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Diet in Hashimoto's disease is a very important element supporting the treatment. Its goal is to reduce inflammatory responses, which may help to reduce the symptoms of the disease. What are the dietary rules for Hashimoto's disease? Which foods are allowed and which are not allowed to be eaten?

Diet in Hashimoto's disease - rules

Protein

The proportion of protein in the diet in Hashimoto's disease should be 15-25% of the energy requirement. Protein amino acids, especially tyrosine, are necessary for the synthesis of biologically inactive T4, which is then transformed, for example, in muscle into active T3.

Tyrosine is also needed for the synthesis of dopamine, adrenaline and norepinephrine, a deficiency of which can exacerbate the mood disorders that are characteristic of hypothyroidism. Although tyrosine is an endogenous amino acid (synthesized by the body), another amino acid - phenylalanine - is required for its production, which must be supplied with the diet. In addition, an increased amount of protein in the diet speeds up metabolism.

Recommended sources of wholesome animal protein are lean meat (poultry, rabbit, beef), fermented dairy products (yogurt, kefir), and eggs. However, soybeans, beans, lentils and peas are good sources of vegetable protein. However, due to the high content of anti-nutrients, their amount in the diet in Hashimoto's disease should be limited.

Low-calorie and protein-deficient diets should be avoided as they may inhibit the secretion of thyroid hormones and reduce the metabolic rate.

Fat

Diet in Hashimoto's disease should contain 25-30% of fats with the reduction of unsaturated fatty acids up to 10% per day. Due to the strong anti-inflammatory properties, it is recommended to consume omega-3 polyunsaturated fatty acids, the source of which are fatty sea fish, linseed oil, and linseed.

In addition to anti-inflammatory properties that inhibit inflammation within the thyroid gland, omega-3 fatty acids will support the synthesis of thyroid hormones. The consumption of saturated fatty acids contained in fatty dairy products should be limited, as their excess may inhibit the synthesis of thyroid hormones.

You should also reduce your consumption of trans fats in fast-food, ready-made confectionery and cookies. Trans fatsshould constitute less than 1% of the body's energy requirements.

Carbohydrates

Good dietary carbohydrate sources for Hashimoto's disease should account for over 50% of energy requirements. It is recommended to consume products with a low glycemic index, which will stabilize the blood glucose level, as patients with Hashimoto's disease may have problems with its proper level.

A symptom of Hashimoto's disease is constipation, therefore a diet in Hashimoto's disease should contain an adequate amount of dietary fiber, i.e. 25-30 g / day. Dietary fiber will additionally stabilize cholesterol and blood glucose levels. The recommended source of carbohydrates and dietary fiber at the same time are whole grains and groats.

You should completely exclude or minimize the consumption of products with a high content of simple sugars, which are found in sweets, cookies, sweetened jams and concentrated juices.

Diet in Hashimoto's disease - anti-nutritional substances

Vegetables and fruits are a very important part of the diet in Hashimoto's disease, because they provide antioxidants and dietary fiber, and their daily consumption should be at least 0.5 kg. However, some plants contain the so-called anti-nutrients such as goitrogens.

Goitrogens interfere with the absorption of iodine, which is necessary for the synthesis of thyroid hormones and may be the cause of goiter formation. Thermal treatment reduces goitrogens by about 30%, therefore the consumption of plants containing these substances is recommended in moderate amounts (preferably after heat treatment), so as not to completely give up a valuable source of important nutrients and dietary fiber.

Products containing large amounts of goitorgen are:

  • soybeans,
  • broccoli,
  • Brussels sprouts,
  • cauliflower,
  • kale,
  • radish,
  • cabbage.

Products containing moderate amounts of goitorgen:

  • millet (millet),
  • peaches,
  • peanuts,
  • pear,
  • spinach,
  • strawberries,
  • sweet potatoes.

Green tea may also have an adverse effect on iodine absorption, as it contains catechins and flavonoids, which may reduce iodine absorption.

Diet in Hashimoto's disease - key vitamins and minerals

The synthesis of thyroid hormones is a complex process, requiring cofactors in the form of minerals and vitamins at various stages of their formation. Studies have shown that people with Hashimoto's disease are worth consideringsupplementation of selected nutrients.

