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High-carb for Hashimoto's?

by (431)
Updated about 12 hours ago
Created March 02, 2012 at 10:01 PM

I feel like all I do is take, take, take, knowledge-wise, on PaleoHacks. Still, here I go doing it again. I gather that people with hypothyroidism should pretty solidly eat more carbs than many paleos- but WHAT IF one has Hashimoto's? So, a low-functioning thyroid but an autoimmune disease? I apologize if this is a stupidly easy question, but there's surprisingly little on Hashimoto's around the Paleo blogosphere.

UPDATE: I found that supplementing with D3 and taking a good multimineral helped a weird amount, other Hashimoto'ers. IFing- I don't think it does, but I don't sleep much so that probably throws fasting experimentation all kinds of off.

8de9776490016df60d49e03f23d656af
601 · May 10, 2012 at 12:03 AM

Apologies, I meant that I've read hypothyroidism and keto don't play well. This is just from anecdotal postings found from generalized Google searches--I haven't done a lot of in-depth research on the claim yet, which is why I kept my comment pretty general :) I doubt it was protein overload--my ratios were pretty consistently 10% carb, 30% protein, 60% fat, calories ranging from 1000-2000 depending upon appetite.

8496289baf18c2d3e210740614dc9082
1857 · May 09, 2012 at 11:33 PM

Was your protein extraordinarily high? That might have been the cause of your thirst. But it could also have been a hypothalamic-pituitary issue: perhaps they were working overtime to produce TSH and it's own releasing factor, TRH. Where have you read that ketosis and thyroid don't play well? And have you read that in general, about hyperthyroidism, or about hypothyroidism?

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3651 · March 07, 2012 at 10:37 AM

I'm flipping through Dr K's " Why do I still have thyroid symptoms..." book. his diet section: Protein breakfast, small amount of protein every 3-4 hrs, avoid blood sugar spikes.  Avoid high carb diet "at the root of hypothyroidism" Eat " veggies, quality protein, or fat" Not good news for the "low carb causes hypo" myth. Where did that start anyway?

Bdc6244bdbd664d2168a8e326018ffbe
431 · March 07, 2012 at 10:08 AM

Oooh, thanks DFH- I don't have access to Amazon delivery at the moment, as I'm overseas, so thanks for the summary! Whats his position on sugar and fructose? Phoenix, are you still testing for Hashimotos? Not that it really matters if you feel that much better, thats amazing.

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289 · March 03, 2012 at 3:57 AM

I also have hashimotos and do well on phd. I have been seeing a practitioner that does dr. K's protocol except she has me on iodine (only after 3 months of selenium supplementation) and it has been nothing short of a miracle for me. Good luck.

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3651 · March 03, 2012 at 2:15 AM

Wow, good for you! What's the deal with eggs? One thing common to these "fix your whatever-osis" books I've noticed is they have a lot of Paleo-leaning good advice, but they got heavier on the protein. My own doc did that too. What's up with that?

9b47142b8ed1074a94b5654410740530
320 · March 03, 2012 at 1:42 AM

Yes, very similar to the MC. Except no cayenne pepper. Dr. K. says no nightshades, and pepper is a nightshade. No dairy, no eggs, no starches of any kind, no legumes. I've been doing the K protocol for about 4 weeks. My crunchy knees (have been that way for 30 years) have stopped crunching. I'm much warmer this winter (I have Hashimotos) and feel so much lighter and clearer in my head. He has you add food back carefully after after 3 months, but I don't think I'll be adding anything back. Not with all of these positive things happening to me.

77877f762c40637911396daa19b53094
78422 · March 03, 2012 at 1:36 AM

Doesn't he also suggest something that looks like the "Master Cleanse" to help with insulin resistance?

D63a9a7789b948a1e88647f6c0e504ca
1453 · March 03, 2012 at 12:48 AM

Most evidence suggests that moderate amounts of cooked cruciferous vegetables are not a problem. More important is to strictly avoid gluten, as there is a LOT of research and commentary (not just in the paleosphere) on the gluten-Hashimoto's link.

5cd573d5c6d863c5e40605014a560502
20 · March 03, 2012 at 12:44 AM

The paleo/primal diet by definition is "well-balanced".Avoiding grains @ refined foods is known to assist in the management of many conditions including autoimmune diseases such as rheumatoid arthritis, Hashimotos thyroiditis and Graves disease.

