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Hashimoto’s Diet: Keys to Success


Hashimoto’s is the most common autoimmune disease in the United States. It is a thyroid disorder and an autoimmune disease. The autoimmune part of the equation makes virtually everything a challenge and this is particularly true when it comes to trying to figure out what to eat.

One of the absolute truths about Hashimoto’s is that no 2 people have the same version of the disease. There are too many variables, people are at different stages of progression, and they have other autoimmune, endocrine, digestive or systemic problems.

So, generalizing about what kind of diet is the best is kind of like asking, “Where do I build my house on this minefield?”

Where Do I Build My House On This Minefield?

You build it where it won’t set off the mines. Some people estimate that 70 – 80% of the immune system is found in the gut. 

Whatever the actual percentage, there is no doubt that what goes through your digestive system has a huge impact on your immune system. Huge.

This concept is just common sense, but many doctors and health care practitioners ignore it. Why? One doctor friend of mine put it to me this way.

He said, “I don’t bother trying to change people’s diets. It’s easier to get an alcoholic to stop drinking than to get people to change the way they eat.”

People are attached to food. It has cultural, emotional and psychological roots that run deep. However, if you have Hashimoto’s and you want to learn to manage it properly, you need to abandon all of that. It will not serve you.

Leaky Gut: Adding Gasoline to the Fire

Many people with Hashimoto’s also have intestinal permeability, also known as leaky gut. A healthy GI tract is one that one has a lush forrest of villi, all held tightly together.

This keeps the bad guys, like bacteria, chemicals, environmental toxins and undigested food out of the blood stream. Unfortunately, chronic inflammation turns this lush forrest into a desert and poor diet, blood sugar imbalances and chronic stress open up wide chasms that a molecular 18 wheeler could drive through.

Many people believe that this actually sets the stage for the onset of autoimmune disease when the immune system shorts circuits and starts confusing other stuff with our own tissue. The one food that is most often implicated in this is gluten.

Fix the Gut, You Slow the Hashimoto’s

Many people also believe that the best way to heal autoimmune disease is by healing the gut. ( I am one of those people. ) So this begs the question, what heals the gut?

The first step to healing the GI tract is to remove all the foods that are creating chronic immune responses. Eventually, you can add them back in one at a time (hopefully). When you do you will begin to discover your own unique set of land mines.

And instead of rummaging around in the dark there are now also diagnostic tests available to help determine which foods cause an autoimmune response in you (More on this in a moment). This can save you a lot of trial and error and can help you identify the really bad ones.

Most of The Foods That Cause the Most Damage Are the Ones You Love

The foods that tend to be the worst are those that you, invariably, love the most. Like ice cream, cheese, bread, and pasta. And there is a biological reason for this. Both foods made from gluten and milk have proteins that are very similar in structure to morphine.

They are called casomorphin in milk and gluteomorphin or gliadorphin in wheat products. Now wonder we love them, we’re freakin’ addicted to them!

Different Camps of Autoimmune Diets

There are a few different camps out there for autoimmune disease diets. Most of them involve elimination and provocation. In other words, you take foods out and put foods back. The biggest differences seem to be which foods you put back.

Once again, the reality is that some people can put some foods back and others can’t. Remember, your Hashimoto’s is not your brother’s or sister’s Hashimoto’s. You have to find your own way. There are some foods that some people will have to eliminate from their diets forever. FOREVER.

And this is the real challenge. Because some people will suffer more from cheating than others. But, even if you feel like the damage wasn’t so bad and you can live with it, it may be destroying valuable tissue like your brain or something that you might want to use later in life.

Cheating can have serious and, sometimes, silent consequences, like the destruction of important tissue.

Here’s a quick overview of the most popular diets currently being used.

Paleo AutoImmune Diet

The Paleo diet or Paleolithic diet, also called the Cave man diet or Hunter-Gatherer diet, is one in which you are told to eat like our nomadic ancestors. Centered around common modern foods, this diet consists mainly of fish, grass-fed pasture raised meats, eggs, vegetables, fruit, fungi, roots, and nuts, and excludes grains, legumes, dairy products, potatoes, refined salt, refined sugar, and processed oils.

Critics argue that this diet is essentially just the Atkins diet with a few updates, but it has a loyal following. And if you really ate like our Paleolithic brethren, that is, you hunted around the African plains with a spear and a few rocks, you would eat a diet that was largely plant based with a few lucky days of meat binging thrown in.

And you would spend a lot of time running and doing old school cross fit maneuvers as you escaped hungry lions and hyenas. Definitely a formula for good health – if you didn’t get eaten.

The autoimmune version of this diet removes grains, eggs, beans, legumes, dairy, soy, refined sugar and salt, all processed oils and nut based oils, and night shades (tomatoes, eggplants, peppers and potatoes) and, sometimes, nuts.

Its really restrictive, but can be quite effective. The real issue seems to be – can you come up with a diet plan that isn’t basically all meat all the time? And you definitely can. You need to make a conscious effort to have plenty of fruit and vegetables.

Some people with Hashimoto’s do very well on this diet and it can dramatically improve the health of your gut on its own. Add some supplements that heal the intestines, as well, and you could have a winning formula. (More on that in an upcoming post)

Vegan Autoimmune Diet

The flip side of Paleo is the Vegan autoimmune diet. It is, essentially a gluten and, in some cases, grain free vegan diet. No meat, no dairy, no eggs, no animals, and no fish. And in some cases, no grains or beans.

Critics of this diet argue that you don’t get enough amino acids from plants alone and many Hashimoto’s folks are also iron,  B12 and Vitamin D deficient and its hard to virtually impossible to effectively keep those levels up without animal products or supplementation.

It also takes a lot of things, pardon the pun, off the table. So it doesn’t leave you a lot left to eat.

But this diet also has its loyal fans and can be very effective in reducing the inflammation that drives the autoimmune process and destruction of the gut. If supplements are added here, and you eat enough, you can also have a winning formula with this approach.

Blood Typing Might Help Determine Which Is For You

Some people think that one way to figure out which version of the autoimmune diet is best for you might be to use blood typing. Those with blood types that need meat (Type O) might do better on Paleo, those who are not big meat eaters (Type A) may do better with the Vegan version.

The remaining blood types (B and AB) might need some hybrid of the two. Which ever you chose it is vitally important to eat as much variety as you can within all these restrictions and to supplement with iron, Vitamin B12 and Vitamin D as it becomes necessary.

Whatever You Choose, Lectins Are Out

All of these autoimmune diets remove lectins. Lectins are nature’s answer to insects long before Monsanto began its evil march towards domination of our food supply.

They are, basically, natural pesticides that live in plants to help them survive the ravages of fungi, bacteria and viruses. They are kind of like natural toxins.

Lectins are carb binding proteins that protect plants and have other functions like protein synthesis and delivery in animals. They’re pretty sticky molecules, which makes them cause problems in our intestines because they get stuck there and start eating away at the walls.

It is believed that lectins leave leaky gut in their wake, in a trail of savaged villi. Once they have wrought their carnage, they breach the walls of the intestines and leak into the bloodstream with lots of other unwanted particles. And the immune system goes nuts trying to deal with it all.

Foods with the highest amounts of lectins are: grains of all kinds (wheat being the worst), legumes (soy being the worst), nightshades (mentioned earlier), and oils made from seeds. GMO foods also have lots of lectins because they are used in genetic modification to enhance pest and fungal resistance.

Further Complications

Salt: Recent studies have indicated that that high salt levels may push the initiation of autoimmunity by driving the TH-17 pathways. Basically, its an on switch.

Problem. Lots of Hashimoto’s people have low blood pressure and desperately need salt. Iodine can also be bad for some Hashimoto’s people. Answer: Moderate salt without iodine (unless you are iodine deficient – there’s always a caveat).

Sugar Issues: Many Hashimoto’s people have blood sugar issues and if their blood sugar goes too high or too low it can really impede their progress. Some of these diets are so restrictive that people’s blood sugars end up dropping and spiking and they wind up defeating the very program that they are on.

Answer: Find the foods you like, eat them often. Start the day with a protein. Don’t ever skip meals.

Anemia: Many Hashimoto’s patients develop anemia for a host of reasons. This can completely undermine any dietary changes you are trying to make. Test for iron deficiency and red blood cell counts and make sure you are supplementing with iron if necessary (especially if you are choosing the vegan route). Vitamin C can also enhance iron absorption.

Cross Reactors: These are foods that have a similar protein structure to gluten and our own tissue. Like gluten, they may have to permanently avoided because they drive the autoimmune attack and disease progression.

