Hashimoto’s Diet: What to Eat and What to Avoid

A Hashimoto’s diet is built on whole foods that supply enough selenium, zinc, iron and vitamin D, keeps iodine near the normal 150 mcg a day, and limits ultra-processed food, added sugar, alcohol and kelp supplements. Diet does not replace levothyroxine, but selenium lowered TPO antibodies in a 2010 meta-analysis in Thyroid, and a gluten-free diet lowered them in a small 2019 trial in women without celiac disease.

Why Diet Matters in Hashimoto’s

Hashimoto’s thyroiditis is an autoimmune disease. Your immune system attacks the thyroid gland, gradually destroying its ability to produce hormones. Levothyroxine replaces the missing hormones, but it does nothing to address the autoimmune process itself [1].

Hashimoto’s thyroiditis, also called Hashimoto’s disease, chronic lymphocytic thyroiditis or autoimmune thyroiditis, is the most common cause of hypothyroidism in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Not everyone with the antibodies has an underactive thyroid yet, which is why the difference between Hashimoto’s and hypothyroidism matters when you read your lab results.

That’s where diet comes in. What you eat influences systemic inflammation, gut barrier integrity, and immune regulation. All three of these directly affect the autoimmune cascade driving thyroid destruction. Diet won’t replace your medication, but it can change how aggressively your immune system attacks your thyroid.

The research is still evolving, but several dietary patterns have shown measurable effects on thyroid peroxidase (TPO) antibodies, thyroglobulin (Tg) antibodies, and thyroid function markers. Most of the trials are small and short, so treat each change as an experiment you track with your clinician through TSH, free T4 and antibody tests.

Hashimoto’s Food List: What to Eat, Limit and Test

The core Hashimoto’s food list is simple: eat fish, meat, eggs, vegetables, fruit and olive oil; limit ultra-processed food, added sugar and alcohol; avoid high-dose iodine; and test gluten and dairy with a time-limited trial. The table summarizes each food group and the reason behind the advice, using the figures explained in the sections below.

The Autoimmune Protocol (AIP) Diet

The AIP diet is a stricter version of the paleo diet designed specifically for autoimmune conditions. It eliminates foods that commonly trigger immune activation and intestinal permeability, then reintroduces them one at a time. Our longer guide to the autoimmune protocol diet covers the phases in detail.

Elimination Phase (30-90 days)

Foods removed:

• Grains (all, including gluten-free grains)
• Dairy (all forms)
• Eggs
• Legumes (beans, lentils, peanuts, soy)
• Nightshades (tomatoes, peppers, eggplant, potatoes)
• Nuts and seeds
• Refined sugars and processed oils
• Alcohol and coffee

Foods allowed:

• All meats and organ meats (preferably grass-fed/pasture-raised)
• Wild-caught fish and shellfish
• Non-nightshade vegetables (leafy greens, cruciferous, root vegetables)
• Fruits (in moderation)
• Healthy fats (olive oil, avocado oil, coconut oil)
• Bone broth
• Fermented foods (sauerkraut, kimchi, kombucha)

A 2019 study by Abbott, Sadowski and Alt followed 16 women with Hashimoto’s on the AIP diet for 10 weeks. Participants saw a significant reduction in systemic inflammation markers and reported improvements in quality of life scores, though thyroid function tests did not change significantly in that timeframe [2]. The autoimmune process takes time to quiet down, and 10 weeks may not be enough to see shifts in TSH or antibody levels.

The study had no control group and combined the diet with coaching and lifestyle support, so it cannot separate the effect of the food from the rest of the program. AIP is a reasonable short-term tool for finding personal triggers, not a diet the evidence says everyone with Hashimoto’s should follow long term.

Reintroduction Phase

After the elimination period, you bring foods back one at a time, waiting 3-5 days between each reintroduction to watch for symptom flares. This is the most important phase because it tells you which foods are actually problematic for you specifically, rather than following a generic restriction list indefinitely.

Keep a simple log of each food, the date, and any change in energy, digestion, joint pain or skin. Foods that cause no reaction go back into your regular diet, which protects you from the nutrient gaps a long elimination diet can create.

Gluten and Hashimoto’s: What the Evidence Shows

The connection between gluten and Hashimoto’s is the most studied dietary factor in thyroid autoimmunity. Several mechanisms explain why gluten may worsen Hashimoto’s:

• Molecular mimicry: Gliadin (a protein in gluten) shares structural similarity with thyroid tissue. Antibodies targeting gliadin may cross-react with thyroid cells [3].
• Intestinal permeability: Gluten triggers zonulin release in susceptible individuals, opening tight junctions in the gut lining. This allows larger protein fragments into the bloodstream, stimulating immune responses.
• Celiac co-occurrence: The rate of celiac disease in Hashimoto’s patients is 2-5 times higher than in the general population.

