I recommend turmeric for clients with Hashimoto’s because it helps support the gut, liver, and inflammatory pathways. Thanks to its anti-inflammatory effect, it can be especially helpful if you are experiencing pain. You’ll find this ingredient in the Chicken Tandoori and Pork Curry Stew.
Berries: Berries are an incredible source of phytonutrients that act as antioxidants in the body. Because they are high in fiber, they also don’t cause a spike in your blood sugar as some types of fruit do. I recommend eating a variety of berries, including blackberries, blueberries, raspberries, and strawberries and more exotic types such as boysenberries, currants, and gooseberries. Blueberries are a rich source of myo-inositol, a nutrient that has been shown to improve thyroid function and blood sugar. Buy organic fruit as often as you can.
Ideally, you should get one to two servings of berries into your diet daily. It’s best to spread these servings out throughout the day, as too much fruit at one time can cause a spike in blood sugar that may lead to tiredness. Even with fruit, you will want to practice moderation, since too much fructose, which is the primary sugar found in fruits, has been linked to insulin resistance and fatty liver disease.
You’ll find recipes that feature all of these healing foods—homemade broth, collagen/gelatin, berries, crucifers, fermented foods—plus plenty of recipes for smoothies, healthy proteins, and good fats in the Cookbook section!
In addition to making sure that you’re incorporating plenty of healing foods into your diet, I want you to pay attention to your macronutrients and micronutrients. My mentor JJ Virgin, nutrition and fitness expert, always says, “Your body is a chemistry lab, not a bank account!” Most diets focus on counting or restricting calories, but, instead, I want you to ensure you are getting adequate amounts of body-healing proteins, fats, and nutrients.
MINDING YOUR MACROS AND MICROS
I have a little quiz for you:
Which of the following is not a required nutrient for humans?
protein
fat
micronutrients
carbohydrates
If you’re scratching your head and thinking that there must be a typo in this question, you’re likely not alone. This was an actual test question (which I got wrong!!) in my first-year biochemistry course in pharmacy school. The correct answer is D. Carbohydrates are not a required nutrient; protein, fat, and micronutrients are all required. I was shocked to learn carbohydrates were not a required nutrient, whereas fat was required for normal cell function! Based on my previous nutritional knowledge, gathered from store displays and sandwich ads, I thought that carbohydrates were the most important food group!
Not only are carbs not required; they’re also the number-one contributor to blood-sugar swings. Blood-sugar swings and blood-sugar imbalances are both common in those with Hashimoto’s and can contribute to anxiety, weight gain, hair loss, irritability, weakened adrenals, fatigue, and increased antibodies. Limiting your carbohydrate intake and making sure that you get plenty of good fats and proteins is key to balancing your blood sugar.
Macronutrients Matter More Than Calories
A lot of people look at foods and see either “high calorie” or “low calorie,” but I want to steer you away from this commonly used quantitative measurement. My experience has shown that placing too much emphasis on calories inspires a restrictive way of eating that’s counterintuitive to eating for health and healing. Although many people can lose weight on a restricted-calorie diet, the weight is typically gained back once the calorie intake is increased again. People who restrict calories, especially those with Hashimoto’s, may also continue to struggle with fatigue, anxiety, skin issues, pain, hair loss, and fertility issues. Some of them actually develop these symptoms because of restrictive dieting.
When we think about reduced-calorie diets from an adaptive physiology standpoint, not getting enough calories sends danger signals to our bodies (excessive exercise can do the same). After all, we still live in bodies with the genes of our ancestors’, and our ancient bodies interpret an inadequate number of calories to mean we are experiencing a famine. In an effort to help us survive, our bodies will send signals to suppress our metabolism when faced with this “famine.” When our metabolism is suppressed, we don’t burn as many calories, and therefore we don’t need to eat as many calories; that’s how a suppressed metabolism can help us survive. As we know, the thyroid gland is the master gland of metabolism; whenever our body receives a signal there’s a famine, it will likely try to slow down thyroid function.
Instead of calories, I advise my clients and readers to focus on using food as medicine to balance blood sugar, nourish their bodies with nutrient-dense foods, and reduce inflammation through avoiding personally inflammatory foods. With these guidelines in place, I then encourage eating until they are full and satisfied, thereby increasing the chance that their nourishment needs are being met. The “full” signal sends a safety message to our bodies.
You eat for nutrient density in much the same way; a nutrient-dense diet is one that excludes processed foods (often carbohydrates) and includes nutrient-packed food such as different varieties of meat, all vegetables, all fruit, nuts, seeds, and eggs (some of these may be omitted depending on which diet plan you are following or because of your specific sensitivities). When these are the core foods in your diet, your body can become healthy from the inside out. The “side effects” of nutrient-dense, blood sugar–balancing, anti-inflammatory nutrition include: shiny and full hair; clear and glowing skin; more energy; a calmer, happier mood; reduced pain; balanced hormones; and even effortless weight loss (in addition to improved thyroid markers!).
It’s not necessary to pay strict attention to how much of each type of macronutrient you’re eating each day, but having a general idea of what to aim for, or even just having the right macronutrient “mind-set” in place, can be helpful. Here are my recommendations for each.
