Hashimoto disease (also known as Hashimoto or autoimmune thyroiditis) is an autoimmune disease affecting the thyroid. With any autoimmune disease, your immune system, designed to attack germs and make the body well, mistakenly attacks itself.

Hashimoto disease occurs when your body attacks the thyroid as if it were a virus. This leads to a decrease in thyroid function and hormone production.

The thyroid is a butterfly-shaped gland attached to the front of your windpipe. It’s part of the endocrine system, which is responsible for producing, storing, and using hormones.

Your thyroid regulates:

  • metabolism
  • growth
  • temperature
  • energy

It’s incredibly important to keep thyroid hormones in balance.

Any disturbance in the thyroid can affect:

When your thyroid doesn’t produce enough hormone, it’s in a state of hypothyroidism. Hypothyroidism affects your body’s metabolism. That’s why changes in weight are often associated with thyroid problems.

Not everyone with Hashimoto disease develops hypothyroidism. However, Hashimoto disease is typically the No. 1 cause of hypothyroidism.

How can you tell the difference between Hashimoto disease and hypothyroidism?

  • Generally speaking, Hashimoto thyroiditis is a disease. Hypothyroidism is a condition that happens as the result of a disease.
  • Hashimoto disease occurs when your white blood cells attack the thyroid and slow it down. Hypothyroidism develops when your thyroid isn’t able to produce enough thyroid hormone.

Many people who have Hashimoto disease eventually develop hypothyroidism. This may take a while because the disease is progressive, meaning it slowly gets worse over time.

Many people who live with Hashimoto disease don’t experience any symptoms at first. As time goes by, one of the more obvious signs of Hashimoto disease is a goiter.

A goiter is an inflamed and enlarged thyroid that makes the front of your neck look swollen.

The most common and easily recognized symptoms of Hashimoto and hypothyroidism include the following:

The good news if you have Hashimoto disease is that the condition can be managed with the right dose of the prescription drug levothyroxine and a careful diet.

While dosage and timing of medication is different for everyone, levothyroxine is the first line of defense against hypothyroidism. It mimics the hormone (thyroxine) the thyroid produces.

Outside of medical treatment, however, there are lifestyle changes related to diet that can have a positive and profound effect on the management of your condition. One example is reducing your risk of other autoimmune conditions like:

  • celiac disease
  • type 1 diabetes
  • lupus

There are specific nutrients you should be regularly consuming to maintain a healthy and functional thyroid. The top nutrients are:

A diet optimizing these nutrients is vital to an overall recovery plan. The best way to get the daily requirement of these minerals and nutrients is to eat a balanced diet. If this isn’t possible, supplements are available.

Avoid eating any food within 1 to 2 hours of taking thyroid medication, since it affects how the medication is absorbed in the body. Always discuss any changes in your diet or medication with your doctor.

In addition, some diets are thought to be beneficial for people with Hashimoto disease:

Iodine

The mineral iodine is common in a Western diet because it’s in foods like salt and bread. For this reason, it’s uncommon for people in developed countries to be iodine deficient.

Still, it’s important to be conscious of the iodine in your diet. Too little iodine can cause goiters in some people. Too much iodine can make hypothyroidism worse. Iodine is vital to the production of thyroid hormone.

Under your doctor’s supervision, you can naturally add iodine to your diet by eating iodine-rich foods such as:

  • seafood
  • table salt
  • dairy products
  • eggs
  • prunes

Be careful if you choose to eat foods packed with iodine, such as seaweed, kelp, or iodine drops, as you may consume too much.

Selenium

The thyroid has the highest selenium content in the entire body.

One study found selenium treatment to be effective for those with Hashimoto thyroiditis, whether used alone or in combination with levothyroxine. According to the Cochrane Library however, more research is needed to guide clinical treatment using selenium.

Another study showed people living with the disease who take selenium supplements have shown a decrease in the number of antibodies attacking the thyroid.

