If you've ever been confused about what to eat because of your Hashimoto's then this is the article for you. I'm going to take away the guessing game that is your Diet... Reduce your stress about what foods you should be eating and what foods you should be avoiding... So that you can get back to what's important: Healing your autoimmune disease. This article is going to go over how you should be approaching your diet after your diagnosis of Hashimoto's. And here's the thing: There is no one-size-fits-all diet that you should be following! Everyone is completely different and that means the diet you need is not the same as your friends or someone on your support group. This article will teach you everything you need to know to get started and feel confident you are on the right track... So let's jump in: ​

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The Secret to Finding the Right Diet for Your Body ​If you want to find the best diet for your body you will need to follow a few rules:

Don't be afraid of Trial and Error (you most likely will not get it right on the first try)

(you most likely will not get it right on the first try) Pick your diet based on your symptoms and other medical problems (blindly picking a diet to follow is NOT the best approach)

and other (blindly picking a diet to follow is NOT the best approach) Don't base your results off of your antibody levels alone (It is possible for your antibody levels to stay the same but for your symptoms to improve and is a GOOD thing)

(It is possible for your antibody levels to stay the same but for your symptoms to improve and is a GOOD thing) Your diet should NOT be a huge source of stress in your life - if it is then it will be counterproductive to healing! (1)

​By following these guidelines you will improve your chances drastically of finding the diet that works for you. ​And remember: Use this outline as a GUIDE - it is not a replacement for medical advice. Will These Diets Help me Lose Weight? You've been conditioned to think that Diet and Exercise are the keys to weight loss. But in Hashimoto's and Hypothyroidism that couldn't be farther from the truth. Changing your diet will HELP you lose weight, but in the majority of patients, it's really just one step. You may lose 5-20 pounds by changing your diet (depending on how much you have to lose) but changing your diet will NOT get you back to your normal weight if your thyroid is underdosed. I've written extensively about ​how to lose weight with Hashimoto's and Hypothyroidism:

As you can see from the case studies above that you can lose weight with each of the diets listed below. The most important part is picking the diet best for YOUR body. ​

Download my Free Resources: Foods to Avoid if you have Thyroid Problems: I've found that these 10 foods cause the most problems for thyroid patients. Learn which foods you should absolutely be avoiding if you have thyroid disease of any type. DOWNLOAD The Complete List of Thyroid Lab Tests: This list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose thyroid hypothyroidism correctly! DOWNLOAD Download more free resources on this page.

Why Diet is the MOST Important Part of Treating Hashimoto's Thyroiditis As you know... Hashimoto's disease is an autoimmune disease - that means your body is literally attacking and killing itself. In the case of Hashimoto's, this attack occurs on the thyroid gland itself!

If left untreated over long periods of time this will ultimately result in the destruction of your thyroid gland tissue. That means your thyroid won't be able to produce thyroid hormone anymore and you will be left with supplementing with thyroid hormone... indefinitely. It doesn't sound pretty, but here's the deal: You can reduce and even prevent the attack on your own thyroid by making some targeted changes. ​While diet is a critical component of reducing the inflammation in Hashimoto's, it isn't the end all be all treatment. In order to treat Hashimoto's, you must reduce inflammation. That means you have to address ALL causes of inflammation including:

Dietary allergies and antigens

Gut Imbalance (Dysbiosis, SIBO, Gut infections, Leaky Gut, etc.)

Physical, Emotional and Physiological stressors

Chemical Toxins and Endocrine Disruptors

Nutrient Deficiencies

Lifestyle changes including improved sleep, exercise and stress reduction techniques

Doing just one of these is a recipe for failure... There is almost no question that your diet may increase inflammation in your body, but it's certainly not the only culprit. And in order to reduce all inflammation, each area must be addressed. So diet (while probably the MOST important aspect of reducing inflammation) is really just the beginning... ​Which Diet is the Best for Reducing Antibody Levels?

