Be careful when switching to this diet if you rely heavily on healthy sources of carbs for energy – sometimes switching to low-carb diets can make patients with Hashimoto’s worse. 

#5. Low FODMAP’s Diet

What in the world are FODMAPs? I’m glad you asked…

It’s an acronym that stands for Fermentable Oligo-Di-Monosaccharides And Polyols. 

It’s really just a fancy name to describe a class of sugars and carbohydrates that are found in certain foods. FODMAPs have been known to cause gastrointestinal issues like gas, bloating, cramping, and irritable bowel-like symptoms (10) in certain groups of people.

For instance, those who have SIBO, or candida overgrowth, appear to be particularly sensitive to FODMAPs and react poorly when eating them (11).

This diet is included here because a large percentage of patients with hypothyroidism (and by extension, Hashimoto’s) suffer from SIBO and/or fungal overgrowth syndromes.

As a result, many thyroid patients stand to benefit from this type of diet whether they realize it or not.

The low FODMAPs diet works by eliminating foods that are high in these types of carbohydrates:

  • Fructose (fruits, honey, high fructose corn syrup)
  • Lactose (dairy products)
  • Fructans (wheat, garlic, onion, inulin)
  • Galactans (beans, lentils, soybeans)
  • Polyols (Sweeteners like xylitol and mannitol, along with stone fruits such as Avocado)

Does it work?

This is definitely a specialty type of diet and not one that I would regularly recommend to the average patient with Hashimoto’s.

In most cases simply removing the primary sources of carbohydrates like bread, pasta, gluten-containing starches, etc. is enough to significantly improve any GI-related issues.

A minority of patients will require the complete removal of FODMAPs especially if they have constipation-predominant IBS or treatment-refractory SIBO.

Otherwise, most patients should stick to the other diets listed above as a starting point (unless otherwise directed by their doctor). 

According to the group data 39% of people felt better, 0% of people felt worse, and 27% of people had reduced antibodies while following this diet. 

More information: 

PROS

  • Up to 50% of patients with thyroid disease also have SIBO which means this diet may help with both gut function as well as thyroid function.
  • It may also help treat candida overgrowth and other fungal overgrowth syndromes.
  • It’s a great diet and option for those suffering from irritable bowel syndrome or other difficult-to-treat gut problems.
  • Very few patients feel worse when using this diet.

CONS

  • Those using this diet saw a minor reduction in antibodies out of all diets surveyed.
  • It doesn’t automatically exclude gluten which can be problematic for some people (you may need further restrictions to feel better).
  • The smallest number of patients felt better on this diet when surveyed.

Who should consider the Low FODMAPs Diet? 

  • People who have Hashimoto’s and have been diagnosed with (or have symptoms of) small intestinal bacterial overgrowth (SIBO for short) and/or yeast or candida overgrowth.
  • People who still have gas/bloating despite adopting a paleo or gluten-free diet.
  • People who have failed less restrictive diets.
  • Quick Tip: This diet may be effective for patients suffering from chronic gas/bloating, abdominal distention, or extreme chronic constipation (1 bowel movement every 4-7 days). If you have these symptoms there is a very high chance you are suffering from SIBO and/or yeast overgrowth. 

#6. The Carnivore Diet

The carnivore diet is kind of the new kid on the block and has really come into prominence over the last couple of years.

There are plenty of case studies from patients with all sorts of medical conditions and autoimmune diseases (including Hashimoto’s) who have seen almost complete resolution in their condition using the carnivore diet.

I have tried it personally and have recommended it to some patients with varying degrees of success.

If you haven’t heard of the carnivore diet, here are the basics.

As the name implies, the carnivore diet allows you to eat meats, dairy, water, coffee, tea, bone broth, and nothing else.

Why does it work so well?

Probably because following it removes most, if not all, of the foods that people typically react to including things like gluten, FODMAPs, lectins, carbohydrates, and so on.

In this way, you can think of it as an extreme type of elimination diet.

Even though it does show promise, there are still some reasons to be cautious before using it.

One of those is safety data.

We just don’t have a lot of long-term studies to know whether it is safe to go carnivore for indefinite lengths of time.

My suspicion is that it’s probably safe for some people, but not for others, and, as a result, I typically reserve recommending this diet when other more conventional diets have failed.

More information:

PROS

  • If don’t correctly, you will be consuming some of the most nutrient-dense foods available.
  • It can be considered as a way to force an elimination diet because foods that cause issues are necessarily excluded.
  • It automatically excludes FODMAPs, oxalates, lectins, sulfites, salicylates, phytates, and fiber.
  • Can dramatically improve gut health in some people.
  • May also help with weight loss.

CONS

  • The long-term safety data for this diet is lacking. It’s hard to know if this is something that can be safely used for an indefinite amount of time.
  • It’s not ideal for those who
  • It may not provide enough carbohydrates for certain individuals (especially those with adrenal fatigue).
  • Some studies indicate there may be a connection between meat consumption and autoimmune disease (theoretically, large consumption of meat may make Hashimoto’s worse).

Who should consider the carnivore diet?

  • Those who have failed less restrictive diets.
  • Thyroid patients who tolerate meat, eggs, and dairy products.
  • Patients with a history of multiple autoimmune diseases.
  • Patients with a history of gut issues/problems.

Diets To Avoid with Hashimoto’s 

Having gone through diets that are beneficial to people with Hashimoto’s we should also go over some diets that you should avoid if you have this condition. 

Some of these diets should be avoided at all costs and others can be used but only if you are working with a skilled practitioner who understands your condition. 

You’ll see what I mean as we discuss these diets:

#1. Low-Fat Diets

I’m referring to the typical low-fat diet that modern medicine and the conventional media sometimes recommend for weight loss and better health. 

Despite these widespread recommendations and beliefs that a low-fat diet is somehow healthy for your heart and waistline, none of these reported “facts” are supported by the literature.

Low-fat diets (even diets low in saturated fat) have never been shown to be effective for weight loss or heart health, but they are unfortunately pushed by many physicians and cardiologists. 

This is especially important for patients with Hashimoto’s and/or hypothyroidism because these patients commonly have problems with weight.

Many patients with Hashimoto’s are told they have high cholesterol (due to low thyroid function) (12) and to “eat less red meat”.

Because of the interplay between thyroid function and cholesterol, however, you can’t determine if someone has a cholesterol problem until their thyroid is optimized.

And because dietary cholesterol intake has a minimal impact on total body cholesterol, this advice falls flat most of the time.

To further complicate the picture, low-fat diets are typically high in sugar which often exacerbates conditions like insulin resistance which worsens weight gain.

The last thing you’d want to do is eat more carbohydrates if your body is insensitive to insulin, as that will only send the signal to store more calories as fat.