Foods rich in selenium include:

  • eggs
  • pork
  • Brazil nuts
  • tuna and sardines
  • beef
  • chicken

While the body does excrete low amounts of selenium, chronic high doses can build up in the body’s tissues and can lead to toxicity.

Brazil nuts are the richest food source of selenium. Since selenium varies widely in Brazil nuts, from 55mcg to 550mcg, it’s often recommended to consume no more than seven Brazil nuts a week.

Those with thyroiditis may be advised to rely on supplemental selenium rather than food sources for more reliable selenium intake.

Zinc

Zinc is an essential element used to produce thyroid hormone. A 2009 study showed that taking zinc supplements increased thyroid hormone levels in people with goiters.

Zinc deficits, like iodine, are extremely uncommon in the developed world. If you want to add more zinc to your diet, the following foods are excellent sources:

  • oysters and shellfish
  • beef
  • chicken
  • legumes such as lentils and beans
  • cow’s milk

Paleo diet

The paleo diet (sometimes called the caveman diet) focuses on eating what humans ate during the Paleolithic period of evolution. The focus is on “hunter-and-gatherer” style food.

The paleo diet is a highly effective diet for Hashimoto’s disease. It eliminates foods that can trigger an autoimmune reaction such as:

  • grains
  • dairy
  • highly processed food

The paleo diet also excludes legumes.

The paleo diet’s anti-inflammatory benefits can be achieved by eating the following foods:

  • lean meat
  • fish
  • seafood
  • fruit
  • vegetables
  • nuts
  • seeds

Gluten-free diet

While foods containing gluten aren’t the cause of Hashimoto disease, for some people, those foods can trigger an autoimmune response. This results in inflammation and tissue destruction.

Gluten is part of every wheat flour product, is found in rye and barley, and can hide in many different foods. You should avoid:

  • wheat
  • barley
  • cookies
  • cakes
  • pizza
  • pasta
  • bread

Gluten-free alternatives for common flour-based foods are available, though they can be expensive. If you’re living with Hashimoto disease, you can try the gluten-free diet and see if it improves your symptoms.

Vegetarian and vegan diets

Vegetarians don’t eat meat.

Vegans don’t eat any animal products, including:

  • honey
  • milk
  • butter
  • eggs

These diets are said to help improve the autoimmune response involved in Hashimoto disease. They also reduce inflammation and promote gut health.

However, be aware that vegetarian and vegan diets may leave you deficient in important vitamins and minerals such as:

  • omega-3 fatty acids
  • iron
  • B-12
  • vitamin D

Supplements should help balance the nutritional deficiencies found in this type of diet.

If you choose to try this diet to help improve your thyroid and gut health, focus on introducing whole, plant-based foods into your diet like:

In addition to foods that help the thyroid, there are specific foods in certain amounts that can have a negative effect on the thyroid. Gluten and goitrogens are the worst foods to have in your diet if you have Hashimoto disease.

Gluten

A 2015 study found a correlation between Hashimoto’s disease and gluten sensitivity. This same study also suggests there’s a link between gluten intolerance and autoimmune disorders in general.

If you’re living with Hashimoto disease and your symptoms aren’t improving with lifestyle changes and medication, try removing gluten from your diet and see if your symptoms improve. Try to avoid foods that include the following:

  • wheat, which is common in breads, cookies, and crackers
  • barley, which is common in soups and stews
  • rye, which is common in bread and whiskey

Goitrogens

Goitrogens are substances that prevent the thyroid from functioning properly. If taken in large enough doses, they can aggravate the thyroid and disrupt hormone production.

Goitrogens are most common in cruciferous vegetables such as:

These foods don’t pose much of a threat if you eat small amounts. You should be especially wary of goitrogens if you have goiters.

However, most people with Hashimoto disease won’t experience a negative effect on their symptoms unless they eat a lot of these foods every day.

With the right combination of medications, nutrients, and diet, Hashimoto disease can be a very manageable condition.