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  • Writer's pictureDr Shawn M. Carney

Hashimoto's disease: Better from gluten-free diet and smoking?

Updated: Oct 6, 2023

The types of things which have been shown to improve Hashimoto's disease might surprise you.

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What is Hashimoto's disease?

Hashimoto’s disease is the most common autoimmune disorder affecting the thyroid gland and most common cause of hypothyroidism in developed countries.1 With a 5-10 time prevalence over men, the reported prevalence in white women is in the 1-2% range among the entire population in the United States.2 In Hashimoto's disease, immune-system antibodies lead to destruction of the thyroid's hormone-producing cells. The disease usually results in a decline in hormone production, which is called 'hypothyroidism'. Hashimoto's disease is also known as Hashimoto's thyroiditis, chronic lymphocytic thyroiditis and chronic autoimmune thyroiditis. The most common laboratory findings include an elevated thyroid-stimulating hormone (TSH), low levels of free thyroxine (FT4), and an increase in anti-thyroid peroxidase antibodies (TPO).

Though multiple things have been shown to potentially trigger Hashimoto's, including genetics, viruses like hepatitis C, medications for bipolar disorder, iodine-containing medicines and nuclear radiation, management of the condition by medical doctors heavily relies on emphasis of hypothyroid support.3 Though this should not be discounted, is there more we can do?

A growing body of literature has shown improvements among Hashimoto's disease patients by altering their diet, specifically from being on a gluten-free diet.4 Though the presence of other auto-immune disease, such as the gluten-intolerant celiac disease, has been shown to have an increased correlation with Hashimoto's disease, some non-celiac patients have also benefited. Some of the studies using gluten-free diet have been careful to make sure participants were not on any medications or other lifestyle changes, so that improvements are more likely attributable to the diet. One study with 34 participants from 2018 measured circulating levels of Hashimoto's autoimmune antibodies and found they decreased compared to the non-gluten free control group, while vitamin D actually increased!5 Food affecting your health is not a new concept, it's just one that many people have lost touch with.

Though a gluten-free diet is innocuous, other things found to improve Hashimoto's disease - not so much. You may have seen information, such as a 2020 literature review from the Journal of Endocrinological Investigation, that states smoking is "protective, but [will increase the risk of Hashimoto’s] when stopped". Smoking is protective against an autoimmune disease? Let’s think about this.

So, what do we know about smoking? Smoking uses the leaves of tobacco, Nicotiana tabacum. Tobacco leaves are high in nicotine, one of the alkaloids found in the plant. But it’s not the only alkaloid. Alkaloids are ingredients that are derived from amino acids and made by a wide range of living organisms including fungi, bacteria, and plants. In medicine, we use a lot of plant alkaloids; they have anti-inflammatory as well as anti-microbial properties. "The anti-inflammatory activities of plant-derived alkaloids have been documented in several animal models of disease".7

When it comes to managing auto-immune diseases like Hashimoto's disease, lifestyle considerations should be made, beyond just balancing thyroid hormone levels on hypothyroidism bloodwork.


The content and any recommendations in this article are for informational purposes only. They are not intended to replace the advice of the reader's own licensed healthcare professional or physician and are not intended to be taken as direct diagnostic or treatment directives. Any treatments described in this article may have known and unknown side effects and/or health hazards. Each reader is solely responsible for his or her own healthcare choices and decisions. The author advises the reader to discuss these ideas with a licensed naturopathic physician.


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