Hashimoto's thyroiditis dietary taboos

The core is to strictly control the long-term and large intake of refined gluten. During the hyperthyroidism period, it is necessary to temporarily avoid high-iodine foods and reduce the daily intake of trans fatty acids.； Dairy products, soybeans, solanaceae, and other "must-avoid foods" reported online fall into the category of individualized intolerances. There are no unified taboo requirements, and there is no need to blindly avoid all foods.

I have come into contact with many newly diagnosed patients, who immediately followed the online list and cut out all suspected problematic foods. Last month, there was a 27-year-old girl whose thyroid peroxidase antibodies were as high as 1800. She lost 7 pounds in half a month after giving up rice, flour, eggs and milk. When she came for a follow-up examination, she could not stand up and even dared not touch boiled eggs. As a result, the antibodies did not drop at all, but her thyroid stimulating hormone spiked to 7, which was not worth the gain.

First, let’s talk about the “gluten-free diet” that everyone hears most often. This is indeed the only dietary adjustment direction that has been proven by most studies to be clearly helpful in reducing antibodies. The principle is also very clear: Hashimoto’s is an autoimmune disease, and about 30% to 50% of patients have gluten intolerance. The molecular structure of gluten is highly similar to that of thyroglobulin. When the immune system attacks gluten, it is easy to “accidentally injure” the thyroid gland, which is what academic circles call a “molecular simulation mechanism.” But there is also a difference that is easily overlooked: the proportion of gluten intolerance in European and American people is much higher than that in Asians. Many people follow foreign popular science and directly quit wheat completely. In fact, it is completely unnecessary. You can definitely try a low-gluten diet for 1 month: replace ordinary noodles and refined bread with quinoa, buckwheat, and brown rice, and eat less pastry snacks. If your fatigue and neck tightness are significantly reduced during this period, and your antibodies show a downward trend in the re-examination, then consider going strictly gluten-free. ； If there is no reaction after eating it, it is okay to eat dumplings and steamed buns once in a while. It is not a mistake to kill all your eating pleasure just for this possibility. By the way, don’t believe those Internet celebrity gluten-free cakes that sell for tens of dollars for a small piece. They add a bunch of sugar substitutes and shortening. The inflammatory response is higher than eating ordinary steamed buns. You will just pay the IQ tax.

After talking about gluten, the question that people ask the most is about iodine. There is actually a huge misunderstanding in this area. Many people think that Hashimoto’s should completely avoid iodine, but this is only half right: if you are in the stage of hyperthyroidism and have obvious symptoms of palpitation, trembling hands, and heat intolerance, the hormones stored in the thyroid gland are leaking out in large quantities at this time. You must temporarily avoid high-iodine foods such as kelp, seaweed, and wakame. You can also temporarily replace iodized salt with iodine-free ones to avoid adding raw materials to the thyroid gland and aggravating symptoms. But if your thyroid function has been stabilized or you are already in the stage of hypothyroidism, completely avoiding iodine will cause problems - iodine is the raw material for the thyroid to synthesize hormones. If the raw materials are gone, the hormone will only be insufficient. There was an aunt in her 50s who never touched iodized salt after being diagnosed with Hashimoto's, and she didn't even touch seafood. Half a year later, she was retested for hypothyroidism, which directly increased the dosage of half a tablet of Euthyrox. Later, she was asked to eat a mixture of half non-iodized salt and half iodized salt, and occasionally some shrimps, and the index gradually stabilized. To put it bluntly, as long as you don’t eat kelp braised pork ribs every day, it’s okay to eat iodized salt normally and eat some seafood occasionally.

As for the claims on the Internet about banning dairy products, soybeans, and solanaceae, there is actually no unified research conclusion so far, and it is more of a problem of "personalized intolerance." For example, if someone has bloating and diarrhea after drinking milk, and their neck feels heavy after eating tomatoes, and their antibodies have increased during a recheck, it means that you are intolerant to this type of food, so try not to touch it. ； But if you have been drinking soy milk for 20 or 30 years and enjoy eating tomatoes and scrambled eggs with rice without any reaction, there is absolutely no need to avoid the food. I have seen many people who, because of strict dietary restrictions, dare not go to a hot pot date with friends, or have to bring their own meals for company team meetings, but instead feel anxious every day. You must know that when emotional stress rises, fluctuations in cortisol can stimulate the immune system much more than eating a bite of tomatoes. Oh, yes, there is another type of food that is recommended to be avoided regardless of whether you are intolerant or not: things containing trans fatty acids, such as milk tea made with non-dairy fat, hand cakes made with shortening, and repeatedly fried snacks. These foods will aggravate the inflammatory response of the whole body and are not good for the thyroid or cardiovascular system. If you are greedy, it is okay to eat it once in a while, but don't eat it every day.

In fact, after dealing with Hashimoto’s patients for so many years, the most common thing I say is: Dietary adjustment is to help the thyroid gland, not to put a shackles on life. If you are really unsure about what you can and cannot eat, you can either get a food intolerance test or keep a food diary for two months, including what you ate, whether you felt uncomfortable that day, and whether your indicators fluctuated during rechecks. Your body will always be more reliable than the list online. If you're really craving for something, it's okay to drink a cup of milk tea or eat hot pot. Don't feel guilty after eating it. It's like your mood is better than anything else.