Hashimoto’s Food Pharmacology

by Izabella Wentz, PharmD.

  I was personally shocked to learn that my three-year bout of acid reflux and chronic cough and my ten-year struggle with irritable bowel syndrome could be solved within three days—just by getting off two foods I was sensitive to! Other symptoms soon disappeared, and eventually I learned how to properly nourish my body and listen to its subtle (and not so subtle) signals that something was not working for me!

  In time, I was able to reduce my thyroid antibodies to the remission range, grow my hair back (very important to a Leo), ditch my carpal tunnel braces, unearth a flat stomach that was hiding under mountains of bloating and stomach pains, and become an overall healthy, happy, and fit person once more (no more panic attacks, mood swings, or bouts of depression).

  Perhaps the best part of my own healing is that I was finally able to follow my dreams, to turn them into goals and then into reality. The brain fog, fatigue, and weakness lifted and revealed the strong and powerful person that was hiding underneath all along. I finally got the chance to become the person I hoped I would be when I was a little girl. I went from a fatigued, moody, and self-doubting couch potato who could barely take care of herself to a woman who feels as though she could do anything on most days. My brain is back, and I can’t even describe the amount of self-confidence that has instilled in me. I’ve become an author, a documentary director, and even a new mom, things I never thought would be possible when I was sick. I’m blown away at the way my life has been transformed through healing my body.

  The butterfly is a symbol for transformation, and I sometimes think it’s no coincidence that the thyroid gland is a butterfly-shaped gland. If you let go of feeling like a victim of your illness and step into your power, your thyroid condition can be the very thing that transforms you into the person you were always meant to be! I love the saying, “Just when the caterpillar thought its world was going to end, it became a butterfly!”

  Ultimately, what I found in my own body and what’s been true for most of the thousands of people with Hashimoto’s I’ve worked with is that Hashimoto’s requires a multifaceted approach. Hashimoto’s symptoms often result from a combination of thyroid hormone imbalances, nutrient deficiencies, food sensitivities, an impaired ability to handle stress, an impaired ability to handle toxins, intestinal permeability, and sometimes one or more chronic infections.

  All this may seem complicated and like a lot of ground to cover, but the good news is that nutrition is the cornerstone of recovering your health, dietary changes can produce profound improvements in your symptoms, and those changes may in some cases produce a complete remission of your condition. Changing your output often starts with changing your input, and there’s no better way to do this than to start with the fuel you put into your body! Yes, you can feel beautiful, fit, calm, and healthy once more!

  BRINGING DIET FRONT AND CENTER

  When I discovered how much lifestyle, diet, and functional-medicine changes helped me, I wanted to let the world know. As a healer and empath, I was saddened that millions of people were suffering because they didn’t have access to this life-changing information. Although I’ve always been somewhat of a reserved and private (albeit very friendly) person, I realized that this information was bigger than me and that I needed to share it with the world. I knew that my unique qualifications as a pharmacist (that is, a trained skeptic of all things nonconventional) and a patient who had been in the trenches was the perfect combination to get this message out into the world!

  Once I found that I could change my health, I felt powerful and limitless. So I decided to follow a lifelong dream of mine, which was to write a book about my experience and newfound knowledge. Despite the fact that my high-school writing teacher called my writing melodramatic and unrelatable and my attempts at humor corny, I decided to step out of my comfort zone and publish my first book, Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause. Hashimoto’s: The Root Cause, as readers have been calling it, was published in 2013 and became a surprise New York Times bestselling book. My biggest shock was at the number of people who related to the book and told me that they saw themselves in it, that I had captured the same emotions they had encountered. I was amazed to discover how many people with Hashimoto’s were looking for ways to take charge of their own health. I was also pleased to receive messages from people who said that the book was so easy to read that they read it in one sitting (and that my corny jokes made the information more digestible).

