Hashimoto’s Food Pharmacology
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Myo-inositol, a naturally occurring sugar alcohol with half the sweetness of sugar, may be a better alternative. Myo-inositol, when combined with selenium, has been reported to improve thyroid function, stabilize blood sugar, and help anxiety. However, it may not be appropriate for people with kidney disease or low blood sugar.
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Alcohol: Drinking alcohol can lead to leaky gut, blood-sugar imbalances, SIBO, and a backlog in the liver as it works to detoxify ethanol. Even a “healthy” glass of red wine can have these effects, which is why it’s advised to avoid all types of alcohol while following the Root Cause Intro Diet. If you miss the taste of alcohol, you can try a few of my favorite substitutes, such as the Hashi-Mojito, which will support your liver and gut with probiotics.
THE ROOT CAUSE PALEO DIET
I based the Root Cause Paleo Diet on a traditional Paleo diet, which is the popular approach to eating that is modeled after the way our ancestors ate, and modified it to specifically benefit people with Hashimoto’s. The result is a diet that’s designed to lower your intake of inflammatory foods and increase your intake of anti-inflammatory foods, including high-quality animal-based proteins, which will help your body repair itself.
The goal of this dietary protocol is to remove stressors that may prevent us from restoring optimal function to the adrenal glands (the majority of my clients with Hashimoto’s have presented some degree of adrenal dysfunction). We accomplish this by making dietary choices that reduce inflammation and help balance blood sugar, since both inflammation and dramatic surges and swings in blood sugar can stress the cells and tissues of the body.
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TESTING FOR FOOD SENSITIVITIES
When I was working as a pharmacist, we were always on the lookout for “true IgE-related allergies” to foods and medications (IgE is a class of antibodies). These were the life-threatening reactions that could cause anaphylaxis, shortness of breath, and rashes! I learned about reactions mediated by the other immune branches in immunology during my first year in pharmacy school, but somehow calling the IgE-related reactions “true” led me to believe that the other types of reactions didn’t matter. Unfortunately, most conventional medical professionals and insurance companies hold that same misconception, and food sensitivity tests are considered “experimental.” This was of course fine with me, because when I “experimented” with removing the foods the tests found to be reactive for me, I felt dramatically better!
The other challenge with food sensitivities is that when we eat the foods that our body is sensitive to on a daily basis, it is very difficult to connect the foods with the symptoms we are having. For example, people who have a dairy sensitivity but continue to eat dairy multiple times a day might be tired, have joint pain, congestion, bloating, and acid reflux daily, but won’t be able to pinpoint the foods responsible for the symptoms. I was personally a bread and dairy addict and had no idea that they were causing me issues.
Every time we eat a food we are sensitive to, the body becomes depleted in its ability to protect itself from that food, and the reactions become less specific and more chronic. If the food continues to be eaten, the body will become more and more sensitive. However, once the sensitizing food is eliminated for a few days to a few weeks, we should generally feel better and experience less bloating, less acid reflux, normal bowel movements, more energy, and so on.
When we are exposed to the food again, the body will actually produce a stronger, more specific reaction, allowing us to recognize which particular food is problematic. This is known as an elimination diet and is the gold standard for food-sensitivity testing.
The Root Cause dietary protocols are based on the elimination diet, in which we remove the most common sensitizing foods found in those with Hashimoto’s; however, some people may benefit from additional trials and testing. There are a multitude of food-sensitivity tests out there, but none of them are perfect. Some may have false negatives; others may have false positives or a combination of both.
The test that I found to be highly accurate for my clients and myself is the Alletess Lab food-sensitivity test. If a food comes up positive on that test, I know that it is a reactive food for that person. However, if the person has been off the food for some time, this test may have false negatives; so if people come up negative for one of the big reactive foods, I recommend going off it anyway and reintroducing it. If you are not quite ready to do an elimination diet or you need to see things in black and white, you may want to look into food-sensitivity testing.