A pilot study by Krysiak, Szkróbka and Okopień, published online in 2018 in Experimental and Clinical Endocrinology and Diabetes, found that women with Hashimoto’s who followed a gluten-free diet for 6 months had significantly lower TPO and thyroglobulin antibodies than a control group, even though none of them had celiac disease [4]. The women were not yet taking levothyroxine, and the trial was small, so larger studies are needed before the result applies to everyone.

Not every Hashimoto’s patient needs to avoid gluten permanently. But a 3-month trial elimination is reasonable for anyone with elevated antibodies or persistent symptoms despite adequate levothyroxine dosing. Ask for a celiac blood test (tissue transglutaminase IgA) before you start, because the test needs gluten in your diet to give a reliable result. If celiac disease is confirmed, a strict lifelong gluten-free diet becomes a medical requirement, and our celiac disease treatment guide explains what that involves.

Key Nutrients for Thyroid Health

Five nutrients carry most of the evidence in Hashimoto’s: selenium, vitamin D, iron, zinc and iodine. The table lists the targets this section discusses, and each subsection explains the research behind them.

Selenium

Selenium is the most evidence-backed nutrient for Hashimoto’s. The thyroid gland contains more selenium per gram of tissue than any other organ. Selenium is required for glutathione peroxidase activity, which protects thyroid cells from oxidative damage during hormone synthesis [5].

Multiple randomized controlled trials show that 200 mcg/day of selenomethionine reduces TPO antibodies by 20-40% over 6-12 months. A 2010 meta-analysis by Toulis and colleagues in Thyroid found this effect across the pooled trials [5]. A 2013 Cochrane review by van Zuuren and colleagues was more cautious: it judged the trials too small and too mixed in quality to support or refute selenium as a treatment [12]. Lower antibodies have also not been shown to reduce the levothyroxine dose people need.

Food sources: Brazil nuts (1-2 per day provides roughly 100-200 mcg), sardines, turkey, grass-fed beef, eggs. The selenium content of Brazil nuts varies widely with the soil they grew in, so daily handfuls can push intake too high. Supplementation is reasonable if dietary intake is inconsistent, but do not exceed 400 mcg/day due to toxicity risk, the adult upper limit set by the NIH Office of Dietary Supplements.

Vitamin D

Vitamin D deficiency is significantly more common in Hashimoto’s patients compared to matched controls. A 2015 meta-analysis by Wang and colleagues in Nutrients found that people with autoimmune thyroid disease had lower vitamin D levels and were more likely to be deficient than controls [6]. Supplementation to achieve serum levels of 40-60 ng/mL has been associated with reduced antibody titers in several studies, though results are not universal.

Get your level tested before supplementing. Clinicians commonly use 2,000-5,000 IU daily for Hashimoto’s patients with low levels, taken with a fat-containing meal for absorption. The NIH Office of Dietary Supplements sets the adult upper limit at 4,000 IU a day, so doses above that belong under medical supervision with repeat testing. Our article on vitamin D optimization covers testing and dosing in more depth.

Iron

Iron deficiency is common in Hashimoto’s, particularly in menstruating women. Low iron impairs thyroid peroxidase function (the enzyme that makes thyroid hormones) and reduces the effectiveness of levothyroxine. If your ferritin is below 30 ng/mL, thyroid hormone replacement may not work as well as it should.

Take iron supplements separately from thyroid medication by at least 4 hours. Iron directly blocks levothyroxine absorption. Ask for ferritin alongside a complete blood count, because hemoglobin can stay normal while iron stores run low.

Zinc

Zinc is required for T4-to-T3 conversion and thyroid hormone receptor function. Deficiency is common in autoimmune thyroid patients. A 2009 study by Kandhro and colleagues in Clinical Nutrition linked zinc supplementation and zinc status to the thyroid hormone profile in patients with goiter [7]. Trials specific to Hashimoto’s are small, so the practical step is to correct a measured deficiency rather than take zinc by default. Food sources include oysters, beef, pumpkin seeds, and lentils.

Iodine: The Nuanced Nutrient

Iodine is essential for thyroid hormone synthesis, but the relationship with Hashimoto’s is complicated. Both deficiency and excess worsen autoimmune thyroiditis. In iodine-replete populations (most of the US and Europe), additional iodine supplementation can increase TPO antibodies and accelerate thyroid damage [8].

