Hashimoto’s Diet: Best Foods To Eat and Avoid To Reduce Inflammation

Hashimoto’s thyroiditis is an autoimmune condition affecting the thyroid gland, which is located at the base of the neck. Hashimoto’s can lead to hypothyroidism, an underactive thyroid, which can lead to frustrating and even life-threatening symptoms if left untreated. Although not a cure for Hashimoto’s, a Hashimoto’s diet may help reduce your symptoms and improve your quality of life. Hashimoto’s diets combat inflammation and support gut health.

From fatigue to weight gain to depression, Hashimoto’s thyroiditis can cause several frustrating symptoms. If you have this autoimmune condition, you may be looking for ways to mitigate the effects on your quality of life. Diet can help.

Several dietary modifications may help slow or prevent the progression of the disease and the development of comorbidities, conditions that occur alongside another. In the case of Hashimoto’s, comorbidities include obesity, hypercholesterolemia (high cholesterol), and type 2 diabetes.

You may have heard of the Hashimoto’s diet. It’s not a single diet protocol, but rather a dietary philosophy that harnesses the power of nutrition, alongside other treatments, including medication, to help manage Hashimoto’s, which affects the thyroid gland.

“Targeted nutrition helps stabilize energy, reduce antibody levels, and address common co-issues like gut permeability, nutrient deficiencies, and blood sugar imbalances,” says Jennifer Habashy, NMD, a naturopathic doctor and assistant medical director at Claya.

In this article, we’ll explore what Hashimoto's is, dietary changes that may help, what foods might be best to reduce or avoid, supplements that may support your health, and more.

Understanding Hashimoto’s disease

The thyroid is an endocrine gland located at your neck’s base. It’s responsible for secreting crucial hormones that help your organs and tissues perform their daily functions. This butter-fly shaped gland also helps manage metabolism and growth.

In the United States, Hashimoto’s is the most common cause of hypothyroidism, an underactive thyroid, meaning the gland isn’t producing adequate hormone amounts of the inactive thyroxine (T4) and the active triiodothyronine (T3). Consequently, the pituitary gland steps in and produces more thyroid-stimulating hormone (TSH) to make your thyroid work harder.

If you have Hashimoto’s, your body attacks or destroys thyroid cells, leading to fibrosis or scarring. The prevalence of the condition in the United States ranges from 5 percent to 20 percent, with more people assigned female at birth affected than those assigned male.

To diagnose Hashimoto’s, a clinician may test your thyroid-related hormone levels and for certain antibodies (immune system proteins) related to thyroid antigens, which cause your body to develop a specific immune response. Research is ongoing as to the underlying causes of Hashimoto’s, but likely a combination of genetic and environmental factors—such as lifestyle, nutrition status, and more, play a role.

The role of diet in managing Hashimoto’s

Nutrition is a powerful management tool for several conditions and overall health in general. That’s why if you have Hashimoto’s, you might consider turning to diet to help manage symptoms and reduce your risk for additional health issues.

Dietary changes are not a cure for Hashimoto’s, but they may work in tandem with medical treatments, such as hormone replacement with oral levothyroxine. Not all people with Hashimoto’s require this medication, but you may need it if Hashimoto’s is causing hypothyroidism.

Key principles of a Hashimoto’s diet

A key principle of a Hashimoto’s diet is to use nutrition to reduce inflammation. Strategies may include reducing pro-inflammatory foods and incorporating more anti-inflammatory foods.

Best foods for Hashimoto’s

Focusing on anti-inflammatory foods, high-quality protein sources, and gut-friendly foods may help with Hashimoto’s.

Anti-inflammatory foods

A 2023 study looked at the relationship between thyroid function and the dietary inflammatory index of patients with Hashimoto’s.

The researchers used data from the National Health and Nutrition Examination Survey from 2007 to 2012 to explore the dietary characteristics of 964 patients. They ranked the patients’ diet based on a dietary inflammatory index, with higher scores indicating a more pro-inflammatory diet. To do this, the researchers used a formula looking at 28 food parameters.

Patients in the study with a higher score had higher levels of TSH and TT4 (total thyroxine), indicating hypothyroidism.

The researchers noted the need for future studies, but wrote in their report, “In order to prevent hypothyroidism more effectively in patients with Hashimoto thyroiditis, it is essential to control dietary inflammation.”

“Combating inflammation is essential in managing Hashimoto’s because the condition itself is rooted in immune dysregulation,” Dr. Habashy says. “Chronic inflammation can worsen thyroid tissue damage and contribute to a range of symptoms such as fatigue, brain fog, mood changes, and digestive issues. By reducing inflammatory triggers, we can help calm the immune response and support overall thyroid function.”