For most patients with Hashimoto’s, it’s a good idea to avoid diets that strongly market themselves as low fat.

Some people do better with lower amounts of dietary fat and that’s okay.

But if you do better on a low-fat diet, your diet should still consist mostly of fruits and vegetables and not sugar-based processed foods.

#2. Calorie Restricted Diets

Have you been told to eat less and exercise more? If so, whoever told you that was recommending a calorie-restricted diet and this is probably one of the worst things you can do for your thyroid health.

Aside from the fact that calorie-restricted diets don’t work for weight loss, they can also be incredibly harmful to your thyroid as well.

We know from studies that as few as 25 days of a calorie-restriction is enough to reduce thyroid function and T4 to T3 conversion (14) by up to 50%.

Put into more easily understandable terms, calorie-restricted diets reduce how much thyroid hormone your thyroid gland produces and may make your hypothyroid symptoms worse.

This is confusing for some patients because these types of diets can sometimes work in the short term.

But even though they may help you lose weight temporarily, they never work long-term.

Those who lose weight by restricting their calories will always find that after about 6-12 months that whatever weight they lost eventually comes back, usually due to the thyroid problems we just discussed.

Whatever you do, do NOT use a calorie-restricted diet if you have Hashimoto’s. You will only make your thyroid function worse and it will ultimately lead to more weight gain down the road.

If weight loss is your primary goal then you need to focus on your hormones including your thyroid as well as insulin, leptin, cortisol, estrogen, progesterone, and testosterone.

Balancing these hormones will give you the long-term weight loss you are looking for.

#3. Weight Loss Diets Full of Processed Foods

This one is kind of an extension of #2 but it’s worth discussing here as well.

What do I mean by weight loss diets full of processed foods?

I’m talking about those weight loss programs that provide you with pre-made processed meal plans that are supposed to make weight loss “effortless”.

I’m not going to name any names here, but I think you can think of a few businesses that provide these meals.

Not only are these meals processed (which means they are often filled with inflammatory ingredients and preservatives that may cause gut problems, inflammation, and make your thyroid worse), but they also are designed to have minimal calories as well.

This means you are getting the worst of both worlds:

Processed foods and a calorie-restricted diet at the same time.

Consuming pre-made meals also does nothing for your long-term success because it doesn’t teach you how to cook, how to plan your own meals, and how to figure out what works for your body.

These skills are necessary if you want to have long-term success with your diet and your Hashimoto’s.

What About Goitrogens?

It’s worth taking a minute to discuss goitrogens while we are on the topic of diet.

Goitrogens are compounds that limit your thyroid from taking up iodine which may, theoretically, lead to decreased thyroid function (21).

The conventional opinion is to avoid these foods if you have thyroid problems.

But, if we followed conventional wisdom when it comes to thyroid management then many thyroid patients would remain feeling symptomatic forever.

So the question really becomes, are goitrogens necessary to avoid?

And that’s slightly more complicated.

The truth is that while goitrogens may potentially promote an issue for some, their negative effects can be offset with adequate iodine intake.

In addition, the beneficial effects of foods high in goitrogens often outweigh any potential negative side effects from their consumption.

To give you an idea of what I mean, just take a look at foods that naturally contain goitrogenic compounds:

Cruciferous vegetables (bok choy, broccoli, Brussel sprouts, cabbage, and cauliflower), and some other foods such as peaches, pine nuts, pears, soy milk, and soybeans.

Some patients with Hashimoto’s are so worried about thyroid function that they completely avoid these food groups. 

And, when you look at the list, you’ll find that it includes some of the most healthy foods on the planet. 

If you are avoiding goitrogenic foods for processed foods then you are almost certainly doing more harm than good.

The truth is that it would require a VERY large amount of these foods to have a meaningful impact on your thyroid gland.

What’s more, the goitrogenic effect of these foods can be limited depending on how you prepare them.

To reduce the impact that these foods have on your thyroid you can consider the following steps:

  • Limit yourself to 6-8 servings of these foods per week and when preparing, make sure to steam them. Steaming foods will reduce their goitrogenic potential.
  • Eat foods that are high in both selenium and iodine. This includes foods like [High Iodine] kelp, kombu, hijiki, arame, cod, dulse, iodized salt, wakame, shrimp, eggs, tuna, nori, prunes, and banana. [High Selenium] Brazil nuts, tuna, halibut, sardines, ham, beef, turkey, chicken, egg, and spinach. The reason to do this is that selenium has been shown to protect against iodine-induced inflammation.

Final thoughts

While the topic of diet can definitely be complex, don’t let it become so overwhelming that you become paralyzed.

If you aren’t sure where to start then just start with some baby steps.

Simple things like removing gluten, eating whole foods, and avoiding processed foods can go a long way to improving Hashimoto’s.

If you are feeling more comfortable then go ahead and jump in with both feet to some of the diets mentioned here.

One thing I would caution against, though:

Don’t fall into the trap that if a certain diet worked for someone else that it will work for you.

Every single one of us is different.

Just like we all look different on the outside, on the inside we all have different needs.

And remember, if you have any questions or concerns about your health make sure to talk to a qualified and knowledgeable practitioner! 

Now I want to hear from you:

Were you aware of all of these diets before you read this article?

Did any diets stand out to you personally?

Have you tried any of these diets before? Did they work for you?

What type of diet are you currently eating and is it helping or hurting your Hashimoto’s?

Leave your questions or comments below!

#1. http://www.ncbi.nlm.nih.gov/pubmed/15650357 

#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3741914/

#3. https://www.ncbi.nlm.nih.gov/pubmed/7828371

#4. https://www.ncbi.nlm.nih.gov/pubmed/24533607

#5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488826/

#6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406911/

#7. https://www.ncbi.nlm.nih.gov/pubmed/28315909

#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977908/

#9. https://www.ncbi.nlm.nih.gov/pubmed/18583936

#10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5390324/

#11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966170/

#12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109527/

#13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4742721/

#14. http://www.ncbi.nlm.nih.gov/pubmed/19208852

#15. https://www.ncbi.nlm.nih.gov/pubmed/17967708

#16. https://www.ncbi.nlm.nih.gov/pubmed/26369574

#17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725446/

#18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371748/

#19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2833301/

#20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1411539/

#21. https://www.ncbi.nlm.nih.gov/pubmed/2464986

#22. Diminished energy requirements in reduced-obese patients

#23. Prediction of energy requirements of obese patients after massive weight loss

About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 70,000+ people have used them over the last 6 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

P.S. Need more help? Check out my free thyroid downloads and resources.