Parasites, Candida and Other Critters: Some people with Hashimoto’s may also also require additional treatment of the ecosystem of their intestines. These can further complicate dietary restrictions and supplementation.

Adrenal Issues: The adrenals play a critical role in intestinal permeability and with insulin resistance. Cortisol causes the intestinal walls to open further and it makes insulin not work a well. So stress management and adrenal love are also really important.

Other Autoimmune Diseases: Many Hashimoto’s people have other autoimmune diseases in various stages of progression and some of these can have a huge impact on the digestive system, such as Type I diabetes, adrenal autoimmunity, liver autoimmune, Crohn’s disease and more. If these factors are present, adjustments must be made accordingly.

And this is just an overview to give you a sense of the complexity, difficulty and variability of what you are dealing with. There are many more issues that can come into play and undermine your progress. These include, the gall bladder, neurotransmitters and the brain, low stomach acid and more!

Diagnostic Testing

There is some terrific diagnostic testing available today that can help to decipher some of these puzzles. We can test for intestinal permeability, cross reactors, additional autoimmune issues, etc. These tests are not that expensive if your doctor won’t order them or doesn’t know that they exist.

Bottom Line:

Diet is critically important in the successful treatment of Hashimoto’s, but a diet that works for someone else may not work for you. You need a program that is tailor made for your unique set of circumstances and related issues.

That’s why I created my program, Healing Hashimoto’s: The 5 Elements of Thyroid Health. In this program you learn the tools you need to successfully identify your unique challenges and how to craft a healing strategy that will work.





Prevalence of celiac disease in autoimmune thyroiditis. Minerva Endocrinol 2007 Dec;32(4):239-43

Celiac disease and autoimmune thyroid disease. Clin Med Res 2007 Oct;5(3):184-92. Review


{ 72 comments… add one }
  • Sandy March 20, 2013, 12:46 pm

    I enjoyed reading your blog entry.

    I have tried both the GAPS Diet and the SCD diet. Both allow no grains. Three times my T3s crashed from elimination of the grains. I was on Synthroid and the doctor added Cytomel to bring my T3s up. Unfortunately I could not tolerate the Cytomel and was forced to add gluten free grains back into my diet. When I did, my T3 came back up and I felt much better. I am not so sure grain free is an option for everyone. I have also had the ALCAT Food sensitivity test which said I could tolerate oats (gluten free). This was incorrect. I adhered to a strict diet eliminating all the food intolerances listed and felt much, much worse when the six months was over. Because of this I do not trust the accuracy of these tests anymore and I have had this test a few times by various companies. They always come up with different results as well. The ALCAT test also said I have no problems with dairy and I don’t believe I do which goes to show one size diet doesn’t fit all like you pointed out in your blog. Dairy isn’t always a culprit.
    I believe the body is capable of healing it’s own leaky gut once you remove the food intolerances from your diet. There is no need to take expensive supplements in order for the gut to heal in my opinion. The body has an amazing capability of healing itself. I also make my own homemade yogurt which I personally feel has really helped my gut to heal.

    • Marc Ryan March 20, 2013, 12:52 pm

      Hi Sandy,

      Great comment! And a perfect example that there are always exceptions to the rule and, in the case of Hashimoto’s, there are no rules. I’m sure you are right that homemade yoghurt has helped you. That’s great that you are doing that. Could you share your recipe with us?


      • Sandy March 20, 2013, 12:58 pm


        I follow the SCD Yogurt recipe. This video on You Tube is great if you are interested in making it. It’s so easy and I use the same yogurt maker as in the video.


        • Marc Ryan March 20, 2013, 1:06 pm


          Here’s an interesting article explaining why your T3 crashed after going off of carbs. http://drcate.com/going-low-carb-too-fast-may-trigger-thyroid-troubles-and-hormone-imbalance/

        • Marc Ryan March 20, 2013, 1:20 pm

          Thanks for the recipe!

          • Sandy March 21, 2013, 8:25 am


            Thank you for posting the link to that article above. After looking further into Dr. Cate’s site I see she is now questioning complete removal of grains. I believe she is an advocate of sprouted grains now. I do believe that low carb is not the way to go with me even if I were to ease into it. I feel much better when I have brown rice in my diet. I don’t think I will chance going grain free again after three failed attempts and feeling quite ill.


    • Helen September 1, 2013, 5:25 am

      Paleo is not necessarily lowcarb, it is carb neutral. Whatever carb level that suits you. Low, medium or high. Going grainfree does not mean having to go lowcarb at all, it just means getting rid of a type of carbs that may trigger inflammation, leaky gut etc. There are many vegetables with good carbs to eat instead of grains. I eat AIP with a high level of carbs from different vegetables like sweet potato, carrots, orange and many others. I feel much better highcarb than low, but can not eat grains. See neutritional charts to find good carbs that can replace grains, it´s worth testing.

      • Marc Ryan September 1, 2013, 5:53 pm

        Hi Helen,

        Great point! Thanks for that insightful comment. That’s very true. Not all carbs are created equal. And one other point that this reminds me of is that carbs are essential for many people with Hashimoto’s because they aid in the conversion of T4 to T3, among other things.

        So yes, good carbs. Generally the bad ones are those containing gluten and those that are heavily refined.


  • theresa April 30, 2013, 6:45 pm

    I was recently diagnosed, I’d say its been about a month or so.
    I’ve been noticing a lot of body chills, and muscle aches throughout the day. I notice that when I get hungry I “bottom out” and can feel my body really just turn into joint pain and aches.

    My husband has been reading a lot on the Gerson diet. Which is all veggies and juicing. I’ve been researching more thyroid targeted diets.

    Do you have an opinion on the Gerson diet for someone with Hashimoto’s?

    • Marc Ryan May 1, 2013, 7:53 am

      Hi Theresa,

      Thanks for your question. I think that there are some really good elements in the Gerson diet. I particularly like the emphasis on juicing and vegetables. My concern for Hashimoto’s patients is the inclusion of Rye bread.

      Rye bread contains gluten which is extremely problematic for Hashimoto’s patients, in my opinion. I am in favor of the autoimmune Paleo diet with a strong emphasis on vegetables.

      I have actually created a Hashimoto’s Diet Plan video that has just been completed. We will be releasing it today to everyone on our list or who is a fan of our facebok page. In it I detail an effective Hashimoto’s Diet. Please check it out. It covers a lot of different issues related to diet and Hashimoto’s.


      • Mo Demers January 7, 2014, 1:42 pm

        I know it has been some time since this initial post, but I’d be very interested in the Hashimoto’s Diet Plan. Can you tell me where to find it now??

        • Marc Ryan January 7, 2014, 3:36 pm

          Hi Mo,

          I no longer offer this as a separate program. It is currently a bonus part of my 6 week program. I also offer a free 30 minute Hashimoto’s Healing Discovery session. In it, you cna share where you are and where you want to be, I can make some suggestions and we can discuss how else I might be able to help. If that interests you, you can schedule by clicking the link on the button in the right column of my home page.


  • Kathy Grauerholz July 18, 2013, 8:52 am

    HELP – just diagnosed with Hashimotos Disease. I was treated for Chronic Lyme disease in 1991 had many inflammatory issues there after and then Graves Disease between treated 2007 – 2010 and supposedly cured. I I am never well . Your site gives me some useful info-

  • Michelle July 30, 2013, 12:09 pm

    I was diagnosed with Hashimoto’s 2 years ago. The doctor started me on a thyroid medication. I tried 2 different kinds(Levothyroxine and Amour). Both of them made me feel 10 times worse, and I was napping even more now(not by choice either). I gave it one last shot with Cytomel(please forgive my spelling). And yeah you guessed it still in the can. I decided to stop all of them and figure out a different way. I have a friend that is a hormone specialist she told me she understood why these drugs weren’t working, my thyroid at the moment was fine. She said to take Gluten out of my diet, that seemed to help a little. Since then I have tried numerous supplements(I take about 40 each day(20 in AM and 20 in PM). I’ve adjusted this and that, taking them according to the issues I incur with Hashimoto’s(fatigue and libido(are the biggest factors right now) but I also have memory, eczema, hair loss, weight, & irritability. Some of them started getting under control, but then every couple of months it will change up on me. I’m at a loss anymore. I’ve almost taken all dairy out of my diet, butter has been the hardest culprit. I even detoxed for a week(which did lower my numbers when I was detoxing and did feel better after getting past the complete toxin clearing). I liked the feeling it gave me so much I began doing it for breakfast and lunch, things were going good and I was even starting to lose a few pounds. But lately(the past 2 weeks) I have been feeling sluggish again and the eczema is coming back with a vengeance. I’m allergic to whey and sulfa. It’s been very hard trying to find a substitute for protein for a juice detox drink and I’m wondering if this might be the reason I’m having issues(since I read the article above that says type blood O needs meat). Do you have any recommendations to help? Also my son who has been struggling with weight since he was 2 and is now 10 we found out has gluten intolerance. I’ve taken him off Gluten for a year and a half, but have seen no changes in his gut. I’ve recently started taking the dairy away, but still not a lot of changes. He has been diagnosed with ADHD, they wanted to put him on Ritalin which I was totally against. I’m thinking his diet may have a lot to do with it. Any suggestions where I might start or that could help him? I know I’m asking a lot, thanks for taking the time to read and help answer any of my questions.