There are MANY different diets you can choose from to help reduce inflammation and autoimmunity, but the important part is finding the right one for you. I've successfully used all of these diets in my patients to help them feel better, lose weight and reduce antibody levels. ​The 5 diets that I want to go over in detail include:

The Elimination Diet

Autoimmune protocol diet

Gluten-free diet

Paleo diet

Low FODMAP's diet

If you've never heard of any of these diets don't worry, I'm going to go over what factors may lead you to choose one over the other and how to pick the best diet for you. When it comes to following a diet the truth is you really will get 90% of the benefit as long as you can remain consistent with whichever diet you pick. So don't get caught up in all the nuances, instead just focus on sticking to the plan.

1 Food Sensitivity Diet (Elimination Diet)

​What is it? The Elimination diet is based on the idea that certain foods may cause negative reactions in certain people. In the most basic sense, you simply remove these foods from your diet and then monitor how you feel. Pretty simple, right? There are two ways to do this diet: 1. Blood testing for food sensitivities: Find specific foods that you are sensitive to using delayed IgG food sensitivity testing. Testing for IgG antibodies will find food *sensitivities* that you may be reacting to, but may not be allergic to. You can find more information in the video below:

When most people think of food allergies they think of allergies to foods like shellfish and tree nuts which may cause swelling of the face airways leading to potentially life-threatening situations. We aren't talking about food allergies like these. Instead, we are talking about sensitivities to certain foods that may make you react with low-grade inflammation, changes in colonic bacteria, depression, anxiety, mood disorders, acne, postnasal drip, etc. This type of food "allergy" is mediated by a different type of immunoglobulin known as IgG. This type of food ​is more sinister and difficult to spot. Why? Because your reaction to the food might be delayed by up to 48 hours AFTER eating the food you are sensitive to. ​ This delayed reaction makes it difficult to put your finger on which foods may be causing you problems and can get really frustrating. ​The delayed IgG food sensitivity testing can be very helpful for patients who don't respond to the traditional elimination diet that simply removes the most common food allergies from the diet. 2. Eliminate foods systematically: Instead of getting the Delayed IgG blood test you can simply remove the major food groups that most people are sensitive to for 30-90 days. This allows enough time for the inflammation to cool down, your GI tract to begin healing and most of the other symptoms you may be experiencing to resolve.

Once you've eliminated your symptoms (and only if you have eliminated your symptoms) you can then begin to slowly reintroduce these food groups back into your body while monitoring how you react.

If you find that ​you feel poorly after reintroducing certain foods back into your diet then you have some great information: Stop eating the food that makes you feel terrible! I've found that this type of diet can be difficult for patients who like things to be black and white. Sometimes people just don't want to give up their favorite foods even if they react poorly to them, so if you fall into this category it may be a good idea to just get the food sensitivity test to see which foods you need to avoid. ​ The most common food groups removed in this diet include Gluten, Dairy, Soy, Sugar, Artificial Sweeteners, Corn, Peanuts, Eggs, and Shellfish.

If you elect to go this route (without the blood testing), then it's best to remove at least the top 5-7 most common food allergens. You don't want to remove too many foods initially because that can make dietary choices very difficult and doesn't always lead to long-term success. You can find an example below of the various phases of the elimination diet: ​

Does it work? ​Yes! The combination of going gluten, dairy, soy free + removing any foods you may be sensitive to by checking your delayed IgG antibodies is one of the most effective methods for determining which diet your body needs. ​ In order for this diet to be effective just remember that you need to stick to it for at least 2-3 months. ​ According to a group study using this diet, 62% of people reported that they felt better, 4.2% said they felt worse, and 43% had a reduction in Hashimoto's antibodies. ​More information: Food Sensitivity Diets​

​Elimination D﻿iet

Allergy Avoidance Diet

PROS Highest reduction in antibodies

Easy Implementation (can start right away)

You don't necessarily need to see a nutritionist to start

A moderate percentage of people felt better on this diet

Can be cost effective if you do not get delayed IgG food allergy testing CONS The highest percentage of people felt WORSE on this diet

Testing can be expensive and at times inaccurate

Requires a lot of time to reintroduce food groups

May take weeks to months to feel better

Who Should Consider the Elimination Diet?