85 thoughts on “Which Diet is Best for Hashimoto’s? 6 Diets Use & 3 To Avoid”

  1. Thank you so much for your posts! I was diagnosed with Addisons and hashimotos in May and am still struggling with weight, fatigue and the correct diet. Your blog posts are incredibly helpful though I still feel overwhelmed!

    Reply
    • Hey Tracy, I’m glad the article was helpful to you.

      Hashimoto’s and health in general can be very overwhelming! My best recommendation is to make sure you find a very caring, knowledgable and understanding Doctor to help you along the way. If you take everything one piece at a time or one step at a time it becomes a lot more manageable (and less overwhelming!).

      Reply
      • It is almost impossible to find doctors that understand fibromyalgia, chronic pain and chronic fatigue along with my thyroid issues. I go from dr to dr seeking answers. My weight increases and I get more depressed. Exercise is all they say, cut calories. Nothing helps, where are you and do you see patients?

        Reply
        • Hey Marjorie,

          I agree it can be very difficult. Most Doctors who specialize in these disorders are out there on the internet somewhere, either with a blog or videos or something like that. I practice in Gilbert, Arizona.

          Reply
        • You and I are in the same boat. It’s a nightmare! Total incompetence. It leaves the patient holding the bag! I’ve been dealing with this since 2014. Suffer with the same as you and more. I’m at the end of the road. Just can’t go on endlessly like this. NO quality of life whatsoever! Good Luck.

          Reply
  2. I loved your article! Thank you for sharing information. I’ve been following GAPS diet for six months, unfortunately antibodies have increased. I’m gluten and lactose free since one year and feel better, but suffering with chronic constipation, fatigue, inflammation, reflux and candida.
    What would you recommend me to do? Thank you in advance!

    Reply
    • Hey Eli,

      I’m glad you enjoyed it!

      Following antibodies isn’t necessarily a perfect science. In some cases patients can improve and still have an increase in their antibodies. For this reason I focus on a combination of antibody levels as well as symptoms. There are some things you can do in terms of taking supplements that may also help to reduce those antibody levels – for instance I am a big fan of selenium for my patients. In addition you may also find some benefit to low dose naltrexone.

      In regards to your constipation I would look to treating your yeast overgrowth and likely SIBO. Once these are taken care of your bowel movement should improve. In the mean time I would try magnesium citrate + vitamin C until you have 1 loose bowel movement per day.

      Reply
  3. Hi Westin, I’ve just read your article on the different diets. I was diagnosed in 1971 with type 1 diabetes, in 2007 with hypothyroidism and 2015 with Hashimotos/thyroiditis. I’ve been gluten free for about 8 months now and feel better for it. A couple of months ago I started eating Paleo and I feel so much better, I’ve even dropped 6 kg which is amazing! However I still have inflammation, anaemia and I suspect candida overgrowth happening that I’m trying to treat with diet and supplements. I also have adrenal problems and I’m about to do my second saliva test and treat that problem. I get so tired and my brain just doesn’t take everything in like it should!

    So my main question is should I start the AIP diet or just stay with Paleo and increase my carbs? I really like the Paleo way of eating as does my husband for the most part!

    Thanks
    Fiona

    Reply
    • Hey Fiona,

      That’s a really difficult question to answer. Generally I would recommend that you stay on paleo while you treat your adrenals and optimize your thyroid function. I will occasionally recommend AIP in patients with multiple autoimmune conditions, however. Bottom line is that finding the best diet for you is a very individualized process that involves trial and error. I would stick to what is working and only make changes if necessary.

      Reply
  4. Hi! Thanks for this wonderful article. Are there any diets you’d recommend for those of us who have Hashimoto’s, insulin resistance AND are vegan or vegetarian? I have been gluten free for three years now (although I don’t monitor non-food items for gluten). I haven’t had any digestive issues, either before or after going gluten-free. I’d love any advice you may have. Thank you again!

    Reply
    • Hey Anna,

      The best way to reverse insulin resistance is with a fasting protocol. Diet is actually only effective in reversing insulin resistance to a certain degree, in many individuals it simply won’t be enough. So in your case it might not be a matter of your diet so much as a matter of the degree of insulin resistance in your body.

      Reply
  5. I have stopped eating the gluten. Mainly because it seems to make me feel bloated and like I ate a brick. Also seems like my fingers would swell up and I would have no bowel movements for days. I still have the weight problem and Im going to take your advise and see if I can find a doctor that will prescribe me something for T-3. Im on synthroid and thats all. In fact I cant seem to lose any weight. Im running and cut sugar, and gluten. I hope this helps for your research. Thanks !

    Deedee Dollins

    Reply
    • Hey Deedee,

      I see patients in your situation on a daily basis! Weight loss for hypothyroid patients is not about diet (though a poor diet will make you gain weight rapidly), it’s about balancing hormones. Often times even getting on the right type of thyroid medication will not lead to 100% normal body weight, though you may still lose 20-50% of the extra weight. Each hormone imbalances contributes to your overall weight and in order to achieve that normal weight each must be balanced.

      Thanks for your comments 🙂

      Reply
  6. Hi,
    Great and informative article. I am curious, you mentioned that going gluten free will not help with inflammation and autoimmunity…what should I be doing, in addition to gluten free, to help with these things? One of the other diets? I feel better on gluten free, but still struggle with losing weight and feeling like I am “swollen” all the time. Any insight is appreciated! Thank you very much!

    Reply
    • Hey Melissa,

      What I meant was going gluten free may not be enough to lower inflammation and autoimmunity in EVERYONE. Though it is a great first step, sometimes a more restrictive diet is necessary.

      If you’ve cleaned up your diet, are gluten free, avoiding excess carbs, etc. and haven’t lost weight it means that your weight is due to some other problem. I see plenty of patients who can’t lose weight on AIP, and for them it’s not about the diet (the food they eat) – it’s about balancing hormones.

      Reply
  7. Great article. Wonderful information.

    I have been GF and low carb for about a month now and not feeling any better or losing any weight. My doctors suggested that I try out GF and low carb. My doctor found that I have insulin resistance,low testosterone,low vitamin D,celiac and hashimoto thyroiditis. What other type of changes do you suggested?

    Reply
  8. Finally, information that connects hypothyroidism and digestive problems–THANK YOU! Having followed a wide variety of healthy lifestyle advice for over 30 years and having no success with my thyroid and digestive problems for most of those years–doctors and alternative practitioners did not make the connection Dr. Childs has made–, this article makes so much sense and gives me a clear path through the self-heal/ diet labyrinth. I’m so excited to start feeling better! Quick question: Around the same time I started taking desiccated pig thyroid for hypothyroid, I became severely reactive (like food poisoning) to garlic. Can I expect this to resolve once I have my thyroid and digestion working properly?