Aim for the RDA (150 mcg/day for adults) through food. Avoid high-dose iodine supplements (especially kelp supplements, which can contain 1,000+ mcg per dose) unless directed by your endocrinologist after testing. Iodized salt, fish and dairy usually cover the RDA in a typical US diet.

Foods to Limit or Avoid

The foods most worth limiting with Hashimoto’s are ultra-processed foods, added sugar, alcohol and high-dose iodine products. None of them is dangerous in small amounts, but each one works against the gut barrier, blood sugar control or thyroid antibody levels the rest of the diet is trying to protect.

Processed and Ultra-Processed Foods

Highly processed foods contain emulsifiers, preservatives, and refined seed oils that increase intestinal permeability and systemic inflammation. A 2015 review by Lerner and Matthias in Autoimmunity Reviews argued that industrial food additives which loosen intestinal tight junctions may help explain the rising incidence of autoimmune disease [9].

Excess Sugar

High sugar intake drives insulin resistance, which impairs T4-to-T3 conversion and increases inflammatory cytokines. Hashimoto’s patients already have a higher baseline risk for insulin resistance. Keeping added sugar below 25g/day is a reasonable target, the same daily limit the American Heart Association suggests for women.

Alcohol

Moderate to heavy alcohol consumption increases gut permeability and disrupts immune regulation. Some epidemiological studies suggest very moderate alcohol intake may be associated with lower thyroid autoimmunity risk, but the mechanism is unclear and the clinical advice remains to limit intake, especially during active immune flares.

The Cruciferous Vegetable Question

Broccoli, cauliflower, kale, and Brussels sprouts contain goitrogens, compounds that can interfere with iodine uptake by the thyroid. This has led to widespread advice to avoid cruciferous vegetables with Hashimoto’s.

The clinical reality: you would need to eat several pounds of raw cruciferous vegetables daily to meaningfully affect thyroid function. Cooking reduces goitrogen content by 30-50%. In iodine-sufficient individuals on thyroid replacement therapy, normal cruciferous vegetable consumption is safe and beneficial. These vegetables provide sulforaphane, a compound with potent anti-inflammatory and Nrf2-activating properties that may actually help autoimmune conditions [10].

Eat your broccoli. Just cook it if you’re concerned.

Soy: Friend or Foe?

Soy isoflavones can inhibit thyroid peroxidase activity in vitro, and soy protein can interfere with levothyroxine absorption. However, population studies show no increased hypothyroidism risk in soy-consuming populations when iodine intake is adequate.

Practical guidance: moderate soy intake (tofu, tempeh, edamame a few times per week) is fine for most Hashimoto’s patients. Just don’t eat soy products within 4 hours of taking levothyroxine. If you consume soy daily, ask your provider to check whether your levothyroxine dose needs adjustment.

Gut Health and Hashimoto’s

Up to 70% of the immune system resides in the gut-associated lymphoid tissue (GALT). Multiple studies have found increased intestinal permeability in Hashimoto’s patients compared to healthy controls. Restoring gut barrier integrity is a logical therapeutic target.

Evidence-based gut support strategies:

• Probiotic supplementation: Lactobacillus and Bifidobacterium strains have shown modest benefit in reducing inflammation markers in thyroid autoimmunity
• Prebiotic fiber: Feeds beneficial gut bacteria. Sources include garlic, onions, leeks, asparagus, and resistant starch
• Bone broth and collagen: Provides glutamine and glycine, amino acids that support enterocyte repair. Evidence is mostly preclinical but mechanistically sound
• Fermented foods: Sauerkraut, kimchi, and kefir introduce diverse bacterial strains and short-chain fatty acids

Persistent bloating, diarrhea or constipation alongside Hashimoto’s deserves its own workup, since celiac disease and small intestinal bacterial overgrowth both turn up more often in autoimmune patients. Our overview of leaky gut explains what intestinal permeability testing can and cannot show.

Medication Timing and Food Interactions

Even the best diet undermines treatment if your medication isn’t absorbed properly. Levothyroxine is notoriously sensitive to food interactions:

• Take on an empty stomach, 30-60 minutes before eating
• Coffee reduces absorption by up to 30%: wait at least 60 minutes after taking your dose
• Calcium, iron, and magnesium supplements block absorption: separate by 4 hours
• Fiber supplements reduce absorption: take at a different time of day
• Proton pump inhibitors (PPIs) reduce absorption: discuss timing with your provider

The American Thyroid Association’s 2014 hypothyroidism guidelines, led by Jonklaas, recommend taking levothyroxine about 60 minutes before breakfast or at bedtime, at least 3 hours after the evening meal [11]. Bedtime dosing suits people who cannot wait an hour for coffee. Whichever schedule you pick, keep it the same every day, because your TSH result reflects that routine.

