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When it comes to addressing hypothyroidism and Hashimoto’s, certain nutritional and herbal compounds are invaluable. All the supplements in the world, however, will fall short if you fail to make the necessary dietary changes to support your condition.

Americans are infatuated with pills, thanks to decades of conditioning from the pharmaceutical industry. It doesn’t matter whether they come from the pharmacy or the health food store, we have a cultural fixation with finding that magic bullet. It’s no wonder—making genuine, lasting changes to your health takes hard work and discipline, the two last things you’ll see advertised on commercials during your favorite television show.

If you want to continue feeling sick, then continue eating the Standard American Diet (SAD). If you want to feel better and you have autoimmune Hashimoto’s, you’ll need to say a permanent goodbye to gluten. Someone emailed recently saying she had Hashimoto’s and wasn’t feeling better even though she was 90 percent gluten-free. When you have Hashimoto’s that’s like being 90 percent pregnant, you need to commit to a 100 percent gluten-free diet, which, thanks to an exploding gluten-free market, is getting easier every day.

You’ll need to repair a leaky gut by removing the foods to which you are intolerant. The worse your leaky gut the longer this list of foods could be. Also, I and many other practitioners are increasingly finding many patients require a diet free of grains, starchy vegetables, and sweets, and need to follow something akin to the GAPS or Specific Carbohydrate Diet (SCD). Newer research shows that healing of the small intestine, the seat of digestion and absorption as well as food intolerances, requires a lengthy abstinence from these foods. I use this diet here.

To support all these efforts you also have to balance your blood sugar imbalances with a diet that is significantly lower in carbohydrates than most Americans are accustomed to, and ditch the unfounded fear of healthy fats.

Going gluten-free is vital first step

Removing gluten is a vital first step if you have Hashimoto’s. Even if you don’t have Hashimoto’s, chances are removing this ubiquitous toxin from your diet will help you greatly. Numerous studies from several countries show a strong link between gluten intolerance and Hashimoto’s. When immune antibodies tag gluten for removal from the bloodstream, where it landed thanks to a leaky gut, this stimulates production of antibodies against the thyroid gland as well. In other words, every time you eat gluten, your immune system launches an attack not only against gluten but also against the thyroid gland. This immune response to gluten can last up to six months each time it’s ingested. It’s just not worth it. Also, as I continue my research and practice in neurology, I never cease to be amazed at how profoundly one’s brain health, a concern for all those struggling with hypothyroidism, can be impacted by removing gluten from the diet.

When gluten-free isn’t enough

Some people with Hashimoto’s give up gluten and feel only marginally better. Many practitioners have found in these cases a diet free of grains, starchy vegetables, legumes, and most sweeteners may be necessary. This type of diet, called a monosaccharide (single sugar) diet, is more commonly known today as the Gut and Psychology Syndrome (GAPS) diet, or the Specific Carbohydrate Diet (SCD). It is based on consuming a diet free of foods that contain disaccharides or polysaccharides, more complex sugars and carbohydrates, such as those in all grains, most beans, and most sweeteners. These complex sugars feed harmful bacteria in the small intestine that prevent its repair or proper function.

For details click here.

Elimination/Provocation diet

People become so accustomed to eating certain foods that they don’t realize those foods are harming them. Instead they think a foggy brain, skin rashes or rosacea, chronic respiratory issues, joint pain, water retention, a distended belly, chronic digestive issues, and more are a normal part of life. Foods that most commonly trigger these reactions are gluten, dairy, eggs, corn, soy, and yeast. Sometimes nuts are a problem. Technically a person can develop an intolerance to any food, especially one that is eaten repeatedly when a leaky gut is an issue.

In the book I outline how to undergo the Elimination/Provocation diet. Basically you eliminate the foods I just mentioned for two to three weeks, then reintroduce each food, one at a time, every 72 hours. Monitor yourself closely for reactions, which can be physical, psychological, or emotional. If you react, then you know that is a food you need to remove from your daily diet. After undergoing the monosaccharide diet or a protocol for leaky gut, you later may be able to add back in one of the formerly offending foods (except for gluten of course). I go over a protocol for repairing leaky gut in the book.