Foods that are anti-inflammatory

• Coffee and tea
• Dark chocolate
• Fatty fish
• Fruits and veggies
• Herbs
• Legumes
• Mushrooms
• Nuts
• Olive oil
• Seeds
• Spices, such as ginger, turmeric, and cinnamon
• Whole grains, such as quinoa, oats, red, and rice

High-quality protein

In the 2023 study looking at the diet quality of patients with Hashimoto’s, the researchers found that those with a higher inflammatory diet also had lower protein intake. And in a 2020 study, researchers found a link between Hashimoto’s and the intake of processed meat.

For these reasons, you may wish to prioritize high-quality protein from lean sources of unprocessed meat and from poultry and eggs. For those on a vegan or plant-based diet, healthy protein sources may include legumes, nuts, seeds, quinoa, and more.

Gut-friendly foods

The researchers who conducted the 2023 study noted that Hashimoto’s may have connections to gut health. In their report, they wrote, “There is a large amount of evidence that pro-inflammatory food may cause intestinal imbalance, bacterial overgrowth, increase intestinal permeability and oxidative stress, and this inflammatory response will promote the occurrence of [Hashimoto’s].”

A study from 2021 analyzed stool samples, inflammatory markers in the blood, and the self-reported diets of 40 patients with Hashimoto’s and 53 without. They found that people with Hashimoto’s had differences in their gut microbiome (the bacteria and fungi that live in the gut) when compared with the participants without the condition. Specifically, they found links with Hashimoto’s to intestinal bacterial overgrowth and damage to the gut lining. From their research and other studies, they hypothesize that humans have a gut-thyroid axis, where the gut and thyroid communicate.

For these reasons, you may wish to focus on foods that promote gut health. Anti-inflammatory foods give you a great start. But you may also wish to include probiotic-rich foods, such as fermented veggies, kefir, and more. Studies have shown that probiotics may be beneficial, potentially because gut microbes serve as a reservoir for T3, preventing thyroid hormone fluctuations.

Foods to avoid with Hashimoto’s

Taking an additive approach to diet can help you naturally eliminate some foods that may be counterintuitive for living with Hashimoto’s; this is simply because we can only eat so much in a day. But you may wish to learn more about foods that could be helpful to reduce or avoid. Here are a few to consider.

High-iodine foods

In one study, even small amounts of supplementary iodine (250 micrograms) caused significant changes in thyroid hormone function in predisposed individuals. Among 40 patients given this modest amount of supplemental iodine, seven developed subclinical hypothyroidism and one became fully hypothyroid. Meanwhile, only one person in the control group experienced thyroid changes during the same period.

Research also suggests that the relationship between population iodine supply and autoimmune thyroid disease could be described as a "U-shaped" function, where both deficiency and excess can lead to problems.

Gluten

People with Hashimoto’s have an increased prevalence of also having celiac disease, an autoimmune disorder. With celiac, the consumption of gluten—a protein in wheat, rye, and barley—causes an immune response that damages your small intestine. Celiac can cause inflammation, nutrient absorption issues, and more that can further exacerbate Hashimoto’s.

People with celiac need to abstain from consuming gluten in their diet. However, skipping the gluten may also be beneficial for people with Hashimoto’s who have other gluten-related conditions. A meta-analysis from 2023 looked at existing studies and articles on the topic. They wrote in their report, “Our results seem to indicate a positive effect of gluten deprivation on thyroid function and its inflammation.” However, we need more research.

Dairy

People with Hashimoto’s may also be more likely to have lactose intolerance, an intolerance to the main sugar present in dairy products. If you are lactose intolerant, eliminating lactose-based products from your diet may help.

Ultra-processed foods

Ultra-processed foods are common in the “Western diet” or “standard American diet” and contain high amounts of added sugar, sodium, unhealthy fats, preservatives, emulsifiers, dyes, and more—all of which can drive inflammation. This inflammation can exacerbate Hashimoto’s. For these reasons, you may wish to greatly reduce your ultra-processed food intake.

Hashimoto’s diet plans and protocols

Some diet plans and protocols may help you manage your Hashimoto’s.

Autoimmune-protocol diet (AIP)

The autoimmune-protocol (AIP) diet is a temporary elimination diet. Under the guidance of a clinician, you eliminate a list of foods for 30 days. Then you slowly reintroduce the eliminated foods, one at a time, to see if they trigger symptoms. One small 2023 study found that the AIP diet could be an effective approach to customizing nutrition for people with Hashimoto’s.

“For some patients, trialing the autoimmune protocol can offer insights into food sensitivities,” Dr. Habashy says, “though I encourage this with guidance to avoid unnecessary restriction.”