A Practical Hashimoto’s Meal Framework

Breakfast: Smoothie with wild blueberries, spinach, collagen peptides, coconut milk, and 2 Brazil nuts (selenium)

Lunch: Grilled salmon over mixed greens with avocado, roasted sweet potato, olive oil, and lemon dressing

Snack: Apple slices with almond butter

Dinner: Grass-fed beef stir-fry with broccoli, carrots, and bok choy over jasmine rice, cooked in avocado oil with ginger and turmeric

This provides selenium, omega-3s, vitamin D (salmon), zinc (beef), and anti-inflammatory compounds without common trigger foods.

This framework is a general Hashimoto’s plan rather than strict AIP: almond butter and rice are removed during the AIP elimination phase, so swap them for fruit and extra root vegetables if you are eliminating. Eat breakfast at least 30 to 60 minutes after your levothyroxine dose.

Does Diet Lower Thyroid Antibodies? What the Studies Found

Diet can lower thyroid antibodies in some people with Hashimoto’s, but the studies behind each approach are small and short. Selenium and a gluten-free diet have the clearest antibody results; AIP, vitamin D and zinc have weaker or indirect evidence. No diet has been shown to replace levothyroxine or to restore thyroid tissue that is already lost.

Track TPO antibodies, TSH and free T4 before a dietary change and again after about 3 months. A falling antibody level is encouraging, but your levothyroxine dose should still follow TSH, not antibodies.

How Diet Fits With Levothyroxine, LDN and Other Treatments

Levothyroxine, a synthetic form of the T4 hormone, is the standard treatment for hypothyroidism caused by Hashimoto’s, according to the American Thyroid Association (2014) [11]. Endocrinologists and primary care physicians adjust the dose based on TSH, and diet works alongside that dose rather than instead of it.

Some integrative and functional medicine clinicians also prescribe low dose naltrexone (LDN) for Hashimoto’s. LDN is used off label for this purpose: naltrexone is FDA approved at standard doses for opioid and alcohol use disorder, and the evidence for thyroid autoimmunity is limited to small studies and case reports. Our article on LDN for Hashimoto’s reviews that evidence, and the broader low dose naltrexone overview covers dosing and side effects.

If you want a clinician who manages hormones in an integrative setting, the hormone therapy clinic directory lists clinics by state; check each profile for thyroid care, since many focus on estrogen, progesterone and testosterone. The hormone replacement therapy guide explains how those treatments are regulated and paid for, which is often cash pay. Listing order on Regenerated.com is not paid ranking, Featured slots are labeled and capped, Verified means credential checks rather than spend, and the directory is free for patients. Inclusion is not an endorsement, and the guide to Featured, Verified and organic listings explains each label.

When to Seek Professional Help

Work with a registered dietitian experienced in autoimmune conditions if:

• Your antibodies remain high despite medication optimization
• You suspect multiple food sensitivities but can’t identify triggers
• You’re losing weight unintentionally or developing nutrient deficiencies
• You want to try the AIP protocol but need guidance on the reintroduction phase

See your endocrinologist or primary care physician sooner if fatigue, weight gain, cold intolerance or low mood return on a stable dose, or if you are pregnant or planning a pregnancy, since thyroid hormone needs usually rise during pregnancy. Our guides to recognizing Hashimoto’s symptoms and managing a Hashimoto’s flare describe the warning signs in more detail.

Frequently asked questions

What foods should you avoid with Hashimoto’s?

Most people with Hashimoto’s do best limiting ultra-processed foods, added sugar, alcohol, and kelp or other high-dose iodine supplements. Gluten and dairy are worth a time-limited elimination trial if antibodies stay high or symptoms persist on a stable levothyroxine dose. Soy and cooked cruciferous vegetables do not need to be avoided when iodine intake is adequate, but keep soy, calcium and iron at least 4 hours away from your thyroid medication.

Is a gluten-free diet necessary for Hashimoto’s?

A gluten-free diet is necessary only if you also have celiac disease, which is more common in people with Hashimoto’s. For everyone else it is optional. A small 2019 pilot study by Krysiak and colleagues found lower TPO and thyroglobulin antibodies after 6 months gluten-free in women without celiac disease. Get a celiac blood test before cutting gluten, then try a 3-month elimination and recheck antibodies with your clinician.

Can diet lower TPO antibodies?