Alletess Lab works primarily through integrative- and functional-medicine physicians, so if you’re working with a physician in that category, you can ask your doctor to order the test for you. I’m also really excited to let you know that I’ve worked with MyMedLab to offer self-order food-sensitivity testing without a doctor’s prescription. The test kit comes with a little blood-spot collection paper that can be mailed from just about anywhere in the world!
MyMedLab offers two options to test for the most commonly eaten foods, a 96 and 184 food panel. I started with the 96 food panel, and it was enough to uncover most of my food triggers. I now repeat the 184 food panel on an annual basis to be sure that I’m staying on top of potential triggers, as our sensitivities and reactions to foods can change with time. Please go to www.thyroidpharmacist.com/resources for self-ordering options and special discounts.
If you already had the Alletess food-sensitivity test done (or another credible test), it may reveal that you are sensitive to something that may be included in the Intro, Paleo, or Autoimmune Diet. If this is the case, don’t eat it!
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If you began with the Root Cause Intro Diet, you will have already removed alcohol, caffeine, dairy, soy, sugar, and gluten-containing grains. We will add to that list some additional items that can stress the body and possibly interfere with healing.
Grains: When I surveyed my readers, 81 percent of them reported feeling better when they went grain free! If you have pain and symptoms of irritable bowel syndrome such as constipation, diarrhea, nausea, or indigestion and if you are prone to depression, eliminating all grains may help lessen these.
We remove all grains to ensure that any substances that would irritate the intestinal lining are gone and also to help balance blood sugar; even gluten-free products made with grains like rice and corn can wreak havoc on our blood sugar. Blood-sugar imbalances have been described by many practitioners who focus on reversing Hashimoto’s as adding “fuel to the fire” in autoimmune thyroid disease.
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THE ROOT CAUSE PALEO DIET
EXCLUDED FOODS
Gluten
Dairy (we also exclude butter and ghee, which are allowed in traditional Paleo)
Soy
Sugar
Alcohol
Caffeine
Grains
Legumes (except green beans and pea protein)
Hot peppers
Iodine-rich foods
INCLUDED FOODS
Meats (all)
Fish and shellfish
Vegetables (except hot peppers)
Fruits (all)
Nuts
Seeds
Eggs
Oils: avocado, coconut, and olive
Hydrolyzed beef protein
Pea protein
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Hot peppers: Due to their ability to cause leaky gut, spicy peppers that produce capsaicin, such as cayenne pepper, chili peppers, red pepper flakes, and so on, are omitted from the Root Cause Paleo Diet. Bell peppers, which do not produce capsaicin, are appropriate to eat on the Root Cause Paleo Diet, as is black pepper, which is produced from peppercorns and is “spicy” due to piperine, a different substance.
Legumes (except green beans and pea protein): The most commonly known legumes are beans, including black beans, soybeans, fava beans, garbanzo beans (chickpeas), kidney beans, and lima beans. Lentils and peas, such as black-eyed peas, green peas, snow peas, and snap peas, are also consid
ered legumes, as are peanuts.
Legumes contain phytates that bind various nutrients and can lead to poor zinc absorption, which may interfere with healing. Deficiencies in zinc have been linked to increased intestinal permeability and susceptibility to infections, so we want to take steps to eliminate anything that may prevent zinc absorption.
I’ve made two exceptions in the legume category, and those are for green beans and pea protein. They are both relatively well tolerated by most people with Hashimoto’s.
Iodine-rich foods: Because we know that excessive iodine intake can be a trigger for Hashimoto’s in those genetically predisposed to it, I recommend eliminating iodine-rich foods such as iodized salt and all types of seaweed, including nori, kombu, kelp, and wakame, from your diet during the Root Cause Paleo Diet. Other iodine-rich foods like spirulina and chlorella (there are some versions that have lower iodine) should also be avoided. Spirulina and chlorella have immune-stimulating properties that can worsen autoimmunity and even cause new-onset autoimmunity.