Balancing blood sugar

Gut health is dependent on balanced blood sugar—blood sugar imbalances create stress, which in turn inflames the digestive tract.  The nice thing about the monosaccharide diet (GAPS, SCD) is that its low-carb nature automatically makes it conducive to both balancing blood sugar and repairing the digestive tract. Outside of that diet, plenty of books and websites are devoted to low-carb diets and how they can balance blood sugar. The average American diet and even the USDA food pyramid are simply too high in carbohydrates, which is not conducive to good hormonal health. I do not advise people to eat a specific amount of carbohydrates as everyone’s needs are different. Instead I ask you to monitor whether you feel sleepy or crave sugar after a meal. If so, you just ate too many carbs for your system. Other tell tale signs can include insomnia or waking up at 3 or 4 a.m., an energy crash in the late afternoon, feeling spacey, irritable or light-headed if you go too long without eating, constant hunger, constant craving for sweets, and difficulty losing weight. If you have any of these symptoms you may have hypoglycemia, insulin resistance, or a combination of the two.

Putting diet to work

One practitioner, Yolanda Loafer, DC, emailed our website to report back on her success with a patient in Romania with whom she had been working long distance. (We get emails from around the world, but only have trained practitioners in the United States.) Because this woman is not able to get any U.S. supplements through Romanian customs, Dr. Loafer worked with her on diet alone and the patient quickly noticed significant improvements. For my upcoming book on brain chemistry I have also received a number of stories on how changing the diet radically improves brain health.

I realize making drastic dietary changes takes a re-education, negotiating meal times with your family, and a sorrowful goodbye to some old favorites. Many people balk at the idea of giving up gluten because they cannot imagine life without toast or delivered pizza. However once they take the plunge, they also realize it’s not nearly as hard as they thought it would be. More limited diets, such as the monosaccharide diet, can mean even more severe changes to your lifestyle and your pantry. So what keeps people going? The huge benefits they reap. I know people whose suicidal tendencies disappeared on a gluten-free diet, or whose chronically distended, upset bellies flattened and quieted on a monosaccharide diet. If compliance is an issue, you may benefit from an online or in-person support group, hypnotherapy, counseling, or some other method to motivate you to stick to your diet and better your health. You’re worth it.

It can be difficult to stick to a thyroid-healthy diet when practically every television commercial, every billboard, and every person around you is tempting you with starchy, processed junk foods. But when people complain they want to eat like a normal person, I say fine, then you will be sick like a normal person.

33 Comments

  • Tracy deMeza August 10, 2010 at 9:25 am

    Wow! Thank you for coming out and connecting the GAPS/CSD diet to your awesome protocol for addressing Thyroid autoimmune disease! I was so sure that your line of reasoning was so in tune with Natasha Campbell-McBrides after reading both your books that I made sure to tell my practioner, Dr Shane Steadman here in Denver about it. My good friend Carol who alerted me to your book originally last year had already made that connection and as a result of the GAPS, has helped her daughter Amy back to health overcoming a chronic candida issue. Thank you for your continued good work and research and I pray that the standard medical world will soon awake to ‘smell the coffee”!!!!!!

  • Carolina Nava August 10, 2010 at 11:59 am

    I’d like to know the opinion that Dr. K has about ayurvedic medicine and diet. It’s really difficult to be gluten free in Mexico, products are barely sold here. I can’t even find quinoa, I really need something that can help me, I eat brown rice, chicken,fruit and non-starchy vegetables. But sometimes I feel the need to eat chocolate….I really need someone’s guidance.

  • Linda Wilbert August 10, 2010 at 1:06 pm

    I am from Germany and talked about Dr. K’s book and diet in a German Hashi forum. There are 2 people I know of who got off gluten and iodine, eat a low carb diet and leave out foods that could cause allergies. They reported feeling better already.
    Some of them ordered Dr. K’s book but the majority don’t know English enough to understand and they would love to see the book translated into German Language.