    • Marc Ryan August 1, 2013, 5:29 pm

      Hi Michelle,

      Thank you for your comment. Wow, it seems that you have a lot going on. A few things jump out at me. First, regarding your son. Diet can be a huge impact on brain function. Gluten in particular has been shown to have a powerful neurological effect, most of it really bad. So I would urge you to get him off of gluten 100%. One important thing to understand is there is no such thing as sort of gluten free or almost gluten free. It gets lodged in the intestines and can take months and months to be cleared by the body.

      The second thing is that there are other foods that may behave like gluten. These are known as cross reactors and they can also have a powerful effect. This could be the reason why you aren’t getting the results that you want. I also recommend eliminating gluten, dairy and soy 100%.

      If this doesn’t work you may need to go on a special autoimmune diet. This is what I put my patients on after I have assessed all the major systems of their body and identified what is going on. The diet itself, while very helpful is often not enough. But when supplements are taken and supported by an autoimmune diet, then the results can be nothing short of miraculous.

      Hope that helps!



  • Robyn Lefor August 7, 2013, 5:45 am

    It took sseven years for me to get the corrrect diagosis of Parkinson’s. The main reason was the extreme pain that I was experiencing in my legs. Rarely do Parkinson’s patients have pain only in their legs. My nuerologist called me a “complicated case”. That was two and a half years ago. My Parkinson’s symptoms are pretty much under control, but this pain persisted. I found a doctor that specializes in Hashimoto’s. I have been on a very restrictive diet(no gluten, no sugars, no red meat, no dairy, no eggs) for three weeks. During that time I had seven days in a row of no pain and increased energy. My last two days have been hard because my pain has returned despite the fact that I am still following the diet. I feel discouraged but I am sticking with the diet until we figure out m personal dietary needs. Your article is very encouraging. Thank you. P.S. I was born with an autoimmune disorder: Psorisis.

    • Marc Ryan August 9, 2013, 10:16 pm

      Hi Robyn,

      Thanks for sharing your story. It’s not unusual to make some progress then to slip a bit back. I encourage you to stick with it. Its also important to understand that there are many things in play here. This truly is complicated. But rather than letting that discourage us, we just have to accept it and start looking at the body globally. Usually multiple systems are involved and you need a multi-system strategy to resolve it. Diet is only one piece.

      Hang in there and please keep us posted on how things progress.


  • Roxanne August 12, 2013, 12:34 pm

    I had Graves Disease about 16 years ago, under control after 1 year of PTU. Went to MD said my thyroid levels are normal except Thyroid Perodoxidase antibodies is 294, indicating Hashimoto’s. Sending me for an ultrasound of thyroid. I have been extremely tired lately, forgot to tell the doctor. Is there anything I can do for the tiredness?? Started a gluten free diet last month. Im not very strict now though. Just looking for answers.

    • Marc Ryan August 17, 2013, 6:04 pm

      Hi Roxanne,

      Thanks for your question. In my opinion, being “sort of” gluten free for someone with Hashimoto’s is like an alcoholic being “sort of” sober. It just doesn’t work. If you want to feel better you need to really commit to eliminating the things that may be causing your fatigue and in my experience the 3 worst offenders are gluten, dairy and soy. These must eliminated 100%. The reason for this is that these 3 foods are the most immmunoreactive foods in our diet, they cause immune flare ups which lead to a more aggressive attack on the thyroid and a more aggressive progression of the autoimmune disease.


  • Kathy August 16, 2013, 7:42 pm

    Had a TPO blood test with a result of 109. I’ve been exhausted all the time for 5-6 yrs approx. Up to 280# which I can’t lose. I was once a VERY active person. I’m 58 & know I still am but for this fatigue. I know it’s “not my age”. That’s who I am. But now I need 12 hrs sleep (actually more) just to feel somewhat rested (which doesn’t last long). I can fall asleep easily cuz I’m so tired. I (usually) am in bed by 5pm. I get off work at 3:30pm. I’ll sleep till I get up at 5:30am. I’m embarrished by this! I’m sleeping my life away. I feel it’s beyond my control. Any thoughts? Thank you!

    • Marc Ryan August 17, 2013, 6:12 pm

      Hi Kathy,

      Thanks for your question. Clearly, you are experiencing hypothyroid symptoms. This can be caused by many things. Are you taking any thyroid replacement hormone? If you are what could be happening is that your cells are not absorbing or utilizing what you are taking. There are many causes of this including: inflammation, liver detox issues, adrenal issues, gut issues and more. The reality is that Hashimoto’s is a multi-system disorder that often requires a multi-system strategy. The best thing to do is to get a proper workup and evaluation.

      Best, Marc

  • A Hughes August 17, 2013, 4:22 am

    I had Lyme disease in 2010. It took my orthopedic dr to be the one to discover it. Early this year in February I became very sick with what I thought to be a stomach virus. I’ve always been sensitive to food and switched from milk to almond milk for many years now. I saw a NP that did blood test that confirmed I have Hashimoto. I’ve seen several Endocrinologist and my GP since and they all insist I take the conventional thyroid drugs which I’m scared to start. I told one Endo doctor it was because I read once you start it you lose the ability to ever produce the natural hormones again. Said she takes it and doesn’t feel so great then she told me either take it or she wouldn’t treat me at all.

    I’m type O negative and now checking into the blood diet but not a big fan of red meat so it’s a challenge. I now use soy instead of coconut creamer because the diet recommends the switch. the NP put me on Thyroid 130 back in February and I’ve been on it ever since. Getting ready to follow up with her on recent blood work done by my GP to see where things are. My concern is the soy. I only buy the organic type because I am afraid of Monsanto GMO and would like to know anyone’s thoughts or experience with soy. My neighbor said she stopped eating it because it made her bleed. Not sure what since that was her only comment. She’s been on the conventional meds for twelve years. Thx!

    • Marc Ryan August 17, 2013, 6:20 pm


      Thank you for your comment. Wow, it sounds like you really have a lot going on. I, personally, am not a big fan of soy. It is one of he foods that seem to be pretty problematic with Hashimoto’s. I would recommend going back to the coconut creamer. There are a number of other foods that can cause problems as well. But eliminating them can make a huge difference in how you feel. Diet alone is not the only answer but it is a very important foundation for the other things you must do.

      Also know that there are many natural options. However, Hashimoto’s is a disease in which your immune system slowly destroys your thyroid. If you can slow the destruction and calm the immune system you have a much better chance of success without medication. Even then in some cases you may have to eventually use medication.

      I offer a free 30 minute confidential consultation if you’d like to learn more about what your options are. There is a button on the home page you can click to schedule a time.


  • Linda B. Maine August 20, 2013, 6:55 am

    I was diagnosed with Hypothyroidism 20 years ago and have been on synthroid ever since. I now have Hashimoto Thyroidism. I have several allergies to medications, enviromental, and food sensitivities/allergies including but not limited to Bakers yeast, Coconut, whole milk, potato, sugar, brewers yeast, onion, rice, tomato, malt, green pepper, garlic and sulfites. I am finding it very difficult to find a diet of foods that I can eat that will help stabilize my disease. I feel best on a high protein low carb diet, however very boring and limited. Do you know how many foods have the above ingredients in them. Most. Entering menopause has only compounded the problem. Was manageable prior to menopause. Any suggestions on diet or how to handle hashimoto’s disease while going through menopause?

    Linda B. Maine

    • Marc Ryan August 20, 2013, 10:56 am

      Hi Linda,

      Welcome and thank you for sharing your story and for your question. Yes, those ingredients are in pretty much everything!

      One simple truth about Hashimoto’s is that it is much more than a thyroid problem and one of the common areas of the body that often needs attention is the GI tract. What you describe is actually quite common and it is important diagnostically because it points to the extent of the issues you may have. Whenever I see severe sensitivities to so many things I start to suspect a compromised barrier system.

