Diet for Hashimoto's disease and hypothyroidism

Hashimoto's Disease and Hypothyroidism – Are They the Same?

As a dietitian, I often hear from patients in my office that Hashimoto's and hypothyroidism are the same. But is that really true? What products are allowed for these problems? And can the diet be the same for both? To explain what each term means, I would like to first explain the structure and physiology of the thyroid gland, which is where it all begins.

Thyroid gland structure

The thyroid is a small gland located near the front of the neck. This is why many people with thyroid problems feel a tightness in their throat, feel the need to drink when eating, and suffer from hoarseness.

Let's get back to the structure of the thyroid gland. It is often associated with a butterfly, because it is made of two lobes surrounding the neck. During the analysis of the imaging test, you can actually see the arrangement of the thyroid lobes in the shape of butterfly wings. In a healthy person, this gland remains practically invisible, because its size fits perfectly into the space between the trachea and the larynx. You have to lift your head up and swallow saliva in this position to see its outline.

But what if the bulge of the gland is very noticeable, for example when you look at yourself in the mirror? Then we may be dealing with a goiter, and it is certainly one of the symptoms of a diseased thyroid.

Thyroid functions

As I mentioned, the thyroid is an endocrine gland, or in other words, a gland that produces hormones. The hormones produced by the thyroid include thyroxine and triiodothyronine . They may be just two hormones, but they have such a big impact on our lives. The thyroid is essential for life, good (read: satisfying) functioning on a daily basis, and monitoring the work of your metabolism.

The main functions of the thyroid gland include:

• weight control,
• influence on the development of the nervous system,
• thermoregulation,
• control of energy metabolism, including influence on carbohydrate and fat metabolism,
• regulation of liver function,
• regulation of oxygen consumption throughout the body,
• the growth of the body and the development of the nervous system during the child's adolescence.

Hypothyroidism and Hashimoto's disease

Hypothyroidism – what is it?

Hypothyroidism is a condition in which the amount of T3 and T4 hormones in laboratory results decreases, while the level of TSH increases. TSH is a hormone produced by the pituitary gland, or more precisely, by its anterior lobe. Its main functions include - on the basis of feedback - sending an impulse to the thyroid gland to produce (or not) hormones.

Rising TSH automatically reduces hormone synthesis and slows down the thyroid function. In short, it receives a signal that it can slow down. If this condition persists chronically, it results in hypothyroidism. In hypothyroidism, iodine deficiency and iron deficiency also often occur.

Hashimoto’s disease – is it the same as hypothyroidism?

Autoimmune Hashimoto's thyroiditis, also known as Hashimoto's disease, is the most common disease associated with this gland and one of the autoimmune diseases. Additionally, it is already considered a disease of civilization. Contrary to appearances, it is not synonymous with hypothyroidism. However, it can be one of the causes of its failure and inhibit the synthesis of thyroid hormones.

Like other autoimmune diseases, Hashimoto's disease is when the immune system attacks its own tissues through excessive stimulation, in this case the thyroid tissue. Intensive secretion of pro-inflammatory cytokines is accompanied by inhibition of the secretion of cytokines responsible for immunotolerance. Then, during the course of Hashimoto's disease, increased tissue fibrosis occurs.

Abnormalities related to inflammation of the gland, its attack by the immune system and changes on the tissue surface lead to gradual impairment of its function, including the production of thyroid hormones. Low levels of thyroid hormones in the human body stimulate the pituitary gland to overproduce TSH, which in the long term can lead to reduced thyroid activity and ultimately to hypothyroidism. Hashimoto's disease is confirmed by laboratory tests, antibody testing and a thyroid ultrasound.

Symptoms of hypothyroidism and Hashimoto's

Hypothyroidism and Hashimoto's disease have different etiologies, i.e. causes of occurrence, but they are similar in… symptoms.

The most common symptoms of a failing or attacked thyroid gland are:

• feeling of throat irritation, difficulty swallowing and hoarseness,
• constant fatigue, lack of energy,
• poor exercise tolerance, rapid fatigue,
• reduced motivation to undertake tasks,
• ineffective sleep (difficulty falling asleep, frequent waking up at night, long waking up in the morning), feeling tired after the night,
• the need for a nap, especially in the second half of the day and after eating,
• feeling cold, freezing feet and hands (even in summer),
• slowing down of metabolic processes, weight gain (despite a constant diet and no change in eating habits),
• feeling of swelling – especially in the face, abdomen and legs, accumulation of water in the body,
• hair loss and brittle nails,
• dry skin,
• sudden mood changes, especially in the second half of the menstrual cycle ,
• low mood, including depression and anxiety (often also associated with increased body weight),
• menstrual disorders : irregular cycles, often anovulatory, up to complete cessation of menstruation (in poorly or completely untreated cases),
• problems with getting and staying pregnant, miscarriages,
• high levels of glucose and insulin in the blood,
• ailments of the digestive system and gastrointestinal tract, reducing the absorption of nutrients and possibly leading to deficiencies.

Nutritional recommendations for hypothyroidism and Hashimoto's disease

Dietary treatment for thyroid diseases should be adapted primarily to the type of disease and its cause, and additionally to the individual symptoms reported by the patient. It is also important whether there are other disease entities (e.g. diabetes, inflammatory bowel disease or pituitary adenomas), how the treatment of hypothyroidism is conducted and what lifestyle the person leads on a daily basis. A well-composed diet is certainly part of the therapeutic procedure.