    Reply
    • Hey Bev,

      I’m glad you found the information to be helpful. Your intolerance to garlic may improve as your digestion improves but it may also be due to something else entirely, hard to say for sure.

      Reply
  9. So thankful to come across your site. I ate horribly for the first 20 years of my life; all processed and refined foods. When I elimated animal products and gluten completely from my diet, i felt better, I lost twenty pounds without stepping foot in the gym but knew I had damage. I did some research and I came across leaky gut and knew I had this so I supplemented with soil based organisms (Prescript Assist for the first 12 months, Body Biotics for the last ten months or so) plus l-glutamine and digestive enzymes. I also cut out grains for about a year and I’ve been refined sugar free for about 15 months. The issue I’m having now is that even though I eat an EXTREMELY clean diet with less than 5% of my diet being processed in anyway and the rest of my diet being whole plant foods, I also practice intermittent fasting eating only between 1-9pm on top of strength training and doing HIIT 5x per week, I’ve gained 20 pounds in the past year that I can’t seem to get to the bottom of. I also have pyrrole disorder which I’ve been supplementing for the past year. I’m a nutrition student and will go on to grad school to study naturopathic medicine next year, I worked in the supplement section of whole foods the last four years and would love to tackle this naturally without medications. What would be ideal percentages for my macros? Because of my pyrrole, I do best on low protein so I’m sitting at about 10% protein, 50% carbs, 40% fat. Odd, but since giving up refined sugar I tend to eat a lot more fat which looks like is good for Hashimoto’s and hypothyroidism. And as far as supplements, I already take zinc, soil based organisms, turmeric with black pepper, magnesium, green vibrance, digestive enzymes, glutamine, evening primrose oil, apple cider vinegar, B vitamins, iodine among a few others. I’m thinking after reading on your site adding in selenium is a must along with vitamin D. Anything else you would suggest? Should I back off on working out so much/so hard? I also this year implemented prolonged water fasts into my life 2 times a year which I’ve done twice, 5 days at a time. I do this for mostly spiritual reasons but also to allow my body to rest. Reading your site it looks like restricting calories makes the thyroid function worse. Could this play into my weight gain? Thank you kindly in advance!

    Reply
    • Hey Sarah,

      Before you start treatment with anything you need to figure out why you gained the weight to begin with so you can target your treatment towards that issue. To start you should focus on a full set of comprehensive labs including hormones and go from there.

      Reply
  10. So… Is fasting for 5 days on water bad for people with Hashimotos or not? I am really looking for a ‘yes’ or ‘no’ answer but can’t find it in the web. Thanks.

    Reply
  11. Hello Dr. Childs,

    I was wondering if you recommend intermittent fasting for somebody diagnosed with hashimoto? I tried the AIP before which went well for me but I didn’t stick to it after 30 days and gained everything back plus more weight. Now I am looking into a new lifestyle/diet. I want to eat what m body can handle. Today is my 3rd day of intermittent fasting. I am feeling OK. No fatigue or too much hunger. But I was not sure if it is OK not to eat every 3 hours.I workout in the morning and eat right after. 7 hours later I eat again probably around 6pm and don’t eat after that until next day post workout. I cannot eat eggs, rice or wheat ,no potatoes and no dairy.I get very uncomfortable for a few days if I do eat these things.

    Reply
  12. I have Hashimoto’s, type 2 diabetes and osteo arthritis. I have a lot of symptoms of a candida overgrowth too, so I’m not sure where to start with diet change! I’m seeing my endo doc next week, and getting back on cytomel (i’m on 250mcg a day of levothyroxin daily). I also have all the symptoms of adrenal fatigue…

    Reply
    • Hey Sandra,

      It’s best to find someone to help guide you so you can get the best results, where to start really depends on what is causing the main problem.

      Reply
  13. Hi. Thanks for all of the information.
    I have had Hashimoto Thyroiditis for 15 years. I had a specialist who never made any recommendations to me other than medication despite me asking whether stress had any bearing on my condition. When her ultrasound of my Thyroid showed no thyroid function whatsoever she said she could do nothing more so to manage meds through my GP. Up until 4 years ago I was managing my health via 100mg Eutroxsig daily and had even lost weight via a 12 week program, but then life got busy, I wasn’t sleeping enough hours, I didn’t know about Gluten and I was trying to reclaim my mornings by boot camp, and the 5:2 diet. This perfect storm saw me exhausted and foggy brained. I changed Dr and I feel better. I am on compounded DHEA and until last month where I weaned myself off it Progesterone(400MG daily), Zinc, Multi, Probiotics, Liver support, Vit D and magnesium. Over this past year however I have gone from 72 kg (which I was concerned about) to 81.5 and climbing.I am 163cm! I am fit and do some form of exercise daily after really cutting back while I recovered from adrenal fatigue for a year. I like feeling fit and run on treadmill 3 times a week, I have a rower which I use 2x week and have started to try to re incorporate toning and weights dvd which I found success with in the past.
    My family have a horrible heart history and have since my mid 20’s had exercise as a daily feature.
    I feel frustrated that despite eating mostly well I see the scales going up.
    I look forward to any suggestions.
    Thanks for your info thus far.
    Melissa

    Reply
  14. Have you read any of Ray Peat’s research? I finally think I may have figured out my diet from reading this. Thank you. I am going to actually try a blend of a few of them probably. First I need to see a Dr though. I haven’t seen one since I was 16 and I am 26 now.

    Reply
    • Hey Elle,

      I’ve skimmed through some of his information but I have been meaning to go back and read more into it.

      I hope it helps and good luck!

      Reply
  15. Seemingly all the right steps- wrong results. September 2016 routine bloodwork TSH shows 73.2 and TPO at 354IU. I felt fine. I am vegan. Dr. prescribed .5 mcg of Levothyroxine and topical progesterone. That day I cut out gluten, switched to low glycemic fruit, no caffeine (only water and herbal tea) added selenium and e and a pro/prebiotic.
    Went back in November. TSH is now at 4.88 but TPO number has skyrocketed from 354 – to over 900 – Yikes. Any ideas on what I’m doing wrong? Any help would be much appreciated.