  In the Root Cause book, I dedicated a chapter to the topic of different diets that had been reported to reverse Hashimoto’s and other autoimmune conditions. My goal at the time was to encourage and empower others to identify their own root causes, that is, the triggers that led to the development of Hashimoto’s, and to give them the tools to establish an approach to feeling better. The book was a manual for healing, but in many ways it was a do-it-yourself manual—there was a lot of personal digging required.

  While many readers found this approach helpful, others felt overwhelmed by the need to do a lot of their own “detective” work as it related to their health; what they wanted was a specific, streamlined protocol, a “Done-for-You Guide” (as one of my readers, Tereska, called it). So I dove back into emerging science in the growing field of functional medicine and evaluated my personal experiments and experience along with my ongoing work with Hashimoto’s patients. Ultimately, I was able to distill all of the information I gathered into three comprehensive and detailed fundamental protocols, which came to represent the core of my second book, Hashimoto’s Protocol.

  Each of these three protocols contained within it a focused dietary approach designed to address vulnerabilities and/or overstressed systems common in people with Hashimoto’s. The Hashimoto’s Protocol also contains Advanced Protocols that focus on additional interventions to take back your health, such as optimizing medications and addressing infections, toxins, and traumatic stress.

  The dietary modifications included in Hashimoto’s: The Root Cause and Hashimoto’s Protocol are essential to the healing process, but as they are only part of that process and a book only has so many pages, readers began asking for more in-depth guidance in food and nutrition. Many people expressed a desire for expanded insight on how to make the diets happen in real life. Could I share more of my favorite recipes? What were my secrets for adding flavor? How do you eat real food without cooking all day? What type of diet was I eating today, so many years after going into remission?

  Although I’m not a professional chef, I love to cook and share nutrition tips with my family, friends, clients, and readers, so I decided to turn my focus to a cookbook and nutrition guide. And it’s finally here, in your hands! It’s been an honor and a pleasure to distill my nerdy nutrition knowledge for you and to share my family’s favorite recipes in the pages ahead!

  You’ll also discover the best strategies for making diet changes an easy part of your life. To make healing approachable and fun, I wanted to create the most helpful, informative, and practical Hashimoto’s nutrition book for you. By design, most of the recipes are really easy to make. I chose these recipes with you in mind, as I know what it’s like to be fatigued, busy, and overwhelmed.

  In sharing this cookbook with you, I am sharing a piece of my heart. Most of the recipes in this cookbook are our family’s favorite recipes, ones that my husband and I cook in our day-to-day life. You’ll notice that many recipes in this cookbook are traditional Polish recipes—many that have been passed on from my mom, grandmother, and aunts. These traditional recipes have been modified to remove reactive ingredients yet keep their delicious taste. I’m excited to introduce these recipes to you and your family. I hope that you enjoy reading and eating from this book as much as I enjoyed creating it.

  As you start using this book in your day-to-day life, I hope it will awaken your inner healing capacities and help you connect with your body’s needs. The goal of this book is to provide you with the tools you need to nourish yourself properly, as
nourishment is what can send safety signals to your body, allowing and encouraging it to heal. If you have Hashimoto’s, your nourishment needs are specific, and both the healing nutrition protocols and recipes I’ve created have been designed to help you meet these needs.

  I also want to provide you with enough information regarding your nourishment needs that you feel empowered to become the undisputed queen or king of your own self-care. This includes understanding how much of each type of macronutrient you will want to consume for optimal healing, what micronutrients and vitamins will be most important to your recovery, and what supplements you can take to support your digestion.

  In Hashimoto’s Food Pharmacology, food and nutrition take center stage and get the full treatment, and what you get as a reader is a deep dive into how to heal yourself with nutrition. This isn’t to say that diet can heal everything—there’s a reason there are other crucial elements in the protocols I created—but strategic adjustments to what you eat each day can produce profound improvements in how you feel.

  This book is written for the nonnutritionist and nonchef. It’s written for the men and women who are ready to take charge of their own health and need a friendly guide that can provide the tools and confidence to optimize their nutrition as well as delicious recipes that don’t require them to spend all day in a kitchen!!