People who react with itching, swelling, hives, runny nose or post nasal drip after eating certain foods

People who also have a personal history of Asthma or Eczema

People who have failed other more basic diets like Gluten-free, Soy free or Grain free and are still symptomatic or still have high levels of antibodies

Quick Tip: You don't necessarily need to have delayed IgG sensitivity testing to get started. It may be necessary for some people but you can get started right away by eliminating the 7 most common reactive foods (listed above).

2 Autoimmune Paleo Diet (AIP)

​What is it? Also referred to as the autoimmune protocol or autoimmune diet, this diet is very similar to the paleo diet except it also excludes Nuts, Seeds, Eggs, Legumes, and Nightshades. The AIP diet is felt to be one of the best diets to reduce antibody levels in Hashimoto's but it is also one of the most restrictive diets out there making it difficult to sustain for long periods of time. To see a case study of one of my patients using AIP to lose weight and feel better please see this post. ​ If you remove all of those food groups, then what is left to eat?​ You can see the list of the allowed foods below:

Vegetables (Except Nightshades)

Fruits

Coconut Products

Fats: Olive oil, Coconut oil, Lard

Fermented Foods

Bone Broth

Grass Fed Meats, Poultry and Seafood

Non-seed Herbal Teas and Green Tea

Vinegar (Including Balsamic without added sugar)

1 Tsp of Maple Syrup and Honey used as sweeteners

All fresh non-seed Herbs

Grass Fed Gelatin and Arrowroot Starch

Does it work? As long as you can sustain this diet it has the highest potential to help reduce antibody levels and improve symptoms. One of the problems with the AIP diet is how restrictive it is which can lead to a lack of consistency by many patients. According to group data 75% of people felt better, 4% of people felt worse, and 43% had a reduction in antibodies while following the Auto-Immune Paleo Diet. ​More information: Autoimmune Paleo

AIP lifestyle​

The Paleo Mom​

PROS A moderate percentage of people felt better on this diet

May help many people feel the "best" fastest

Includes gut healing foods like bone broths

Good support community online

Easy access to recipes online CONS A high percentage of people felt WORSE on this diet

Lots of restrictions initially, making compliance difficult

Requires a lot of time to reintroduce food groups after phase 1

Patients may start reacting to foods they didn't react to previously

Who should consider the Autoimmune Paleo Diet?

People who have multiple autoimmune conditions (in addition to Hashimoto's), multiple food sensitivities and multiple medical problems

People who have failed other less restrictive diets (Gluten-free, paleo, dairy free, etc.)

People who want to jump to the "best diet" and are willing to make drastic changes to their diet

Quick Tip: I don't typically recommend that all Hashimoto's patients start with this diet because for many patients less restrictive diets are enough to lower antibody levels and improve symptoms - if you fit into the categories above I would strongly consider AIP to start.

3 Gluten-Free Diet

​What is it?

If you don't already know about gluten here is a quick primer: Gluten is a name that includes multiple proteins found in wheat, rye, and barley. There are two varieties of problems that people can have as it relates to gluten: 1. Celiac disease : People with this condition have an autoimmune response when introduced to the protein which results in damage to the intestines, inflammation and MANY other signs and symptoms. Patients with this condition typically have elevated blood levels of Gliadin, Transglutaminase-2, and Endomysium which you can find on serum testing. ​The autoimmune and inflammatory component from coming into contain with gluten results in direct damage to the intestinal wall. This damage leads to increased intestinal permeability ("leaky gut") and a variety of symptoms including i﻿﻿ncreased risk of developing autoimmune diseases (2) like Hashimoto's thyroiditis. This process happens through molecular mim﻿icry. (3) Basically, you consume portions of undigested proteins that float in the bloodstream and your body mistakes these pieces of protein for parts of your body and then attacks itself. Obviously not something you want going on in your body, but what about non-celiac gluten sensitivity? Is it even a real thing? It turns out it is and its supported by plenty of data... (4) 2. Non-celiac gluten sensitivity : ​ People with this condition still have a reaction to gluten but the reaction is much more sinister and much more difficult to diagnose. Traditional blood tests for gluten antibodies are all negative (5) which may make patients falsely believe that they can tolerate gluten without a problem. Unfortunately, non-celiac gluten sensitivity still causes plenty of problems both in the intestinal tract and outside of the intestinal tract and that's one of the ways that some experts recommend diagnosing the condition:

