Nutritional Management of Thyroiditis of Hashimoto

Abstract

Since the thyroid gland is one of the organs most affected by autoimmune processes, many patients with thyroiditis of Hashimoto (TH) seek medical advice on lifestyle variance and dietary modifications to improve and maintain their hyroid function. In this review, we aim to present and discuss some challenges associated with the nutritional management of TH, focusing on environmental and dietary deficits, inflammatory and toxic nutrients, cyanotoxins, etc. We discuss the relationships among different diets, chronic inflammation, and microbiota, and their impact on the development and exacerbation of TH in detail. We share some novel insights into the role of vitamin D and melatonin for preserving thyroid function during chronic inflammation in autoimmune predisposed subjects. A comprehensive overview is provided on anti-inflammatory nutrients and ecological diets, including foods for cleansing and detoxification, which represent strategies to prevent relapses and achieve overall improvement of life quality. In conclusion, data from biomedical and clinical studies provide evidence that an appropriate dietary and lighting regimen could significantly improve the function of the thyroid gland and reduce the reactivity of autoantibodies in TH. Compliance with nutritional guidelines may help TH patients to reduce the need for medicines.

Keywords: anti-inflammatory nutrients; autoimmune Hashimoto’s thyroiditis; detoxification; ecological diet; proinflammatory.

Figure 1

Gut–thyroid interaction in health and disease (autoimmune thyroid pathology and cancer). Thyroid diseases are frequently associated with dysbiosis. On the one hand, dysbiosis changes the immune response by encouraging inflammation and decreasing immunological tolerance, disrupting the intestinal membrane and increased intestinal permeability (a.k.a., “leaky gut”), resulting in increased antigen exposure and local inflammation. On the other hand, dysbiosis can directly affect thyroid hormone levels due to bacterial deiodinase activity and TSH inhibition [74]. The gut microbiota also regulates the absorption of thyroid-related nutrients such as iodine, selenium, zinc, and iron. All of them are required for thyroid function, and there is a definite correlation between thyroid dysfunction and changes in these minerals’ levels. Probiotics have been demonstrated to be effective in thyroid problems and can have a good effect. The healthy or diseased thyroid gland can also influence microbiota via many mechanisms, including melatonin. Legend: green arrows (wide and thin) denote a predominantly positive impact, while pink arrows (wide and narrow) indicate a primarily negative effect.