Diet and Hashimoto’s Thyroiditis 101

One of my favorite movie lines of all time is when Forrest Gump says to his beloved Jenny “we go together like peas and carrots”, meaning you can’t have one without the other.  That’s how I view autoimmune disease (AI) and food sensitivities . . . they just seem to go together.

One of the most common autoimmune diseases is a form of hypothyroidism called Hashimoto’s Thyroiditis.  Like many AI diseases, affected individuals go undiagnosed for a long period of time, struggling with a plethora of symptoms that seem unrelated.  Because unwanted weight gain and depression are associated with Hashimoto’s, it is not uncommon for me to refer clients for diagnosis and treatment of a possible thyroid disorder.

The thyroid gland is a 2-inch butterfly-shaped gland located at the front of the neck. Though the thyroid is small, it has no small job and affects many organs in the body. It produces thyroid hormones that regulate metabolism (hence the weight gain when it is under-functioning), body temperature (feeling cold is a common symptom), cholesterol levels and the heart, menstrual cycles (problems with heavy periods are not uncommon) and more.  Other symptoms of a flagging thyroid are constipation, fatigue, depression and thinning hair (including eye brows).  Hashimoto’s affects about 5% of the population, mostly middle aged women  . . . . as if we didn’t have enough to deal with already.  It’s no wonder that with this constellation of symptoms people wander into the dietitian’s office frustrated and ready to make diet changes.

Like with all AI disease, the body mistakenly senses an invader and launches an attack, destroying the thyroid so it can’t release the appropriate amount of hormones to keep things running smoothly.  Treatment of hypothyroid includes taking synthetic thyroid hormones, such as Levothyroid or Synthroid.  While there is better living through chemistry, taking a pill is not a panacea and one still has to address diet concerns.

The big bugaboo with Hashimoto’s is unexplained weight gain.  Since Hashimoto’s often occurs around the time of menopause, it compounds issue of weight gain for women because menopause itself is associated with weight gain.  The number one priority is to get the disease under good management, then you can address the weight issues. The diet for weight reduction needs to be calorie and carbohydrate controlled.  The focus should be on lean meats, vegetables, fruits, high fiber foods, heart healthy fats and omega 3s.  This type of diet will also help with rising cholesterol levels and the constipation that often accompanies a thyroid that is pooping out.  Exercise is another one of those “peas and carrots” sort of things when it comes to weight reduction.  And as an added bonus it a natural antidepressant.

Several nutrients can be out of whack with Hashimoto’s.  Iodine, a trace mineral necessary for the production of thyroid hormones, can be obtained easily from iodized salt, but do not take excess iodine supplements as this can, ironically enough, also trigger hypothyroidism symptoms.  Hashimoto’s has been linked to vitamin D deficiency in at least one study.  If you have Hashimoto’s, or any AI disease for that matter, have your vitamin D level checked to see if supplemental D3 may be necessary.  The highest concentration of selenium is found in the thyroid gland, and it has been shown to be a necessary component of enzymes integral to thyroid function.  Have your selenium level tested to ensure normal levels. Approximately 30% of people with autoimmune thyroid disease have a B12 deficiency.  Severe B12 deficiency can be irreversible, so have your levels checked.

Certain foods may also play a role in Hashimoto’s.  Studies have shown that there is an association with celiac disease, another AI disease, and Hashimoto’s, so removing gluten from the diet may also be necessary.  Those with non-celiac gluten sensitivity also often report improvement in symptoms when they eliminate gluten, so a trial of a gluten free diet may be beneficial to see if symptoms can improve.  Cruciferous vegetables such as broccoli, cauliflower and cabbage naturally release a compound called goitrin, which can interfere with the synthesis of thyroid hormones. However, this is usually a concern only when coupled with an iodine deficiency.

Heating cruciferous vegetables removes much or all of this potential goitrogenic effect.  Soy is another potential goitrogen. The isoflavones in soy can lower thyroid hormone synthesis, but it doesn’t appear that consuming soy causes hypothyroidism in people with adequate iodine stores. If you eat soy, do so in moderation.  Millet, a gluten-free grain, may suppress thyroid function, so if you like eating millet, it is best to choose another grain source.

When it comes to thyroid medications, it’s important to understand that some medications can interact with common nutritional supplements. Calcium supplements have the potential to interfere with proper absorption of thyroid medications, so you must consider the timing when taking both. Studies recommend spacing calcium supplements and thyroid medications by at least four hours.  Coffee and fiber supplements lower the absorption of thyroid medication, so you should take them one hour apart.

So whether or not you agree that peas and carrots go together, it’s hard to dispute that diet and Hashimoto’s do.

Mary Beth George, MEd, RD/LD, LPC

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