Diet can lower TPO antibodies in some people, according to small trials. Selenium at 200 mcg a day lowered antibodies in a 2010 meta-analysis by Toulis and colleagues, and a gluten-free diet lowered them in a 2019 pilot study. A 2013 Cochrane review rated the selenium trials low quality, and no study shows that lower antibodies mean less medication. Track antibodies, TSH and free T4 before and about 3 months after any change.

Should I take selenium for Hashimoto’s?

Selenium is the most studied supplement for Hashimoto’s, and most trials used 200 mcg of selenomethionine a day for 6 to 12 months. It is a reasonable option to discuss with your doctor, especially if your diet is low in selenium. Count all sources, including Brazil nuts and multivitamins, and stay under the 400 mcg daily upper limit set by the NIH Office of Dietary Supplements, because excess selenium causes hair loss, brittle nails and nerve problems.

Can I drink coffee if I have Hashimoto’s?

Coffee is fine for most people with Hashimoto’s as long as it is timed around levothyroxine. Coffee taken too soon after the pill can cut absorption by up to 30%, so wait at least 60 minutes after your dose. If that wait is impractical, ask your doctor about taking levothyroxine at bedtime, an option the American Thyroid Association accepts. Coffee is removed during the AIP elimination phase but can be reintroduced and tested.

Are eggs and dairy okay with Hashimoto’s?

Eggs and dairy are fine for many people with Hashimoto’s, and eggs are a useful source of selenium and vitamin D. Both are removed during the autoimmune protocol (AIP) elimination phase, so the way to know whether they suit you is a structured reintroduction, one food at a time, 3 to 5 days apart. If you eat dairy or take calcium, keep it at least 4 hours away from levothyroxine.

Related Reading

• Hashimoto’s Thyroiditis: The Evidence-Based Guide (Pillar)
• Hashimoto’s Symptoms: Early Signs Most People Miss
• Hashimoto’s vs Hypothyroidism: What’s the Difference
• Leaky Gut Diet: Foods That Heal and Foods That Harm

Sources

1. Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017;390(10101):1550-1562. doi:10.1016/S0140-6736(17)30703-1 ↩
2. Abbott RD, Sadowski A, Alt AG. Efficacy of the autoimmune protocol diet as part of a multi-disciplinary, supported lifestyle intervention for Hashimoto’s thyroiditis. Cureus. 2019;11(4):e4556. doi:10.7759/cureus.4556 ↩
3. Vojdani A, Tarash I. Cross-reaction between gliadin and different food and tissue antigens. Food Nutr Sci. 2013;4(1):20-32. doi:10.4236/fns.2013.41005 ↩
4. Krysiak R, Szkrobka W, Okopien B. The effect of gluten-free diet on thyroid autoimmunity in drug-naive women with Hashimoto’s thyroiditis: a pilot study. Exp Clin Endocrinol Diabetes. 2019;127(7):417-422. doi:10.1055/a-0653-7108 ↩
5. Toulis KA, Anastasilakis AD, Tzellos TG, et al. Selenium supplementation in the treatment of Hashimoto’s thyroiditis: a systematic review and a meta-analysis. Thyroid. 2010;20(10):1163-1173. doi:10.1089/thy.2009.0351 ↩
6. Wang J, Lv S, Chen G, et al. Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients. 2015;7(4):2485-2498. doi:10.3390/nu7042485 ↩
7. Kandhro GA, Kazi TG, Afridi HI, et al. Effect of zinc supplementation on the zinc level in serum and urine and their relation to thyroid hormone profile in male and female goitrous patients. Clin Nutr. 2009;28(2):162-168. doi:10.1016/j.clnu.2009.01.015 ↩
8. Laurberg P, Cerqueira C, Ovesen L, et al. Iodine intake as a determinant of thyroid disorders in populations. Best Pract Res Clin Endocrinol Metab. 2010;24(1):13-27. doi:10.1016/j.beem.2009.08.013 ↩
9. Lerner A, Matthias T. Changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease. Autoimmun Rev. 2015;14(6):479-489. doi:10.1016/j.autrev.2015.01.009 ↩
10. Houghton CA. Sulforaphane: its “coming of age” as a clinically relevant nutraceutical in the prevention and treatment of chronic disease. Oxid Med Cell Longev. 2019;2019:2716870. doi:10.1155/2019/2716870 ↩
11. Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670-1751. doi:10.1089/thy.2014.0028 ↩
12. van Zuuren EJ, Albusta AY, Fedorowicz Z, Carter B, Pijl H. Selenium supplementation for Hashimoto’s thyroiditis. Cochrane Database Syst Rev. 2013;(6):CD010223. doi:10.1002/14651858.CD010223.pub2 ↩