      In the GI tract this is what is commonly know as leaky gut or intestinal permeability. When I work with patients with these types of issues, I recommend testing for intestinal permeability to see the extent and the severity of the damage and then I provide supplements and a special diet for repairing and rebuilding. This takes time and patience but it can be repaired to a large extent. And as you repair those barriers foods that you could not tolerate in the past, you may be able to restore to your diet.

      Menopause may also exacerbate this because many of the hormonal changes can lead to a further breakdown of these barrier systems. I offer a free 30 minute confidential consultation if you’d like to discuss this further. You can schedule by clicking the link on the home page.

      Best, Marc

      • Linda B. Maine August 22, 2013, 5:18 am

        Thank you Marc. I will look into the GI Tract part of this. I did have another question. Pertaining to caffeine. I drink two cups of coffee per day. Do you feel caffeine/coffee is bad for folks with this disease and/or do you feel it would prohibit weight weight loss? I would love a free 30min. consultation. However, there is one problem. I live in Maine and you’re in California…:(

        Thanks, Linda

  • Ana August 30, 2013, 8:18 am

    Hi! I just found your blog and I already got a lot of information from this little post.I was diagnose over ten years ago. I have been on different doses of syntroid through this journey but my levels had never been able to stabilize. I originally was on generic syntroid but every time I got a new lot my levels changes. I went gluten free on January 2012, I never felt better! Lately I have been feeling low on energy and achy, but my levels are normal. I was looking for and anti inflammation diet and found your post. I would like to know more about the Paleo autoimmune diet. Do you have a post I can check out? Also that Gerson Diet sounds good, minus the rye bread which I don’t eat anyway. Please I am desperate i want to feel normal and the tiredness and pain dont help. I am very active I run and cycle and go to the gym but with no energy is hard to do anything like that. I currently take 200mcg of selenium and 1000mg of Vitamin D3 and a multivitamin at night. Any info, links I would really appreciate it. Thanks in advance.

  • Sarah August 30, 2013, 4:33 pm

    I have had Hashimotos since in was 16. Eight weeks I was told this by my specialist.
    Misdiagnosed for 20 years. Through trial and error for 20 years, I’ve maintained.
    Just had a thyroidectomy three weeks ago. Fatigue is an understatment. I started with extraction therapy. Whole food processing with fruits and veggies. Felt fantastic. Starting the Paleo soon. I’ve never had sugar issues or salt issues. I just never add salt because I’m used to not eating processed food. Love reading others stories. Marc I will look into your regiment. I am not a fan of the word diet. What is your Facebook page called?

  • Susan Brittain September 5, 2013, 4:49 am

    I was diagnosed with Hashimotos eighteen months ago and also have a small goiter as well as several nodules. I have had no medication or real advice on what to eat and what not to eat. I am still learning what is gluten free and what isn’t. I am also a vegetarian so the paleo diet does not appeal at all. I use rice milk, no form of margarine, a minimal amount of cheese on the odd occasion. I eat a lot of fruit and veg and love my salads. Instead of cutting everything that I need to cut out in one hit, I am removing it slowly that way I won’t crave it and my system won’t get so much of a shock. I love chocolate so I have gone to a gluten free chocolate and it is yum! I take a magnesium supplement as well as a supplement to aid in a healthy thyroid and adrenals.

    Now I get to my question. Can you please tell me what fruit, vegetables, nuts and salads I must stay away from? I know I have to cut cheese and bread out. Thats not an issue as I will go gluten free with the bread.

    Thank you for your time

    • Marc Ryan September 5, 2013, 2:55 pm

      Hi Susan,

      Thanks for your comment and question. It’s a bit more challenging being vegetarian and having Hashimoto’s. Principally because of the general tendency to have difficulty absorbing nutrients. In particular, you need to check on iron, B12 and B6 and potentially other vitamins and nutrients like magnesium, selenium and vitamin D.

      These may all need to be supplemented. As far as what you must stay away from, it is generally grains that cause problems in the gut. The Paleo folks are very anti-lectins which are very common in all grains and beans. I have found peas and mung beans to be well tolerated. Nuts can also be problematic, almonds in particular seem to cause problems with many of my patients and myself.

      You know, everyone is a little different. The best thing to do is eliminate all beans grains and nuts except peas and mung beans for a period of time (30 days) and then reintroduce them one at a time.

      There is also testing available that I do with my patients to check for cross reactive foods: these are foods that behave like gluten. The important thing not to do is to just ignore these potential deficiencies. These must be monitored and corrected if deficiencies are found because if they worsen they can cause a whole cascade of health problems.


  • Teresa September 17, 2013, 8:48 am

    This blog is very informative. Thank you! I have a 12 year old son who was diagnosed with ADHD 4 years ago. Recently, his thyroid was tested because although he has no symptoms of thyroid disorder, his family history contains a lot of thyroid cancer. He was found to be hypothyroid and have Hashimoto’s. He is thin and athletic, full of energy, with none of the typical hypothyroid issues. After reading Dr. Kharazzian’s book, we have eliminated gluten from his diet. He doesn’t feel any differently, maybe because he has always felt well. I’m beginning to wonder whether a leaky gut could have led to both his Hashimoto’s and ADHD symptoms. Is it possible for someone to have a leaky gut with no digestive symptoms? Do you have any recommendations for pursuing treatment? His endocrinologist and pediatrician are only interested in treating symptoms. He has an upcoming appointment with a pediatrician with some interest and training on natural treatments. Do you have any suggestions as to what i should ask this doctor to do besides check for leaky gut?


    • Marc Ryan September 17, 2013, 11:04 am

      Hi Teresa,

      Thank you for reaching out! You have a number of excellent questions, let me address the issue generally and then answer them one at a time:

      Firstly, there are a couple of things to be aware of when treating Hashimoto’s. Number 1, it is a progressive disease. Like all autoimmune disease it goes through stages, some stages can last many years. Number 2, it is a multi-system disorder so sometimes symptoms pop up in unexpected places, like the brain, or the gut or the adrenal glands.

      1. Is it possible for someone to have a leaky gut with no digestive symptoms? Yes, symptoms that may be caused by leaky gut include neurological, psychological and cognitive issues that have no apparent link to digestion.

      2. Do you have any recommendations for pursuing treatment? Because of the complexity of the problem there is no simple answer to this question. This is a bit like asking, “How do we fix global warming?” There are many possible courses of action and those depend on proper evaluation and assessment. If the doctor or practitioner is unaware of the complexity, they may fail to find the cause of the problem. It’s a a bit like trying to save a forest. If you are only conscious of a few trees and those trees look healthy, then you might miss the rest of the forest that is not doing well at all.

      3. Do you have any suggestions as to what I should ask this doctor to do besides check for leaky gut? Since ADHD is your son’s chief complaint, then some workup of brain nutrition and function should be done.

      In addition, I offer a free 30 minute Hashimoto’s Healing Discovery session. In it we can discuss the specifics of your son’s case, I can find out where he is and where you want him to be, and I can make some suggestions that could be helpful. And, finally I can share with you how I can help. If that interests you, there is a link on the home page to schedule an appointment.


  • Tiara October 5, 2013, 12:12 am

    I am 17 and have recently been diagnosed with Hashimoto’s. I am hoping the medication will help me have more energy. I’m curious about trying a gluten-free diet and a little nervous because I love my bread and pasta lol. Since I’m neither rich nor a cook, I’ve mostly been relying on the good old Kraft dinner and ramen diet. Can you suggest some cheap, easy to prepare alternatives to pasta please? Would be a great help. I don’t see myself having trouble avoiding cakes and cookies because i dislike those and love vegetables, but the bread and pasta are definitely going to be difficult haha.

    Oh! And with meat–I’ve been told I may be slightly anemic (my birth mother is) and I’m type O positive, which means I probably should be eating more meat, but I am just not a meat eater! The only meat I like is chicken! Do you have any suggestions about that???

    • Marc Ryan October 6, 2013, 9:33 pm

      Hi Tiara,

      Thanks for reaching out! First thing I would recommend is getting good cookbook and learning how to cook. Depending on what’s going on with you, it’s best to have a diet that, at minimum doesn’t include gluten, dairy or soy. Hashimoto’s is an autoimmune disease and these foods are the most immunoreactive. Meaning they wind up your immune system. When your immune system is wound up, you get a more aggressive attack on your thyroid and more destruction of thyroid tissue.

      If you are anemic, this is a major issue. Because when your body is anemic, nutrients and oxygen aren’t getting to the cells of your body. Your chances of improving your health are very poor. I would encourage you to get a blood test that looks at your red blood cell counts and your iron levels.

