I have Hashimoto's disease, an autoimmune condition involving my thyroid, the body's 'thermostat' regulator. In the process of discovering my diagnosis for Hashimoto's and another autoimmune disease (ankylosing spondylitis), I asked a number of doctors whether or not diet had any impact on my health. For the most part, I was looked at like a simpleton and told that diet didn't matter.
Their only recommendation was that we wait and see and keep an eye on developments. In other words, we wait until a sufficient amount of tissue was destroyed by my immune system—and only then would we take action.
I didn't want to wait for my thyroid to be destroyed. The reasons why diet matters are pretty logical: first, most of the immune system lives in the gut (by some estimates as much as 70 to 80 percent), and there is an enormous amount of research supporting the idea that dietary proteins cause immune responses.
In addition, the immune system that is found in the gut is very much intertwined with the body's tolerance to its own proteins. Autoimmune diseases like Hashimoto's are the result of the loss of self-tolerance—our immune system short-circuits, and the job it performs naturally (cleaning up old cells and dead tissue) morphs into something more destructive and dangerous.
There are many theories about what leads to this change, and it seems to have numerous causes. But the bottom line is that diet is integral to the disease process; therefore, it's the foundation of any successful treatment for autoimmunity.
And from my personal experience, I can tell you that I didn't start to feel any better until I went all in with my diet and made some pretty significant changes. First I gave up gluten, dairy and soy, and then I tried the autoimmune Paleo protocol. This is a diet that eliminates all foods that are potentially inflammatory, such as those I just mentioned as well as grains, nuts and seeds, nightshades (tomatoes, peppers, eggplants and white potatoes), alcohol and coffee.
This led to a dramatic improvement in my weight; I lost 25 lbs (11 kg) of bloating and inflammation. My overall energy, endurance, memory and cognitive ability also improved. My TPO (thyroid peroxidase) antibody level—a marker of autoimmune thyroid disease—dropped from 1,200 to 153.
As a result, I have become a firm believer in the power of diet and lifestyle changes.
Functional medicine, as the name implies, focuses on improving function in the body. The basic premise is that if your body is functioning optimally, you will be healthy.
And it makes sense: form follows function. Good health is dependent on your organs and glands, muscles, tendons and bones all working properly.
So, a functional medicine practitioner (like myself) will use common diagnostic tests (like blood, stool and saliva tests) to determine your baseline health. Then, they will prescribe supplements and diet and lifestyle changes to help your body to function better.
After doing that for a period of time, they will retest and re-evaluate you to determine whether or not these interventions work.
Traditional Chinese medicine (TCM), in my view, is the original functional medicine. Since ancient times, Chinese doctors have been concerned with how the different parts of the body interact. And much of the emphasis of Chinese medical diagnosis is on specific patterns of dysfunction.
The reason for this is quite logical. Any disease (and Hashimoto's is no exception) goes through different stages of progression. And often, as it progresses, more organ systems become compromised and stop functioning properly. Therefore, the goal is to stop and, hopefully, reverse that progression and restore proper function in the body.
The autoimmune Paleo approach
Gluten is an important trigger in all autoimmune diseases. And celiac disease is not a food sensitivity; it is an autoimmune disease.
Also, leaky gut, or intestinal permeability, the breakdown of the intestinal lining, is a necessary ingredient for autoimmune disease to develop. And there are many foods that resemble gluten and may cause an immune response in the digestive tract.
These include grains, legumes and dairy products, and they all can contribute to leaky gut. Nuts, seeds and nightshades are also foods that can increase damage to the gut. They do this by either directly damaging the intestinal lining or by encouraging the growth of bacteria and yeast in the small intestine that can cause damage.
Some of the most destructive substances are lectins, digestive enzyme inhibitors, saponins and phytic acid.
So the first phase of any healing thyroid diet is designed to simplify your diet and remove all of these destructive substances so that you can heal.
A 2016 study published by Italian researchers in the journal Drug Design, Development, and Therapy focused specifically on overweight patients with autoimmune thyroiditis (Hashimoto's) and used a diet almost identical to this.1
The results were pretty impressive. The dieters not only lost body weight, but also fat mass and had lower levels of thyroid antibodies linked to Hashimoto's.
The foods and substances that are avoided in the autoimmune Paleo diet are things that can contribute to the destruction of the gut. By removing them from the diet, the gut lining is able to recover. And when we add TCM insights for supporting the internal organs as well, we can create significant healing momentum.
This almost always results in a lessening of symptoms and healing for those with autoimmune disease.
The reintroduction phase
Once you have done the elimination phase of the autoimmune Paleo diet (usually for 30 to 60 days), the next phase involves reintroducing foods, one food at a time, to see if you react to them.