  • Raoul August 10, 2010 at 1:47 pm

    It may be harder to eat in a thyroid healthy way in Mexico if you are looking to contiue to eat as always but withut gluten. The eaiest way to avoid gluten is to avoid grains altogether, My family all has gluten problems so we just quit grains, period. No one needs grain. There is no dietary requirement – for anyone – to have grains. Or other carbohydrates, even.

    All carbohydrates turn to sugar eventually, and that just tampers with the blood sugare and insulin mechanism and nobody needs that. Fruit is full of fructose, the same thing as the abhorred but addictive high fructose corn syrup (HFCS). Different people can tolerate more, and less, of these foods.

    I have Hashimoto’s and about a year and a half ago stopped all grains, roots and fruits. The Hashimoto’s is still raging, and I have found I am mercury toxic. As that gets mobilized and removed, I am certain my body will be able to heal much better now that my diet has been excellent for a good amount of time.

    My 18 year old daughter eats this way, too; it is wonderful to see a young person who is so eager to restore her health that she will, even in the company of her friends, eat the way she must.

    • dmc April 8, 2013 at 1:37 am

      Fruit is not full of the same fructose found in HFCS…… plz do your homework.

      DMC

  • Clementine August 10, 2010 at 8:58 pm

    From the time someone with Hashimoto’s Disease kicks gluten, how long would you say it would take to feel a difference? 30 days? 6 months?
    Thanks in advance.

    • Blair January 17, 2014 at 9:03 am

      For me, days. With significant improvement (energy, consistent sleeping, no more brain fog, no more anxiety, no more rollercoaster blood sugar episodes) within a week. I’ve also lost ten pounds in two weeks (and I’m a short woman, so that’s significant).

      I was diagnosed with Hashimoto’s in my mid-twenties and have been “managing” it with biannual blood work and Synthroid dosage adjustments, with my GP, for seven years. But I kept gaining weight, having many of the other symptoms, and feeling depressed and anxious. I have done “paleo” diets in the past but couldn’t stick to it. That always made me feel much better, especially regarding energy levels and sleep patterns. But doing gluten free and sugar free (except limited fruit, mostly berries), has made a huge difference. Try it and see if it works for you! I’m hoping the weight loss will result in a lowered Synthroid dosage at my next appointment, in another couple of months. But be careful – if you lose weight and are on a too-high dosage for your size, you may experience hyperthyroid symptoms (not fun) and incur long-term bone density and heart damage. So keep in touch with your doctor.

  • Dr Charles Parker August 11, 2010 at 3:23 am

    Dr K,
    Look forward with anticipation to meeting you one day at the NeuroScience meetings! Great post here, see so much of this everyday, and appreciate you insights into the diet for thyroid recovery. As a traditional psychiatrist who has decided to enter that more informed, *comprehensive* medicine, territory I share your concern about simply diagnosing by appearances.

    Many thanks,
    cp

  • Steven Wright August 11, 2010 at 10:30 am

    Great post and the quote about American society is spot on I see it everyday!

    The SCD diet has completely reversed my IBS issues and I’m just now starting to sort out any left over thyroid issues. I’ve chronicled my SCD journal on my blog at http://scdlifestyle.com/category/steves-scd-diet-journal/

    If any readers are interested I co-authored a book on how to properly start and execute the SCD diet which can be found at http://www.scdlifestylebook.com/

    We also offer a free guide on how to properly start the SCD diet in the next 24hrs which can be downloaded here http://scdlifestylebook.com/free.php

    I encourage everyone to try SCD or GAPS as most people don’t even realize just how sick they are until they get rid of grains and other problem foods!

  • This is a great article. I was gluten, dairy and soy free but I still had a lot of issues. It took the edge off but wasn’t helping me heal. I’ve been on GAPS now since last October and my life has completely changed because of it. Thanks so much for the informative information!