      Also, I don’t know if you are aware of it, but I offer a free 30 minute Hashimoto’s Healing Discovery session. In it you can share with me where you are and where you want to be and I can make some suggestions that can help right away. And we can talk about how I may be able to help. If that interests you, you can schedule by clicking the button on the right hand column of the home page.


      • Tiara October 7, 2013, 11:11 pm

        Thank you. So far I haven’t had much energy to cook at all, especially when it’s just for me, but like I said I’m hoping that will improve with time. Just one other question I was wondering about! My doctor prescribed me iodine, but I’ve read that a lot of doctors do not reccomend taking iodine. As I live far away from his clinic, it’s difficult to ask the questions I need to know. I am not sure whether he prescribed it because I am iodine deficient or just because. My question is whether I should take it until I am able to see him again. Do you know if iodine deficiency may be more common in Native Americans?

  • Doris October 7, 2013, 11:14 am

    I was just recently diagnosed with Hashimoto’s and while frantically researching online, came across your website, which seems so thorough, well organized, very informative, and I appreciate the references/links. So, thank you, for making time to help others, I will definitely be following you on FB.

    I was curious as to your thoughts on Iodine painting/coloring. I understand that the general consensus is for one with Hashimoto’s to avoid iodine altogether, but until tests are done to confirm levels, would you recommend painting a thyroid lump/goiter? I have read that only what is needed will get absorbed.

    I have had some sensitivity testings done, and am a bit confused with the results. If I am lactose intolerant, how come the test for milk shows only mild/moderate sensitivity, whereas a for food like broccoli that I am supposed to avoid for Hashimoto’s I am not at all reactive?

    Thank you so very much in advance for any insight, and I am not sure if your consultations are ever done over the phone, or only in person.

    • Marc Ryan October 7, 2013, 12:44 pm

      Hi Doris,

      Thank you for your kind words! As you can see, I’m quite passionate about helping people with Hashimoto’s. I generally do not recommend administering iodine prior to testing for it. The chances of you being iodine deficient in the US are pretty slim. I have worked with plenty of people who have gotten worse with iodine supplementation.

      Great question regarding sensitivity testing. This brings to light a couple of important issues. Firstly, tests are imperfect, there are many proteins that these sensitivity tests do not test for. So, they might have tested for the wrong protein. Secondly, the degree of sensitivity on a test result does not always correlate with the immune response that you get from the food. Mild to moderate or equivocal is still positive because it means your immune system will react to it. The immune system is used to destroying tiny proteins. So even an apparently small response could result in an aggressive attack on your own tissue. The issue with foods like milk products is that they strongly resemble some of our own tissue. So when our immune system defends against them, we get friendly fire. Not good.

      I think there is a lot of hysteria around foods like broccoli that is completely overblown and inaccurate. If you look at the research, there is very little evidence that shows definitively that plants in this family are going to cause or exacerbate goiters. And the health benefits of these foods are enormous. So as long as you don’t eat wheel barrow loads of them, you’ll be fine.

      I do offer phone consultations, in fact I work with people all over the world. I also offer a free 30minute Hashimoto’s Healing Discovery session. In it you can share where you are and where you want to be, I can offer some resources and suggestions that can help right away and we can discuss how I might be able to help. If that interests you, please click the buton in the right column of the home page to schedule. I look forward to chatting with you!


  • Kiran October 12, 2013, 1:36 am


    Yep!!I am suffering from Hashimoto’s thyroditis……but the thing i want to ask you , dear doctors is there any permanent cure for this,other than the lifetime intake of synthetic thyroid tablets or steroid treatment…???…I came to know that homeopathy and Ayurveda is having a permanent cure for this….but i don’t know how its gonna effect my body…i am a person who is suffering from chronic anemia too…but the thing is that even after taking the iron tablets and vitamin tablets there is still no much difference in my Hb count….and also my ESR remains out of the normal level.
    My father is also suffering from this….and i am an Asiatic Indian (in case it differs regionally)

    • Marc Ryan October 14, 2013, 8:24 am

      Hi Kiran,

      There is no “permanent cure” for Hashimoto’s. This is a multi-system disorder and it requires a multi-system approach. You must learn how to properly manage it. The reason you are having difficulty getting your blood count up is because of the impact of hypothyroidism on absorption.

      Work on your digestive system with Ayurveda and homeopathy and this may improve.


  • Marie October 18, 2013, 10:00 am

    Hi Marc,
    I have not been diagnosed with Hashimoto’s yet. If I do no have hair loss or joint issues, could I still have it? Because everything else points to yes for me. I am on two types of thyroid medications and still have extreme fatigue- just spent four days in bed and still exhausted and my pain level was off the charts, brain fog, pain in neck, shoulders, back, lower back and hips. Been diagnosed with Fibro & adrenal gland exhaustion by naturopath & rheumatologist. Some say fibro is just a diagnosis when they don’t know what is wrong with you…beginning to wonder. I am not gluten or dairy free. Do not like soy products anything with that gives me extreme gas & bloating. Gluten does not, nor does dairy or grains.

    • Marc Ryan October 21, 2013, 5:17 pm

      Hi Marie,

      You may or may not have Hashimoto’s. I would still encourage you to get off of gluten and dairy because they can cause so many health problems. Even if they don’t cause digestive problems they can cause a host of neurological problems and be one of the causes of your pain, fatigue and brain fog issues.


  • Karen LaManna October 29, 2013, 11:43 am

    I came across your site and very glad I did. I’m not sure what is going on with me…but I feel some things are a little strange which started my search 😉
    I went to the doctor in 2010 complaining of constant fatigue, I got blood work done and the doctor thought maybe heart related so I had an echo done and it came back saying I had an enlarged heart and was diagnosed with hypotrophic cardiomyopathy and a pacemaker/def was recommended. I wanted a second opinion to be sure bc I never thought I had heart issues, long story short they said the same thing and the following week I had the surgury bc they said it was that urgent. While at a follow up appt I mentioned I get hoarse/scratchy voice at times and felt and I felt a lump on my throat
    I was sent for a thyroid/biopsy and was told I had goiters growing and then had my complete thyroid removed. I still get a raspy voice at times and I just feel like something weird is going on w my throat. I am 52 always been healthy and never on medications now I am taking daily meds, an aspirin, bisroprol (heart), synthroid, 2 water pills everyday and now my latest blood work they have added 2vitamin d 1000mg each, and my heart doctor says I have metabolic syndrome?? I’m 5’5 and 179.5 my husband and I have started walking everyday for the past month and we walk 4 miles and I did lose some weight but I can’t get out of he 170’s so I am looking to change my diet. I have gone from no pills to 7 a day. The only reason I am mentioning the heart being enlarged is bc I read on a blog that that is also a symptom of Hashimotos.. Don’t know if any of this makes sense but over the past 3 years when I google my symptoms it always brings me back to Hashimoto’s. One other completely random thing I’ve noticed is I scratched myself and there is such a strong metallic smell to my blood..does that mean too much iodine?? I know this all sounds weird I am just thinking that most of my issues could be solved with proper food so that is where I am at now trying o come up with a healthy food plan. Does this all sound like unrelated symptoms to you? Thank you! Karen

    • Marc Ryan October 29, 2013, 1:12 pm

      Hi Karen,

      Thanks for reaching out! As a matter of fact, it could be related. The one thing I am often emphasizing to anyone who will listen is that Hashimoto’s is a multi-system disorder. And one area that can definitely be impacted is the cardiovascular system and the heart. When this gets complicated with things like high cholesterol (which can also be caused by hypothyroidism) and other systemic problems you get what is, essentially a vicious cycle.

      The best way to deal with this is a multi-system approach that includes diet, proper supplements (like Vitamin D and others) and lifestyle changes. Sometimes all that’s needed is an entire overhaul of your life. 🙂

      So in answer to your question, I think your instinct is absolutely right. I would just encourage you to not take half measures, but rather work with someone who understands the breadth of what you are up against and has an approach for dealing with it.

      I don’t know if you are aware of it, but I offer a free 30 minute Hashimoto’s Healing Discovery session. In it you can share where you are and where you want to be, I can make some suggestions that will help right away and we can discuss how I can help. If that interests you, you can schedule by pressing the button on the right column of the home page. I usually do Skype for international calls.


  • rebekah November 19, 2013, 12:01 am

    Thank you for this site! I’ve been sick all over for too long!

