The best diets for Hashimoto's thyroiditis (HT) patients are the gluten-free diet, paleo diet, and vegetarian and vegan diets. Micro-nutrients to integrate in diet for patients with HT are Iodine (150-290 µg/day), Selenium (55-75 µg/day), Zinc (34-40 mg/day), Vitamin D (1500-2500 IU/day), and Vitamin B12 (2.4-2.8 µg/day). The worst foods for patients with HT that should be avoided are gluten, goitrogens, alcoholic drinks, food additives, and supplements (gums, lecithin, and coffee and fiber supplements). This chapter explores the dietary management of Hashimoto's disease.
TopIntroduction
Hashimoto's thyroiditis is part of the spectrum of chronic autoimmune thyroid diseases (AITD) and is associated with thyroid hypofunction, lymphocytic infiltration and production of thyroid auto-antibodies such as thyroid peroxidase antibodies (TPO-Ab) and thyroglobulin antibodies (Tg-Ab) (Caturegli, 2014; Mazokopakis, 2007a; Mazokopakis, 2010; Mazokopakis, 2007b; Mazokopakis, 2014). Although the exact mechanism of progressive thyroid tissue destruction is not clear, Hashimoto's thyroiditis is considered a disorder of T cell-mediated immunity, caused by an interaction between susceptibility genes and environmental factors, the research of which is still inconclusive (Mazokopakis and Kotsiris, 2014). In the majority of patients with Hashimoto's thyroiditis, life-long levothyroxine (LT4) substitution to achieve normal circulating thyrotropin (TSH) levels, is required (Topliss, 2016; Pearce, 2013) The additional role of diet for the management of Hashimoto's thyroiditis is usually overlooked and careful supplementation of possible deficiencies in Hashimoto's thyroiditis is recommended for the dietary management of these patients.
In addition, the co-existence of Hashimoto's thyroiditis with other organ-specific diseases (e.g. pernicious anemia, vitiligo, celiac disease, type 1 diabetes mellitus, autoimmune liver disease, primary biliary cirrhosis, myasthenia gravis, alopecia areata, sclerosis multiplex, Addison's disease), and non-specific non-endocrine autoimmune diseases (e.g. rheumatoid arthritis, systemic lupus erythematosus, Sjögren syndrome, systemic sclerosis), should be evaluated (Dillas, 2011; Boelaert, 2010).
The Best Diet for Hashimoto Disease
There are specific nutrients that should be regularly taken to maintain a healthy and functional thyroid. The top nutrients are Iodine (I2), Selenium (Se) and Zinc (Zn). 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, but if this is not possible, supplements are available. Diets beneficial for patients with Hashimoto disease include paleo diet, gluten-free diet and vegetarian or vegan diet.