Hashimoto disease (also known as Hashimoto 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, and 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 completely controlled 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) produced by the thyroid.

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.

There are specific nutrients you should be regularly taking 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 one to two 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.

Selenium

The thyroid has the highest selenium content in the entire body. There’s no solid scientific evidence backing the use of selenium to treat Hashimoto.

However, 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

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, and highly processed food).

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

  • lean meat
  • fish
  • seafood
  • fruit
  • vegetables (avoid starches such as potatoes)
  • 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 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 give the gluten-free diet a try to see if it improves your symptoms.

Vegetarian and vegan diets

Vegetarians don’t eat meat. Vegans don’t eat any animal products, including milk, butter, and 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 can leave you deficient in important vitamins and minerals such as iron, B-12, and 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 suffering from Hashimoto disease and your symptoms aren’t improving with lifestyle changes and medication, try eliminating 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 pollutants 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 and diet, Hashimoto disease can be a very manageable condition.