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What Is The Best Diet For Hypothyroidism?

A guide to thyroid diet options to help manage symptoms.
What Is The Best Diet For Hypothyroidism?
Last updated:
1/7/2022
Medically Reviewed by:

In this article:

  • Is there a perfect diet for hypothyroidism?
  • Principles of a healing diet
  • Diets for hypothyroidism
  • How to approach a thyroid-friendly diet
  • Strategies to maintain a long-term diet


Is there a perfect diet for hypothyroidism?


Sad to say, there is no perfect diet for hypothyroidism, just as there is no perfect diet for every human being. Indeed, the human diet must consist of key nutrients to sustain physiological processes, and many of us are deficient in essential components that support optimal functioning. While we all need the same basic ingredients to sustain our bodies, the necessary amount, and form that those ingredients come in vary person by person. If you struggle to manage your hypothyroidism symptoms, your diet can be an excellent tool to gain control. 


You're not the only one who thinks figuring out your diet for hypothyroidism is daunting. There are 89 million search results for precisely that, so where to begin?


There is a lot of information and a lot of opinions out there. What we know for sure is that the Standard American Diet (SAD) - pun intended - is not working. 


Hypothyroidism is when your thyroid hormone production drops. The thyroid is the butterfly-shaped gland at the base of your neck. As part of the endocrine system, the thyroid produces hormones that regulate your body's energy use, along with many other essential functions.


Too little thyroid hormone slows the body's metabolism, which means it takes more time to burn calories at rest. Hypothyroidism affects an estimated 20 million Americans, and many of these people have experienced results from healing from within. 


Principles of a healing diet


Every person is unique with individual sensitivities. Depending on the make-up of the microbiome in our digestive tract, as well as our genetic material, particular food can be sources of healing or stress. It's important to listen to your body and learn what you do or do not tolerate. You may find that your body responds particularly well to one diet or another, of you may need to make modifications to make an eating method work for you.

At the core, eating a thyroid-friendly diet tailored to your specific needs may help to minimize your symptoms and to maintain a healthy weight. We encourage eating whole, unprocessed foods and lean protein. Some principles can guide you in finding what is healing for you:


Identify your sensitivities


Each person has unique sensitivities to certain foods, micronutrients, food additives, and chemicals. 


Remove your triggers 


If you know that certain foods aggravate your system, avoid them. While this seems obvious, it is easier said than done. Many of us have foods that we love because they are a part of our tradition, culture, or environment. However, you should weigh the benefits of eating foods that trigger inflammation, autoimmune flareups, or gastrointestinal upset. 


Add foods that heal


Some foods have restorative nutrients that can help improve thyroid function, including zincseleniumomega-3's, and iodine


Replenish nutrients


If you are sensitive or allergic to certain foods, you can develop nutrient absorption issues and create a bacterial imbalance in your gut flora. Over time, this may lead to malnutrition. Fuel your body with non-irritating foods that are rich in essential nutrients.


Hydrate


Water is the principal chemical in the human body. It accounts for over 60% of our body weight. Unless you have a condition that requires limiting fluid intake such as heart or kidney failure, focus on drinking plenty of water. 



Options for diets for hypothyroidism


There are endless diet variations out there, and it may be hard to decide which is best for you. Most diets aim to achieve specific health goals. So, the best diet for you takes into account your personal health goals and your individual sensitivities.


Ahead, a review of possible diets for hypothyroidism.


Elemental diet


Meant for people with severe digestive issues, such as Crohn's disease or eating disorders, an elemental diet involves consuming pre-digested nutritionally complete formulas. Solid foods are eliminated to allow the digestive tract to rest. Typically, this diet is prescribed or monitored by a medical provider or nutritionist.


Pros

The elemental diet can reduce inflammation because macronutrients, such as proteins and carbohydrates, are already broken down. This diet shows proven results for people who have Crohn's disease, eosinophilic esophagitis (EoE), and small intestinal bacterial overgrowth (SIBO)

Cons

This diet is not for weight loss. While many people may lose weight following the elemental diet, it's intention is to heal a severely damaged digestive tract. Because of the limited food options, people on this diet may experience irritability, fatigue, and frustration in the initial stages. Furthermore, elemental formulas can be expensive, especially if insurance does not cover the cost. Any person on this diet should have a doctor or nutritionist following their progress.  