Protein: Proteins are chains of amino acids, which are used within the body to build and repair cells and tissues and to fuel the fight-or-flight response. People with chronic health challenges need more protein in the diet to help support greater repair demands. When you think of protein, I want you to think of your body getting more raw fuel to create thyroid hormones, patch up the leaks in your intestines, and repair neglected parts of your body, such as your joints, skin, hair, and nails.
The average person requires about 1 gram of protein per kilogram of body weight per day (roughly 0.5 gram per pound of body weight). However, people who are over age sixty-five and/or have chronic illness and/or are more active may need up to 1 gram per pound of body weight daily. Here’s a chart showing how much protein you need.
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RECOMMENDED DAILY PROTEIN INTAKE
WEIGHT (IN POUNDS)
PROTEIN (IN GRAMS)
100
45–100
150
68–150
200
91–200
One cautionary note: If you have severe kidney disease and are not on dialysis, you may not be able to tolerate high amounts of protein.
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In addition to getting protein from foods, it may also be helpful to obtain protein from protein powder. As people with Hashimoto’s often have deficiencies in digestive enzymes, they may have trouble extracting protein and various nutrients from the foods they’re eating. Because it’s already broken down into fine form and separated from other ingredients, protein from powder is generally easier to digest than protein from foods. Protein powder is also easy to incorporate into the diets via smoothies!
Even if your digestion is perfect and you eat a 4-ounce serving of steak (31 grams of protein) and a 4-ounce fillet of salmon (25 grams), you will have eaten 56 grams of protein—not enough for most people. In addition to using digestive enzymes (see here for more info), I also recommend adding hypoallergenic protein powders for most of my clients with Hashimoto’s. As an example, one scoop of my Root Cause AI Paleo Protein P
owder will give you 26 grams of protein.
Fat: Although we’re finally coming out of the decades we spent fearing fat, there’s still a lingering mind-set that keeps us from eating enough of this energy-rich macronutrient. My message to you is this: don’t fear the fat; it’s essential for brain function, healthy skin, shiny hair, and the formation of cell membranes. The key is to eat good fats, which are found in salmon, fish oil, olive oil, coconut oil, and avocados, and stay away from bad fats, primarily trans fats, found in most baked goods, fried foods, margarine, packaged cookies, certain cereals, and some frozen dinners. If you see any type of “hydrogenated oil” on the ingredient list, you should skip it. As a rule of thumb, the more active you are the more protein you’ll need. When you eliminate processed foods from your diet, you will essentially have eliminated almost all forms of trans fats.
The other important point to remember regarding fats is that you want to aim to eat more omega-3 fatty acids than omega-6 fatty acids (again, this won’t need to be something you pay too much attention to if you’ve cut out processed foods). You will naturally achieve the right balance of these different types of fatty acids when you eat plenty of good fats and avoid processed oils like sunflower, soybean, corn, and canola oil along with conventionally raised meats.
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WHICH PROTEIN POWDER IS SAFE FOR HASHIMOTO’S?
The problem with most varieties of protein powder on the market is that they are usually based in dairy and/or soy, which are usually highly reactive foods in those with Hashimoto’s. Egg white protein is a better option, although unfortunately I’ve seen people with Hashimoto’s develop a reaction to eggs, even when they had not done so before, after using egg white protein. As people in the early stages of their healing Hashimoto’s journey have intestinal permeability (which we are aiming to repair!), they are likely to develop food reactions to difficult-to-digest proteins.
The three types of protein powders I’ve found to be the best tolerated by people with Hashimoto’s are hydrolyzed beef protein, pea protein, and hemp protein, respectively. Pea protein and hemp protein are plant-based protein. Although generally well tolerated, they are not complete proteins (don’t contain all essential amino acids), and hemp protein may be problematic for some people with estrogen dominance concerns.
Of the three, hydrolyzed beef protein is the best tolerated. Hydrolysis is a process that breaks down the protein into tiny parts to make it easier to digest; therefore it’s less likely to be reactive and less likely to cause new reactions, even in people with intestinal permeability. I know that hydrolyzed beef protein powder may not sound that appetizing, but is surprisingly tasty (it has a slight milky flavor).
By popular demand (and because I wanted a hydrolyzed beef protein for my daily smoothies), under my Rootcology brand I created AI Paleo Protein, an unflavored hydrolyzed beef protein that’s compliant with even the strictest autoimmune protocol. Rootcology also carries a vanilla-flavored hydrolyzed beef protein, Paleo Protein (appropriate for the Intro and Paleo Diets; see Chapter 4), and an Organic Pea Protein (appropriate for the Intro Diet and, in some circles, the Paleo Diet). You can find them at Rootcology.com, or you can use any other type of hydrolyzed beef or pea protein; just be sure they don’t contain soy- or gluten-based fillers. For a free smoothie recipe guide, go to thyroidpharmacist.com/food.
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Carbohydrates: As I was shocked to learn in pharmacy school, carbohydrates are not a required element of our diet. Up to 50 percent of people with Hashimoto’s may have carbohydrate metabolism issues, and a low-carbohydrate diet has been shown to be beneficial for Hashimoto’s.