  • mary wells December 13, 2013, 5:19 pm

    I’ve had Hashimotos for three years and get some digestive issues. In terms of tasty breakfast powders for smoothies, I’ve tried all of ’em and this one I like the best – Plant Fusion Phood Shake, Vanilla, 31.8 Ounces by Plant Fusion. Wholefoods sometimes does it but its way cheaper on Amazon.
    Its obviously gluten, dairy, whey, soy and sugar free but most of them that fit this remit are a little chalky, whereas this one is not. All plant protein, and comes with the correct balance of digestive enzymes too.

    • helenwleeHelen December 18, 2013, 4:51 am

      Real food and smoothies from fresh plants and fruit is the best and the safest for all with autoimmune diseases. Avoid processed “food” like this completely. There is no need for any powder-shakes at all. You need proper food, whole food and plenty of it to heal. Clean elimination diet is the best start and sometimes a lifestyle to reduce inflammations and help to hela the body.

  • Marissa D December 17, 2013, 6:19 pm

    I was tested positive for ANA last months and further test results state that I tested positive for the Antithyroglobulin Antibody. My T3, T4 hormone levels came back normal. The doctor said there is nothing that can be done and its not a big deal. However I feel terrible all the time. I can’t see how it’s not a bid deal to have my body attacking itself. Is there a specialist I should be going to because my doctor said there is no one that can help I just have to take tests to see if my T3 and T4 levels are within range throughout the year.

    • Marc Ryan December 17, 2013, 7:25 pm

      Hi Marissa,

      Thanks for reaching out! The reality is that there is a void in our current medical model for treating autoimmune disease. There is no one in the conventional medical system that treats this. This is why the doctor says nothing can be done and its not a big deal. He is wrong on both counts. There is a lot that can be done and it is a very big deal because autoimmune disease is progressive and if you don’t do anything about it you are setting yourself up for more and more misery.

      This is exactly what I do. I treat this aspect of the problem. What does that mean? Firstly, you must identify the triggers for autoimmune disease. These can be varied and numerous, but everyone has them. We must find yours and eliminate them. Then we must work on calming the aggressive part of the immune system that is attacking your own tissue and we must strengthen the regulatory part of the immune system that naturally controls all of this.

      I work with people all over the country and help them learn how to effectively manage and control their autoimmune disease. Our goal is to get this to a place that looks like remission. It can be done. Here’s what I suggest, read my blog, especially this one on autoimmune disease: http://www.hashimotoshealing.com/hashimotos-is-an-autoimmune-disease-so-why-is-everyone-ignoring-the-autoimmune-part/

      The next thing I recommend is that we have a conversation. I offer a free 30 minute Hashimoto’s Healing Discovery Session. In it we can explore this further and I can make some suggestions that will really help you. And we can discuss how I can help. If that interests you, please go to my home page and schedule your frtee session by clicking on the button in the right hand column.

      There is a lot you can do, but you need to work with someone, like myself, who understands what to do. I look forward to chatting with you.


  • Emma December 20, 2013, 1:36 am

    My Husband has been diagnosed with hashimotos and depression and anxiety. He suffers from sever brain fog and spasms which the doctors say is a manifestation of his anxiety but this just doesn’t make sense: I really believe is thyroid is playing a big part in his symptoms. He is on thyroxine at the moment but his tsh is still high and the endo advised to increas his intake to 200 twice a week; too much thyroxine seems to make his symptoms worse. It seems the doctors aren’t taking how he is feeling seriously; he just seems to get worse and worse. He went back for a thyroid check and they only tested his tsh – not his t3, t4 or antibodies. I am currently trying to figure out what’s good for him food wise and what’s not. He loves meat and breads – he is happy to change any bread or pasta to gluten free however some websites say even this isn’t good enough for a hashis sufferer. I’ve just got him to love eggs which takes away carbs in the morning but now I’m not sure if the are good or bad!! Any advice would be appreciated cause right now he wants to stay in bed and never get out!!

    • Marc Ryan December 26, 2013, 10:25 am

      Hi Emma,

      Thanks for your question. Firstly, issues involving anxiety and depression can be directly related to the impact that Hashimoto’s is having on the brain. This disease is not just a thyroid issue, or just an autoimmune issue. It develops into multi-system problem. One of the systems that is impacted is the brain. You can have problems in the brain resulting from too little thyroid hormone, from autoimmunity to brain tissue, to permeability of the blood brain barrier or more.

      The key is to evaluate this properly and to create a strategy that includes diet, lifestyle changes and othe things if necessary to address this problem. I offer a free 30 minute Hashimoto’s Healing Discovery session. In it he can share what is going on with him, I can recommend some things I think could help right away and we can discuss how else I may be able to help. If you are interested, please schedule an appointment using the button on the home page.


      • gibbo January 1, 2014, 4:43 am

        While I found your blog quite interesting and quite accurate in relation to a number of points I propose that these diets are more effective simply because they suppress chronic elaboration of pro inflammatory cytokines, deranged t-cell driven autoimmunity and end the aberrant epigenetic events that may trigger these illnesses.

        I’m afraid the concept of leaky gut syndrome or increased permeability is wildly discounted by the wider medical fraternity not because there is almost no peer reviewed research in any and contemporary medical journal, but also because it doesn’t make sense physiologically. If raw food particles and constituents were able to freely enter the blood stream it would quickly cause septicemia; and certainly they could never enter the blood brain barrier without fataly altering CNS pH.

        I think its possible that chronic exposure to high complex carbs and inflammatory foods effect stomach bacterial make up in a way that sensitized the innate immune system triggering potentiated and prolonged pro inflammatory cytokine elaboration or t cell self tolerance loss via molecular mimicry.


        • Marc Ryan January 3, 2014, 4:43 pm

          Hi Gibbo,

          Wow, that’s quite a mouthful. I think what enters the bloodstream are fragments of proteins. Here’s the reality, a lot of things enter the bloodstream. This barrier is quite permeable. They aren’t huge food particles, they are tiny fragments of protein and they cause an antibody response. In normal circumstances the immune system destroys them. With Hashimoto’s and other autoimmune diseases there is an immune chain reaction that also triggers an attack on our own proteins (this is the problem of molecular mimicry).

          Yes, these diets work because they anti-inflammatory and inflammation is at the very root of the destructive inflammatory process that autoimmune disease. I also think that it’s not just the stomach, or the intestines, it is a multi-system problem. Again a type of chain reaction that results in the release of inflammatory cytokines, and aberrant epigenetic events.

          Much of it is aberrant.


  • Unal January 9, 2014, 2:24 pm


    First of all, thank you for sharing this useful article. I used to have Hashimoto around 3 years ago, and I used some medicines to cure this disease. Although the pills corrected my hormone levels regarding Hashimoto, they have caused my face becoming hairy (btw. I am a lady.). Consequently, I stopped taking them without asking to my doctor as she increased the daily dosage.

    About one month ago, I went to another doctor with the complaint of unexpected acne breakouts on my face, and also I asked for Thyroid tests. Via them (As I remembered that he only tested my TSH level without measuring T3 and T4.), he interpreted that although there are no continuing signals of Hashimoto; however, according to the ultrasonography, I have had some hypoechoic nodules upon my thyroid. Therefore, he ordered me a thyroid scintigraphy. 10 days later, I am going to have my scintigraphy done. Regardless of what the doctors said, for four days, I have started being a vegan since I had felt some kinds of meat & dairy intolerance. Moreover, I have also cut off eating food containing gluten, and started to take a list of daily levels of protein- and calcium intake. Today, thanks to your article and suggestions, I am going to replace soy milk etc. with almond milk & its derivates. The points I want to ask about are,

    – Is it possible for my acnes to occur because of this illness?
    – Is scintigraphy a reliable way to detect the behaviour of nodules -benign or malignant-? Is it worth a radiation exposure?
    – In my country, unfortunately, society is not aware of the significance of being a vegan. Thus, I have experienced numerous difficulties in finding gluten-free and vegan restaurants and even food in supermarkets. I also do not rely upon the health system in my country, and hospitals are a way to put more stress in shoulders. So, it turns to be a real kind of “torture”. Is there any way to replace a gluten-free, sugar-free, dairy-free, soy-free and vegan life with alternatives?

    Thank you in advance for all. 🙂

    P.S. I have iron deficiency and Type A (-).

    • Marc Ryan January 13, 2014, 10:18 pm

      Hi Unal,

      Thanks for your comment. I have a few things to say about them. Firstly, there is no cure for Hashimoto’s, the nodules are a very clear sign that it is still there and that the autoimmune process continues. I recommend cutting out gluten, dairy and soy. I do not recommend going 100% vegan. In my experience it doesn’t seem to work with Hashimoto’s. This is due largely to the fact that there are so many potential causes for deficiency that this diet doesn’t work because you must also cut out grains and beans.

