Hashimoto’s thyroiditis is often misunderstood as solely a thyroid problem, but it’s actually a whole-body issue that signals a systemic battle. In the video above, Efrat LaMandre, a family nurse practitioner with a Ph.D. in Integrative Medicine, emphasizes that focusing only on your thyroid when treating Hashimoto’s means you’re looking in the wrong place.1
Your thyroid, like a thermostat, regulates your body’s functions. In Hashimoto’s, your immune system mistakenly attacks your thyroid, leading to an underactive thyroid (hypothyroidism).
While conventional medicine typically treats this with synthetic thyroid hormones, it doesn’t address the root cause. It’s like mopping up water from a leaky ceiling without fixing the hole — you’re managing symptoms without addressing the underlying issue.
The Gut-Thyroid Connection: Understanding Leaky Gut
At the heart of Hashimoto’s lies a crucial connection to your gut health, specifically leaky gut syndrome. LaMandre explains that if you have Hashimoto’s, you likely have leaky gut.2 This condition occurs when your gut lining becomes permeable, allowing substances like undigested food particles and toxins to enter your bloodstream. Of particular concern for Hashimoto’s is gluten, a protein found in wheat and other grains.
LaMandre provides a detailed explanation of how gluten can be problematic for those with Hashimoto’s thyroiditis, focusing on the concept of molecular mimicry. Gluten, a protein found in wheat and other grains, contains two main components: glutenin and gliadin. It’s the gliadin component that can cause issues for people with leaky gut.
When you have a leaky gut, a specific part of the gliadin molecule called alpha-gliadin can enter your bloodstream. Your immune system recognizes this as a foreign invader and produces antibodies to attack it. Here’s where the problem escalates: the gliadin molecule is structurally similar to an enzyme in your thyroid called TPO (thyroid peroxidase).3
This similarity leads to a case of mistaken identity in your immune system. The antibodies created to attack gliadin can also attack your thyroid’s TPO enzyme due to this structural resemblance. This phenomenon is called molecular mimicry. Every time you consume gluten, you’re potentially triggering an immune response that not only targets the gluten but also your thyroid tissue.
LaMandre paints a vivid picture of this process: “Imagine this over years and years of sandwiches and pizza and cake and cookies — each time it’s an actual assault on your thyroid.”4 Initially, your thyroid may manage this assault, and your tests might appear normal. However, over time, the cumulative damage can lead to thyroid dysfunction and hypothyroidism.
This explanation underscores why simply taking thyroid medication isn’t a solution for Hashimoto’s. If you continue to consume gluten, you’re perpetuating this cycle of autoimmune attack on your thyroid. That’s why many functional medicine practitioners, recommend a gluten-free diet as part of a comprehensive approach to managing Hashimoto’s thyroiditis.
Understanding this mechanism can help you appreciate why dietary changes are crucial in managing Hashimoto’s and supporting your overall thyroid health.
How Leaky Gut Drives Disease
A thriving gut ecosystem contains a rich variety of microorganisms that collaborate to safeguard your health. Fostering beneficial oxygen-intolerant bacteria, including the vital Akkermansia species, enhances your intestinal defense mechanisms and promotes an environment conducive to overall wellness.
These advantageous bacteria ferment dietary fibers, producing short-chain fatty acids (SCFAs), particularly butyrate. This compound nourishes colonic epithelial cells, reinforcing the intestinal barrier. SCFAs also encourage mucin production, creating a protective shield against pathogenic bacteria.
A decline in oxygen-intolerant bacteria can result in increased intestinal permeability, or leaky gut, allowing toxins, undigested food particles and harmful microbes to penetrate your bloodstream, potentially instigating systemic inflammation and chronic health issues.
Oxygen-intolerant bacteria play a crucial role in converting indigestible plant fibers into beneficial fats. They flourish in an oxygen-free environment, which requires sufficient cellular energy to maintain. However, factors such as seed oil consumption and exposure to toxins like endocrine-disrupting chemicals (EDCs) in plastics, along with electromagnetic fields (EMFs), can impair this energy production, making it challenging to sustain the ideal no-oxygen gut environment.
Further, a leading cause of death is, in my view, endotoxemia resulting in septic shock. This occurs when you secrete endotoxin from facultative anaerobes, otherwise called oxygen-tolerant bacteria, which shouldn’t be in your gut.
These pathogenic bacteria secrete a very virulent form of endotoxin, also known as lipopolysaccharides (LPS), which can cause inflammation if they translocate across the compromised gut barrier into systemic circulation. Leaky gut, or a disturbed microbiome, is therefore one of the foundational causes of all disease.
Your microbiome, the community of bacteria in your gut, is also crucial for converting the thyroid hormone T4 to its active form, T3. Certain bacteria produce enzymes necessary for this conversion, while others can inhibit it.
For healthy thyroid function, you need to make sure T4 can be efficiently converted into T3. To encourage the conversion of T4 to T3, eat a diet of whole, unprocessed or minimally processed foods and make sure you include enough protein and healthy, easily digested carbs that won’t cause intestinal irritation or endotoxin production, such as whole fruit.
Beyond the Gut: Other Factors Affecting Your Thyroid
While gut health plays a significant role, other factors can impact your thyroid function in Hashimoto’s. Chronic stress can trigger or exacerbate Hashimoto’s by causing inflammation and disrupting cortisol levels, which in turn affects thyroid hormone conversion.
Environmental toxins, particularly EDCs and heavy metals, can also interfere with thyroid hormone production and function. Viruses and infections, such as Epstein-Barr virus, may play a role in triggering autoimmune responses that affect your thyroid.5
In my recent interview with U.K. clinician Keith Littlewood about endocrine health, he also explained that estrogen dominance and estrogen excess are among the primary causes of thyroid disruption, as estrogen inhibits the conversion of T4 to T3. In terms of diet, high polyunsaturated fat (PUFA) intake, including linoleic acid, is a major culprit, as PUFAs interfere with your cell’s ability to use active thyroid hormone.
