Should I try the AIP diet with Hashimoto's disease?

Autoimmune disorders affect an estimated 50 million Americans, and that number is rapidly increasing. Historically, autoimmune diseases were most common among women, where 8 in 10 people with these disorders were female, commonly in their 40s and above. But the demographics are changing, and autoimmune diseases in men and adolescents are now on the rise, too. The reasons for these changes remain elusive, but there are strong connections between our environment and autoimmune disease.

Some estimates suggest that about one-third of cases of autoimmune disorders come from our genes. The other two-thirds of cases stem from our environment, including where you live, what you eat, and your lifestyle. Consequently, some contributing factors of autoimmune disorders may be in our control, especially diet and lifestyle. We know making dietary and lifestyle changes can be especially helpful in managing autoimmune thyroid conditions like Hashimoto's disease.

In particular, many people with Hashimoto's disease may benefit from trialing a strict elimination diet like the AIP diet to control Hashimoto's symptoms and decrease overall inflammation.

What is Hashimoto's disease?

Hashimoto's disease is the most common cause of hypothyroidism in developed countries like the United States. Hypothyroidism is a condition where the thyroid does not produce enough thyroid hormone to support the body's metabolic needs. Hashimoto's is an autoimmune disorder where the immune system mistakenly attacks the thyroid gland, causing chronic inflammation and possibly the thyroid gland's eventual failure.

The thyroid is perhaps one of the most underrecognized organs in the body, often playing second fiddle to organs like the heart, brain, and kidney. But, hormones produced by the thyroid play a critical role in supporting every cell in the body by directing its energy use. They even help regulate your heart rate, blood pressure, gastric motility, and fertility.

Because every cell in the body needs thyroid hormones, all body systems can suffer from a lack of thyroid hormone circulating in your bloodstream.

Common signs and symptoms of Hashimoto's disease include:

• Fatigue and malaise
• Weight gain
• Cold intolerance
• Slowed thoughts and movements
• Muscle weakness and joint pain
• Depression
• Constipation
• Dry skin and thinning hair
• Irregular periods

What causes Hashimoto's disease?

Like most autoimmune disorders, it isn't easy to pinpoint precisely what causes Hashimoto's. One of the leading theories of environmental causes of autoimmune diseases like Hashimoto's is leaky gut theory. Studies suggest that tight junctions in the intestinal membrane lining your digestive tract may widen, allowing toxins to escape and enter the bloodstream. This intestinal permeability may worsen if the gut microbiome is out of balance. There becomes an overgrowth of "bad" bacteria in the intestines.

The gut is also home to about 70% of the immune system. So, when something is off-balance in the digestive tract, it encourages the immune system to become exceedingly active, causing it to attack even healthy cells in the body.

Digestive issues in Hashimoto's disease

People with Hashimoto's disease commonly suffer from digestive symptoms like constipation, diarrhea, bloating, gas, abdominal cramping, heartburn, and indigestion.

An underactive thyroid can have several effects on the digestive tract, including slowing gastric motility and decreasing stomach acid. Because of these changes, it is hard to digest food thoroughly and cause food to sit in the gut for too long. Thus, it is common for people with Hashimoto's to have digestive issues like celiac disease, SIBO, or irritable bowel disease.

To complicate matters further, people with hypothyroidism often have reduced bile flow from their gallbladder. Bile is necessary for digesting certain foods, and it also may be a natural antimicrobial agent. Thus, people with too little thyroid hormone may be lacking enough bile to maintain a healthy microbiome. Furthermore, gallbladder issues may impact T4 and T3 conversion.

Using nutrition to manage Hashimoto's disease

There are many reasons why diet can be a powerful tool for managing symptoms of Hashimoto's disease. We know that our digestive health plays a role in the formation of autoimmune disorders. We also know that many people with Hashimoto's struggle with digestive issues can upset the gut microbiome's delicate balance.

The autoimmune protocol (AIP diet) is a leading dietary approach that promotes the immune system's healing and gut lining in people with autoimmune disease. The AIP diet is a two-phase elimination diet that enables you to identify and ultimately avoid the foods that may trigger inflammation and disease-specific symptoms. By eliminating inflammatory foods, people can repair their intestinal membrane and control other gut disorders like IBD.

The AIP diet is a more stringent form of the Paleo diet. The AIP diet eliminates all foods that commonly trigger inflammation, including gluten, grains, pseudo-grains, dairy, sugar and sweeteners, legumes, nuts, seeds, nightshade vegetables, eggs, alcohol, caffeine, and food additives. The first phase of the diet consists of a one to three-month elimination phase followed by a slow, intentional reintroduction phase.

During the reintroduction phase, you reintroduce eliminated food groups one at a time over a period of time and assess your reaction to each. If a reaction occurs, including ___, it may indicate sensitivity to these foods. It would be best if you continued to eliminate them from your diet and retest for tolerance again in a month or more.

The AIP diet emphasizes lifestyle modifications beyond just your food choices. The protocol prioritizes adequate sleep, stress reduction, and regular physical movement. All of these categories are known to impact symptoms of Hashimoto's disease directly.

Research shows that with better control over diet and lifestyle, TPO antibodies decrease, and symptoms generally improve in patients with Hashimoto's disease.

Suppose your Hashimoto's disease has caused hypothyroidism. In that case, it's essential to first optimize your thyroid function with thyroid hormone replacement medication in addition to making diet and lifestyle modifications. Thyroid hormone replacement medication replaces the thyroid hormone that your body is not producing. Without proper levels of thyroid hormones, you're fighting an uphill battle.

To understand your thyroid function, consider taking a thyroid blood test. You can take $30 off your first purchase of an at-home thyroid test kit with coupon code POTG on Paloma Health’s website. The test kit includes TSH, free T3, free T4, and TPO antibodies, with the option to add-on reverse T3 and/or vitamin D.

If you've been diagnosed with Hashimoto's disease and want to manage active and ongoing symptoms better, the AIP diet may be a good option for you. Remember that this protocol is a framework. The ultimate goal is to reintroduce as many foods as possible to maintain a diverse and healthy diet while still keeping symptoms to a minimum! The elimination phase is not a long-term solution.

A note from Paloma Health

Paloma Health offers a mobile app that gives you step-by-step guidance to follow the autoimmune protocol (AIP diet). You get education, tools, and motivation to identify your dietary and environmental triggers, manage inflammation, and track your thyroid symptom improvement. Download for free on iOS and Android.