    Reply
  16. Hi there,

    Just discovered you through Pinterest. I’m so screwed up I don’t know where to begin. I need a good doc who truly cares. Something that is about impossible to find in Florida. All I hear is how my levels are’within range NORMAL”. Really than why do I feel so awful? Bed bound. Recently diagnosed with Hashimottos and Endo increased my Levothyroxine to 50mcg after 2 yrs of being on 25mcg. I have lost so much of my hair which is TERRIFYING to me! Out of all the horrible that’s happening to me that is the WORST! All this doc wants to do is blame everything on my advanced Fibro (diagnosed in 1986 at UofM) Chronic Fatigue Syndrome and sleeping (when I do) for only 1-3 hours a night for many, many years. I’ve lost count. Brain fog? I have redifined that term. I used to be so constipated, got up to 21 days. Tried EVERYTHING. Nothing worked. All I got told was to eat more veggies. My husband was so scared for me and started going to my appointments telling the doctor exactly what I ate. If I ate any more veggies I would have been a rabbit. That’s what I told the doctors! I was almost a vegan at that time. Now I go both ways. I cut out my Carafate for my peptic and that helped me. I resigned myself that I will probably either have diahhrea or be constipated. Here’s what is going on w/ me: Ridiculous pain I am under a pain management doc, he doesn’t have a handle on it yet, 7 bulging deteriorated discs, Ankilosing Spondylitis thru my spine, Planter Fascitis in both feet, endless migraines that last days/weeks at a time, blurry vision that changes (6-8 times in the am I had really bad bloodshot eyes), Mengioma of the Tentorium again, I was treated with Radiosurgery back in 2000. I have been a tumor factory since I was young. At 21 I had just under 11lbs of tumors, resulted in surgeon taking all but 1/4 of an ovary. 16 months later another operation, a tumor on the 1/4 ovary, scar tissue and lots of adhesions, 14 months later back in again for my final female operation. I had 2 tumors on top of each other on the 1/4 ovary, bowel had attached itself to my uterus, uterus was badly inflamed and “full of cysts” surgeon took what was left. For the next 13 yrs I was on 3 different hormones, depending on the day of the month determined which I took. I thought I was always going to feel the misery because I was do young when I ended up with a complete hysterectomy. Wasn’t until we moved and I got lucky and got a female gyro who became unglued when she saw the crazy hormone combo and put me on my Premarin 1.25 EVERYDAY of the weeek and within 30 days I began to feel NORMAL again. It was truly unbelieveable!! So I bring that part of my health history up because I can’t get an answer from this current Endo IF that and having 16 rounds of Radiation has anything to do with why I’m feeling so horrible. From all of my own reading, it seems like I may be suffering with Adrenal failure failure as well. What do you think???? I am NOT functioning like I once was with the CFS. He wants to blame all of it on me having CFS and Fibro for so many years. THAT IS A COPOUT to me!! I know my body! I’ve lived in it for 54 years. I’ve been under some intense non stop serious unrelenting stress for the past 13 years alone since my husband died. Actually add another 18 months onto that from the time he got sick and died because he didn’t get his new heart in time. I was his caregiver. He spent 9 0f those months in 5 different hospitals around our state. I never left his side. So it’s no surprise to me with all that’s happened (losing E/th because of health ins/meds before Pres O got me the ACA) my body in EVERY way has paid such a huge price for the unmeasureable stress. I don’t have any fight left in me. I’m at a loss because I don’t have the money to get the medical help I desperately need. I don’t know where to hold from here. Do you have any suggestions? I’m at such a loss. If we’re lucky enough to land a great, caring, compassionate doctor who is dedicated to helping us get the answers to feel better than we get the positive results we’re desperately wanting. Right now to feel as worn out and exhausted as I always did with having CFS/Fibro— that would be so much better than how I feel now. My memory is suffering so bad as well. Total darkness in my head trying to remember the simplest of things! It’s extremely embarrassing. It really concerns me now because it’s so out of control. I’m so sorry this turned out to be a book. I didn’t mean for that. I didn’t even list the arthritis issues. And I think forgot some things. There is way too much going on in my body! I CANT cope anymore! I still have to survive. Trying desperately to switch my line of work from CNA to Medical Biller because of the pain. I don’t know how much longer I can go on like this. And if rump takes my insurance from me, we’ll he will be responsible for what happens next. Wish someone had a wand and could help me feel NORMAL. Thank you so much for your help, Janice

    Reply
    • Hey Janice,

      The single best thing you can do is seek out a local provider to help you further. As you suggested, without the addition of physician support it’s not likely that you will get significant improvement. If you haven’t already you can try to manage what is in your control to manage (diet, stress, sleep, exercise), but if you’ve done what you can there and you aren’t seeing improvement then you will likely need hormonal/medication support.

      Reply
  17. Hi Doctor, Unfortunately I fall into all of the diet categories and I’ve done most of them. Which diet do you recommend? I also tried Juicing diet & Ketogenic diet & did not do well. Please help. ThankYou! Berta

    Reply
    • Hey Berta,

      For some patients changing their diet won’t be enough by itself, in order to figure this out you will need a complete hormone + functional analysis by someone knowledgable.

      Reply
  18. Hi Dr.Childs,

    I suffered from hypothyroid since I was 12. My doctor never told me about any diets and now after 30 years researching this on my own I came across your site. Thankyou for all this info. I just wanted to ask which diet is best for me since I also have PCOS. Can I still have gluten free corn flour and honey?

    Kush

    Reply
    • Hey Kush,

      I would focus on a diet which is low in refined carbohydrates first to help treat insulin resistance.

      Reply
  19. I have tried AIP, keto, very low calories 500 a day, paleo, FODMAPS, and weight watchers. Weight watchers is the only one that previously worked. All others I lost at most 15lbs of the 35 lbs that I gained – and then I gained it right back. I am currently 35 lbs heavier than I was before my diagnosis with hoshimotos

    Reply
  20. Thank you for your blog!!! I lost 25 lbs going gluten free. Gained it back……now I simply cannot lose it. I feel helpless. I have always been in shape and maintained a normal weight. I am on 2 thyroid meds and tons of supplements. Won’t touch an egg to save my life. Now in your article, I see peanuts, tomatoes, shellfish….I will begin to remove from my diet……I will update you…..Aside from wiring my mouth shut……eeeeekkkkkk

    Reply
  21. Hello Dr. Childs. Four weeks ago I had two parathyroid glands removed. I had been irradiated after birth for a skull tumor. I’m 70 years old and have suffered for the last 4-5 years from GERD, kidney stones as well as kidney stone surgery, osteoporosis, essential tremor and depression. I look forward to the success of the surgery with regard to these issues. During the last 4-5 years and definitely since the surgery I have been gaining weight despite efforts to watch my diet and exercise. Does your advise apply to the parathyroids as well as the thyroid? I had a biopsy of one of my tumors on my thyroid and it proved benign and not necessary for removal. Thank you for your advice.

    Reply
  22. I was recently diagnosed with eurothyroid hashimotos and am just starting my gluten free journey, so this was all very helpful! I’m curious, why are oats on the “run” list for a gluten free diet?

    Reply
  23. Dr. Childs: In your article about Reverse T3, you mentioned that high Reverse T3 can cause serious problems for the body. Could you please be more specific as to exactly the type of serious problems this causes over time if left high?