  • luis martinez b. August 23, 2010 at 8:05 am

    I live in mexico,and I would like to share some tips on finding proper food while on scd and gaps.I deal with hypothyroidism and I have found a great relief out of gluten.You can share my e’mail with them. Thanks. lmb

  • Debbie August 23, 2010 at 9:57 am

    Interesting article. I have been on a low carb diet since 2006, gave up gluten in January 2009. Got diagnosed with Hashimoto’s in January 2010. I don’t feel *bad* but not sure I feel great either. But my doctor only wants to treat me with either levoxyl or synthroid, and wants to put me on STATINS too as my cholesterol is much higher than usual – but I think that is a symptom of uncontrolled hypothyroid myself, and feel statins are useless for women anyway, and my HDL (62) and triglyceride (65) numbers are fine all, so I ain’t taking any statins.

    But it’s so frustrating dealing with the medical establishment – who won’t even CONSIDER anything beyond synthroid or the next pill. I think I’d be feeling much worse if I was not gluten-free and pretty low carb.

  • Teri Lawrence September 4, 2010 at 10:57 am

    Are you able to direct me to a recipe for Dr.K’s chicken broth? Any foods or recipe’s would be most apreciated.Thanks.

  • Groover September 5, 2010 at 4:28 am

    I’m an athlete and have recently been diagnosed with Hashimoto’s. I’ve been living Vegetarian for many years (since I was 13) and was wondering if it is possible to follow the above mentioned diet and still remain Vegetarian?

    • admin September 6, 2010 at 7:49 pm

      It will be different for everyone. Hopefully you do not have an intolerance to eggs or dairy. The important thing is to keep your blood sugar stable and not overdo the carbs, and make sure you are getting enough nutrients such as B12 and zinc.
      Elaine

  • Virginia September 9, 2010 at 9:15 am

    I would like to have practitioner’s list names in Belgium!… I have been on diet and exercise for sooo long… and gain weight like nothing… My energy levels sometimes are at the floor with only 36 years!. I am with a nutricionist now and taking 115 mgs of levotiroxyne and have not been able to loose weight in 3 months period of dieting.

    By myself I discovered that gluten is not doing well on my intestines and stomach, but never had an intolerance test and asked my nutricionist to give me a gluten free diet and have felt much better since then…

    Virginia

    • Chantal De Cauwer April 16, 2013 at 1:28 am

      I also live in Belgium and am looking for a good doctor to manage my Hashimotos.
      Did you find somebody ?

      Please let me know.

      Chantal.dc@telenet.be

  • chrissy September 16, 2010 at 9:04 am

    I am so amazed at how much better I feel since I have listened to this dr. k. I had hashimoto’s disease and antibodies were 1000 or higher. I removed gluten and my antibodies went to -10. dr. k is amazing and have saved so many lives by thinking differently

  • Jen September 18, 2010 at 6:20 am

    Heard about you on a podcast.
    CFIDS and Hashi – anti TPO almost 700 but thyroid levels not all that off.
    CFIDS 4 years before Hashi. Sick and housebound for 10 years.
    Negative candida test (bloodwork). No celiac symptoms at all. No weight issues (BMI of 20), thyroid hormone levels stable pretty much since start of T3 and T4 supplementation.
    No thyroid symptoms (I think..unless the CFIDS ‘masks’ them. I didn’t notice I had Hashi either)
    Tried gluten free diet once for 2 weeks – made no difference at all.
    Should I try gluten free for longer? (especially with high likelyhood of XMRV+ in mind, how much could a glutenfree ‘fix’ if retrovirus is cause, and is GF diet really worth the trouble / money ?)