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MY FAVORITE BLOOD SUGAR–STABILIZING SOURCES OF FATS AND PROTEINS
Avocados
Chia seeds
Chicken
Coconut milk
Coconut, avocado, and olive oils
Duck fat
Eggs and egg white protein (if not sensitive)
Grass-fed beef
Hydrolyzed beef protein
Lamb
Nuts (except peanuts)
Olives
Pea protein
Pork
Salmon
Sardines
Seeds
Tallow
Turkey
Whitefish
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THE ROOT CAUSE AUTOIMMUNE DIET
After following the Intro Diet and the Paleo Diet, you will have already excluded gluten, dairy, soy, and grains, the most common reactive foods for those with Hashimoto’s. If you are still experiencing symptoms, especially gut-related symptoms, after following these two diets, my recommendation is to step up to the Root Cause Autoimmune Diet. In Hashimoto’s Protocol, this diet appeared as part of the Gut Balance Protocol, which included the use of enzymes (read about the best enzymes for digestion later in this chapter) and other supplements to help heal the gut. The diet adds to the list of excluded foods eggs, nightshades, nuts, and seeds, which have proven to be reactive foods for some people with Hashimoto’s. It is also recommended that you add 1 to 2 cups of homemade Bone Broth to your daily regimen, which will assist in the healing of your gut.
Eggs: Eggs are an excellent source of protein, but can be a reactive food for some people with autoimmune conditions such as Hashimoto’s. In my reader survey, 48 percent of people reported that they felt better on an egg-free diet. Eggs contain the enzyme lysozyme, which has the ability to bond with bacteria and proteins as it moves through the digestive process, collectively forming what’s referred to as a lysozyme complex. A lysozyme complex is sort of like a fireball of potential irritants, which, if you have leaky gut, can pass through intestinal gaps and activate the immune system.
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THE ROOT CAUSE AUTOIMMUNE DIET
EXCLUDED FOODS
Gluten
Dairy (including butter and ghee, which are allowed in traditional Paleo)
Soy
Sugar
Alcohol
Caffeine
Grains
Legumes
Hot peppers
Iodine-rich foods
Eggs
Nuts
Nightshades
Seeds
Stevia
INCLUDED FOODS
Meats (all)
Fish and shellfish
Vegetables (except nightshades)
Oils: avocado, coconut, and olive
Fruits (all, especially coconut)
Hydrolyzed beef protein
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Nightshades: Similar to those eliminating eggs, 47 percent of people who responded to my survey said they felt better eating a nightshade-free diet. Symptoms associated with eating nightshades included joint aches, pain, swelling, tingling, and numbness. Nightshades are a specific family of flowering plants and the fruits and vegetables they produce, including: tomatoes, potatoes, eggplant, bell peppers, tomatillos, spicy peppers (such as Thai peppers and chili peppers and the spices produced from them), goji berries, and cape gooseberries. Nightshades contain alkaloids, which are chemical compounds that can be reactive substances in some people.
Nuts: Nuts are a highly nutritious source of protein and healthy fats, which is why I encourage keeping them in your diet until you reach this level. Despite these nutritious qualities, however, nuts can be tough to digest; they contain oxalates and phytates, both “antinutrients” that can interfere with mineral absorption. Nut allergies are also increasingly common, which suggests that the number of people who are sensitive to them is probably growing too. For people with Hashimoto’s, almonds in particular are reported as one of the top reactive foods (it is the fourth most common after gluten, dairy, and soy). This may have something to do with the fact that people are more likely to eat them every day as a snack (the Almond Board has been doing its job!), increasing the risk for a sensitivity to develop. In the Root Cause Autoimmune Diet, almonds and other nuts are excluded, but even if you don’t react to them now and you add them back in later, I recommend rotating them with other foods, eating them every three to four days.