You will want to limit your carbohydrate intake while healing from Hashimoto’s. This will help you balance your blood sugar, and you will likely find that you feel significantly more clearheaded, more energetic, and less anxious with a lower-carbohydrate diet. You should also see your thyroid antibodies trending downward with this kind of dietary plan. Some people with Hashimoto’s (though not all) may even benefit from an ultralow-carbohydrate diet such as a ketogenic diet.
I recommend staying away from processed carbohydrates as you set off on your healing path. You can eat natural carbohydrates such as sweet potatoes and berries, but not too much at first! For best results you may want to limit your servings of carbohydrates to one or two a day if you’re still in the early stages of your healing journey and struggling with blood-sugar swings. For some of my clients, even too much fruit can throw them off! Generally, having the carbohydrates later in the day seems to be more balancing. You will be able to improve your tolerance for carbohydrates as you heal.
Micronutrients Important to Hashimoto’s Recovery
Nutrient depletions are always a factor in Hashimoto’s thyroiditis. In fact, I would argue that due to our current farming practices and Western diet, nutrient depletions are a factor for most people! Eating conventionally grown foods, taking medications, and having food sensitivities, gut inflammation, poor digestion, malabsorption, gut infection, an altered flora, and hypothyroidism in itself can lead to nutrient depletions.
Even people who are eating organic, nutrient-dense diets are at risk for nutrient deficiencies, as factors like low stomach acid, fat malabsorption, gut infections, and a deficiency in digestive enzymes will result in an inability to properly break down the nutrients from the foods that they’re eating. In addition to addressing digestive challenges, supplementation of important nutrients for Hashimoto’s may need to be implemented. Let’s take a look at some of the nutrients that you may need to support during your healing journey, starting with those required for thyroid function.
NUTRIENTS REQUIRED FOR THYROID FUNCTION
The thyroid relies on a selection of highly specific nutrients to perform optimally, and each nutrient has its own important job! Various nutrients are required for proper thyroid function, while others are needed for proper immune-system, gut, and adrenal function.
If you develop nutrient deficiencies, your body will send out signals in the form of symptoms. Many of these symptoms may be written off as simply consequences of age or environment, but oftentimes supplementation can eliminate them! Here is a list of common nutrients that can be deficient in those with Hashimoto’s as well as some of their respective symptoms.
Any combination of nutrient deficiencies is possible, but among these I’ve identified seven nutrients that are most likely to be deficient as well as supplements that have proven helpful for a significant number of people with Hashimoto’s. Some of these can be taken safely without specific testing, while others require testing to ensure proper use. I have more nutrient solutions strategies for you than I could fit in this book; please visit thyroidpharmacist.com/food to get a free done-for-you guide on these!
Four Safe Supplements
The four thyroid supplements that are safe and helpful for most without lab testing are thiamine, selenium, magnesium, and zinc.
Thiamine (B1)
Thiamine is responsible for converting carbohydrates into energy and also helps with the digestion of proteins and fats. Thiamine is necessary for proper release of hydrochloric acid in the stomach, which is required for proper protein digestion—essential for healing from Hashimoto’s. People with Hashimoto’s and Crohn’s disease have been found deficient in thiamine. Symptoms of deficiency include fatigue, low blood pressure, and adrenal issues, and low levels may contribute to irritability, depression, abdominal discomfort, and trouble digesting carbohydrates.
In 2013, I wrote an article about thiamine, and to this day I still get hugs from readers telling me that they’ve turned their life around with thiamine. One woman wrote saying that her thyroid fatigue was so severe she had to go on disability, but then supplementing with thiamine allowed her to recover her energy and go back to work. Thiamine also helped me resolve my fatigue along with the low blood pressure I battled for as long as I could remember! My blood pressure has tested normal ever since I started this supplement a few years ago.
/> Since most of the foods that contain thiamine are restricted throughout two of the three healing diets I will be recommending, supplementation may be necessary to achieve optimum levels. Research studies have shown that a daily 600-mg dose of thiamine for as little as three to five days can produce benefits such as more energy, better brain function, stabilized blood pressure, and improved blood-sugar tolerance. I recommend Benfomax from Pure Encapsulations for thiamine supplementation.
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SIGNS AND SYMPTOMS OF NUTRIENT DEFICIENCY
NUTRIENT
COMMON SIGNS AND SYMPTOMS
B Vitamins
Fatigue, stress, tongue grooves
Vitamin B12
Fatigue, depression, neurological issues, brain fog, tingling extremities, nerve damage, digestive deficiencies, seizures, anemia
Vitamin C
Poor immune function, poor detoxification
Chromium
Hypoglycemia, fatigue, elevated cholesterol, blood-sugar abnormalities
Ferritin/Iron
Low levels on test, hair loss, breathlessness, fatigue, anemia, mood swings
Folate
Elevated homocysteine, birth defects, tongue grooves, anemia
Magnesium
Headaches, constipation, pain, muscle cramps, anxiety, reflux
Omega-3s
Dry skin, eczema, mood swings, dandruff, stiffness
Hashimoto’s Food Pharmacology Page 7