  Are you ready to dive in?

  1.

  Hashimoto’s and the Healing Potential of Food

  After my own Hashimoto’s diagnosis in 2009, I wanted to figure out what I could do to be the healthiest person with Hashimoto’s that I could be. I wanted to know if there was anything I could do to address my symptoms, and if there was anything that could be done to reverse my condition or at least stop its progression. So I set out to find the root cause of my condition and ended up on a health journey that got me out of my comfort zone—which was that of a conventionally trained pharmacist, skeptical of all things natural—and on the way to vibrant health!

  Throughout this journey, I’ve been able to eliminate all of my symptoms and get the condition into remission by using a variety of interventions, most of which have been discussed in my books Hashimoto’s: The Root Cause and Hashimoto’s Protocol. The most profound of these strategies were those that centered around food and nutrition, and although there may be many moving pieces to resolving a Hashimoto’s diagnosis, we can always start to heal ourselves using food and nutrition!

  As I’ve gone on to work with thousands of other people with Hashimoto’s, either in person or through my programs (as well as hearing feedback about interventions shared in my first two books or my blog), I’ve found that food always plays an indispensable role in helping people feel better. In this book, I’ll show you how to use food for healing. Before we get into the dietary details—and the cooking fun!—I want to offer an overview of Hashimoto’s thyroiditis and why it is that diet has such a powerful impact on the condition.

  WHAT IS THIS THYROID GLAND YOU SPEAK OF?

  Chances are, if you picked up this book, you already know what the thyroid is. Just so that we’re on the same page (no pun intended), the thyroid gland is a butterfly-shaped organ located in the neck below the Adam’s apple. It produces thyroid hormones, which affect the function of just about every organ system in the human body, including stimulating the metabolism of the foods we eat, extracting vitamins, and producing energy from food. They are also vital to the production of other hormones as well as to the growth and development of our nervous system. The thyroid has been called the “thermostat” of the body, as it maintains our temperature. Indirectly, thyroid function affects every reaction in the human body, since the temperature has to be just right for these reactions to take place properly.

  UNDERSTANDING HASHIMOTO’S

  Hashimoto’s thyroiditis is an autoimmune condition, which means it is a disease characterized by the immune system’s attack on our own cells. In Hashimoto’s, the cells under attack are located in the thyroid gland; in other autoimmune conditions they are in different parts of the body. When the immune system attacks the thyroid the way it would attack a bacterium, virus, pathogen, or other harmful invader, it causes damage to the thyroid gland, which will likely result in a reduced ability of the thyroid gland to make sufficient thyroid hormones for the whole body. This is known as hypothyroidism, or an underactive thyroid.

  Hashimoto’s causes most cases of hypothyroidism in developed countries, including the United States, Canada, Europe, and other countries that add iodine to their salt supply (in developing countries that do not fortify with iodine, iodine deficiency is the primary cause of hypothyroidism). Yet very few of those who are diagnosed with hypothyroidism will ever be tested for Hashimoto’s or even informed that they may have an autoimmune condition. Instead, they are usually advised to take synthetic thyroid medication to correct their underactive thyroid, a step that, although necessary and helpful, does not address or correct the underlying destruction of the thyroid gland. This unfortunate oversight can allow the immune system’s attack on the thyroid to continue.

  In many cases, this oversight is a product of the conventional medical model, which instructs doctors to treat the majority of thyroid disorders, no matter what the cause, with synthetic thyroid medicine. Once on this path, a person’s typical treatment plan will entail regular testing of thyroid hormone levels and adjustments of medication as needed, as well as screening for additional autoimmune conditions.