Gut and Psychology Syndrome (GAPS) diet


The Gut and Psychology Syndrome diet (GAPS) aims to heal chronic inflammatory conditions in the digestive tract, such as leaky gut syndrome. This diet strictly eliminates grains, pasteurized dairy, refined carbohydrates, and starchy vegetables. The theory behind this diet is that foodborne toxins may enter your bloodstream if your intestinal wall is highly permeable and affect your brain. Primarily designed to treat children with learning disabilities, including autism and attention deficit disorder, adults may also adapt this diet to decrease inflammation and improve brain cognition.  


Pros

The GAPS diet can be beneficial for people with autoimmune conditions including Hashimoto's. Research suggests some correlation between leaky gut and autoimmune conditions. Eliminating foods that increase gut permeability may also reduce chronic inflammation.

Cons

The diet is very restrictive and may lead to malnourishment if a nutritionist or doctor does not monitor your progress. Furthermore, evidence that the GAPS diet treats any mental or physical condition is anecdotal to date. 


Gluten-free diet

A gluten-free diet involves avoiding foods that contain gluten, a protein found in including wheat, rye, and barley. A gluten-free diet is medically recommended for people with celiac disease, an autoimmune condition in which eating gluten can damage the small intestine.  Research suggests that celiac disease may be more common among people with hypothyroidism than the general population. People with a gluten sensitivity may also benefit from a gluten-free diet to avoid discomfort and inflammation.

Pros

A gluten-free diet may decrease your intake of processed and fatty foods. An increase in fruits, vegetables, and lean proteins may help you feel less fatigue, a common symptom of hypothyroidism.

Cons

Eliminating enriched whole-grain foods from your diet may result in deficiencies in nutrients such as calcium, iron, and niacin. You may also experience constipation, another common symptoms of hypothyroidism, if you do not get enough dietary fiber on a gluten-free diet.

Paleo diet


The popular paleo diet is rooted in the practice of eating foods that were likely part of the human diet in the Paleolithic era, dating 2.5 million to 10,000 years ago. The theory guiding this diet is that the modern human diet does not meet the genetic needs of the human body. According to the discordance hypothesis, farming practices introduced new food staples into the human diet. Yet, our bodies have not adapted to using these nutrient resources. The overarching idea behind this hypothesis is that our modern diet has given rise to chronic diseases such as obesity, heart disease, and metabolic disorders.


Pros

The paleo diet consists of foods high in protein from lean meat and rich in potassium from lots of fruits and vegetables. The paleo diet also encourages eating healthy unsaturated fats such as avocados and olive oil, as well as and eliminating processed foods. Eliminating many farmed foods (such as foods high in sugar or salt) may reduce chronic diseases.

Cons

Certain food groups that deliver essential nutrients for modern humans are eliminated by this diet, including legumes (high in magnesium and selenium), dairy (a rich source of calcium), and whole grains (high in fiber). Furthermore, modern humans are not genetically identical to Paleolithic humans, nor are the plants and animals that were part of the human diet during that period. 

Find out which Paloma nutritionist is right for you:

Ketogenic diet

The ketogenic diet, commonly referred to as the keto diet, is a low-carb, high-fat diet. This diet involves significantly reducing your carbohydrate intake and replacing it with healthy fats. Eating a diet low in carbs forces your body into a metabolic state called ketosis. Ketosis is the body's process of efficiently burning fat for energy because it does not have enough carbohydrates to burn. During this process, the body also turns fat into chemicals called ketones in the liver. These ketones supply energy for the brain.

Pros

Eating a low to moderate amount of carbs is very effective for maintaining a healthy weight.

Cons

A ketogenic diet may cause a significant reduction in insulin levels. Insulin is used to process glucose in the blood and transport it around the body. Too little insulin can impair the liver's ability to convert the inactive thyroid hormone thyroxine (T4) to the active hormone triiodothyronine (T3). Additionally, if the body remains in ketosis too long, too much acidity can built up in the body leading to inflammation, affecting those with hypothyroidism who may already struggle with chronic inflammation.

Vegetarian or vegan diet

A vegetarian diet typically abstains from animal meat products. Variations may include vegans who do not consume animal meat or dairy products, lacto-ovo vegetarians who eat eggs and dairy products, and pesco-vegetarians who consume fish in addition to eggs and dairy. This way of eating is densely plant-based, adding more fruits and vegetables to the diet.  While diets that eliminate animal products may not specifically benefit hypothyroidism, they may protect against autoimmune conditions like Hashimoto's thyroiditis. Because vegetarians tend to have lower body mass index (BMI) than nonvegetarians, some studies show that they have lower levels of inflammatory markers that are typically present in autoimmune conditions.