      Acne may be caused by this disease. This is a disease of inflammation. Acne is caused by inflammation, as well.

      Yes, scintigraphy is a reliable way to determine the behavior and structure of nodules. It’s a good test to have done. The radiation question is a good one. If you have nodules that are suspicious for malignancy, it’s a good idea. To avoid radiation you could always have an ultrasound done first. This is not as detailed as scintigraphy, but it often gives you enough information to start with.

      I don’t recommend being vegan. I recommend being Autoimmune Paleo. Check out Mickey Trescott at AutoimmunePaleo.com . She Has Hashimoto’s and was vegan, but changed to this type of diet because it made her feel so much better. This way you can be gluten free, diary free, soy free, bt still have some sugar (mostly from fruit) and have meat, vegetables and fruit. It’s a bit easier than trying to do what you mentioned and it also seems to work better with people with Hashimoto’s.


  • Elizabeth January 12, 2014, 11:53 pm

    I’m looking at what you’re recommending and I’m concerned this is a diet which is not healthy in the long run, especially if you’ve got other health factors and/or family medical history issues to consider. I fear that by focusing on the Hashi’s, one could possibly aggravate other conditions.

    For example, as a woman, I’m concerned if I cut out all dairy, I’m going to be at greater risk of osteoporosis in later life. I’m sure you’d recommend some kind of calcium supplements, but here’s the rub: calcium supplements can interfere with the absorption of levothyroxine, even if you wait the recommended four hours. So, you can actually be making your problem *worse*!

    Too, I do know for a fact that high powered vitamin supplements — which I assume you would recommend to make up for all of what we *aren’t* getting in this very limited diet — severely affect my ability to absorb levothyroxine. When I was pregnant, my OB prescribed a standard high-powered pregnancy vitamin supplement. My endocrinologist had already gotten my levels at an optimum point for pregnancy before I became pregnant. In just one month, my levels soared — because the vitamin supplement *always* made me suffer severe vomiting. (And in fact, vitamins almost always make me nauseous; my mother was a big advocate of natural vitamin supplements when I was growing up, and I can’t tell you how many breakfasts I threw up after taking them. Nor did any of them help my eczema in the slightest.) I always waited at least four hours and usually eight before I took the supplements, so that should not have been an issue. We cut the high powered stuff and on the OB’s advice, I ended up taking Flintstones with folic acid and eating additional folic-rich foods. My T levels became manageable once more.

    Too, cutting out legumes as a healthy protein alternative does not seem wise. Granted, as someone who tends to be slightly anemic, red meat’s not a bad thing to eat — but by the same token, I’ve got a family history of Type II diabetes. Eating a great deal of meat is NOT a good idea. Stick with fish? I love fish, but too much mercury is going to be just as bad for me as the Hashi’s. That cuts us down to chicken, which does nothing for the anemia problem. Iron supplements? Those are as contraindicated as calcium for the Synthroid absorption.

    Also, could you please provide a scientific, reputable cite for the “meat eating” vs. “non-meat eating” blood types? I’m type A, and as I mentioned, tend to be anemic. I’ve also been low on vitamin D and B12. The former I’m trying to get just by playing a little longer every day outside with my little girl. One of the best foods I can eat for B12 is yogurt…but that’s dairy, and verboten in this diet.

    Are there any scientific studies which have been performed by a reputable source (i.e., the Mayo Clinic or the like) which supports your recommended diet as a healthy *long-term* solution for someone with Hashi’s, and if so, do you have a link? I’m willing to consider this as a possibility (and I will ask my endocrinologist what he thinks, too), but I need to see some lab evidence that is not alternative medicine based. Thanks.

    • Marc Ryan January 13, 2014, 10:38 pm

      Hi Elizabeth,

      Thanks for your comment. I’ll try and address all of your points, one at a time.

      1. The idea that dairy is the only source of calcium is absolute propaganda and, frankly nonsense. Here’s a post I wrote on food sources of vitamins and minerals: http://www.hashimotoshealing.com/food-sources-of-vitamins/
      These are all good sources of calcium: sesame seed, kelp, agar, dulse, collard greens, kale, turnip greens, almond, soybean, mustard greens, filbert, parsley, dandelion greens, brazil nut, spoon cabbage, watercress, chickpea, white bean, pinto bean, horseradish, pistachio, red pepper, figs, sunflower seed

      You don’t need dairy or calcium supplements. Eat a diet that is varied and includes healthy normal amounts of those foods.

      2. Ditto for high powered vitamin supplements. Read that post and you will find foods that provide every one of those vitamins. Also, I am not in favor of the shotgun approach to supplementing vitamins and minerals. I recommend doing the proper testing to determine if you have a deficiency, then supplementing and then doing follow up testing to see if the levels have normalized. If they have you then you are done with supplementing. Of course, with Hashimoto’s there are many reasons why hypothyroidism can lead to vitamin and mineral deficiencies so this must be done relatively regularly.

      3. Why is meat contraindicated with Type II diabetes? You lost me there. Please show me something evidence based on that one. The issue with legumes is that they contain lectins which tend to wreak havoc with the gut. Intestinal permeability and autoimmune disease (like Hashimoto’s) go together like Leo DiCaprio and Scorcese. Hand and glove, as it were.

      4. I’m not a big advocate of blood typing. I should retract that from that post, I have since looked further into it and I think it lacks good science. So, you got me there.

      5. If it’s science you’re looking for with Paleo and autoimmune disease I’ll point you to a scientist. Check out Paleo Mom. She is a scientist and someone who healed herself using the Paleo approach. Her work is riddled with good research (in fact she sites over 1200 studies in her book).http://www.thepaleomom.com/autoimmunity/the-autoimmune-protocol


  • Lainey January 16, 2014, 1:02 pm

    I am 57 yo female and was dx with Hashi in 2009 based on Anti-Thyroid Peroxidase of 65, Anti-TG ABS of 115 with Anti-TPO ABS of <20. My tTg has been identified as endomysial antigen, which I understand has over 99% specificity for gluten sensitive enteropathy.

    My Dr n-e-v-e-r suggested a gluten free diet and when I read your blog and pulled out my old blood results, I was surprised to see this yet not informed.

    I had a thyroid ultrasound which showed thyroid gland mildly enlarged along with multiple bilateral nodules. Largest nodule measure (left) 14x15x13mm and (right) 37x23x18mm. No perithyroid abnormality or lymph adenopathy detected. My FNA of right & left nodules is C/W hyperplastic/colloid nodule with no tumor cells.

    I am currently on daily dose of 50mcg Synthroid. My TSH is now 1.53 (from 3.14) and my internist just ordered a more comprehensive TSH screening.

    About 2 yrs ago, my S/S included fatigue, irritability, bowel issues (alternating constipation & normal – no diarrhea), and joint pain – specifically in my hips. Blood tests showed low levels of Vit D and B12. After the initial Vit D treatment, now taking Vit D3 supplement – 2000 IU/daily, and B12 supplement – 1000 mcg/daily. Recent tests show back up to above mid-level range of "normal".

    Still have bouts of fatigue, bowel issues, and joint pain. Last year, I lost 40 lbs (now at 210) using Weight Watchers plan and maintained the loss for 6+ months. Feeling better but issues persist.

    For joint pain, I started taking glucosamine/MSM/Chondroitin supplement. W/I 60 days had a major bout of urticaria. I checked the ingredients and noted the "made with shellfish". My sibling has many allergies including shellfish. I stopped taking it and the symptom abated in 7-10 days. I am now taking Solgar shellfish-free version and am starting to get relief in my hands/wrists/elbows/shoulders. As a licensed massage therapist, this is a very important improvement – especially my weekly schedule of 15-20 hrs providing massage services. Hoping to continue receiving relief with my back and hips. Oddly enough, my knees and feet are fine.

    I am now gearing up to lose another 40 lbs. My problem is that despite drinking copious (and I mean copious) amounts of water, constipation is always a big problem for me during any weight loss program. I found I really need to add back in fat calories to get relief. I am not sure why, just know it is.

    I use almond milk and coconut (lite) milk when making my morning fruit/yogurt smoothie, love veggies, and am definitely a carnivore (pork is my fav). Pasta so does not agree with me (feel nauseous), but I have no problems with my weekly pizza fix (2 slices max) or occasional bread/yeast rolls. I cannot have bread in the house – I can easily consume the whole loaf in a few hours. Besides the guilt trip of doing so, I might have an occasional bloating feeling.