Paleo-style diet adapted for Hashimoto’s

The Paleolithic-diet sticks to foods that humans ate during the Paleolithic era. When adapted for Hashimoto’s or other autoimmune conditions, it’s called the autoimmune paleo diet, which is the same as the AIP diet mentioned above.

Mediterranean diet

The Mediterranean diet is naturally anti-inflammatory. It prioritizes plant-based foods, including fruits, veggies, whole grains, legumes, nuts and seeds, and olive oil. It also includes moderate amounts of fish, poultry, dairy, and eggs and allows for small amounts of red meat. Research shows that the Mediterranean diet may have a “protective effect against thyroid autoimmunity.”

Nutrients and supplements to support Hashimoto’s disease

Your body requires essential micronutrients in the form of vitamins and minerals for optimal functioning. Some micronutrients support metabolism and thyroid health. Boosting your intake of these may help you manage Hashimoto’s. While these can be gleaned from food, if you’re deficient, supplementation may be beneficial. However, you should consult a health care provider before adding supplements to your diet.

Selenium

Selenium is a mineral required for thyroid hormone synthesis, and some research has found that supplementation for people with Hashimoto’s who are not on hormone replacement therapy may be of benefit. You can get selenium from Brazil nuts and some seafood. However, selenium toxicity can occur from ingesting too much. So always consult your health care provider before upping your intake.

Zinc

Zinc is another mineral that supports the thyroid by metabolizing thyroid hormones. Zinc deficiency may also be a contributor to hypothyroidism, and supplementation may improve thyroid function. You can get more zinc in your diet by eating shellfish, legumes, pumpkin seeds, and some nuts. Zinc toxicity can occur from overconsumption, so, again, be sure to consult your health care provider before adding a significant amount.

Vitamin D

Thyroid autoimmunity and vitamin D deficiency share links, and vitamin D supplementation may help reduce antithyroid antibodies and inflammation. One study found that vitamin D supplementation reduced autoimmune disease by 22 percent.

You can get vitamin D from fortified foods, fatty fish, egg yolks, mushrooms, and more. Sun exposure also helps up your vitamin D, but too much sun exposure presents concerns regarding the development of skin cancer.

You can also take a vitamin D supplement, but toxicity can occur from getting too much of the “sunshine vitamin.” Again, talking to your health care provider regarding supplementation is always wise.

Omega-3 fatty acids

Omega-3 fatty acids are not micronutrients but rather healthy types of fat, a macronutrient. One study found that omega-3s, especially marine-derived forms, reduced autoimmune disease by 15 percent. You can add omega-3s to your diet by consuming fatty fish, seaweed (be aware of the iodine content in seaweed), nuts and seeds, and more. You can also take an omega-3 supplement in the form of fish oil or algae oil. Again, consult your healthcare provider if you’re considering supplementation.

Integrating lifestyle changes with diet

In addition to making dietary changes, making lifestyle changes can also help you manage Hashimoto’s. These include managing stress, prioritizing quality sleep, and getting regular physical activity.

Working with a healthcare provider

Revamping your diet can be a challenging process. You may wish to enlist the help of a medical professional, such as those at Parsley Health, to give you expert customized guidance and help you address any issues along the way.

Key Takeaways

• Hashimoto’s thyroiditis is an autoimmune condition affecting the thyroid gland.
• The thyroid gland produces hormones that are crucial for many bodily processes, and Hashimoto’s can cause the thyroid to be underactive.
• Although not a cure for Hashimoto’s, a Hashimoto’s diet may help reduce your symptoms and improve your quality of life.
• Hashimoto’s diets tend to be anti-inflammatory and gut-friendly, and they eliminate any trigger foods that may worsen symptoms.
• For a customized Hashimoto’s diet and management plan, Parsley Health can help. Reach out for a free consultation.

FAQ

What foods should I avoid with Hashimoto’s?

If you have Hashimoto’s, you may wish to avoid high-iodine foods and ultra-processed foods, the latter which can cause inflammation. Additionally, some people with Hashimoto’s will need to avoid gluten (if they have celiac disease) and lactose (if they are lactose intolerant).

What is the most effective diet with Hashimoto’s?

Research indicates that the Mediterranean diet may be the most effective at supporting the health of people who have Hashimoto’s. Other options include the autoimmune protocol (AIP) diet, also known as the autoimmune paleo diet.

Can you eat rice with Hashimoto’s?

Yes, you can eat rice if you have Hashimoto’s disease. Whole-grain options, which are unprocessed, are best.

Can you eat eggs with Hashimoto’s?

Yes, you can eat eggs with Hashimoto’s. Some evidence does suggest that some people with the condition may have an egg intolerance. Working with a clinician to undergo the autoimmune protocol (AIP) diet may help you determine if eggs are safe for you.