Pros

Eating a plant-based diet may decrease complications associated with a range of chronic conditions, including Hashimoto's thyroiditis.

Cons

All vegetarian diets may be low in calcium, vitamin D, vitamin B12, and zinc. Vegans may be at risk of inadequate iodine intake as animal products tend to be rich in iodine. The American Dietetic Association recommends that those who do not eat eggs or dairy products be awareness of the need of iodine supplementation.

Mediterranean diet

The Mediterranean diet focused on anti-inflammatory fish and seafood, whole grains, nuts, seeds, legumes, and healthy fats. Red meat, butter, and processed foods are avoided on this diet.

Pros

The Mediterranean diet helps with thyroid conversion by reducing inflammatory foods in your diet. This diet is also rich in omega-3 fatty acids which provide cellular membrane integrity which protects them from becoming damaged and enables your cells to communicate well with each other.

Cons

This diet includes a lot of fish, and high levels of mercury (often found in fish) may act as an endocrine disruptor. Low mercury options include salmon, cod, tilapia, and sardines.


Autoimmune protocol (AIP) diet


The autoimmune protocol diet (AIP) is a food-based approach to reducing inflammation created by autoimmune disorders. The AIP diet consists initially of a stringent elimination diet followed by a slow, methodical reintroduction process to rule out reactivity. The goal of this diet is to bring balance back into the body. Designed by Dr. Kharrazian, this diet helps people with autoimmune conditions, including Hashimoto's.


Pros

Because this diet recommends only healthy foods, many people do feel better eating non-processed foods. Similarly, part of the autoimmune protocol is to adopt a healthier lifestyle, which includes more sleep, better stress management, increased physical activity, and greater emphasis on healthy social relationships.  

Cons

This diet is more restrictive than the paleo diet in its initial phases. Therefore, it can be hard to follow. It also requires dedication to first eliminating many foods and then slowly reintroducing foods in small quantities.   

 

FODMAP diet


The fermentable oligo-di-monosaccharides and polyols diet (FODMAP) aims to eliminate fermentable carbohydrates. This elimination can improve overall gut health in people with sensitive digestive systems and irritable bowel syndrome (IBS). A low-FODMAP diet avoids high-FODMAP foods, including lactose-containing dairy products, specific fruits and vegetables, wheat and rye, garlic and onion, and natural sweeteners such as honey and agave. AIP is a three-part diet: Elimination, Reintroduction, and Personalization.

 

Pros

There have been many studies that have found the low-FODMAP diet to be particularly beneficial for people with IBS. While it's required to eliminate certain foods in a food group, there are alternative options in the same group that are low in FODMAPs, which can still provide essential nutrients.

Cons

The low FODMAP diet can be labor-intensive, as you must commit to eliminating all foods required by the diet in the beginning. It requires much preparation and planning for meals. Furthermore, some consider this diet a secondary form of treatment for IBS, as adhering to this diet can be very challenging. 


Candida diet / body ecology diet (BED)


The body ecology diet (BED) aims to restore balance in your digestive health and the unique ecosystem in your body. The foods recommended in this diet primarily aim to rid the body of candida (yeast), as well as make the blood more alkaline and strengthen the immune system. The theory behind this diet is that an overgrowth of yeast can create an imbalance in all body systems. This imbalance may cause immune deficiencies, allergies, skin disorders, hormonal imbalance, weight gain, and anxiety/depression. Initially, the diet begins with a cleanse before advancing to a strict diet. 


Pros

There is much anecdotal evidence that this diet is helpful for people suffering from conditions that are difficult to treat medically. Many of the foods listed in this diet are healthy and may offer many health benefits overall. 

Cons

There are no evidence-based studies that support the claims of BED to date. Also, this diet can be quite restrictive and can be particularly challenging if you are not able to meal plan, cook, or if you are on a tight budget. Because of its restrictive nature, this diet may cause you to miss out on essential nutrients.


Low residue fiber diet


Fiber is in fruits, vegetables, and grains, and the body cannot digest it. Eating foods high in fiber creates more bulk in your stool, which must pass through your system. This diet may be helpful to people with a narrowing of the intestines or have had damage or surgery on their digestive tract. The goal of this diet is to rest the bowels by lessening stool bulk until your diet returns to normal.


Pros

Following a low fiber diet can help return your bowels to a healthier state. This diet may improve abdominal conditions such as diarrhea, abdominal pain, and cramping. After your digestive system has recovered, you can reintroduce these foods slowly. 