    Also I am in a Catch 22 situation. My ex-Dr. told me that I burn only 1300 kcals daily and if I wanted to lose on Weight Watchers, I would need to reduce my points from their 30 points daily to 20 points daily. All was working well, I lost 25 lbs from Jan 2017 to April 2017….but my reverse T3 is sky high…mine is 33.2 (ranges is 9.2–24.1). My Hashimoto titers are sky high as well (TPO Ab 77 (range is 0-34) Thyroglobulin Antibody is 1.9 (range 0.0-0.09).
    My Free T3 is 3.21 (range is 2.72-4.19). My cortisol was done separately and my nurse practitioner told me it was normal (do not have a copy yet). My sex hormones are also in normal range…
    So the diet is more likely my cause…it is 20 points with emphasis on protein and veggies and limited carbs.

    I began gaining weight this past week ….even on 18 points….no sugar except that of strawberries….

    In order to reduce my reverse T3, my NP and I decided to go from 4 grains on Naturethroid to 2 grains and 2 capsules to 3 of T3 daily. (I do take selenium on my own)….

    My question is: Is if feasible to even be able to continue with 20 points and keep my reverse T3 in check and lose weight without the reverse T3 climbing up again? Or do I take T3 and the 2 grains and see a gain.
    Reducing my Naturethroid will cause me to gain weight and lowering my points to lose weight on WW will cause my reverse T3 to go up.

    What, if anything, are any answers for me. I do have Hashimoto’s, Grave’s and Epstein-Barr virus.

    Thank you in advance.

    Gloria Hawkins

    Reply
    • Hi Gloria,

      The more you calorie restrict (less than 1,200 calories per day) the worse your metabolism will get. This will continue to happen until you reach a point where you will be eating 700-800 calories per day just to maintain your weight. Calorie restriction is not a long term solution to weight loss and will always cause damage long term. I’ve gone over how to treat this in detail on other posts on this blog.

      Reply
  24. I’ve suffered with Hashimotos Thyroiditis for over 6 years, I gained 10 pounds per year no matter what diet or exercise I used, and I finally made a decision at the start of this year to go gluten free. I was able to reduce my thyroid antibodies (thyroid attackers) from well over 100 down to 22 in just 2-1/2 months from going JUST gluten free! It works! In early March, I started working with a functional doctor to do blood work, trigger testing, and went on a more paleo diet. We added more diet restrictions…no dairy, no sugar, no grains/oats, no alcohol, and no nuts/seeds. I also have to refrain from any vegetables and fruits that I have a moderate or extreme sensitivity and just under 8 weeks into this, I’ve lost 13 pounds without any exercise. I’ve started looking at my food as more medicine than enjoyable and delicious fuel. 🙂 Detox and hormone balancing will occur in the next 8 weeks but I already feel more normal than I have in the last decade! Good luck with your own journey!

    Reply
  25. I have Hashimoto’s and Hypothyroidism. What brought me to an Endocrinologist were thyroid anti-bodies discovered from testing by a dermatologist that was treating my vitiligo. I’ve been on Armour for the last 9 years and I feel fine, it seems to me my only issues was controlling my weight which I have been able to do with a high protein/low carb diet, but it seems I have to stay on that type of eating for the rest of my life. I guess because of the vitiligo I would not believe I had a thyroid issue because I don’t feel fatigue or brain fog, or depressed or any of the other complains I read that some many suffer from but yet I know there’s an imbalance because I have vitiligo and that’s what I want to get to the source of and of course no one seems to have real answers for but the thyroid and leaky gut seems to be at the source of where this issues stems from and that’s really why I’m here hoping that one of your diets can help…

    Reply
  26. Hello! I was wondering if fasting is really right for everyone. I have adrenal dysfunction, estrogen dominance, and Hashimotos. I read conflicting information all the time about whether fasting is really ok for people with these issues, particularly with restoring the adrenals and the need to eat breakfast (when I tried IF, I would wait to eat until lunch).
    In the past, I’ve had restrictive eating habits and over-exercise, so my BMR is already reduced to around 1450.
    Thank you!

    Reply
  27. Hello,
    Thank you so much for this post! It was really helpful! Quick question, you mention a book and a 4 week program but the amazon link does not work. Could you tell me the name of the book please? I am a bit overwhelmed and would be nice to have an outline!

    “While deciding what diet you ultimately need may take a combination of time and trial and error, it is critical that you get started right away.

    Don’t be afraid to make some mistakes along the way – it happens for every patient.

    What is important is that you just get started.

    With that in mind I am recommending this book as a solid starting place.”

    Thanks for your help!
    Kristin

    Reply
  28. Hi there,

    Thank you for all of this information! 2018 is my year to figure out this body of mine and heal and feel like myself again!
    In December I read about the diets and choose to start eating Paleo since I have hashimotos. All of my levels are in a good range and I am taking levoxyl and liothyrine for 3 yrs now. I am 37 years old and have a very hard time losing weight. It doesn’t matter what I try, or how much I workout. I have a lot of inflammation in my body and I have not felt well for a long time even though my thyroid numbers are good. Since starting paleo 2 weeks ago, I feel way worse than I did. My gut is a mess. I am horribly boated, belly aches, and gasy. I should mention that I had already been eating a gluten free diet for 2 years before that since my daughter has celiacs. Should I give it a few more weeks? Or should I do paleo and low-fodmaps or switch to low fodmaps diet only? I did struggle with candidiasis a year ago. Itching in between my fingers. I found a wellness doctor in my area that I am going to see next week that has an infrared sauna that I am going to use and also do a 10 day metagenix cleanse. Any insight and thoughts would be so helpful. Thank you! Jessica

    Reply
  29. Greetings Doctor,

    I am curious what do you suggest for vegans? Everything is high protein low carb. I have hypothyroidism,(diagnosed 1-2 years ago) 50 yrs old and have put on weight. I am trying to eliminate processed foods and remain whole foods plant based to see if that helps. I am on 112 mcg of Levothyroxine. My doctor won’t prescribe the T3 meds Cytomel because it is really expensive and I have no insurance. Too damn tired to exercise in the morning anymore like I’ve done most of my life. However, I do walk and hike. It is all just so frustrating sometimes.
    Thanks.

    Reply
  30. I have Hashimoto’s and an underactive thyroid…I can’t figure out which diet to try, I tried working out for 6 days a week 2 hrs at a time and I couldn’t really lose the weight.

