If you have read some of the posted comments from thyroid and autoimmune thyroid forums and Facebook groups, chances are you’ll come across people with Graves’ disease and Hashimoto’s who experienced dramatic improvements in their health just by changing their diet. Some people do nothing but eliminate gluten from their diet, and yet feel significantly better. Others need to be more strict with their diet in order to receive great results. However, one question you might have is whether or not eating well simply helped to improve the health of these people, or did making these dietary changes reverse the autoimmune component of their condition? I’m going to discuss this in this blog post.
Although the focus of this blog post is on whether changing one’s diet alone can reverse Graves’ disease and Hashimoto’s, I’d like to briefly review the triad of autoimmunity and discuss the four main categories of autoimmune triggers. According to the triad of autoimmunity, in order for autoimmunity to develop you need 1) a genetic predisposition, 2) an environmental trigger, and 3) an increase in intestinal permeability (a leaky gut). As you know, we can’t change your genes, but we can reverse autoimmunity by removing the trigger and healing the gut.
Focusing on the environmental triggers, there are four main categories of these triggers:
1. Food
2. Stress
3. Chemicals
4. Infections
As you can see, one of the main categories is food. So it is possible that food can be a trigger, and if a specific food is the sole trigger, then eliminating this food from one’s diet can reverse the autoimmune component. If this is the case, then why do some people who eliminate gluten, or perhaps even follow a strict autoimmune Paleo diet for a few months, not get into remission? There are a few obvious answers, with one being that food isn’t a trigger in everyone. In many people the main trigger is stress, chemicals, and/or infections. If this is the case, then eating well alone won’t reverse one’s condition.
Another reason why a person who follows a strict AIP diet might not get into remission is because they have multiple triggers. In other words, certain foods might be a trigger, but they might have one or more triggers from the other categories I listed above. I see this quite frequently, as a person might feel significantly better when eliminating certain foods, but they are still symptomatic, their thyroid antibodies are still high, etc. This usually means that not all of the triggers have been removed.
It’s also worth mentioning that a person might clean up their diet and not feel better, and then prematurely decide that food wasn’t the main trigger, when the real problem is that they weren’t strict enough with their overall diet. For example, someone might completely go gluten and dairy free, but they might react to another food (i.e. corn). Or perhaps cross contamination is an issue, as a person might think they’re completely avoiding a certain food, but somehow they’re getting exposed to it. This is especially a concern when eating out. These are just a few things to consider when evaluating your diet.
Which Foods Can Be Triggers?
The truth is that you can have an immune system reaction to any food. However, this doesn’t mean that all foods are potential autoimmune triggers. For example, while I don’t do a lot of IgG food sensitivity testing, I have done such testing on some of my patients, and I’ve seen people test positive for healthy foods such as broccoli and asparagus. While one can argue that eating these foods might cause inflammation (if one is sensitive to them), and perhaps even prevent the gut from healing in this situation, they aren’t autoimmune triggers.
On the other hand, gluten, dairy, and corn are potential triggers of autoimmunity. This is why most natural healthcare practitioners will advise their autoimmune patients to avoid these foods. This is especially true when trying to restore one’s health, but a strong argument can be made to continue avoiding these common allergens even after achieving a state of remission.
How Can Food Trigger Autoimmunity?
Something called molecular mimicry may explain why certain foods can trigger autoimmunity. I’ve discussed molecular mimicry in past articles and blog posts, as it seems that certain foods contain antigenic substances that have amino acid sequences similar to those of human proteins (1). When someone eats these foods, this can result in the production of antibodies that not only react against the food antigens, but the body’s own tissues. An example of this is gluten, as there is some evidence that gluten has a similar amino acid sequence to the thyroid gland, which can cause the body to develop antibodies not only against gluten, but the thyroid gland as well.
Removing Your “Leaky Gut Triggers”
In addition to environmental triggers playing an important role in thyroid autoimmunity, it’s also important to mention that different factors can cause a leaky gut. In the past I’ve mentioned how gluten causes a leaky gut in everyone, and so if gluten is the only autoimmune trigger and is also the only “leaky gut” trigger, then avoiding gluten alone might be the solution to reversing the autoimmune component of Graves’ disease or Hashimoto’s. I say “might” be the solution because even after removing the trigger and healing the gut, you might need to do things to reduce proinflammatory cytokines and increase regulatory T cells, which is also necessary to suppress the autoimmune component.
