Issue #287  March 9, 2015

Welcome to KnowYourThyroid.

Today, we are talking about food, specifically foods that affect your thyroid funcion.




Top 7 Hashimoto’s Food Myths

By Izabella Wentz, PharmD, FASCP

I wanted to share some of the most common myths and questions I hear about food, the thyroid and Hashimoto’s. Hope this article helps you figure out the optimal diet for you!

As the case often with myths and “urban legends”, many of the these are based in facts that have been misunderstood and twisted.

1.    Myth 1: Goitrogens need to be avoided in Hashimoto’s, so I can’t eat broccoli. 

Truth: Those poor cruciferous vegetables! Delicious and healthy vegetables like cabbage, Brussels sprouts, broccoli, kale and cauliflower have gotten a bad rap due to some old nomenclature and outdated patterns in thyroid disease. Goitrogen is a word that was coined in the 1950’s to describe a substance that causes the formation of a goiter, also knows as an enlarged thyroid gland. It’s a very deceiving word, and can mean a variety of different things for different substances, ranging from suppressing the release of thyroid hormone to changing the way thyroid hormone gets produced in the body to suppressing the absorption of iodine.

In relation to cruciferous vegetables, they are have been identified as “goitrogenic” because they have the potential to block iodine absorption.

This was a concern in the 1950’s, as then, the primary reason for hypothyroidism was due to iodine deficiency, and any further changes in iodine levels were potentially problematic. However, since public efforts have been made to add iodine to the salt supplies of most industrialized countries, Hashimoto’s has become the primary reason for hypothyroidism, responsible for 90-97% of cases of hypothyroidism in the United States. Iodine deficiency is not wide spread in people with Hashimoto’s, and thus eating cruciferous vegetables (unless a person is otherwise sensitive to them) is perfectly healthy for people with Hashimoto’s and should not impact thyroid function. In the case that a person does have hypothyroidism due to iodine deficiency, he/she can still enjoy crucifers as long as they are cooked or fermented. Cooking/fermenting will break down the iodine blocking content.

There is one goitrogen that I do always recommend avoiding with Hashimoto’s, and that’s soy. You can read more about the breakdown of the science behind goitrogens HERE. 

2. Myth 2: I do not need to get off gluten, tests said that I was not sensitive

Gluten is a substance found in wheat, barley and rye. Gluten is a staple of the Standard Western Diet, in America, Europe and Australia, and it is found in breads, cakes and pastries and most processed foods. People with Hashimoto’s are more likely to have Celiac disease compared to others, and getting off gluten helped some people dually diagnosed with Celiac and Hashimoto’s shed their Hashimoto’s diagnosis (antibodies went into remission, and thyroid function returned to normal). However, it’s not just Celiac disease.  My personal and clinical experience has shown that non-Celiac gluten sensitivity is one of the biggest triggers in Hashimoto’s.

Lab testing can be very helpful, especially if you get the right kind of testing, (I’ll be writing about my favorite food sensitivity lab test, soon) but unfortunately testing technology is not perfect. More often then not, false negatives can be seen for common reactive foods like gluten, dairy and soy. The best test for figuring out if you are sensitive to gluten is doing an elimination diet, when you avoid gluten for 2-3 weeks, then try it again to see if you react to it.

In surveying my clients, 90% of them felt better on a gluten-free diet. Only 10% were diagnosed with celiac disease. Going gluten free can help alleviate many symptoms associated with Hashimoto’s, such as fatigue, hair loss, bloating, constipation, diarrhea, pain, acid reflux, weight gain and many others, as well as can reduce the autoimmune attack on the thyroid gland.

Going gluten free is one of the first things I recommend with Hashimoto’s. If you sign up for my email list, you can get my Gluten Free Quick Start Guide and favorite recipes.

3. Myth 3: Almonds are a health food. I should eat them everyday

In an effort to eat a healthier, nutrient dense diet, many people turn to almonds as a substitute to eating grains. This is because almonds are very tasty and quite versatile, they can be made into Paleo breads, used as a substitute for bread crumbs and can be eaten as snacks.  Unfortunately many people can be sensitive to almonds, and in fact, after gluten, dairy and soy, almonds are one of the top reactive foods for people with Hashimoto’s. I often see people develop new food sensitivities because they have not healed their guts (see Myth #7). You run a greater risk of becoming sensitive to almonds if you eat them over and over again, day after day. If you don’t react to them now, rotate them with other foods, eating them every 3-4 days.