Balanced diet for hypothyroidism

The diet in hypothyroidism should be varied, diverse and seasonal, based on good quality products and excluding highly processed foods. In addition, it is worth focusing on providing the right amount of minerals and vitamins, and also remembering about the appropriate heat treatment of dishes, because in hypothyroidism we often deal with improper functioning of the digestive tract and insufficient secretion of digestive enzymes.

You've probably heard that many people with hypothyroidism have problems with constipation? This is because a deficiency of thyroid hormones negatively affects metabolism and reduces the regularity of bowel movements. Therefore, a diet for a person with hypothyroidism should include an appropriate amount of fiber, preferably from vegetables and fruits, which affects intestinal peristalsis.

In any case, if dietary fiber appears in the diet, remember to drink at least two liters of water a day. Water deficiency in the intestines causes insufficient swelling of the fiber and irritation of the intestinal mucosa, which manifests itself in the digestive tract with flatulence and abdominal pain.

Also read our article: Irritable Bowel Syndrome and Your Period .

Hashimoto's Diet

An appropriate diet for Hashimoto's disease should, above all, be strongly anti-inflammatory and exclude products that stimulate the immune system.

Foods that can stimulate the immune system and thus increase inflammation in the thyroid include: wheat (sometimes also other cereals containing gluten), milk and dairy products, eggs, nuts, sesame, nightshades, citrus fruits and lean poultry. The diet of people with Hashimoto's should also not include products rich in trans fats. Their excess increases inflammation in the body.

Remember, however, that each person reacts differently to individual food products, so the individual properties of a given organism and the nutritional preferences of the person for whom we are creating a sample menu should be taken into account.

Ingredients essential for hypothyroidism and Hashimoto

You already know for sure that a person struggling with thyroid disease should avoid restrictive diets, regular meals are important, including fresh fruit and vegetables in the sample menu. But do not forget that in hypothyroidism and Hashimoto's disease we usually deal with a deficiency of several basic nutrients, including vitamins and minerals.

I encourage you to have regular diagnostic tests to check if your body is sufficiently nourished. This is important because by taking care of these substances in your daily diet and supplementation plan, we can reduce the number of unpleasant symptoms and improve thyroid function, which is beneficial to our health.

These are the nutrients you should remember first if you or someone you love is struggling with hypothyroidism and Hashimoto's:

• zinc,
• selenium,
• omega 3 fatty acids,
• vitamin D3,
• iodine.

Zinc deficiency and hypothyroidism

Zinc is an extremely important element that takes part in the regulation of basic metabolism. It has anti-inflammatory effects and is a strong antioxidant. Zinc takes part in the synthesis of the hormone triiodothyronine and supports the liver in detoxification processes. Long-term zinc deficiency leads to reduced thyroid activity, decreased thyroid hormone conversion and increased thyroid antibodies.

The diet for hypothyroidism should provide adequate amounts of zinc, and it is found in whole grain products, sea fish, pumpkin seeds, sunflower seeds and wheat germ.

Brazil Nuts for Selenium Deficiency

Selenium, next to zinc, is the most important mineral element in the fight against Hashimoto's disease. It takes part in enzymatic reactions and inflammatory reactions, where it plays the role of a strong antioxidant. Its deficiency leads to increased inflammation and oxidative stress in the thyroid gland. Remember, however, that selenium excess is just as dangerous to health as selenium deficiency, and it should only be taken with a proper zinc level.

Products rich in selenium include primarily sea fish and seafood, dairy products, legumes and Brazil nuts.

Omega-3 fatty acids

Polyunsaturated fatty acids, especially omega-3 acids, have proven anti-inflammatory effects. They participate in biochemical reactions, including increasing the sensitivity of triiodothyronine receptors. And for those struggling with skin problems in Hashimoto's disease, I have good news: omega-3 fatty acids reduce ailments such as dry skin, flaking, itching, pimples and acne.

Good sources of polyunsaturated fatty acids are fish, flax seeds and good quality vegetable oils. Avoid too many nuts and seeds, especially peanuts, which are a rich source of omega-6 fatty acids, which can be harmful in excess.

Daily Vitamin D Requirement

You have certainly heard about the many health-promoting properties of vitamin D, also known as the sun vitamin. But did you know that its supplementation should be mandatory in thyroid diseases? Vitamin D3 - in addition to having a strong antioxidant effect - additionally reduces the excessive response of the immune system to its own antigens, or in simpler terms, protects the thyroid gland from autoaggression.

Daily vitamin D3 requirements should be determined by your doctor or clinical dietitian as they vary with season, gender, age, lifestyle and diet.

What about iodine?

Iodine is essential for the synthesis of thyroid hormones. Too low doses of iodine in the daily diet lead to a decrease in the synthesis of T3 and T4, with a simultaneous increase in TSH, which can consequently lead to hypofunction of the gland. Additionally, changes in the structure of thyroid tissue may appear. At the same time, too high doses of iodine taken by a person increase inflammation in the body. Therefore, the decision to supplement iodine should not be made on your own.

Goitrogens and Hashimoto

Goitrogens are substances found in certain foods that, when consumed in large quantities, can limit the absorption of iodine. They are often referred to as goitrogenic substances. These primarily include legumes and cruciferous vegetables. Goitrogenic substances negatively affect the absorption of iodine. Although the diet contains a high supply of iodine, the content of goitrogens affects its deficiency.

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