Cure vs. Remission vs. Improvement
In some of my webinars and articles I’ve discussed the difference between “cure” and “remission”, and how Graves’ disease and Hashimoto’s can’t be permanently cured since they involve a genetic component. While “getting into remission” doesn’t sound as good as “being cured”, this still involves the elimination of one’s symptoms, normalization of thyroid markers (include thyroid antibodies), and correcting other imbalances related to the autoimmune thyroid condition. And it is possible to stay in remission for a prolonged period of time, as I’ve been in remission from Graves’ disease since 2009, although I’ve dealt with some other health issues over the years, most notably Lyme disease, which I discussed in a previous blog post.
On the other hand, many people experience an improvement in their symptoms and/or labs upon changing their diet, but they don’t go into remission. For example, they might have a reduction of their symptoms, but they don’t completely go away. Or their blood tests might improve, but they’re still not in balance. Keep in mind that in some cases of Hashimoto’s the thyroid panel can’t be normalized, which is why you also want to monitor the thyroid antibodies, along with other tests that were out of range. If you experience some positive changes after modifying your diet but don’t get into remission, please don’t become discouraged, as this is very common. When this is the case, in most cases there are other triggers/imbalances that need to be addressed.
How Do You Know If Food Is Your Only Trigger?
As for how to know if food is your only trigger, in my opinion, the best way to find out is through an elimination and reintroduction diet. If you avoid all of the allergenic foods (gluten, dairy, corn, etc.) and your symptoms resolve and your thyroid panel and antibodies normalize, then you know that food was the main culprit. On the other hand, if your symptoms don’t improve and/or your blood tests don’t normalize, then there are most likely other triggers present. As I briefly mentioned earlier, sometimes removing the trigger alone isn’t sufficient, as you might need to do other things to reduce the inflammation.
I mentioned IgG food sensitivity testing earlier, and you might wonder if this is something you should consider doing. In some cases this can detect food triggers, although false results are common, which is why I don’t recommend such testing to all of my patients. Earlier I also mentioned that not every food that tests positive on an IgG food sensitivity panel is an autoimmune trigger. I realize that many people don’t want to stop eating foods that have gluten and dairy, but this is the best way to find out of these are triggers. Plus, even if gluten isn’t a trigger it’s best to be avoided, especially while healing your gut.
Is It Necessary To Eat A Strict Diet If Food Isn’t The Main Trigger?
If you’re pretty sure that certain allergens aren’t a trigger in your case, you might wonder if it necessary to continue avoiding these. For example, if you followed an elimination diet for at least 30 days and didn’t experience any improvement in your symptoms or thyroid markers, is it okay to reintroduce gluten, dairy, and other common allergens? I get this question asked a lot, and I usually recommend to continue avoiding the “allergenic foods” at least until one’s health has been restored…even if they aren’t responsible for triggering autoimmunity.
This is especially true with gluten, as I reminded you earlier how the research shows that gluten causes a leaky gut in everyone. And since dairy and corn cross react with gluten (eating these foods can produce gluten antibodies), one can argue that it’s best to avoid these foods as well. In fact, some natural healthcare practitioners recommend for people with autoimmune conditions of all types to permanently avoid gluten, dairy, and corn. I’d be lying if I told you that I’ve avoided all of these 100% since I’ve been in remission. But I’ll also admit that anytime myself or anyone else with an autoimmune condition is exposed to these food allergens they’re taking a risk.
What’s Your Experience With Avoiding “Food Triggers”?
Please feel free to share your experience with eliminating some of the allergenic foods discussed in this blog post. If you received good results when avoiding gluten, dairy, corn, etc., and perhaps even achieved a normalization of your thyroid antibodies after doing this, please feel free to share your experience in the comments section below. On the other hand, if you strictly avoided these common allergens and didn’t see any positive changes, I’d like to hear from you as well. Perhaps you didn’t notice a difference in your health when avoiding gluten, dairy, or corn, but noticed a significant improvement when avoiding another food or allergen (i.e. soy, eggs, nightshades, etc.)