Intestinal symptoms : Bloating, abdominal pain, diarrhea, epigastric pain, nausea, gas, acid reflux, IBS like symptoms and constipation

: Bloating, abdominal pain, diarrhea, epigastric pain, nausea, gas, acid reflux, IBS like symptoms and constipation Extraintestinal symptoms : Fatigue, headaches, anxiety and other mood changes, brain fog, numbness/tingling, joint and muscle pain and skin changes including rashes or random outbreaks

Do you have any of these symptoms but negative blood tests for Celiac disease? Or have you removed gluten in the past and felt better when you did? Only to find out that your symptoms return when you start eating it again? If so then you might have non-celiac gluten sensitivity. (6) In addition to the symptoms listed above NCGS can also cause increased inflammation and increase intestinal permeability just like Celiac disease leading to much of the same increased risk of developing autoimmune diseases. For this reason, (and many others) it may be smart to avoid gluten altogether if you have Hashimoto's whether you have Celiac disease or non-Celiac gluten sensitivity.

Does it work? Again, going gluten-free will usually result in SOME improvement in symptoms (7). In my experience, up to 80% of patients with Hashimoto's have some improvement when going gluten-free. Occasionally sticking to a gluten-free diet can be difficult if the patient isn't serious about removing all sources or if they aren't careful. Even when I consciously went gluten-free I continued to find small sources of contamination in food products and condiments month later. According to group data 88% of people felt better on this diet, 0.73% of people felt worse, and 33% of people had a reduction in antibodies. ​More information: Gluten-Free Living

Celiac.org

Mayo Clinic Gluten-Free Diet

PROS The highest percentage of people felt better on this diet

Lots of free information and guides online

Good support community online CONS Can be difficult to remove ALL sources of gluten

Lots of gluten-free junk food available - it's easy to eat an unhealthy gluten free diet

Going gluten-free isn't enough for most patients

Who should consider the Gluten-Free diet?

All patients with Hashimoto's (Going gluten-free for 3 months should be standard for any newly diagnosed Hashimoto's patient)

Patients with a family history of Celiac disease, Hashimoto's or other Thyroid problems

People who have chronic migraines, chronic headaches, acne or multiple gastrointestinal symptoms

Quick Tip : Most people benefit from going gluten-free (even if you decide on a different diet you should still ALSO be gluten-free for 3 months). Don't fall into the trap of thinking that if you have negative antibodies to gluten that you are fine to eat it. Most people do MUCH better cutting out gluten.

4 Paleo Diet

​What is it? Another very popular diet, and for good reason. The paleo diet consists of real whole food that attempts to mimic the diet of the paleolithic man/woman and removes inflammatory industrial seed oils, GMO food products, refined grains and added sugar. Put into a simple graphic: ​

Paleo diets tend to be higher in healthy fats with moderate amounts of protein and generally fewer carbohydrates.

One of the dangers of going paleo is actually reducing your carbohydrates too much because the most common sources of carbs are generally forbidden. While reducing the number of carbohydrates can be good in certain medical conditions (leptin and insulin resistance), reducing all sources of carbohydrates can result in worsening fatigue in some patients. Another potential pitfall of eating a paleo based diet is consuming too much protein. High levels of protein can activate the mTOR pathway (8) and influence leptin levels leading to worsening leptin resistance and inflammation. (9) As long as healthy fats, proteins and carbs are balanced the diet is excellent - but it does require some manipulation and personalization. Does it work? Many of my patients start with a modified paleo type of diet and then manipulate their macromolecules based on their symptoms and lab tests. The paleo diet is a great starting point because there is plenty of information including recipes and diet guides available on the internet to help with transitioning your diet. In addition - according to group data 81% of people felt better, 3.2% of people felt worse and 27% of people had a reduction in antibodies after adopting the paleo diet. ​More information: The Paleo Diet

​Nom Nom Paleo

​Paleo Leap - Paleo Diet 101

PROS A large percentage of people felt better on this diet

Lots of free information and guides online to help beginners

Good support community online

Free Recipes online

Lots of research backing the health claims CONS May not include enough carbs for those with Adrenal problems and thyroid problems

Some people can have problems maintaining body weight due to a lower amount of carbs

May be too restrictive for certain individuals

Who should consider the Paleo Diet?