Like LaMandre, Littlewood emphasizes that fixing your thyroid problems isn’t as simple as taking thyroid hormones. You need to use a comprehensive approach that addresses what you’re eating — avoiding low-carb and low-calorie diets — your stress levels and your exposure to environmental pollutants, like EDCs.
Foods to Avoid if You Have Hashimoto’s
Building on the gut-thyroid connection discussed earlier, it’s crucial to understand the role of certain foods in exacerbating Hashimoto’s symptoms. In the video above, Dr. Westin Childs, a thyroid specialist, emphasizes the importance of avoiding gluten, dairy and soy if you have Hashimoto’s thyroiditis.6
As mentioned, gluten can have a proinflammatory effect on your gut lining. This is particularly problematic for those with Hashimoto’s, as it can further aggravate your already compromised immune system. Research shows that adopting a gluten-free diet helps reduce inflammation of the thyroid gland and improve its function, especially in individuals with Hashimoto’s thyroiditis.7
Childs recommends avoiding gluten for at least 90 days to see if you notice any improvements. Dairy products can also be problematic for many Hashimoto’s patients, potentially causing inflammation through lactose intolerance or reactions to milk proteins like casein. Completely avoiding dairy can lead to improvements in thyroid lab tests.8
Soy products are another concern, as they can interfere with thyroid function by blocking iodine uptake and they’re an estrogenic food. It’s advisable to avoid soy, including highly processed forms, in general but especially if you have Hashimoto’s.
Coffee, Alcohol and Processed Foods: Hidden Thyroid Disruptors
While you might not immediately associate these items with thyroid health, they can have significant impacts on your Hashimoto’s management. Coffee, despite its popularity, may be damaging to thyroid function. Childs points out that coffee can suppress your brain-thyroid connection, potentially reducing free thyroid hormone concentrations.9
It can also interfere with thyroid medication absorption and put additional strain on your adrenal glands. Even decaf coffee is best avoided if you have Hashimoto’s. Alcohol should be considered a poison to your thyroid gland and liver, both crucial for proper thyroid function. It can alter liver metabolism, an important site of T4 to T3 conversion, and directly suppress thyroid function.10
Processed foods are another category to be wary of. These are widespread sources of toxic seed oils rich in linoleic acid that, as mentioned, interferes with your cell’s ability to use active thyroid hormone.
These industrial seed oils, often marketed as “vegetable oils,” undergo extensive processing and can cause inflammation when incorporated into your body’s cellular structure. Seed oils to avoid include soybean, peanut, corn, safflower, canola and sunflower oils, among others.
As for sugars, while natural sources, like ripe fruit, raw honey and maple syrup, can be part of a healthy diet, refined sugars, often hidden in processed foods, can contribute to inflammation and insulin resistance, indirectly affecting your thyroid function. By eliminating these toxic seed oils and refined sugars from your diet, you’re taking a significant step in managing your Hashimoto’s and supporting overall thyroid health.
Raw Vegetables and Goitrogens: A Balancing Act
While vegetables are generally considered healthy, some raw vegetables can potentially interfere with thyroid function in Hashimoto’s patients due to their goitrogenic properties.11 Goitrogens are substances that can inhibit iodine uptake in your thyroid gland.
Vegetables like broccoli, Brussels sprouts and kale contain these compounds, which can be especially problematic when consumed in large amounts or if iodine intake is insufficient. You can reduce the goitrogenic effect via cooking, which is why I highly recommend cooking your vegetables thoroughly.
Lectins can also increase gut permeability (leaky gut) and disrupt your gut microbiome, which can trigger or exacerbate autoimmune responses in conditions like Hashimoto’s thyroiditis.12 Some of the highest sources of lectins are uncooked beans, peanuts, cashews, whole grains and raw nightshade vegetables.
Keep in mind that fruits and vegetables are rich in fiber, which is a complex carbohydrate. While complex carbs are beneficial for the gut microbiome, I don’t recommend filling your diet with them right away. If you have an impaired microbiome, complex carbs can worsen your health by feeding the pathogenic bacteria in your gut.
If you’re experiencing bowel issues after eating complex carbs, that means your gut isn’t well-equipped to digest them. To address this problem, you need to improve your mitochondrial function and their ability to produce enough cellular energy. Once you achieve that, you can benefit from complex carbohydrates again.
Until then, slowly incorporate complex carbs into your diet. Start with fresh fruit juices, and once your body can tolerate that, move on to healthy, whole ripe fruits and then onto other more complex carbohydrates.
Holistic Approaches to Managing Hashimoto’s
To effectively manage Hashimoto’s, you need to take a comprehensive, systemic approach that goes beyond just treating thyroid symptoms. Consider eliminating gluten from your diet to reduce the autoimmune attack on your thyroid, and be sure to support your gut health by eating a diet of whole, unprocessed or minimally processed foods.
Manage stress through techniques like meditation or adaptogenic herbs, such as ashwagandha. Certain nutrients for thyroid health can also be beneficial, including iodine (in moderation),13 selenium to protect the thyroid, zinc for hormone conversion and vitamin D for immune support.14
Vitamin B12 supplementation can help combat fatigue and brain fog often associated with Hashimoto’s, while low vitamin B12 levels have been associated with a higher risk of autoimmune thyroid diseases (AITD).15
Remember, while thyroid medication is often the go-to treatment for Hashimoto’s in conventional medicine, it doesn’t target the underlying causes. By addressing the root causes and taking a holistic approach, you can optimize your overall health and better manage your Hashimoto’s thyroiditis.