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4 · March 02, 2012 at 11:26 PM

i wish you good luck. and hope you find some answers.

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3499 · March 02, 2012 at 11:22 PM

It's definitely not an easy question, and as far as I know, far from being a solved one.

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78422 · March 02, 2012 at 11:13 PM

How do you defined "well balanced"?

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8 Answers

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270 · March 03, 2012 at 12:57 AM

I have Hashimoto's and have found that I do best on a Perfect Health Diet kind of plan. You also want to find a doctor that knows how to treat it. It's very tricky. If you haven't already, check out Kharrazian and Haskin.

A0d4481f4b568e4edc7d8c72102dcfc1
289 · March 03, 2012 at 3:57 AM

I also have hashimotos and do well on phd. I have been seeing a practitioner that does dr. K's protocol except she has me on iodine (only after 3 months of selenium supplementation) and it has been nothing short of a miracle for me. Good luck.

8508fec4bae4a580d1e1b807058fee8e
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6229 · June 08, 2012 at 3:17 AM

Here's a 37 year old woman (now Paleo) Hashimoto's patient who's a certified athletic trainer, licensed physical therapist, and trigger point therapist.

http://www.washingtonian.com/blogs/wellbeing/health/how-a-gluten-free-paleo-diet-changed-my-life.php

The article: All of your blood work looks fine. The only thing that comes up is thyroid antibodies, but that???s nothing to worry about.??? My primary care doctor said these words to me in 1999, after I told him I???d been feeling anxious and jittery and couldn???t sleep for days at a time. I???d just had my first child a few months before, so since nothing else could be determined, the most obvious diagnosis was that I had postpartum anxiety and depression.

But while the symptoms went away over time with treatment, they were soon replaced by a mind-numbing fatigue. Little did I know that my own body was in the process of attacking itself because of an autoimmune disease called Hashimoto???s Thyroiditis.

Fast-forward to 2007. I had been under a tremendous amount of stress over the year. Though I continued to exercise, somehow I gained almost 20 pounds, and my hair began falling out in clumps. Even after eight hours of sleep, I was still so exhausted I could barely get out of bed in the morning.

I began researching my symptoms. My doctor???s words came back to me, and I began reading everything I could find on thyroid disorders. After getting an ultrasound, I discovered I had *nodules on my thyroid.*So with medication, over a few months I began to feel like I was getting some energy back. But my weight didn???t change, and exercise still proved too painful.

The impact this disease had on my life in the beginning was huge. I had been an athlete my entire life, swimming competitively in college, running 10Ks, and doing triathlons. At 37, I suddenly found myself unable to walk three miles with my children. To say that I was afraid for my future would be an understatement.

Going Gluten-Free

About a year into treatment for Hashimoto???s, I mentioned to a coworker that I felt better, but still not great. He suggested I try going gluten-free for a few weeks. I resisted, because I loved cereal, bread, and pasta. But then I learned that celiac disease is an autoimmune disease, and people with one autoimmune disease are more likely to be diagnosed with others over the years. I decided to give it a go.

After two gluten-free weeks, I felt 80 percent better. I was feeling more energetic, and gone were the cramps and painful bloating. I began to lose a little bit of weight, and I had the energy to begin gentle bodyweight exercises again. That was two years ago.

The Paleo Life

Then last spring I heard rumblings about the Paleo lifestyle. I researched the principles and learned that grains like wheat, rye, and barley can cause damage to the gut lining and put people at high risk for autoimmune diseases, including Hashimoto???s Thyroiditis, type 1 diabetes, and lupus. I went Paleo and cut out all of my gluten-free treats and dairy, increased my intake of coconut milk and oil, and began consuming larger quantities of grass-fed meats.

Almost immediately I noticed a difference in how I felt. My joint and muscle pain slowly faded away, I felt more rested when I woke up in the morning, and my brain felt sharp again. I even lost most of the weight I had gained over the years.

In the six months since I went Paleo, I???ve gone from not being able to walk a few miles to running, hiking, rock climbing, and weight lifting. My blood work looks good, my thyroid nodules are smaller, and I feel like I???m back to living the healthy life I had before Hashimoto???s decided to wreak havoc on my body.

More important, I don???t feel deprived of anything, because being able to play with my kids again is more important to me than eating pizza.