    Reply
  31. Thanks, Dr. Childs. I’ve learned so much about what to look into with my Hashimoto’s. I love how you outlined that you can’t just focus on diet alone or stress alone etc. One needs to become healthier multi-systemically. Many of your responders are women and I just wanted to add to any of those who may be in this category that toxic/foreign objects in the body are severe endocrine disruptors and can lead to dysfunctional thyroid. These include breast implants, IUD’s, silicone mesh devices, etc… I had breast implants for 6 years and I believe they wrecked my immune system and thyroid. For women wanting more information please visit: healingbreastimplantillness.com
    For many people, it can be mold or heavy metal toxicity. Eliminating toxicity in our bodies and immediate surroundings is equally important as focusing on diet changes.

    Reply
  32. I have spent over 10 years trying to manage my thyroid condition (Hashimotos) for over 10 years using diet and supplements and its still not under control. Mostly because I can’t afford all the supplements I need to make proper headway. Unfortunately It’s gotten to the point where there are no safe foods, it seems like I react to everything. I started taking LDN a few months ago. At first, it seemed to be helping, but lately not so much as my TPO has gone up again. I’m interested in your thoughts regarding the GAPS diet. I also have Asperger’s syndrome, so I’m thinking it should help. Only I’ve tried to do the intro and crashed badly… not getting enough carbs. Had to stop and add in more carbs but that triggered a binge spree, which had aggregated things. Any advice would be very welcome. I am limited financially so whatever would help most will be my focus.

    Reply
  33. Thank you for this article. I am pescetarian and dairy free. I have coeliac and hashimoto’s. I am allergic to peanuts and chocolate. I feel like there is nothing left for me to eat. Oestrogen excess has just triggered a major bout of fatigue and weight gain with hashimoto symptoms.

    Reply
    • Hi Amanda,

      You may benefit from individual advice from a nutritionist and/or it may be a good idea to get a food sensitivity test.

      Reply
  34. Westin,

    Your article was excellent.I really enjoyed your abundant knowledge. I would definitely go to you if lived close but I live in Amarillo.

    I was diagnosed with adrenal fatigue, hashimoto’s, depression and leaky gut. I have a question concerning can you have inflammation in your arteries, and muscles.

    Also I find that people with Hashimoto’s definitely have sleep problems especially with insomnia. How do you deal with sleep problems with your patients. Thank you.

    Reply
    • Hi Guy,

      Yes, you can have low-grade inflammation in the arterial wall. There is a test which can identify this from the Cleveland heart lab but I can’t think of the name right now.

      Reply
  35. This was very helpful. I am diagnosed with Hashimoto’s last 5 years, Ankylosing Spondylitis, Endometriosis and PCOS at one point. I exercise regularly (HIIT) and eat a Keto diet for the great majority of time. I currently am on Synthroid, T3, LDN and despite eating a calorie restricted diet just can’t seem to lose weight. I have been strict Keto for 14 weeks and lost a nominal amount of weight. I am going to request the Insulin Resistance, Leptin Resistance blood work to see if that may be a contributor. My question is after being Keto will this blood work show a true picture of my insulin and leptin levels? I am tired of being fatigued, in pain, random rashes, memory loss and restricting calories and feeling like instead of getting better, I get a new diagnosis. Would appreciate some guidance as I’ve exhausted what I believe my options to be. I’m even doing ozone therapy and IV therapy. Many Thanks

    Reply
    • Hi Melinda,

      If you are doing the keto diet your leptin/insulin will reflect that on your labs but they are still considered “true”.

      Reply
  36. Thank you so much for this blog.
    My I ask your advice? I was recently diagnosed with Hashimoto’s and lymes disease. I also was prediabetic. Side note: I have been gluten free for years
    My doctor told me to go on keto. I have done this for almost 7 months now and have not seen to much improvement. What diet would you recommend? My antibody numbers are still out of sorts as well. Thank you so much!

    Reply
    • Hi Kortney,

      Your diet will need to be tailored to your body and hormones which means that there really isn’t a specific diet that you need. The best way to figure out what will work best is working with a health coach or a knowledgeable physician to help guide you.

      Reply
    • Hi Karen,

      Sorry about that! The link should be updated and fixed now 🙂 It’s called the Hashimoto’s 4-week plan.

      Reply
  37. What would you recommend for vegans? I am vegan for ethical reasons so meat and bone broth are out of the question for me. I have been gluten-free for several years.

    Reply
  38. A great article and video, thank you. How do you feel abut Whole30? I and on day 2 of my 2nd round and feel as though I have had a flare up. Possibly from going off sugar and the carbs. If it causes a flare-up could I not have enough carbs in my diet?

    Thank you!

    Reply
    • Hi Mary,

      I think whole30 is generally a fairly good diet, I don’t have anything against it. It’s plausible that the change in diet could cause those symptoms but I would put my money on some other cause.

      Reply
  39. I’ve been diagnosed with Hashimoto’s recently. I’ve started a paleo diet, somewhat AIP (so restrictive). My problem is eating high fat. I had my gallbladder removed awhile ago, likely due to so many health issues like this, that went undiagnosed. In any case, what do you suggest for people like me, to eat fat and it get digested properly? I’ve taken digestive enzymes and sometimes ones with ox bile but the bile ones don’t seem to do well for me. Any advice would be hugely appreciated.

    Reply
    • Hi Julianna,

      Most people become more accustomed to the high fat intake over time. Your best bet is to give it time, slowly increase fat consumption, and take enzymes.

      Reply
  40. Hi. My husband has hypothyroidism and has been gaining weight steadily. Up nearly 30# in a couple years. Recently he began to really cut down on portions, is eating a lot of salads and nuts. However, he gained 5#! He rides a stationary bike and does a 30-minute workout daily. He is starving most days and still gaining. I follow the whole 30 and lost 20#, but I don’t have thyroid issues. He is very frustrated and I just don’t know how to help him. His doctor just increases Synthroid dose and doesn’t address a diet. After reading your article I am confused and don’t know which is best for him.

    Reply
  41. Hi,
    I have been reading your site with great interest. My 12 year old daughter was diagnosed with Hashimotos 3 years ago :((( and it’s been a steep learning curve having discovered that endocrinologists are largely unable/uninterested to help.

    She was a fit and healthy child at diagnosis (found Hashimotos when a dr spotted her swollen thyroid – TSH initally 7, TGAB 932, TPA 320). No symptoms other than anxiety and problems getting to sleep. They started her on 50mcg Levothyroxine – no notable improvements made to her symptoms but reduced TSh to 2, antibodies remain high.

    We have been gluten free since diagnosis ( tested negative for celiac – would love to put her back on gluten as it has not reduced antibodies but do not want to risk other symptoms.) Would you recommend we try ? The strict diet negatively affects her life.

    Symptoms are still anxiety, trouble sleeping and now brain fog – she seems to experience problems in regulating her blood sugar and can swing from high to low – with flushed cheeks.

    Any advice you can give would be fantastic as we feel lost and unsure of what to do next. Are they Lab reference ranges for children? We are UK based.