  • jason kennedy October 18, 2010 at 4:36 am

    Very well written blog! it is very hard to find something that is very innovative, unique and knowledgeable views,i really admire your views Thanks ..keep it up

  • A concerned hashimoto's patient May 23, 2011 at 5:28 am

    I’m calling BS on this gluten free shit. I haven’t eaten gluten in years not because I was trying to avoid gluten but because I was avoiding grains and starchy vegetables in attempt to manage my diabetes because they tend to be high in carbs. Only through this diet and ALOT of exercise did I lose 100 pounds. But as far as hashi’s is concerned NOTHING improved. I am feeling every symptom I ever had and even worse because all this exercise is really draining my adrenals. Medication is the best way to treat this. I am not saying synthroid is the best but it is impossible to cure this disease with diet alone. If you felt u cured this just from altering your diet you never had this disease to begin with.

    • Nick September 1, 2013 at 11:14 am

      Your adrenals MUST be addressed properly as your hypothyroid treatment
      is only making it worse. It is a golden rule in treating hormonal dysfunction.
      Exercise may be interfering with your cortisol levels, not necessarily a good thing when you may have adrenal insufficiency and hashi’s.
      My opinion, not associated with gluten-free diet.
      You may have sustained substantial impairment already, where a gf diet may not make a notable difference.

  • A woman August 8, 2011 at 7:37 pm

    So I eat gluten-free, dairy-free, try to aim for more protein/veggies than carbs, mostly organic, my skincare/bath/body are all organic and I always do the natural route on everything I can if and when possible (like coconut oil for dry areas on skin, jojoba oil for dry scalp, etc.). I workout, exercise daily (0ver an hour). I am on t3 and t4 medication. Waiting for this miracle weightloss. I’ve done this for YEARS. I am a positive thinker and I go to bed late sometimes, so that I do need to work on. De-stressing, I do try with baths, walks, candles, massages, positive thinking/prayer, etc. I avoid caffeine/coffee b/c that is a big no-no with my stomach. I supplement with B’s, C, D3, Omegas, strong probiotics, minerals/vitamins like selenium and calcium/magnesium/zinc. I’m far from perfect (I do need to cut out Splenda, yes I know about all the toxins of sweeteners, so I do use honey or go without). I screwed up stuff in the past with a mostly vegetarian/tons of soy diet and too much stress. I’d like to think that eventually it’s reversible, and completely manageable.

  • sandra W. August 13, 2011 at 7:47 am

    I have been gluten free for at least 8 months and don’t see a difference in my hashis, i still have same amount of antibodies; i still cannot regulate my T levels and have found to have high RT3. Even taking T3 alone doesn’t help. Then it goes too low. I wonder if there is a Dr. K trained doctor here in Mexico City that I can be referred to. I have been trying to see about going to San Diego to see Dr K but it is difficult for me.

  • Karen October 23, 2011 at 2:17 pm

    I elimated all grains, and my TBO dropped from 165 to 45 in a month.
    Not eating gluten was not cutting it. I had to stop corn and rice.

    I was getting horrible edema and could not fit into my pants, and my face
    and arms were getting puffy and hard. I’m doing lymph drainage and accupuncture 2 x s a week, and eating protein (I don’t care about fat as long as it’s grass fed and vegtables) and I’m losing a few pounds. I also elimated caffiene and slurged on supplements recommended by Dr. K’s protocol through my internist before I start throid medication. Magnesium and the body work has helped with constipation.

    I’m still having symptoms but slowing down some symptoms before I try medication. I would say to others please check your allergies so you do not through more fuel into the flame. My MD recommended coconut oil and it only inflamed me because I have a strong intolerance towards it.

    I doubt I will be eating out much anymore, there is too much cross contamination in those kitchens!

  • Diane March 13, 2012 at 9:55 am

    I once corrected my Hasimoto’s going grain/sugar free when I was 31. That was 31 years ago, but somehow I knew bread made me fat and ill, so I did what my instincts told me too. Still had Candida issues the last 20 years on and off and never felt my thyroid was completely normal. Then I did a gluten challenge at age 61 knowing I’d comply better to the diet if I knew I was gluten intolerant. It destroyed me. I’m hypo/hyper now (Hasimoto’s), gluten intolerant, have 22 + other food intolerances, Candida, non-erosive reflux, and chronic fatigue. My diet is austere eating only fresh meats, fish, veggies, and salad since I have to eat for Hasimoto’s and Candida at the same time. Garlic kills me, so I got a severe reaction when ingesting it unintentionally. Restaurants don’t honor my allergy requests. I got gastritis from that one expose. I’m hoping this diet and nutritional support will once again restore my health like it did 30 years ago.