People who have tried going gluten-free but still have room for improvement in their symptoms

People with any of the following: Acne, Depression, Anxiety, Fatigue, Eczema, Environmental/Seasonal allergies, Post nasal drip, IBS/IBD, GERD, Chronic constipation

People who are unsure of what diet is best for them - this is a GREAT first place to start

Quick Tip: The Paleo diet is great to start with because of the supportive online communities that exist. Be careful when switching to this diet if you rely heavily on healthy sources of carbs for energy - sometimes switching to low carb diets can make patients with Hashimoto's worse.

5 Low FODMAP's Diet

​What is it? What in the world are FODMAP's? I'm glad you asked... It's an acronym that stands for Fermentable Oligo-Di-Monosaccharides And Polyols.

It's really just a fancy name to describe a class of sugars and carbohydrates that are found in certain foods. FODMAP's can cause gastrointestinal issues like gas, bloating, cramping and irritable bowel-like symptoms (10) in certain groups of people. Those who have SIBO, or candida overgrowth, appear to be particularly sensitive to FODMAP's and react poorly when eating them. (11) This diet removes these food groups by eliminating foods that are high in these types of carbohydrates:

Fructose (Fruits, Honey, High fructose corn syrup)

(Fruits, Honey, High fructose corn syrup) Lactose (Dairy products)

(Dairy products) Fructans (Wheat, Garlic, Onion, Inulin)

(Wheat, Garlic, Onion, Inulin) Galactans (Beans, Lentils, Soybeans)

(Beans, Lentils, Soybeans) Polyols (Sweeteners like Xylitol and Mannitol, along with stone fruits such as Avocado)

Does it work? This is definitely a specialty type of diet and not one that I would regularly recommend to the average patient. In most cases simply removing the primary sources of carbohydrates like bread, pasta, gluten-containing starches, etc. is enough to significantly improve any GI related issues. A minority of patients will require the complete removal of FODMAP's especially if they have constipation-predominant IBS or treatment refractory SIBO. Otherwise, most patients should stick to the other diets listed above as a starting point (unless otherwise directed by their Doctor). According to the group data 39% of people felt better, 0% of people felt worse, and 27% of people had reduced antibodies while following this diet. ​More information: Low FODMAP Diet

​IBS Diet

​FODMAP's and Paleo

PROS Will also treat SIBO and Candida overgrowth

Great Diet for those with IBS

Zero patients felt worse on this diet CONS Smallest reduction in antibodies out of all diets

Doesn't necessarily exclude gluten

Smallest number of patients felt better on this diet

Who should consider the Low FODMAP's Diet?

People who have Hashimoto's and have been diagnosed with (or have symptoms of) Small Intestinal Bacterial Overgrowth (SIBO for short) and/or Yeast or Candida overgrowth

(SIBO for short) and/or Yeast or Candida overgrowth People who still have gas/bloating despite adopting a paleo or gluten-free diet

People who have failed less restrictive diets

Quick Tip : This diet may be effective for patients suffering from chronic gas/bloating, abdominal distention or extreme chronic constipation (1 bowel movement every 4-7 days). If you have these symptoms there is a very high chance you are suffering from SIBO and/or yeast overgrowth.

Soy-Free and Wheat-Free Diets If you didn't already notice there were a few diets that weren't mentioned above but were in the original data. ​Namely: Soy free and Grain free. I didn't elaborate on these diets because they are self-explanatory and because for the most part they should be a component of other diets and I wouldn't recommend using them in isolation. But, to complete the data let's go over them...