    Thank for any advice you can offer – Nikki xx

    Reply
  42. Thanks so much for all your informative articles! Like most people with Hashimoto’s I also struggle with weight loss. I live in Canada so getting Naltrexone prescribed is pretty much an impossibility. Also the price of the supplements online with the exchange rate is out of reach for me as I am a retired senior with a fixed income. Have tried most of the diet suggestions with little positive results and still have the gastro problems. My doctor is not very knowledgeable about this but I have a pharmacist who is very helpful. Can you recommend any health food supplements that are readily available to help with weight loss?

    Reply
  43. Hello, I have been diagnosed with left ear Ménière’s disease, migraines ( without headaches ), I just had surgery at Columbia university ( endolympatic decompration sac ) . I am currently following Ménière’s disease diet ( which is similar to migraines diet) but Lots of ppl and doctors telling me to follow migraine diet because migraines triggers Ménière’s disease as well, so I have to stop eating food that contain tyramine, etc .. although is very complicated…
    anybody can help or suggest a link that can help and guide me please – thank you !

    Reply
  44. Hello everyone
    I also have Hashimoto’s, metabolic syndrome, T2 Diabetes, high blood pressure, and insulin resistance, non-alcoholic fatty liver disease, gallbladder stones, and osteoporosis, diagnosed over a 5 year period. All the doctor did was write prescriptions.
    All the meds I was on kept me from being able to lose weight and made me feel even worse, besides not helping with anything. The final straw: adding Janumet to Jardiance last year. I got so sick I couldn’t stay more than 10 minutes away from a bathroom, everything I ate went through me or came right back up. Four days of that and I was also dehydrated. This occurred over the Christmas holidays; impossible to contact my doctor.
    Well, that was 4 days without meds as well, as nothing would stay down.
    I drank water and searched the Internet for info on the meds, which finally led me to YouTube and 4 doctors with insightful videos on my health problems, which I went after one at a time: first the liver with apple cider vinegar with water before meals, and milk thistle. I alternate with lemon water just for a change of taste. Then I found a desiccated thyroid replacement on Amazon, which really helped.
    Next, I eliminated all sugars and grains: no bread, rice, pasta, pizza and alas, no donut holes. I didn’t return to taking the prescriptions because I also lost about 18 pounds over 2 weeks, even though that wasn’t my goal.
    Then I found out about keto and my outlook on life changed from despair to hope. I have been eating high-fat, low-carb along with intermittent fasting for almost 3 months now and am considering going completely carnivore for the next 3 to see if the T2D will resolve. My most recent A1C went from 7.5 to 6.4 which is a huge improvement already.
    I am adding nutritional yeast, and ground flaxseed for fiber to every second day’s meal and it seems to help. I credit my success so far to Dr. Ken D. Berry’s videos, Dr. Jason Fung’s videos, Dr. Eric Berg’s videos and also Dr. Sten Ekberg’s most excellent explanations on what works and why. I am very optimistic about becoming healthy and reversing insulin resistance with the help of enlightened doctors and their helpful videos on YouTube.
    To anyone still looking for answers: just start with a tablespoonful of unfiltered, organic apple cider vinegar in a small glass of water before you eat anything, it will help. Then try other things, as is suggested here on this site. It won’t be long till you find what works for you. You don’t have to make all the changes at once, and you are not alone.

    Reply
  45. Thank you for taking the time to makes these posts! I’m newly diagnosed hashimotos and have been gluten free for about two months and have seen a great decrease in antibodies… what I can’t figure out (thyroid specialist I’m seeing is minimal help with anything other then telling me my lad results) how do I determine how long I go gluten free? Is this life long on and off GF due to flare ups?

    Reply
  46. Dr Childs,
    The link on the Elimination Diet is going to the wrong website. Can you update this to link it correctly please? Thank you and for all your wealth of information on this!
    Shawna

    Reply
    • Hi Norbert,

      If the goitrogens remain in cabbage juice during the processing then, yes, it’s possible that that could happen.

      Reply
  47. Thank you for your articles. I do love reading them but I must say, I am confused about the 6 diets that may work and the 3 that wont for Hashimoto’s patients. There is a LOT of wonderful information, but I have to ask, what about people who are one of the few that do not have any Antibodies. I found out, via a thyroid ultrasound, that I am probably in late stages Hashimotos. I was told that one side/lobe was dead (it was black) and the other side/lobe was grey. Both sides had only one small nodule each, but no goiters. The entire thyroid looks like a dark gravel road, not smooth as it should. As I mentioned, I was tested for all of the different antibodies and all them came back as non-reactive. I have been on a Paleo / Gluten Free Diet for 11 months and I still do not feel better. Several months ago, I started the AIP diet, still not feeling great. 5 months ago I was tested for low minerals, vitamins, etc., and discovered I was low in a few. I have been taking high quality supplements for all of these areas and the only thing that has happened is that I have sudden anxiety that I have never had before, have extreme bouts of emotion and depression, have a sensation that something is constantly stuck in my throat… Do you have any thoughts? or advice on the type of diet that works for seronegative antibody patients. Oh I have read everything I can get my hands on, listened to podcasts, read Internet articles, etc… I appreciate your time.

    Reply
    • Hi Shannon,

      I’m not able to provide personal recommendations regarding which diet you should be using but I can tell you that the diets listed here are still relevant for those in your situation. While you are technically seronegative at this point in time it’s more accurate to say that you are in end-stage Hashimoto’s. This distinction is important because those people with seronegative Hashimoto’s tend to have a much easier time managing their disease whereas those in end-stage Hashimoto’s will have a much more difficult time due to the permanent thyroid damage that is present. Having said all of that, the diet information still applies in your situation it’s just unlikely that it will be curative or restorative to thyroid function whereas this may be true in someone with earlier stage disease. Hope this clarifies!

      Reply
  48. I believe that diet #5 low FODMAP would be better for me as I suffer from yeast overgrowth and severe gut issues! I just recently found out that I was lactose intolerant and I have cut out all lactose but I do still eat Cooper cheese daily ( just 1-2 slices). I started having yeast overgrowth about 8 months ago and I’ve taken the only antibiotic that’s supposed to work for it on three occasions and none of them have cleared it up. I’m taking a womens health probiotic that supports vaginal and gut health and it seems to be helping with the yeast overgrowth but it’s causing diarrhea on a daily basis. Oh and I’m 53, post menopause and was diagnosed with Hashimoto’s at 19. Unfortunately over the years my pcp just put me on levothyroxine and rarely adjusted my dose. Now I’m seeing an endocrinologist and I did some of my own research and decided that Tirosint would be better than levothyroxine. What are your thoughts about my issues?

    Reply

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