  One of the problems with this treatment plan is that pharmacological restoration of normal thyroid-stimulating hormone (TSH) levels doesn’t always result in the resolution of symptoms. In other words, on-paper improvement doesn’t translate to a state in which the person actually feels better. I’ve had some clients share with me that this is the “worst part of the condition,” because a doctor will end up insisting that their symptoms must be all in their head, since the blood-test results are normal. In this scenario, no one wins. The patient only grows increasingly frustrated, and the doctor, even a well-meaning one, comes across as increasingly dismissive. And still the discussion of Hashimoto’s is unlikely to arise.

  If you have an autoimmune thyroid condition, there is another factor that can add to the confusion: a fluctuation between or even simultaneous occurrence of hypothyroid and hyperthyroid symptoms. As thyroid cells are damaged and destroyed by the immune system, thyroid hormones that are usually stored inside of the cells are released into circulation, leading to an excess level of thyroid hormones. This causes what is referred to as transient or temporary hyperthyroidism, which can create symptoms such as weight loss, anxiety, and irritability. Then, once the extra thyroid hormones are cleared out of the body, the damaged thyroid gland will have a difficult time making enough thyroid hormones, and symptoms of hypothyroidism will emerge. These symptoms include fatigue, cold intolerance, and joint pain (see the sidebar here for a more complete list of symptoms).

  Beyond the clinical discussion of symptoms, another aspect of Hashimoto’s that doesn’t get enough attention is what it really feels like to be someone with the condition—what thoughts and feelings can dominate your life and how profoundly the condition can impact your internal world. I know what it’s like, and I hope sharing my experience and the experience of others with the condition will reassure you that you’re not alone, and you can get better!

  WHAT IT FEELS LIKE TO HAVE HASHIMOTO’S

  I have a confession: I used to think that thyroid conditions were “boring” in pharmacy school! After all, you either had too much thyroid hormone and needed a pill to lower your levels or not enough and needed a pill to boost your levels! My own personal health journey has taught me that Hashimoto’s is anything but boring and that there’s much more to it than just thyroid hormone levels. Of course, working with thousands of people with the condition has confirmed this every time! What I’ve discovered is that the experience of Hashimoto’s is one that is filled with not just a wide range of symptoms, but a wide range of emotions too.
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  In reality, medications don’t always resolve thyroid conditions or lead to a disappearance of symptoms. For people with Hashimoto’s, this can lead to feeling a loss of control over their physical body and even their mind. When I asked my Facebook community, “What does it feel like to have thyroid disease?” a lot of the responses centered around this sense of loss. One woman described it as feeling “like you don’t recognize yourself anymore in many ways.” She said, “You keep trying to find the old ‘me,’ but she’s long gone. I miss the girl I was before Hashimoto’s.” Another said, “I feel like a completely different person, and I can’t seem to get that person back. I hate that. What is worse is, no one gets it, not your friends, family, doctors. Kind of breaks the spirit.”

  After my thyroid diagnosis, I experienced a feeling of dissociation from myself. I became numb and apathetic toward life, unable to feel any emotion, good or bad. I no longer had a desire for the things that made me human, such as being close to others, making friendships, following my passions, and loving the people in my life.

  Although I like to focus primarily on solutions and steps for healing, these feelings can be a very real part of the experience of Hashimoto’s, and I want you to feel that your emotions are validated. It’s important to take some time to comfort yourself and show yourself kindness for what you are going through. I want you to understand that you’re not going crazy, that many of your symptoms may be related to Hashimoto’s, and that you can get better!

  TESTING FOR HASHIMOTO’S

  Because the symptoms shift and can sometimes be nonspecific, it can be tough to get a definitive diagnosis of Hashimoto’s. As I mentioned, I personally experienced symptoms for almost a decade before being diagnosed. Sadly, ten years between the appearance of symptoms and the proper diagnosis seems to be the norm among the patients I’ve talked to. Even when they receive the proper diagnosis, they usually don’t get the right treatment. Of course, my goal is to help shorten your path to healing by providing information that lets you become a proactive, empowered patient, one who doesn’t need to wait for answers and instead knows what action steps to take. An essential part of this is having an understanding of the most important thyroid tests. Let’s take a look at these.