Dear Eric,
Thank you very much for this great post. I’ve been following your blogs since 2016. I was diagnosed with Graves Disease in 2015 and thanks to your posts I started looking into what food could do vs medication. A local natural health doctor advised me and based on a complete bodyscan, blood test and faeces test I skipped gluten, diary products, and some specific food items which triggered a leaky gut. I was then very surprised about some. As you mention in your blog here, some types of food are fine for others whereas others are not. So apart from skipping gluten, diary products, I also avoided paprika powder, salmon, peanuts, corn, soja, and eggs. Mind you, this was also in combination with 3 types of natural health supplements. After 5/6 months my blood levels were fine. I went into a remission again (this was also stress related an caused by a sudden happening) and my physician suggested an iodine therapy. I refused and instead started with the supplements and diet again.Right now I am still trying to eat gluten and diary free as much as possible, but, as you also mention, it is very difficult if you have to eat out for work. I also want to comment on your line: ‘…or their blood tests might improve, but they’re still not in balance’. I believe this is also true for me. Currently my blood levels are fine, but I still have symptoms such as a high heart rate. Would you know perhaps why this is? Thank you very much.
Thank you for your comment Irini. I’m glad that you held off on getting the radioactive iodine, and that’s great about trying to avoid gluten and dairy, along with taking certain supplements, etc. As for still having a high heart rate in the presence of normal thyroid hormone levels, there can be a few reasons for this. One can be that the thyroid hormone levels are within the lab reference range, but still on the high side. High cortisol can also cause an elevation in heart rate, and this is something I commonly see. Infections are another possible cause, and sometimes they can be difficult to detect.
After roughly 20 years of Graves and taking small amounts of medication on and off, I ended up with low T4 and TSH on the lower end (always has been). My T4 usually always picks up again however for the past 2 years it hasn’t. Instead it has remained between 10 and 11 and my TSH began increasing up to 5.6 half a year ago – I was told that it was likely I have Hashimoto’s and that they could start me on treatment.
Having learnt that there was a chance to ‘cure’ this through diet, I embarked on the AIP diet to some extent (though not organic or pasture raised food), exercise and a positive mindset. I lost a lot of weight in the first couple of months and am still prone to losing if I don’t make sure I eat enough.
My recent tests showed TSH at 3.6, T4 at 10.2 (dropped to its lowest level in the past 2 years) and antibodies 1000). The doctor didn’t know what AIP was and said that the antibodies levels were neither here nor there, though for me that showed positive results). He was ready to discharge me saying that they don’t treat unless TSH gets to about 8. Only when I queried why the T4 levels weren’t picking up did he decide that they should do adrenal tests (though I’m thinking that this may be more related to the pituitary); I will be doing them next week.
Anyway, with diet still in mind I have started intermittent fasting over eating on and off throughout the day and have put a focus on more sleep. I feel more alert though still tired and very forgetful however my hair has stopped falling for more than a month now so I believe some benefit must have come from the AIP. I intend to try and grow some organic veg this year and try to avoid the dirty dozen and stress. Hopefully there might be some further improvement.
Thank you for providing some very informative and helpful articles. 🙂
Thank you for sharing your experience Sophie. It is common for people to have antibodies for both Graves’ disease and Hashimoto’s. While it’s great that you followed AIP and focused on improving other lifestyle factors (i.e. sleep), it sounds like diet alone might not be the answer, which of course I discussed in this blog post. And so while I think it’s great that you will be growing organic veggies and doing things to help with stress, please remember that there can be other triggers that haven’t yet been detected.
Are you aware of Alpha-Gal Allergy?
No, but will look into it. Thank you!
As a correction on my post info: my antibodies dropped to less than 600 after being over 1000.