Soy Free Diet: 63% of people felt better, 1.2% of people felt worse and 35% had a reduction in antibodies while on this diet. ​Grain Free Diet: 81% of people felt better, 0.74% of people felt worse and 28% had a reduction in antibodies on this diet. Diets To Avoid with Hashimoto's ​Having gone through diets that are beneficial to people with Hashimoto's we should also go over some diets that you should avoid if you have this condition. Some of these diets should be avoided at all costs and others can be used but only if you are working with a skilled practitioner who understands your condition. ​Let's dive in:

1 Low-Fat Diets

​Why you should avoid this diet: I'm referring to the typical low-fat diet that modern medicine and the conventional media recommends for weight loss and better health. Despite these widespread recommendations and beliefs that a low-fat diet is somehow healthy for your heart and waistline, none of these reported "facts" are supported by the literature. Low-fat diets (even diets low in saturated fat) have never been shown to be effective for weight loss or heart health but they are unfortunately pushed by most physicians and Cardiologists.

This is especially important for patients with Hashimoto's or Hypothyroidism because these patients commonly have problems with weight. They are often told to "eat less and exercise more" for weight loss. Hashimoto's patients commonly have cholesterol problems as well (due to low thyroid function)(12) and are commonly told to "eat less red meat". The problem is: these people don't have a cholesterol problem, they have a thyroid problem. Unfortunately, nowadays low-fat has become synonymous with high sugar (13). Foods that have "low-fat" or "non-fat" on the label should be avoided at all costs. Quick tip: Some people do better with lower amounts of fat and that's ok. But if you do better on low-fat your diet should still consist mostly of fruits, vegetables - not sugar based products.

2 Any and All Low-Calorie Diets

Why you should avoid these diets at all costs: Despite the fact that calorie-restricted diets don't work for weight loss! They can also be incredibly harmful to your thyroid function... 25 days of a calorie-restricted diet is enough to reduce thyroid function and T4 to T3 conversion (14) by up to 50%.

Whatever you do, do NOT use a calorie-restricted diet if you have Hashimoto's. You will only make your thyroid function worse and it will ultimately lead to more weight gain. Also avoid the mentality of counting calories - calories matter, but your hormones matter so much more. ​

Special Considerations Each of the diets above needs to be modified slightly in the setting of certain medical conditions. ​I've highlighted some of the more common conditions and how you can consider altering your diet if you have one or more of these conditions... Blood Sugar Issues (Pre-diabetes, Diabetes & metabolic syndrome) Blood sugar issues are so common that nearly 50% of adults in the United States has either pre-diabetes or diabetes. (15) And Hashimoto's patients are no different. In fact, they are at increased risk for blood sugar problems. How do you know if you have blood sugar problems? You can have your doctor order the following tests: Hgb A1c, fasting blood sugar, fasting insulin levels. You can also personally check your own blood sugar with a glucometer after eating meals. Healthy blood sugar levels when fasting are in the 70-80 range (16). A healthy Hgb A1c is less than 5.5 and fasting insulin levels should be < 5. If you fall above this range you likely have blood sugar problems... How does this affect your diet? Well, the traditional advice to fight high blood sugar is to exercise more and eat less. This is the WRONG answer for people with Hashimoto's. Well, it's bad advice in general but especially if you have Hashimoto's. The best way to address blood sugar issues is by reducing unhealthy fattening carbohydrates and incorporating high-intensity exercise (17) with intermittent fasting routines (18). This can pose a problem with Hashimoto's patients because they commonly have Adrenal problems. Consider these ideas if you have insulin resistance: Optimize your thyroid medication if you are on it! Work out only if you have the energy, and until your dose is optimized I would recommend against high-intensity training. Start out slowly with walking and build up as you tolerate it. Do not incorporate intermittent fasting until your adrenals have been addressed and your thyroid medication is optimized. Avoid calorie-restricted diets, they will only make your thyroid worse. Eat at least 20% carbohydrates to start with. Avoid high sugar foods and opt instead of healthy sources of carbohydrates like vegetables and healthy starches.​​ Adrenal Related Problems

