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Hashimoto’s Thyroiditis: Dietary Insights
- Raye McDonald MS, RDN
- Mar 27
- 4 min read
Updated: Mar 28
Organization: Root Health, Nutrition & Wellness
Author: Raye McDonald, MS, RDN
Publish Date: 3/27/25
What is Hashimoto’s?
Hashimoto’s Thyroiditis is an autoimmune disorder of the thyroid gland in which the immune system recognizes the thyroid gland as foreign and attacks it, leading to an increase in inflammation and a decrease in function of the gland. Hashimoto’s can cause both Hyperthyroidism, in which the thyroid gland is producing excess thyroid hormone, and Hypothyroidism, in which the thyroid is not producing enough thyroid hormones. Hashimoto’s is a chronic condition that can be managed with dietary and lifestyle changes.
What triggers an autoimmune condition such as Hashimoto’s?
The progression of an autoimmune condition has 3 components:
Genetics
Environmental trigger
Intestinal permeability
In short, for someone to develop an active autoimmune condition they must have a genetic predisposition, an environmental trigger such as trauma, stress, or infection that impacts the gene expression, and damage to the intestinal lining, known as intestinal permeability. While there are ways to help mitigate the potential for developing an autoimmune condition by limiting stress and supporting gut health, it is often out of our control.
How to Manage Hashiomoto’s
Hashimoto’s can be managed through dietary, supplementation, and lifestyle modifications. Due to the role that the gut plays in developing an autoimmune condition, it can be helpful to support the gut right off the bat. This involves removing potentially problematic foods such as dairy and gluten, supporting proper digestion, healing the intestinal lining, and balancing the gut microbiome. This process may look different for each individual.
Molecular Mimicry
Molecular mimicry is a mechanism that plays a role in autoimmune conditions. The process in which the immune system mistakes a foreign substance for a self-antigen.
Gluten and Hashimoto’s
A protein structure found in gluten has a very similar peptide sequence to that found in the thyroid, which may trigger an autoimmune response, causing the immune system to attack the thyroid gland
Dairy (Casein) and Hashimoto’s
Similar to gluten and Hashimoto’s, the protein, casein, which is found in dairy, has a similar structure to that of the thyroid gland, leading to a further attack on the gland when it is found in the diet.
Dietary Recommendations
Treating Hashimoto’s is very individualized especially when it comes to dietary changes. While many people do well when removing just gluten and dairy, there is a smaller population of individuals who may have to remove additional foods such as grains, nightshades (potatoes, tomatoes, eggplant, peppers), soy, eggs, legumes, nuts, seeds, and/or caffeine.
It can be beneficial to start by removing both gluten and dairy from the diet as both have been shown to be problematic in Hashimoto’s as well as other autoimmune conditions due to Molecular Mimicry, as described previously. While some may notice immediate changes in the way they are feeling after removing both gluten and dairy, others may not see changes for several weeks, therefore adhering to a strict diet for several weeks to months will be important to determine therapeutic effects.
Additional Dietary Restrictions
Nightshades are a category of plant foods that include potatoes, tomatoes, eggplant, and peppers. Nightshades contain lectins which may cause an immune response that can worsen Hashimoto’s symptoms, however, this is not the case for everyone and will require a period of elimination and reintroduction to determine severity.
Soy has been shown to be problematic in those with Hashimoto’s for a number of reasons including blocking of thyroid peroxidase enzyme, decreased medication absorption, and goitrogenic activity. Goitrogenic foods such as soy may inhibit iodine uptake, an essential nutrient for thyroid hormone production.
Grains can be problematic for those with Hashimoto’s due to the effect they have on the gut and blood sugar regulation. Grains such as rice and corn can be damaging to the intestinal lining, contributing to intestinal permeability and thus progressing the autoimmune condition. Research shows that many patients with Hashimoto’s feel a relief of symptoms when removing grains.
Other potentially problematic foods include eggs, nuts, seeds, and legumes
The Autoimmune Protocol (AIP) Diet
The AIP diet is often used for those struggling with Hashimoto’s and other autoimmune disorders as a way to pinpoint which foods may be problematic for them. The AIP diet consists of an elimination diet lasting about 4-6 weeks and then a reintroduction phase to rule in and out problematic foods. The AIP diet is very restrictive and is only meant to be followed temporarily as a way to determine the individual dietary needs of the patient with Hashimoto’s.
Foods that are restricted in the elimination phase of the diet:
Gluten
Dairy
Soy
Grains
Legumes
Nightshades (tomatoes, potatoes, eggplant, peppers)
Nuts
Seeds
Refined sugars
All processed foods
Alcohol
Foods to consume during the elimination phase:
Vegetables- all excluding nightshades
Fruit (fresh or frozen)
Animal proteins- (ideally grassfed and organic)
Vegetable oils- olive, avocado, coconut
Fermented foods including sauerkraut, pickles, kombucha
Herbs and spices (excluding those from chili peppers and seeds)
Natural sweeteners including maple syrup and honey
Vinegar- balsamic, apple cider, red wine (all sugar-free)
Bone broth
The reintroduction phase consists of adding one new food back in at a time and should be closely monitored by a practitioner. It is important to note that the AIP diet is a therapeutic approach for treating autoimmune conditions that should not be implemented long term.
If you are struggling with an autoimmune condition and need more nutritional support, visit us at www.roothealthnj.com for more posts, recipes, and webinars, or contact us for a discovery call to become a patient.
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