4. Myth 4: The best source of Selenium is from eating Brazil nuts

Selenium deficiency has often been cited as a trigger for Hashimoto’s. Selenium is a required nutrient for proper thyroid function, and has been shown to reduce the autoimmune attack on the thyroid gland. However, this effect is dose responsive, and thus selenium is considered to be a narrow therapeutic index supplement. Studies have been done on the specific dose of Selenium needed to reduce thyroid antibodies. Doses below 200 mcg were not helpful for reducing thyroid antibodies, and doses >900 mcg per day were found to be toxic. Selenium content in Brazil nuts can vary ten fold, depending on where the Brazil nuts were grown. This means that a Brazil nut can contain anywhere from 55 mcg to 550 mcg of Selenium. Unless your Brazil nuts were tested for Selenium content, you may be unknowingly overdosing or under-dosing yourself.   Also, many people with Hashimoto’s may be sensitive to nuts! Selenium methionine in supplement form, at a dose of 200 mcg has been clinically tested to show a 50% reduction in thyroid antibodies, over the course of three months. Some clinicians may recommend a dose as high as 400 mcg per day. I’ve had great results with Pure Encapsulations brand Selenium .

5: Myth 5: Raw dairy is fine for Hashimoto’s, it’s only the pasteurized dairy that’s problematic

Proponents of this myth rely on the information that pasteurization process changes the protein structure of dairy proteins, making them more reactive. However, if you’ve already been sensitized to the dairy proteins casein or whey from drinking conventional milk, consuming raw dairy, organic dairy, lactose free milk, or goat’s milk may still be a problem. Perhaps if you drank raw dairy your whole life, you may have not developed a sensitivity, but in general cow’s milk is difficult to digest for most adults with Hashimoto’s.  Goat’s milk is highly cross reactive as well for those with cow milk sensitivity. Camel milk, however, may be well tolerated by people with Hashimoto’s as the proteins are different enough not to cross react. Symptoms like nasal congestion, constipation, acid reflux, joint pain and thyroid antibodies can improve by going dairy free. Dairy was a huge trigger for me, now 60% of my clients report felt better on a dairy free diet!

Read more about my acid reflux/dairy story HERE and why you should avoid dairy HERE.

6. Myth 6: Low carb eating is bad for people with thyroid issues 

Some people report feeling tired after starting a protein/fat heavy diet like the Paleo diet, but this is not always due to needing carbohydrates. In fact, some people with autoimmune disease and Hashimoto’s feel amazing on a ketogenic diet (a low carb diet where the body breaks down fats for fuel, instead of relying on carbohydrates). If you’re feeling tired on a diet that is mostly comprised of fats and proteins, this could be due to low stomach acid, which leads to improper protein digestion. Most people with Hashimoto’s have been found to have low stomach acid/no stomach acid, and this impairs our ability to digest protein foods. Improper protein digestion may make us tired because digestion takes a lot of energy, and people who are low in stomach acid may find themselves naturally gravitating towards carbohydrates for energy, as carbohydrates do not need as much digestive juice as proteins for proper digestion.

Increased intake of proteins coupled with a lack of carbohydrates may results in feeling more tired as a result of protein being a bigger burden, as well as we may have a harder time getting nutrients for energy from our foods. Try starting your day with a  green smoothie (to help along digestion, lowering the burden), increasing your veggie intake and taking the protein digestive enzyme Betaine with Pepsin, before you determine if low carb is a good choice for you or not. Many people have found that taking this supplement helped with fatigue. A guide on how to use Betaine with Pepsin can be found in my Digestion and Depletion book chapter. You can read it for free by subscribing HERE. Other options for increasing stomach acid and improving digestion include hot lemon water, or a teaspoon of apple cider vinegar in a glass of water with protein containing meals.

You can read more about additional interventions for overcoming thyroid fatigue HERE.

Myth 7: Diet can heal everything: If I just take out more foods, I will be healed

While some people have had great success though changing their diets, even going into complete remission from Hashimoto’s, this is not always the case. Don’t get me wrong, eating a nutrient dense diet that is free of reactive foods can do wonders, and is one of the first things I recommend, but if you’ve been on a clean diet for 3 months and not seeing results or getting stuck, you likely have an unwanted guest living inside of you and causing inflammation within your gut. This gut infection that is preventing you from healing. Gut infections lead to intestinal permeability, one of the main triggers of Hashimoto’s. Most infections require targeted treatments such as herbs, antibiotics, antifungals or antiprotozoal agents in order to be eradicated. Otherwise, the person can be sensitive to whatever foods he/or she is eating. Be sure to get tested for a gut infections ASAP, so you don’t run the risk of losing more foods. The tests I recommend include the Bacterial Overgrowth Breath Test-Genova KIT for SIBO (small intestinal bacterial overgrowth), GI Effects Gastrointestinal Function Comprehensive Profile (One day collection)-METAMETRIX KIT for bacterial/fungal infections and the GI Pathogen Screen with H. pylori Antigen-BioHealth KIT for parasitic infections/H Pylori. You can view all of the tests I recommend HERE , and I cover them in greater detail in my book, Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause.

Read more about non-diet related root causes HERE.

Hope that this information helps you on your journey!

Your Thyroid Pharmacist,

Izabella Wentz, PharmD, FASCP

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