Yes, I’m aware of this, and after being diagnosed with Lyme disease this definitely was a concern. For those reading this who are unfamiliar with Alpha-Gal allergy, this is a meat allergy that can be caused by certain ticks:
https://acaai.org/allergies/types/food-allergies/types-food-allergy/meat-allergy
I’ve been in remission for almost four years after being diagnosed with Grave’s disease in 2015. Initially, while I was in an advanced stage of the disease and knew virtually nothing about my condition, I followed medical advice and took high doses of methimazole and deralin to reduce symptoms. That gave me some breathing space to find out about alternative therapies and I soon discovered that dietary and stress ( traumatic abuse and divorce) factors were significant triggers in my case. I have been gluten free for at least 20 years due to earlier health issues that were improved by avoiding gluten, and I was always a flexible vegetarian/vegan focussing on organic, non-packaged and home-grown foods for ethical reasons. I suspected that I might have other intolerances including corn, soy and dairy, namely cheese and yoghurt. I gave up drinking milk when I was a teenager due to sinus issues. You can see a pattern here. Compromised health => food intolerance => avoidance of food group => improved health. It’s all been a lot of trial an error but here I am, more or less well with minor non-distressing and intermittent symptoms, drug free, fit and active and surprisingly immune to things like the common cold and other ailments that other people seem to suffer on a frequent basis. I do take occasional high concentration doses of the herb, Bugleweed to quell increases in heart rate, magnesium, B vitamins, selenium, Vitamin D and macro amounts of iodine in a pharmaceutical preparation as these minerals are in short supply in our Australian soils and I think my genes have a mineral deficiency trigger factor as well. I also have a genetic B12 deficiency that causes numbness in my toes and hands and feeling cold even in the middle of summer. I am more or less vegan now with the exception of butter which I love and I cant say it is causing symptoms definitively. I avoid sugar and consequently have developed a rather strange aversion to sweet foods including fruit, although I am sensible and occasionally eat a couple of dried apricots. I also avoid grains as much as possible (even gluten free) and starch-based flours and make a bread out of organic rice flour and buckwheat . My diet is somewhat monastic, but nor do I have cravings. I am 52 yo, healthier than have ever felt, super fit, fashionably muscular without even trying (no, i dont go to a gym, I work hard in the forest all day and ride a bike everywhere) and brimful of energy. I think that says a lot about why people are unhealthy these days.
Thank you so much for sharing your experience Jayn, as it sounds like you’ve done some wonderful things to improve your health over the years. One thing I’ll say is that I haven’t taken bugleweed since getting in remission in 2009, and while I know you said this is occasional, I’m wondering if something is missing. Also keep in mind that factors other than high thyroid hormone levels can cause increases in heart rate, such as cortisol surges and overt/hidden infections.
For the first 40 years of my life, I only ever met one person who had a food allergy.
Vaccines are the major cause of autoimmune diseases, and autoimmune diseases are just the tip of the iceberg, as far as what vaccines are doing to people and animals.
Thank you for your comments Sue. I’m not sure if vaccines are the main cause of autoimmunity, but I agree that they are a factor, and here are some blog posts I’ve written on this topic:
https://www.naturalendocrinesolutions.com/archives/can-vaccines-trigger-thyroid-autoimmunity/
https://www.naturalendocrinesolutions.com/archives/can-the-flu-shot-trigger-graves-disease-and-hashimotos-thyroiditis/
https://www.naturalendocrinesolutions.com/archives/whats-your-experience-with-vaccines/
I have Hashimoto’s disease. I tried a strict paleo diet, plus no caffeine, nightshades, corn, soy and very limited alcohol for 1 year. Unfortunately, no improvement. I’ve concluded my symptoms are stress related and heart palpitations are probably side effect of levothyroxine.
Karen, I’m sorry that following a strict diet didn’t result in an positive changes. Stress definitely can be a big factor, although please don’t dismiss the other categories of triggers I mentioned (infections and chemicals).
I have tried all kinds of diets and supplements and thyroxine. My hashimoto induced skin allergy has not gone away. I am now vegan, avoid gluten and sugar, go for sauna everyday – but it still troubles though better than before. I have found some days when i sweat normally in a room – i feel better. Most days i dont.
Can you suggest anyone who specializes in hyperthyroid issues for cats? My cat has this and he is on methimazole plus ten different kinds of herbal remedies. He can’t sleep through the night and gets up three to four times. This is ruining my health because I have to get up to look after him.