Jod

Iodine is a key element needed for the synthesis of thyroid hormones because it is built directly into them. Iodine deficiency results in a decrease in T3 and T4, enlargement of the thyroid gland and the formation of goiter. The need for iodine for an adult is 150 μg / day.

The main sources of iodine in the diet are iodized table s alt, sea fish (haddock, cod, halibut, pollock), milk and dairy products. However, we should remember that the iodine content in food products depends on its content in soil and groundwater.

Studies show that an excess of iodine in people with Hashimoto's disease can increase the inflammatory process within the thyroid gland. Sensitivity to iodine is also determined individually, so before starting supplementation, you should consult your doctor or dietitian.

Selen

Selenium deficiency disrupts the tissue conversion of T4 to T3 and the functioning of glutathione peroxidase, an enzyme that prevents oxidative damage to the thyroid gland. The effect of selenium on the body depends on the supply of iodine. Proper supplementation has been shown to reduce the levels of any-TPO and anti-TG antibodies.

The daily selenium requirement for an adult is 55 μg / day. It is enough to eat 2 Brazil nuts to cover the daily selenium requirement. Other food sources of selenium include salmon, chicken eggs, and buckwheat.

Selenium can be supplemented (selenomethionine) in selected clinical cases. However, before introducing supplementation, it is worth consulting a doctor or dietitian, because excessive selenium intake is toxic to the body. An excess of selenium in the body can also increase the excretion of iodine in the urine.

Zinc

Zinc, like selenium, is a substance with antioxidant and anti-inflammatory properties, therefore it will suppress the reactions resulting from the autoimmune system in the thyroid gland. Zinc deficiency results in a decrease in the level of thyroid hormones and an increase in the level of anti-TPO antibodies and anti-TG antibodies in the blood.

The daily requirement of an adult for zinc is 8-11 mg / day. The best food source in the diet is oysters, but in our climate zone it is not a product that is eaten too often. Other food sources of zinc include wheat germ, liver, pumpkin seeds, and cocoa. In the case of a deficiency of this element, supplementation in a dose of 10 mg / day in the form of zinc citrate may be considered.

Iron

Iron is necessary for the conversion of thyroglobulin to T4 and T3 by thyroid peroxidase. Therefore, its deficiency reduces the synthesis of thyroid hormones.Iron deficiency occurs in up to 60% of people with hypothyroidism, and anemia can be a symptom of this. Women are particularly prone to iron deficiency, as they may experience heavy periods.

The diet of people with Hashimoto's disease should include easily digestible sources of iron (heme), such as liver, beef, eggs. To improve iron absorption, you should consume foods rich in this element together with foods rich in vitamin C, e.g. red pepper, currant, parsley. However, you should avoid consuming products that impede the absorption of iron, e.g. red wine, tea.

Vitamin D

Vitamin D, apart from its participation in the regulation of calcium metabolism, participates in immune processes. Studies have shown that vitamin D levels are lower in people with Hashimoto's disease than in he althy people.

Therefore, according to the recommendations from 2022, Hashimoto's disease is a risk factor for vitamin D deficiency. Taking into account that in our climate zone (autumn-winter period), skin synthesis of vitamin D is insufficient, it should be supplemented.

According to the current guidelines for the Central European population, adults are recommended to take 800-2000 IU of vitamin D per day in the fall and winter, depending on body weight. In people diagnosed with vitamin D deficiency, it should be higher (even up to 10,000 UI / day) and used until the optimal concentration of vitamin D in the serum is obtained.