Adrenal fatigue is incredibly common in Hashimoto's patients and it should not be ignored! If you find yourself crashing in the afternoon or NEEDING caffeine to keep you going - then your adrenals are most likely suffering. The fatigue from Hashimoto's is usually a crushing fatigue first thing in the morning, but as you get up and moving you may tend to have more energy. This energy you get after a few hours comes from your adrenals - and they only last so long. This cycle is one of the reasons that many people with Hashimoto's also suffer from Adrenal fatigue. There are a few tips you should know about how to make appropriate changes to your diet if you suspect you have this condition... (I do recommend either Salivary testing or DUTCH urine testing to diagnose adrenal problems - don't treat if you aren't sure) ​

​My recommendations if you have diagnosed adrenal fatigue: Use an adrenal supplement (or combination of adrenal glandulars + adrenal adaptogens) ​Eat a moderate amount of carbohydrates in your diet, 15-30% of total calories are healthy carbs. Experiment with what works best for your body (start out at 20%). Don't be afraid to eat meals more frequently if you need to. You may need to eat every 2-3 hours in the beginning. Eat protein with every meal and have an especially high protein breakfast (at least 40 grams). Make sure to eat enough sodium (salt)! If you are having salt cravings you can put 1/2 to 1 teaspoon of salt in a tall glass of water and drink that in the morning. Make sure to add salt to your food as well. Avoid caffeine and alcohol! Caffeine puts excess strain on your adrenals every time you consume it. Use an adrenal supplement (or combination of adrenal glandulars + adrenal adaptogens) Gut and digestive problems

Gut and digestive problems are also very common in Hashimoto's. Unfortunately, several things can go wrong when your thyroid is low... Low thyroid hormone leads to slower peristalsis (19)(the movement of your GI tract) leading to constipation and an increased risk for reflux, bacterial overgrowth, and yeast overgrowth. Not only that but about 20% of T4 is converted to T3 in the GI tract (20). This means that any problems of the GI tract may result in lower thyroid hormone, which may then cause further GI issues in a vicious cycle. It can be difficult to break the cycle and the first step starts with getting on the right kind of treatment protocol, but there are also some dietary special dietary considerations you should consider: ​Consider a low FODMAP's diet. Make sure to add fermented foods into your diet daily (Kimchi, Kefir, Beet kvass, Sauerkraut, etc.) - Go easy on fermented foods if you have SIBO. Add in probiotics in the form of Soil-based organisms. Lactose based probiotics may make some GI issues worse. Consider advanced stool testing for definitive diagnosis (It's hard to treat if you don't know what you're treating). Consider adding 1-2 cups of Bone broth to your diet each day (helpful for repairing gut lining). A Word About Goitrogens ​What are goitrogens? Goitrogens are compounds that limit your thyroid from taking up iodine and which may theoretically lead to decreased thyroid function. (21) The conventional opinion is to avoid these foods if you have thyroid problems. But, do you really have to? Foods high in Goitrogens include Cruciferous vegetables (Bok choy, Broccoli, Brussel sprouts, Cabbage and Cauliflower), and some other foods - peaches, pine nuts, pears, soy milk, soybeans, etc.

Some people are so worried about thyroid function that they completely avoid these food groups. And, when you look at the list, you'll find that this list includes some of the most healthy foods on the planet. The truth is that it would require a VERY large amount of these foods to have a meaningful impact on your thyroid gland. What's more is that the goitrogenic effect of these foods can be limited by how you prepare them. To reduce the impact that foods have on your thyroid you can consider the following steps: Limit yourself to 6-8 servings of these foods per week and when preparing make sure to steam them (to remove goitrogenic compounds). Steaming these foods will reduce their gotroigenic potential. Eat foods high in both selenium and Iodine, this includes foods like [High Iodine] kelp, kombu, hijiki, arame, cod, dulse, iodized salt, wakame, shrimp, eggs, tuna, nori, prunes, banana. [High Selenium] Brazil nuts, tuna, halibut, sardines, ham, beef, turkey, chicken, egg, spinach. Consuming both iodine and kelp may have a protective effect on your thyroid gland. Where to Start + 4 Week Hashimoto's Eating Plan

While deciding what diet you ultimately need may take a combination of time and trial and error, it is critical that you get started right away. Don't be afraid to make some mistakes along the way - it happens for every patient. What is important is that you just get started. With that in mind, I am recommending this book as a solid starting place.