Welcome to Episode 99. I’m so glad you are here. Thanks for tuning in. My daughter and her friend were reading reviews for this podcast and came across a lot of really nice ones. Thanks so much for leaving reviews so more people can find the show. They also came across a couple of one star reviews because I was too political in a couple of episodes. The reviews said  they were listening to me to get away from all the craziness in the world and didn’t appreciate hearing about politics. One mentioned something about the former president and I think it may have been because I suggested we should respect the title, no matter who has it. So I just want you all to know, I do want this to be a place where you can come to let go of what is going on in the world and focus on yourself and your health. I will do better to keep things focused on you as best I can. Everyone is entitled to their opinion though and I do respect that as well, I’m not so sure it deserves a one star review but I get it. We are all polarized these days and cancel culture is a thing. If you feel so inclined, a rating or review would be helpful to get more people to find the show so more people can be helped. I truly do this so you don’t have to suffer like I have and that is the only reason. It takes a lot of time and thought and a little bit of money to put this out so please spread the word if you feel it is worth it- and let me know if you think I could be doing better. My plate is full- overflowing in fact and I don’t want to put out crappy content.  Ok. Enough about that. I really am truly grateful that you all tune in and listen and know that I really do this for you all. 

Today I am going to talk about a study I found discussing diet and hashimoto’s. I was just putting dishes away one morning and wondered if anyone had done any studies on Hashimoto’s and gluten and I had just been discussing a gluten free diet with one of my clients who has been a bit resistant. Sometimes having data to back up what I am saying can be not only helpful but also when you use science to back up what you are saying in addition to clinical experience or even the experience of others with the same condition it kind of validates everything. 

I went to searching the PubMed database using the words gluten and hashimotos and nothing came up so I messed around with my search terms and found a couple of studies I thought were interesting and they validate what myself and other practitioners have been saying about the effects of gluten and diet in general on hashimoto’s patients. 

The amount of research done on diet and hashimoto’s is slim and much research on the topic of this disease doesn’t take in to account our reduced quality of life. You wouldn’t be here if you didn’t have Hashimoto’s or know someone who has it. It is the most common autoimmune disorder and the cause of hypothyroidism in countries like the US that are NOT deficient in iodine. 

Primary hypothyroidism which is where your thyroid isn’t actually producing thyroid hormone and affects around 1-3% of the population. Sub clinical hypothyroidism is when you have a high normal or just over the high normal level of TSH on a lab test and all other labs, typically only T4 is measured, are “normal”. This affects around 4-10% of the population. 

As you probably know, women are more affected than men and I hope to uncover why that is over the coming weeks in my hormone class but my hunch is that because the thyroid is part of the endocrine system along with sex hormones, I think there is a connection between all the parts of the endocrine system but thyroid and sex hormones in particular. 

I was listening to my professor on a podcast and he said something I think we all need to keep in mind. Science is ever evolving and what we thought we knew to be true 20 or 30 years ago turned out to be not so great advice sometimes. His example was the whole low fat diet craze in the 80’s. Turned out to be sooo wrong. Another example was back when Pelegra was around. It was thought that a black fly was causing it and it turned out to be a B vitamin deficiency. And then there was the doctor who suggested that his colleagues wash their hands between working on corpses and delivering babies to potentially prevent the death of the women giving birth. Hmmm. Novel idea. He actually lost his medical license for that I believe. Turns out he was right. 

So the point I’m making is that what I am telling you is what the science shows today. Don’t take what I am telling you as set in stone fact and there is no other answer to be found. I’m telling you what I am reading in the science and the science is rarely settled. Critical thinking is important. Always. Keep that in mind. 

I guess what I know to be true now is that thyroid disease is increasing and women suffer from it more than men and according to the National Health and Nutrition Examination Survey (NHANES) Hashimoto’s occurs in 4.8 per 1000 people in the US. 

Your thyroid hormones control your metabolism. Not just your weight but also the metabolism of your skin- think poor wound healing. It controls growth and how your body develops. They also are a part of the production of proteins that build bone and cartilage, production of enzymes (which do all kinds of things in the body but also includes digestive enzymes), and they help produce other hormones. 

Weight gain and the inability to lose weight are common though I have seen plenty of people with hashimoto’s not have an issue with weight. In severe hypothyroidism though your metabolism can be slowed by up to 50% which can create obesity without you doing anything different. A slowed metabolism can also screw up your blood sugar regulation. 