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Diet in Hashimoto's disease - allowed and contraindicated products

Products and dishesRecommendedNot recommended or recommended in moderate amounts
Drinks
  • still water
  • fruit and herbal teas
  • milk (depending on individual tolerance)
  • freshly squeezed vegetable and fruit juices
  • drinks: almond, oat, rice
  • coffee
  • alcohol
  • water and sodas
  • black and green tea
Dairy
  • low-fat yoghurts and kefirs
  • lean curd, eggs (depending on individual tolerance)
  • fatty cottage cheese
  • yellow cheeses
  • processed cheese
  • cream
Meat and fish
  • veal
  • lean beef
  • turkey
  • chicken
  • rabbit
  • s altwater and freshwater fish
  • pork
  • mutton
  • fatty beef
  • duck
  • goose
  • offal
  • smoked meat and fish
  • cured or fried
Fat

Oils:

  • sunflower
  • rapeseed
  • linen
  • olive oil
  • sesame paste
  • butter
  • lard
  • hard margarines
  • peanut butter
  • coconut milk
Vegetables
  • carrot
  • parsley
  • celery
  • potatoes
  • squash
  • pumpkin
  • zucchini, cucumber, beets, tomatoes, lettuce, peppers, mushrooms, avocados
cruciferous vegetables (broccoli, Brussels sprouts, cauliflower, turnips, radishes), onion vegetables (onion, garlic), legumes (beans, peas, lentils, soybeans, chickpeas) sweet potatoes, spinach
Fruits
  • apple, banana,
  • berries: blueberries, wild strawberries, raspberries, blueberries
  • citrus
  • apricots
  • nectarines
  • cherries, cherries
  • plums
  • kiwi
  • currant
  • gooseberry
  • mango
  • pineapple
  • pear
  • strawberries
  • dates
  • peaches
  • pickled and dried fruits
Bread, flour, groats
  • wheat, rye and barley flours and gluten groats (depending on individual tolerance)
  • oats
  • amarantus
  • brown rice
  • buckwheat
  • whole grain pasta
  • rice flour
  • corn flour
  • millet
  • Cassava (tapioca)
  • white rice
Desserts
  • kisiele
  • jelly
  • fruit mousses
  • fruit smoothies
  • ice cream
  • bars
  • ready-made cakes and pastries
  • white chocolate
  • greasy cream on cream
Nuts and seeds
  • brazil nuts
  • almonds
  • walnuts
  • hazelnuts
  • pumpkin seeds
  • sunflower seeds
  • sesame
  • peanuts

Diet in Hashimoto's disease - what can you drink?

In sicknessHashimoto's is recommended to drink about 2 liters of fluid a day, depending on body weight. Preferably in the form of mineral still water or freshly squeezed vegetable and fruit juices (but remember that they contain a lot of simple sugars).

Coffee is not forbidden as long as there are no symptoms following consumption. It is similar with alcohol. However, you should bear in mind that alcohol can increase inflammatory responses in your body.

Black and green tea should be consumed between meals, not during meals, so as not to interfere with the absorption of key minerals.

Diet in Hashimoto's disease - food hypersensitivity

In people with Hashimoto's disease, a frequent occurrence of food hypersensitivity to proteins contained in milk, its products and eggs. Recent scientific research focuses on the individual tolerance of people with Hashimoto's disease to milk proteins (e.g. casein). Another problem is lactose sugar intolerance, which occurs in 30% of adults.

Lactose intolerance may affect the absorption of drugs (levothyroxine). It has been shown that lactose intolerant patients need higher doses of the drug to achieve the same blood levels of the hormone than those without lactose intolerance. Milk and milk products are a good source of iodine and complete protein. Therefore, it is not recommended to follow a routine dairy-free diet without proper research.

In addition, people with Hashimoto's disease are more likely to coexist with various forms of gluten sensitivity, such as celiac disease. It is estimated that 3.2% to 43% of people with Hashimoto's disease have some form of gluten sensitivity.

Worth knowing

Diet in Hashimoto's disease - general recommendations

  • eat 4-5 meals a day regularly with 3-4 hours breaks
  • avoid starvation and very restrictive calories
  • add a source of wholesome protein to each meal
  • eat complex carbohydrates, the source of which should be whole grain cereals, vegetables and fruits that do not interfere with the absorption of key minerals
  • eat at least 0.5 kg of vegetables and fruits a day, as they are an excellent source of dietary fiber and antioxidants
  • eat good quality fats from fish, unrefined oils, seeds and nuts
  • drink about 2 liters of fluid a day, preferably in the form of still mineral water
  • don't forget that the diet gives the best effect with regular physical activity

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Diets