Hashimoto’s thyroiditis is a somewhat common auto-immune disorder that affects the thyroid gland. It affects more women than men and is usually diagnosed in early adulthood. Typical symptoms of low thyroid function include unexplained hair loss, weight gain, dry skin, and intolerance to cold. If you’re suffering from any of those symptoms, your doctor may order a blood test to see how your thyroid is functioning.
Standard medical treatment for Hashimoto’s focuses on monitoring levels of thyroid hormone and supplementing with replacement hormone as needed. Beyond that, a conventional endocrinologist isn’t likely to have much, if anything, to say in regards to diet or lifestyle changes. But women with this diagnosis often stumble across a lot of alternative therapies online… including a controversial diet called the Auto-Immune Protocol.
Joining me to discuss the role of nutrition in supporting a healthy thyroid is Sunny Brigham, a clinical nutritionist who specializes in digestive health, healthy weight loss, and all things thyroid, including Hashimoto’s disease. She’s also an adjunct professor at the Maryland University of Integrative Health.
Below are highlights from our conversation. Click play on the audio player above to hear the entire discussion.
Monica: Can you give us a quick overview of the basic tenets of the AIP?
Sunny: The goal of the auto-immune protocol is to remove inflammatory foods from the body, foods that the immune system tends to react to. You remove grains, legumes (including peanuts), nuts, seeds, most fruit, some vegetables, nightshades, various seasonings, alcohol, coffee, tea, chocolate, popcorn. Effectively, you’re down to meat, a handful of vegetables, and 1-2 servings of low sugar fruit daily. And then you systematically reintroduce foods to identify reactions.
Monica: In your opinion, how strong is the evidence to support the AIP approach? Have there been good, peer-review studies on outcomes, or is this mostly anecdotal evidence?
Sunny: There’s very little evidence to support AIP as an approach to healing Hashimoto’s or other autoimmune conditions. From my research, there are no systematic reviews and only one peer-reviewed study on AIP. The study found that while study participants felt better and their hs-CRP was lowered, it had little effect on their antibody numbers or their thyroid function. The study was very small as well… only 17 women to start, with 16 to finish.
Now, that doesn’t mean it isn’t helpful, there just isn’t a ton of research on it right now. I feel this is an area that needs to be explored more. But I feel this way with so many other aspects of nutrition interventions and diseases today.
Monica: Tell us about your clinical experience with the AIP.
Sunny: When I first started my practice, I used the AIP often. But, as you know, we evolve as practitioners as we learn more about people and our clients. It’s not something I use in my practice today, for several reasons.
Just about everyone else I’ve seen on AIP really struggles. Some regress as soon as they add in foods. While the AIP diet is promoted as a 3-month plan, it’s very deceiving because it doesn’t take into account the time it takes to reintroduce foods.
Others find it so restrictive that they can’t stick with it. People feel like they’re missing out on life because they can’t eat outside the home. They can’t have the fun foods that the rest of the family is having. They give up and blame themselves.
Monica: What do you see as the most impactful steps that women with Hashimoto’s can take to optimize their health and well-being?
Sunny: It’s not just diet and it’s not just medication. For someone to truly optimize their health and well-being with an auto-immune condition, it’s a fine balance between stress management, physical activity, personal boundaries, sleep quality, food and nutrients, and medications if they need them. Nutritionists and physicians need to work together in this approach.
Monica: There is a lot of questionable information and advice out there for women with Hashimoto’s and hypothyroidism. Are there other myths or misinformation about nutrition and Hashimoto’s that you’d like to clear up?
Sunny: Many women avoid soy or cruciferous vegetables because they’re goitrogens. But they aren’t thinking about all the wonderful nutrients that are contained in these vegetables. People may not need to avoid them if their bodies aren’t reacting to them. We need to focus more on how our body feels and what makes it feel good vs what makes it not feel good… and start there.
You can learn more about Sunny Brigham’s holistic approach to health and nutrition on her website: CompleteHealthSB.com