There is plenty of research to support the Paleo lifestyle as part of the comprehensive treatment plan for autoimmune diseases. A good place to start is by reading The Paleo Solution by Robb Wolf. The book explains the science and includes an index at the back listing 30 pages of research articles that helped convince me to take on this diet.

From my frustrating and trying experiences, my approach to working with my own patients as a physical therapist and trainer has changed. As part of my objective to treat the ???whole person,??? I want to be sure I provide my patients with as much information as possible, so it doesn???t take them five years to get back to living, like it took me. It was a long journey, but it feels good to be in my skin again.

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3651 · March 03, 2012 at 1:18 AM

Maybe the go-to book is Dr K's, since Hashi's is his thing. I have it and just looked, Dr K's advises big protein breakfast (sounds familiar), no more carbs than you can tolerate, and he explains that, and the rest PHD or Paleo sounding. He discusses blood sugar problems a lot, and an anti-inflammatory diet, which Paleo is.

E0250b1e6dc5ec1539ffb745042b4d80
3651 · March 07, 2012 at 10:37 AM

I'm flipping through Dr K's " Why do I still have thyroid symptoms..." book. his diet section: Protein breakfast, small amount of protein every 3-4 hrs, avoid blood sugar spikes.  Avoid high carb diet "at the root of hypothyroidism" Eat " veggies, quality protein, or fat" Not good news for the "low carb causes hypo" myth. Where did that start anyway?

Bdc6244bdbd664d2168a8e326018ffbe
431 · March 07, 2012 at 10:08 AM

Oooh, thanks DFH- I don't have access to Amazon delivery at the moment, as I'm overseas, so thanks for the summary! Whats his position on sugar and fructose? Phoenix, are you still testing for Hashimotos? Not that it really matters if you feel that much better, thats amazing.

E0250b1e6dc5ec1539ffb745042b4d80
3651 · March 03, 2012 at 2:15 AM

Wow, good for you! What's the deal with eggs? One thing common to these "fix your whatever-osis" books I've noticed is they have a lot of Paleo-leaning good advice, but they got heavier on the protein. My own doc did that too. What's up with that?

9b47142b8ed1074a94b5654410740530
320 · March 03, 2012 at 1:42 AM

Yes, very similar to the MC. Except no cayenne pepper. Dr. K. says no nightshades, and pepper is a nightshade. No dairy, no eggs, no starches of any kind, no legumes. I've been doing the K protocol for about 4 weeks. My crunchy knees (have been that way for 30 years) have stopped crunching. I'm much warmer this winter (I have Hashimotos) and feel so much lighter and clearer in my head. He has you add food back carefully after after 3 months, but I don't think I'll be adding anything back. Not with all of these positive things happening to me.

77877f762c40637911396daa19b53094
78422 · March 03, 2012 at 1:36 AM

Doesn't he also suggest something that looks like the "Master Cleanse" to help with insulin resistance?

5cd573d5c6d863c5e40605014a560502
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20 · March 02, 2012 at 11:03 PM

A well balanced diet, with high quality protein is advised for Hashimotos thyroiditis. Be sure to avoid cruciferous veg (ie: cabbage, broccoli, kale, brussel sprouts etc) as they may decrease thyroid function even more. Avoid wheat, grains, sugars and highly processed foods. ~herbalist~

D63a9a7789b948a1e88647f6c0e504ca
1453 · March 03, 2012 at 12:48 AM

Most evidence suggests that moderate amounts of cooked cruciferous vegetables are not a problem. More important is to strictly avoid gluten, as there is a LOT of research and commentary (not just in the paleosphere) on the gluten-Hashimoto's link.

5cd573d5c6d863c5e40605014a560502
20 · March 03, 2012 at 12:44 AM

The paleo/primal diet by definition is "well-balanced".Avoiding grains @ refined foods is known to assist in the management of many conditions including autoimmune diseases such as rheumatoid arthritis, Hashimotos thyroiditis and Graves disease.

77877f762c40637911396daa19b53094
78422 · March 02, 2012 at 11:13 PM

How do you defined "well balanced"?

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1857 · May 09, 2012 at 11:26 PM

First things first: Hasimoto's is the most common cause of adult hypothyroidism in the United States. It is autoimmune in nature, the antibodies being directed against the thyroid stimulating hormone (TSH) receptor, which it competitively inhibits (i.e. It binds the receptor and won't let go, so TSH can't do its job). As with most autoimmune diseases, Hashimoto's is associated with a full complement of other autoimmune diseases, one of the more common being celiac. In celiac, the body responds to gluten more aggressively than usual, modifying the protein such that it mimics receptors on the enterocytes lining your small intestine. Thus, the antibodies of celiac begin to attack the brush border of the intestine, robbing it of the excess surface area it provides for effective nutrient absorption, and causing malnutrition, diarrhea, gas, bloating, etc.

