Hashimoto’s disease diet – what to eat and what to avoid?

What is Hashimoto’s disease and what are its symptoms? How important is a well-balanced menu? What is worth including in the diet in this disease entity, and which products should be limited? In today’s article you will find all the most important information!

Hashimoto’s disease is one of the most common thyroid inflammations. It affects both men and women, but eight and a half times more often it is diagnosed in the female sex. People in their fourth and fifth decade of life are most at risk. The immune system starts to act against the thyroid tissues. This is manifested by the accumulation of autoreactive lymphocytes infiltrating the thyroid tissue, which triggers the appearance of an antibody against the body’s antigens. In simple terms, the immune system begins to treat the thyroid cells as foreign and begins to fight them off.

The consequence is a dysfunction of the gland, and with it, the secretion of thyroid hormones. In the initial phase, due to the increased release of hormones from tissues damaged by lymphocytes, hyperthyroidism is observed. However, in most cases, Hashimoto’s disease leads to the production of too few thyroid hormones, thus developing hypothyroidism.

Symptoms of Hashimoto’s disease

Unfortunately, most of the symptoms of Hashimoto’s go unnoticed for years, and a correct diagnosis of the disease is often made by chance or by another test. If you are experiencing concerns such as:

• Constant fatigue, even with little activity
• facial swelling, puffiness,
• gaining weight, even with a proper diet,
• muscle pain and stiffness of joints,
• difficulty breathing,
• deterioration of mental well-being,
• greater intolerance to cold,
• nail brittleness,
• dryness of the skin,
• hair loss,

is definitely a sign that you need to see a doctor. Remember, however, that a diagnosis of Hashimoto’s disease does not mean radical action as when cancer is detected. Hashimoto’s is not a verdict, but treatment will require some changes in both your lifestyle and nutrition. What should you bear in mind during treatment?

Dietary recommendations

The main task of the diet in Hashimoto’s is to provide adequate amounts of nutrients, minerals and vitamins to the body. It is also crucial to follow the rules of healthy eating, such as: eating regular meals, proper hydration and physical activity, as well as eliminating highly processed dishes, fast-food and sweets. Studies show that with this disease entity, more attention should be paid to supply:

Zinc
Alleviating the symptoms of Hashimoto’s is similarly influenced by balancing the level of zinc. Its sources are: pumpkin seeds, wheat germ, buckwheat groats, meat, eggs, rennet cheeses.

Omega-3 fatty acids
Hashimoto’s disease is an inflammatory disorder, therefore the use of an anti-inflammatory diet is extremely important. Omega-3 fatty acids have such an effect and can be found in products such as Atlantic salmon, European anchovies, sardines, herring, mackerel and trout.

Antioxidants
Products containing flavonoids, e.g. berries, citrus fruits or allin-containing garlic and onions, have a similar effect to omega-3 fatty acids. Products rich in antioxidants are dried herbs, e.g. basil, oregano, rosemary or spices: cinnamon, ginger, cloves. Due to their antioxidant properties, vitamins are also helpful: A,C,E.  Vitamin C is found in significant amounts in parsley, but a good source of it are: peppers, tomatoes, currants, strawberries. In turn, good sources of vitamin E are oils, e.g. sunflower, rapeseed, almonds or nuts: hazelnuts, walnuts.

Vitamin D
Strengthens the innate immune response. Studies show that its deficiency is often observed in Hashimoto’s sufferers. Supplementation of the deficiency results in improved parameters. Vitamin D from food is supplied to the body only to a small extent. Most of it comes from skin synthesis. It is worth noting that creams with UV filters block the production of vitamin D in the body. Reduced production is also noted in people with a significant body fat content. Current recommendations indicate that supplementation is necessary even in healthy individuals.

Iodine
It is necessary for the production of thyroid hormones. Sources include seafood, cod, halibut, salmon, mackerel, as well as eggs, dairy products and iodised salt. However, care must be taken not to exceed the reference values, as excess iodine can lead to an exacerbation of the immune response in Hashimoto’s.

Selenium
Studies show that supplementing with selenium has a beneficial effect on the absorption of medication taken for hypothyroidism. Selenium is found in products such as Brazil nuts, tuna, halibut, brown rice, eggs and fortified products.

Iron
Its deficiency reduces the activity of hormone production. Good sources are pork liver, meat – especially beef and veal, fish such as sardines, and egg yolk. The absorption of iron from animal products is much higher than from vegetable products.

Goitrogenic substances
With Hashimoto’s disease, it is important to pay attention to products containing goitrogens (goitrogenic substances). These impede the production of hormones, leading to an increase in antibodies. They are found in cruciferous plants, i.e. savoy cabbage, kale, cauliflower, broccoli, spinach, kohlrabi or turnip greens, or brassicas: e.g. Brussels sprouts. This does not mean to exclude them from the diet, but only to reduce their portions, frequency of consumption and to introduce appropriate processing. They should not be eaten raw, cooking min. 20 min. (without the lid) reduces goitrogen activity by 30%, as well as during grinding and freezing.

Soy and soy products
As studies show – they impair the absorption of levothyroxine which results in the need to increase the dose of the drug in people with Hashimoto’s hypothyroidism. In addition, soy isoflavones impair the production of thyroid hormones in the presence of iodine deficiency. Therefore, consumption of products such as soy milk, tempeh, tofu should be limited.

Gluten and lactose
It is a misconception that gluten and lactose should be eliminated in Hashimoto’s diet therapy. According to scientific research, there is no indication for a gluten-free diet in Hashimoto’s. The only indication for a gluten-free diet is celiac disease. The fact is that celiac disease and Hashimoto’s very often occur simultaneously, and then in fact the use of gluten-free diet (in people with celiac disease and Hashimoto’s at the same time) improves Hashimoto’s parameters.  This has the effect of reducing the dose of medication in such people. The same is true for a diet that excludes lactose products, where a lactose-free diet is also not recommended in people with Hashimoto’s, if there is no lactose intolerance coexisting.

If you want to take a look at your diet and monitor the consumption of nutrients listed in the article, use the Fitatu application. More information about Fitatu can be found at: https://www.fitatu.com

Bibliography:
1. Luty J., Bryl E., Hashimoto’s disease – genetic and environmental aspects, Department of Pathology and Experimental Rheumatology, 2017, 1-6.
2. Teng W., Shan Z., Teng X. et al. Effect of Iodine intake on thyroid diseases in China, New ENgl. J. Med. 2006, 354, 2783-2793.
3 Zakrzewska E, Zegan M, Michota-Katulska E., Dietary recommendations in hypothyroidism with Hashimoto’s disease comorbidity, Bromat Chem Toxicol 2015, XLVIII, 2, 117-127.
4 Fruzza AG, Demeterco-Berggren C., Jones KL Unawareness of the effects of soy intake on the management of congenital hypothyroidism. Pediatr, 2012, 130, 3, 699-702.
5. Bakr HG., Meawed TE., Relevance of 25 (OH) Vitamin D deficiency on Hashimoto’s Thyroiditis, Egypt J Immunol., 2017, 2, 53-626
. Kus K., Zielińska K., Hashimoto’s disease – effectiveness of gluten-free diet, Polish Review of Health Sciences 2016, 49, 370-376.
7. Bossowski A., Otto-Buczkowska E. Thyroid diseases with autoimmune background, Endocrine System, 2011, 2, 1-13.
8. Liontiris Ml., Mazokopakis EE. A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients.Points that need more investigation, Hell J Nucl Med., 2017, 20, 1, 51-56.