Cons

Many healthy and nutrient-dense foods are high in fiber. On this diet, you must avoid foods like whole grains, dried and fresh fruits, fresh vegetables, beans, seeds, and nuts. If you are on this diet for an extended period, it is advisable to consult with a nutritionist to verify you satisfy your nutritional needs.


Elimination diet


The elimination diet aims to eliminate any foods that contribute to intolerance, sensitivities, or allergies. Between two and twenty percent of the worldwide population suffers from food intolerance. This diet is considered the gold standard for identifying triggers. Symptoms that may indicate food intolerance include nausea, vomiting, diarrhea, constipation, abdominal cramping, eczema, and anaphylaxis. 


Pros

This diet bases itself on your personal experience with food. Therefore, you decide what to eliminate based on your symptoms and attempt to reintroduce in five to six weeks. 

Cons

If you have a known or suspected allergic response to certain foods, it is vital to consult an allergist and reintroduce foods based on your provider's recommendations. Some food allergies can be life-threatening and should be avoided altogether. 

How to approach a thyroid-friendly diet


The way that you approach your thyroid-friendly diet plays an important role in achieving your health goals. You'll need a roadmap if you are considering a complete overhaul on your diet.

Most dietary methods are not long-term solutions. Indeed, some diet methods are designed to clean out your system, allow your system to rest, or reset your unique ecosystem. For example, if you suffer from severe inflammation in your digestive tract or Hashimoto's flare ups, you may consider eating an elemental diet for a week or two, followed by the Autoimmune Protocol Diet, and then the Paleo diet as your long-term diet.


Transitioning off a short-term diet


If you strictly follow a specific diet, you may need to wean off of the diet slowly. For example, if you have been following a gluten or dairy-free diet and are planning to re-introduce those food items, you may want to do so slowly. When your body doesn't get certain foods and nutrients, such as lactose and gluten, you may develop a sensitivity that can throw off your digestive tract.


Some diets can be extreme, such as the elemental diet. It is essential to work with a nutritionist and your doctor to monitor your progress as you advance your diet. Similarly, if your doctor recommends a diet following a medical diagnosis or procedure, you should develop your diet based on their recommendations for your safety and the best outcome.


It is important to note that some diets are healing diets, not meant for the long term. For example, the elemental, low fiber, and candida diets aim to heal the digestive tract. Following these diets for an extended time may lead to malnourishment because essential nutrients may be left out. 


Strategies to maintain a long-term diet


Following a diet can be hard and takes commitment. Frequently, diets involve more than just adding and eliminating certain foods. Success with following a diet also consists of making changes that affect your habits, relationships, and lifestyle.


Here, ten strategies to help you stick with a healthy diet:

  1. Find your motivation - Whether its to control your hypothyroid symptoms or be able to hike with your friends, figure out what will motivate you. Consider even putting an image on your pantry to remind you of your motivation.
  2. Research your diet  - Knowledge is power. Understanding why you are avoiding or adding certain foods can help you move beyond satisfying your tastebuds.
     
  3. Meet with a nutritionist - When mapping out your health goals, consult with a nutritionist to design a diet that is specific for your individual needs.
  4. Have realistic expectations - If your goal is to lose a certain amount of weight in a short time, you may become discouraged and abandon the diet altogether.
  5. Clean out your pantry - Get rid of unhealthy foods in your house to minimize the risk of diet cheating.
  6. It's not all or nothing - If you slip up on your diet, move on, and choose healthier foods for the rest of the day. Let go of self-judgment and aim to do better in the future.
  7. Pack healthy snacks - Keep a high-protein snack on hand to prevent quick-fixes like drive-thru lunches.
  8. Start your exercise habits with your new diet - Studies show that simultaneously starting a new diet and exercise program can increase your chances for success.
     
  9. Mindful eating is key - Taking time to appreciate the food you are eating has profound impacts on developing behavioral changes. 
  10. Don't diet alone - Find someone else to hold you accountable. Even if you are not following the same diet, supporting one another can increase your chances of success. 

A note from Paloma Health

Diet alone will not cure hypothyroidism. Always talk to your doctor before making significant dietary changes that could affect your condition. Think of your eating plan as a complementary treatment to your thyroid hormone replacement therapy to help relieve symptoms of hypothyroidism.

Paloma Health gives you the opportunity to work with a nutritionist in collaboration with a physician to determine nutritional status for optimal thyroid health.

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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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