So clearly gluten is out; as most grains and legumes, glutenous or otherwise, tend to be among the most heavy in inflammatory antinutrients and omega 6 fatty acids, those are out too. Some folks react poorly to nightshades, though I've never found data to suggest this is autoimmune in nature, so take those as you will. There aren't too many high-carb foods left: sweet potatoes and yams tend to be rather easy for most folks to digest, so they're probably ok, as are most tubers. Fruits are probably alright, especially in moderation and when avoiding fructose-dense apples and the like. Fats tend not to elicit an immune response, so there's no qualm there (aside from the usual reasons to avoid omega six pro-inflammatory fats).

Thyroid hormone has as its precursor the amino acid tyrosine with 1, 2, 3, or 4 organified iodines attached. TSH itself is composed of two subunits, each of which is a string of just over 100 amino acids that are glycosylated (glucose is attached) prior to binding one another and being released. This means some glucose is needed to increase THS levels and overcome the antibodies displacing it, but there is no reason to believe this is more easily accomplished through dietary glucose (carbs).

In short, I'm unsure why folks keep insisting that high-carb diets are helpful for low thyroid levels, especially Hashimoto's (which is, again, the most common cause of hypothyroidism in at least the U.S., and additionally in most industrialized countries).

Am I missing something?

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601 · May 09, 2012 at 9:59 PM

I've been wondering this, too. I'm currently being evaluated for possible Hashimoto's.

I decided to try a ketogenic diet in December and January--I lasted about six weeks. I was miserable the whole time. Continual thirst no matter how much (or little) I drank and continual jaw pain were the end of that diet and me. Not losing any weight was the icing on the giant cake o' misery. Was it the (potential) Hashimoto's? I don't have a clue, but I've since read that keto and thyroid issues don't play well together.

8de9776490016df60d49e03f23d656af
601 · May 10, 2012 at 12:03 AM

Apologies, I meant that I've read hypothyroidism and keto don't play well. This is just from anecdotal postings found from generalized Google searches--I haven't done a lot of in-depth research on the claim yet, which is why I kept my comment pretty general :) I doubt it was protein overload--my ratios were pretty consistently 10% carb, 30% protein, 60% fat, calories ranging from 1000-2000 depending upon appetite.

8496289baf18c2d3e210740614dc9082
1857 · May 09, 2012 at 11:33 PM

Was your protein extraordinarily high? That might have been the cause of your thirst. But it could also have been a hypothalamic-pituitary issue: perhaps they were working overtime to produce TSH and it's own releasing factor, TRH. Where have you read that ketosis and thyroid don't play well? And have you read that in general, about hyperthyroidism, or about hypothyroidism?

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287 · May 09, 2012 at 9:53 PM

I'm still pretty confused myself. I have Hashimotos and before I knew of or read Dr K's book I took Iodoral (a high potency iodine) that worked wonders of reducing my enlarged goiter. I started to get some side effects on Iodoral and stop taking it, then read Dr K's book that says Iodine is like putting gas on a fire. I didn't experience that... and I figured out later that those side effects I thought was from Iodoral was actually related to another health issue. Since being on the Paleo diet for 2+ months I wonder if I'm getting enough salt & carbs with my diet, and consider going back to taking Iodoral for fear my thyroid will start acting up. It's been pretty good now for a couple years.

I don't go to endocrinologist anymore because all they want to do is push me to go on synthroid which I refuse to do for many reasons. Mainly because my thyroid is working fine without it and I don't want to take a pill that prevents my thyroid from functioning on it's own again. Also, I take selenium daily which is my replacement for any medications.

6722034d5b2df25daa5a19ccd4f1280b
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0 · September 03, 2013 at 5:10 PM

i was diagnosed with hashi three weeks ago. My labs came out fine so my doctor refuses to treat me. However, I have so far gained 10 lbs and have tremendous hair loss. I am trying the autoimmune diet but still the hair loss is too much.
' currently taking selenium, Vit E, Vit D, mutlivitamin and krill oil. Is there anything to stop the hairloss?

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