Seeds: Although seeds don’t to seem to be a reactive food for an overwhelming number of people with Hashimoto’s—only 7 percent of those who completed my survey reported a seed sensitivity—they have the potential to aggravate an already irritated gut. Seeds tend to resist digestion and might contribute to symptoms if you have trouble digesting proteins.
The list of included foods on the Root Cause Autoimmune Diet may seem short, but in practice it translates to countless options for delicious eating. Some of my favorite meals to enjoy while following the Autoimmune Diet include Creamy White Chicken Stew, Mango Salsa, and Twice-Baked Sweet Potatoes. You’ll find recipes for these, and several others that you can try while sticking to this diet, in the Cookbook section.
KNOW THAT HEALING IS POSSIBLE: SUCCESS STORIES
In case you’re hesitant about trying a radical diet, I wanted to share a few stories from readers just like you from around the world who have implemented the various healing diets mentioned in this chapter. If they did, you can too.
SUE: I did both the food-sensitivity testing and the autoimmune Paleo diet for about a year. My moderate autoimmune psoriasis cleared about 90 percent. Also, I lost weight, which put me into a healthy weight range. I also reduced my Tirosint [hypothyroidism med] from 88 mg to 75 mg.
LANE: Huge difference!! Eliminating gluten-containing grains and dairy completely as well as limiting sugars, alcohol, and processed food changed my life. My thyroid and Crohn’s symptoms are not all-consuming anymore. I don’t have bloating and stomach discomfort after I eat anymore. I don’t constantly pass gas, so I can attend group yoga classes again . . . and not embarrass my teen daughter! I’m not glued to the toilet half the day. I can think again in my engineering job. I can’t even imagine how awful my life would be if I didn’t make these relatively easy changes. These changes are not big sacrifices—I still eat out just fine—and I have a wonderful future to look forward to! Thank you Izabella Wentz for all you’ve done to help inspire us to take healing into our own hands!
BONNIE: After reading Root Cause, I gradually gave up gluten, then dairy, sugar, alcohol, and coffee. Then I followed Paleo for six months before going completely AIP. About then I started following recommendations from Dr. Wentz’s Hashimoto’s self-management course and then her book Hashimoto’s Protocol. I was on my way to remission! After eighteen months on AIP, my thyroid antibodies were in the normal range, and I gradually started reducing my dosage of thyroid hormone. Now I am in the process of gradually reintroducing foods with the eventual goal of sta
ying Paleo 80 percent of the time. I have never felt better!
JOANNA: With the elimination diet, no gluten, no dairy, no sugar, no grains, etc., I reversed Hashimoto’s and got best results in ten years!! Hair grown back! Sleep galore! Bloating gone! Puffy face gone!! Miracles!!!
CHRISTINA: Started strict AIP plus good probiotics in October and noticed a difference within a week—the terrible morning joint pain was almost completely gone. Next, my energy started returning and brain fog started lifting. Within a month, joint pain was almost completely gone, energy was so great, brain fog way better, superdry skin improving, hair starting to grow back, and I had lost almost 10 pounds of water weight. I was honestly shocked that just diet and supplements had made such a difference. I’ve been able to reintroduce a few things, and that’s made the diet changes more doable.
SARA: I was diagnosed with Hashimoto’s in October, and after reading your books in November I gave up gluten, grains, dairy, refined sugar, and junk. My thyroid gland has dramatically decreased in size. I was getting to the point where I was choking on foods because of my enlarged thyroid. This is so much better. I have a follow-up with ultrasound in March and am excited to see the objective outcome of my diet changes. My brain fog is improved, though there are still days it’s there.
My endocrinologist never once mentioned that diet would/could help. She literally told me there was nothing I could do about my new diagnosis. So thank you, Izabella, for your books and your guidance!
NICOLE: Went gluten, dairy, soy, sugar, canola oil, iodized salt, and alcohol free for four months. Added selenium, vitamin E, and vitamin B12, betaine with pepsin, and liver support . . . lost 8 kilograms, had more energy, less bloating, and less inflammation in joints.