  • Carrie June 4, 2013 at 4:45 am

    Can you weigh in on what you think about Almond Milk? Many things I have read say almonds are good, others say avoid almonds but what about almond milk for Hashis? If not almond, soy or cow milk, are there any options that are OK besides Coconut Milk?

    Also, can you recommend the best comprehensive blood test panel to have done for a good baseline marker? TSH, T3, T4, Reverse T3, Ferritin, Thyroid Antibodies, Estrogen…..what else?

    And what are you thoughts on blood tests for food intolerances? I know they often show false positives, but I have eliminated just about all I can eliminate and don’t know what else to do identify as possible problems?

  • Michelle July 4, 2013 at 8:39 am

    You wrote about Hashimoto’s and repairing a leaky gut. What is the correlation between them?

  • Carla November 20, 2013 at 1:11 pm

    Hi, I was diagnosed with Hashimoto’s earlier this year and was given levothyroxine which I found very helpful. However, my recent bloodwork showed that I’ve stopped producing TSH, so my dose was lowered from 50mg to 25, and I’ve really been suffering, it has thrown me into depression. I am hesitant to try a gluten-free diet… for one thing, it’s seems to be very much the fad diet of the moment that everyone is prescribing as a kind a panacea, which makes me skeptical. Additionally, I present differently than other patients with Hashimoto’s. I am very skinny, even underweight if I’m not careful and I tend to be hypoglycemic. So cutting healthy sugars out of my diet seems like a bad idea.
    If gluten-free really will make me feel better, I’m willing to try it, but I want to know if it actually pertains to the Hashimoto’s symptoms that I suffer from. Any feedback you have would be greatly appreciated.

    • Diane January 3, 2014 at 5:02 pm

      Carla, it’s definitely not a fad diet. I would have thought so, too (and indeed, used to) but reading “Wheat Belly” finally made me understand the problem. Wheat is not what is used to be for centuries…when it was the staff of life. About 50 years ago, food scientists tinkered with it in an effort to increase yield (and they were successful!), but in the process, totally changed its composition and its properties. By this point, all the wheat grown commercially is this messed-up version and it seems to be responsible for so many of our modern ailments.

      Regarding your experience with Hashimoto’s, is it possible for you to join the Hashimoto’s 411 Facebook group? There are many people there just like you, who don’t seem to fit the typical profile yet have their own symptoms that need to be addressed to prevent further problems. You could pose your questions and get lots of good answers–I’ve seen it again and again. If you’re not on Facebook, check out http://www.hashimotos411.com. The group and website were created by those who were helped by Dr. K’s book and protocol. Good luck!

  • Taylor January 19, 2014 at 12:23 am

    Had hash\\’s for 5 or 6 yrs! Very sensitive to the meds..my tsh started at 10 dropped and anious ato 4.5 (I felt too nervous with a low number) now yts later tsh is 70.0! My cortisol is high and adrenals are affected! I exercise and do lose weight at times, watch what I eat, so I\\’m not over weight, I weigh 110 lbs but was wondering if g-free can help my tsh? Or a nutritionist? I do not want to try anymore pills or herbs too scared

  • Rosalind February 3, 2014 at 1:18 am

    I have high level antibodies – so, Hashimotos. My doctor put me on Armor (1 grain). I put on weight while on it, my energy did increase and now I’m off it I can feel the my energy has lowered.

    My question is – Should I take Armor and up the dose to (??)or should I just concentrate on fixing my adrenals and probable leaky gut and leave the Armor alone??

    Rosalind

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