And as we all know, after getting your diagnosis, and getting on medication you still may have symptoms of fatigue, irritability, dry skin, hair loss, nervousness, and a poor quality of life. The American Dietetic Association and the American Thyroid Association appear to have no recommendations for diet and hashimoto’s. There is some research on a gluten free diet and hashimoto’s which shows it can be beneficial but the researchers speculate that it would be too difficult to maintain a gluten free diet because it is so restrictive and would lower the patients quality of life. I am here to tell you that is not true and if the gluten free diet improves your symptoms of fatigue, brain fog, hair loss, irritability etc- which would you rather have? It is a choice you can make. You don’t have to feel like crap and blame your doctor. You do have control of your life don’t you?

It is interesting that the one study done on the autoimmune protocol teaching diet and lifestyle changes in an online program didn’t improve labs but did improve symptoms. The study was only ten weeks long so I would argue that it could take longer to see improvements in antibodies and other labs since it didn’t take you ten weeks to get the autoimmune disease in the first place. The body is amazing and wants to heal but sometimes there is so much damage, ten weeks is not enough to see significant change. And that is okay. Know that healing takes time and some effort. It doesn’t happen overnight or magically. 

The science is on the fence about whether a gluten free diet will be helpful or not. Clinically I have seen it reduce antibodies and bring people back to life. The study protocol for a new diet called Diet4Hashi in the paper titled Evaluation of Qualitative Dietary Protocol (Diet4Hashi) Application in Dietary Counseling in Hashimoto’s Thyroiditis: Study Protocol of a Randomized Controlled Trial by Wojtas et al., (2019) which is basically the description of the protocol for their proposed study on this diet in helping hashimoto’s says that you should eat vegetables several times a day, eat calcium rich foods several times a day, fruit once a day, whole grains once a day and animal foods (rich in selenium and zinc) several times a week and nuts and seeds can be eaten several times a week. This is their protocol for what you should eat. Very vague and based kind of the dietary guidelines. 

They say you should limit your raw cruciferous veggies to one time per week, sugar to once a week which includes drinks, fast foods or processed foods once a week, soy products can be consumed twice a month and alcohol once a month. This is not a bad diet to be on but it is what everyone should be on so the question remains as to whether you need to do anything extra special for Hashimoto’s. I might argue that you do, at least in the beginning. Most of us when we are diagnosed are dealing with a breakdown of more than just thyroid. Likely you also are having blood sugar issues, female hormone issues, digestive issues either all at the same time or you have at least one of those issues. Your gut likely needs to be healed.. there is so much. 

While this study isn’t done yet is is just one more way of looking at diet and Hashimoto’s. I did find another study called The Effect of Gluten-Fee Diet on Thyroid Autoimmunity in Drug-naive Women with Hashimoto’s Thyroiditis that studied women between the ages of 20 and 45 to see if a gluten free diet would affect autoimmunity, the HPT axis or thyroid brain signals and thyroid lab markers.  One group was on a gluten free diet for 6 months and the control group had no diet change instructions. 

The idea behind this study is that Hashimoto’s and celiac disease together are a very common occurrence so much so that one study done led the researchers to conclude that all autoimmune thyroid patients should also be screened for celiac disease. In the gluten free diet study, the women did not have a celiac diagnosis but had positive antibodies for it along with positive TPO antibodies and “normal” thyroid labs. At the end of the 6 month study, the gluten free diet group 6 of the 16 patients in the gluten free diet group still had positive antibodies for celiac disease and all 18 in the control group or non gluten free diet had the antibodies. Turns out the gluten free diet was well tolerated- meaning easy to follow. The gluten free diet also lowered TPO antibodies and thyroglobulin antibodies and increased vitamin D levels but it did not have an effect on TSH, T4 or Free T3 or Free T4 and the women in the gluten containing diet group had no change in antibodies. 

It is curious that vitamin D levels went up on the gluten free diet. They also referenced another study where taking vitamin D in supplement form reduced antibodies too. Pretty cool stuff if you ask me and also some good data to maybe nudge some people in the direction of a gluten free diet. 

I re-recorded part of this because that first study was all I was going to talk about but it wasn’t anything conclusive and felt kind of like a waste of time. I double checked what episode this is and turns out this is episode 99! So when you search for the “transcript” of this episode it is under 99. 

That is all for today. I’ve been sitting on this for a few weeks wanting to add to it but spent all day yesterday reading two studies for one discussion forum post - not because they were that long but because they were hard to understand! I figured I’d just give you what I had so far on this topic. I hope it was helpful! 

Thanks for being here! I appreciate you!!!