    How would I proceed from here in further managing my Hashi's? Is a total gluten free diet necessary? I am also pre-diabetic and my Dr highly "encouraged" me to lose 40 more pounds and continue my power walks (5x weekly – 5 to 8 miles each session).

    Thanks for taking the time to read my lengthy "story".

    • Marc Ryan January 16, 2014, 11:23 pm

      Hi Lainey,

      Thanks for sharing all of that! In my opinion, a 100% gluten free diet is an absolute necessity. With Hashimoto’s gluten is the detonator of both the autoimmune disease and it’s progression. Regarding how to proceed to further manage your Hashimoto’s, there is no easy answer.

      The most important thing to understand is that this is a multi-system disorder and it requires a multi-system strategy. It’s not just a thyroid problem, or just a thyroid and autoimmune problem. Over time complications involve every major system of the body including the digestive tract, the stomach, the gall bladder, the liver, the brain, the adrenals, the pancreas, and on and on.

      You need to either figure out yourself or work with someone who can help you determine where else it is and fix all of it. In working with patients, the one thing that I see time and time again from those who don’t get the results they want is that they do too little or they do it in a half hearted way.

      A few pills and or supplements isn’t going to get it done. This requires an entire life overhaul. That’s what I offer my patients, and a very clear strategy about how to get there. If you want to be successful you need to unwind all the web of vicious cycles that have been created.


  • tash January 21, 2014, 2:04 am

    Hi Marc, I have greaves diseasebbt but am on carbimazole n propranalol..since taking them for a year I have gained 15 kg.. if I reduce meds the weight gain stops yet the greaves symptoms kick in…when I take minimal meds n eat clean fruit, salad, veg, chicken, brown rice, sweet potato I gain weight. If I eat junk food I am fill nauseas and bloated and will gain 1kg overnight each n everytime. I really want to strip weight as quickly as possible … will soy free wheat free grain free and dairy free cause weight loss?

    • Marc Ryan January 21, 2014, 9:34 am

      Hi Tash,

      Yes, in virtually every case I’ve seen, if you eliminate dairy, gluten, soy and grains you will lose weight. Those are the primary sources of sugar and inflammation that lead to weight gain.


  • CBE January 22, 2014, 9:56 pm

    I recently went to a new PMD for a physical. I didn’t bother going down my list of all the “weird” things that have been making my life miserable for the last 3 years. After hearing “it’s just stress” every single time, I started getting embarassed and feeling like I was just complaining. Plaguing fatigue, itching, frequent peeing, fecal impactions, constant clearing my throat and feeling like there is a lump, diarrhea, dizziness, vertigo, muscle cramps, tingling hands, joint aches, muscle fatigue, insomnia, night sweats, sweating, hair loss, weight gain, cold feet, severe heat intolerance, low blood pressure, elevated liver enzymes, constant nausea, irritated gall bladder, crying and the worst of it all? Raging anger. For no reason. There are times I think I could’ve danced around the fire with the devil and had good time. Lucky me for a conscience and rational thinking prevailing. Anyways, the Doc ordered an Anti-TPO test based on my mothers hypothyroidism. Bam. Lab result: 100. I have an appointment with an Endocrinologist to get a diagnosis, but I’m almost sure it Hashimotos. I’m a 31 year old RN. I’m too young and love my job too much to feel like I got hit and dragged by a Mack truck. Any advice? Where do I start to prevent any further damage? What are the autoimmune food tests you talked about? I didn’t see anything specific listed?

    Thanks from me and my thyroid.

    • Marc Ryan January 24, 2014, 12:33 pm

      Hi CBE,

      Thanks for sharing that and for your question. Asking a general question about advice or where to start with Hashimoto’s is not an easy question to answer. Here’s a post I recently wrote for Facebook that sums it up pretty well, I think:


      I’ve worked with an awful lot of people with Hashimoto’s (this is all I do) and I’ve spent years studying and looking at research on how this condition impacts the body.

      And the most important thing I have learned is that Hashimoto’s is much more than a thyroid problem. It’s an autoimmune disease, but it’s not just an immune system problem either. It’s an all-over-your-body problem.

      Your body is not a machine. Like the earth, it’s a complex group of ecosystems that all interact. And these ecosystems can all be adversely affected by Hashimoto’s. When this happens you get a downward spiral of vicious cycles all feeding on one another.

      With Hashimoto’s and hypothyroidism you often wind up with a multi-system disorder. It creates webs that can lead to problems with virtually all the major systems of the body.

      These include issues with the brain, the adrenals, the liver and gall bladder and problems with the digestive tract like acid reflux, leaky gut, as well as body wide pain and inflammation and more.

      All of this can result in anxiety and depression, gall stones and poor liver detoxification, poor absorption of vitamins and nutrients, poor conversion of thyroid hormone, blood sugar imbalances, terrible fatigue and immune responses to various triggers from foods to environmental toxins and chemicals.

      Hashimoto’s is not a simple condition that can just be fixed by some thyroid replacement hormone and/or a surgical removal of the thyroid. This works for some, but millions of others have done one or both of these things and don’t feel any better at all.


      You have to be able to see the big picture. Then you have you have to isolate each system and look at the interactions and start working on healing the whole body. This requires several steps.

      The first thing you must do is find the most destructive triggers and eliminate them. After that, you need to identify which systems are involved and start repairing them.

      When you do this, something magical happens. All of those vicious cycles get turned on their head and start having a positive impact on the other systems. When that happens, you can stop triggering the immune system and start to restore balance. Then the body can heal itself.

      In the beginning, this will give you glimpses of more good days than bad ones and if you stay the course and work on the big picture you can even sometimes get this condition into a state that resembles remission. (But remember that’s not permission to go back to everything that got you sick in the first place.)

      To put it another way. You must adopt a Hashimoto’s lifestyle. That is what I teach my patients and what I try to share about in my posts here on Facebook and on my blog at http://www.hashimotoshealing.com. Healing Hashimoto’s requires you to go all in.


      1. Step One: Understand Which Systems Are Impacted

      The first step is to get a proper diagnosis that will lead you to understanding which systems make up your unique web of vicious cycles. The key is to work with someone who understands this.

      In my practice, I specialize in treating people with Hashimoto’s. I know which diagnostic tests are appropriate and I have worked with hundreds of people with this disease and lived through it myself so I’ve seen a lot of permutations and variations.

      2. Step Two: Take Your Diet Seriously

      Hashimoto’s is an autoimmune disease. 70% of the immune system is found in your digestive tract. What you eat has a huge impact on the state, quality and severity of your autoimmune disease. Anyone who tells you otherwise has no idea what they are doing, plain and simple.

      Some foods serve you, some cause you harm. In my practice I prescribe a special Hashimoto’s diet that is the foundation of the work we do. I have found that people who won’t make the dietary changes that they need to heal are just setting themselves up for failure.

      3. Step Three: Heal Your Adrenals

      For a lot of people with Hashimoto’s the adrenals are a critical piece of the puzzle. Did you know that the label on Synthroid and other thyroid replacement hormone warns that if a patient has adrenal insufficiency they should not be prescribed the drug?

      That’s how important the adrenals are. They can be the difference between you turning this thing around and you treading water and not improving or just continuing to get worse. In my practice we do proper testing evaluation and treatment of the adrenals.

      4. Step Four: Heal Your Gut

      This is really closely related to Step Two. The gut is where your immune system lives. Many really smart people believe that issues in the gut like intestinal permeability (leaky gut) are actually one of the root causes of Hashimoto’s and other autoimmune diseases.

      When you heal your gut, you heal everything else: your brain, your immune system, your thyroid, your adrenals and more.

      5. Step Five: Remove the Triggers

      You have to find and eliminate the triggers that drive your autoimmune flare ups and the progression and destruction of this autoimmune disease. We’ve already mentioned the dietary triggers. Where are the other ones?

      Environmental toxins and chemicals (these include some drugs) can be triggers. Blood sugar imbalances can be another important trigger.

      Stress can be another trigger and if ignored can torpedo your progress.

      In my practice we take you through all of these steps and we teach you along the way how to identify what your unique set of issues, triggers and solutions are.

      Then we create an action plan and help guide you out of the woods. You can heal your Hashimoto’s, but healing requires acceptance, and it requires adopting a new lifestyle that will support your body and your immune system and that will provide you with the foundation to get lasting results.

      And last but not least, remember to have fun. To laugh and enjoy the life you have. There is a lot in this struggle that is not fun, but what we try to do is to empower you with the knowledge you need, but also make it enjoyable and entertaining.

      Because there’s nothing worse than doing all this work and not being able to enjoy the process. A sense of humor can be healing all by itself.


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