Hashimoto's and Your Diet

One of the questions I get asked most frequently by my patients is “what diet should I follow?” I consider this somewhat of a delicate question for many reasons but most profoundly, because I don’t believe there is a one-size-fits-all-diet for thyroid disorders.  But let’s dig into what I talk about with my patients when asked this question.

First off, if you know my personally and are my patient, you know I am all about realistic goals.  I am about sustainable lifestyle goals, not insanely dogmatic limitations that you can commit to for 13 days before throwing in the towel.  Now sure, if we all lived in a vacuum and perfection was not only attainable but also maintainable, I would certainly recommend a perfectly clean diet.  Part two of this is that I never ask my patients to do something I am not willing and able to do myself. I really take this to the next level and don’t ask my patients to do anything I haven’t already done myself.  If I can’t do it, how can I ask someone else to? So in short, if it’s stringent dogmatism your searching for, you won’t find it here. With this pretense understood, let’s dig in.

My first pick for diet recommendations, especially in the case of Hashimoto’s, the autoimmune disease associated with hypothyroidism, is always to get an IgG food allergy test.  Despite the approach for autoimmune disease of conventional medicine being “well, you have an autoimmune disease, we’ve named it, diagnosed it and there really isn’t anything to be done here;” functional medicine’s approach is quite the opposite. Autoimmune disease is our jam.  Why? Because we start to get to the “root cause” of it, inflammatory factors, lifestyle issues, et al, and we fix those to reduce your autoimmunity burden or ideally put it into remission. One of the first places I start with Hashimoto’s, is a deeper look into food mediated inflammation and I often use IgG food allergy testing to find out the exact foods driving this reaction. 

Often times, people don’t want to do testing, to pay the money and they just want a quick-fix recommendation.  I get it and of course I accommodate this request. But let me start by saying there are general anti-inflammatory diets that can help for large populations of people but obviously, we are not all biologically identical so there are individual variations within these diets. But, if I had to blindly pick one diet for everyone, I would recommend a paleo-based diet. Why? Because for the majority of people, paleo is low inflammatory.  I also find that it is fairly sustainable, especially in health centric cities like Austin (Picnik anyone?).  I’ve had too many patients try to go to extremes of Autoimmune Paleo (AIP) and throw in the towel too quickly and give up all together, returning to processed foods filled with inflammation and absent of nutrients.  In all honesty, I also haven’t conquered the AIP diet so I simply don’t feel right recommending it to my patients. And yes, I fully realize this could create an army of angry readers, I’m sorry, I’m human too (and a mom, how do people do it???).  The other main reason I recommend paleo blindly is because after seeing hundreds of food allergy results, the majority of people show high levels of inflammation from three sources: dairy, grains and legumes.  I see it over and over in black and white and although we must always return to the concept of no-one-size-fits-all for almost any topic of life, we have to start somewhere. 

I have seen plenty of people for which even paleo is simply too overwhelming. I get it, truly I do.  Hear me genuinely say I would much rather you start small and start somewhere, than be too overwhelmed with grandiose goals to begin. Just begin.  For these people, I have them just begin with gluten.  I ask that they give up gluten completely for three months.  Why three months?  The half-life of IgG component of our immune system, what drives chronic inflammation that is hard to know that it’s happening is (think fatigue, malaise, brain fog) is 26 days.  So in three months, you can reset your inflammation enough by cutting gluten out to feel a heck of a lot better.  Which is my goal. If I can get you feeling better there is so much more likelihood you’ll want to continue on in this journey. Who knows, in six or nine months maybe you’ll want to go dairy free! Every single person I have ever asked to go gluten free, that actually did, has never regretted it.  They have never returned to see me and said that it was a waste of their time and energy. You know what they repeatedly say? It was life changing.  But the key is getting to the point where you actually feel better.

This biggest takeaway from all of this? Make a sustainable choice to improve your health. The changes we make to small everyday habits make the biggest impact in our long-term health.  I encourage this, make just one small change, but make it one you can sustain.  Before you know it, you’ll be ready to make another.


Be well,


All the (realistic) answers involved in when to take your thyroid medication.

All the (realistic) answers involved in when to take your thyroid medication.

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