This phase of the autoimmune Paleo approach is essentially a test to see what you can and cannot eat after the elimination period. There are people who have spent several years healing their gut and still find that they are sensitive to a number of foods.
In my clinical experience, I have found that most people who have been recently diagnosed or are new to this approach tend to be have some energetic deficiency, according to TCM.
Deficient conditions are those characterized by metabolic weakness and depletion. Hypothyroidism, adrenal fatigue and exhaustion, malnourishment and weakness caused by trauma or surgery are all examples. In some cases of deficiency, there are specific systems of the body or organs that are depleted and need to be strengthened.
These different types of deficiency include blood deficiency (found in various anemias), yin deficiency (found in some organs such as the kidneys, liver, or heart), yang deficiency (very similar to endocrine disorders like hypothyroidism and adrenal fatigue) and qi deficiency (basic metabolic weakness).
Dietary treatment of deficiency conditions involves nutrient-dense foods and supplements that tonify or strengthen and help the systems and organs of the body to rebuild. A basic qi-deficient type of diet can also be considered a kind of base diet that should be returned to after treating excess conditions or infections.
Qi deficiency diet
The basis of the diet is complex carbohydrates with some high-quality protein and lightly cooked vegetables. Fresh, locally grown, seasonal food is preferable, as it is most nutritious and will have the most vibrant qi.
Food should be lightly cooked, steaming or blanching vegetables just enough to preserve a light crunch. Green leafy and delicate vegetables like broccoli and beans are best cooked this way. Heavier root vegetables and grains should be cooked longer and slowly so that they retain their qi, shape and texture.
Easily digested carbohydrates such as sweet potatoes and starchy root vegetables should make up a larger proportion of the diet (40-60 percent). The remainder should be cooked greens and red and yellow vegetables (30-40 percent) and a small proportion of high-quality animal protein (10-20 percent).
Soups and stews are particularly beneficial for qi-deficient conditions. You can also batch cook on weekends to last the entire week. Taking time to cook your own foods can be healing and therapeutic on its own.
Targeting nutrition for the spleen will also benefit the lungs and vice versa.
Symptoms of qi deficiency
•Weakness, lethargy and/or fatigue
• Decreased motivation
• Brain fog and dull thinking, sensing or feeling
• Poor appetite
• Weak digestion
• Susceptibility to colds and flu
• Difficulty recovering from illness
• Poor hair growth
• Pasty, pale complexion
• Shortness of breath
• Perspiring easily with exertion
• Low libido
• Muscle weakness
• Aversion to cold, feeling chilled easily
• Frequent urination
• Dull, brittle nails
Qi deficiency dietary recommendations:
Eat all food cooked and warm. Slow cooking of soups, stews and broths is particularly effective
Chew your food thoroughly.
Try simple combinations of a few ingredients; more frequent, smaller meals and regular mealtimes
Consume a high proportion of complex carbohydrates and vegetables, less meat (nutrient-dense meats like organ meat are recommended)
Avoid excessive fluids during meals, overeating, missing meals and multitasking during meals
Why does your body start attacking itself?
There's no single cause for autoimmune conditions like Hashimoto's thyroid disease, which causes an underactive thyroid.
In many people, there is some exposure to a virus or other pathogen, like Epstein-Barr virus (or other herpes viruses), Coxsackie virus or
Some researchers have theorized that these viral fragments resemble thyroid tissue, and that is why the immune system attacks the thyroid after fighting the virus.
There may also be exposure to environmental toxins like mercury or bisphenol A, and these form what are called "neoantigens"— new antigens made up of the chemical plus our own tissue.
The formation of these neoantigens initiates an immune response, which may result in antibody production against the chemical-human tissue hybrid. Exposure to the chemical and the production of antibodies against various tissue antigens may result in autoimmune reactivity.
Exposure to gluten and celiac disease can be factors in the development of autoimmune thyroid disease.1
Stress can also play a major role in the expression and worsening of autoimmune diseases including Hashimoto's.
In a retrospective study published in the journal Autoimmunity Reviews, researchers noted that "a high proportion (up to 80 percent) of patients reported uncommon emotional stress before disease onset. Unfortunately, not only does stress cause disease, but the disease itself also causes significant stress in the patients, creating a vicious cycle."2
Recipes for healing qi deficiency
Sweet Potato Pasta with Pesto
Makes 4 to 6 servings
This is a nourishing, delicious, light and filling dish that's also gluten-free, dairy-free and vegan. You can prepare the pesto ahead of time, if desired. Sweet potato pasta can be found at Asian markets or ordered online.
Sweet potato pasta
12-ounce (340-g) package of sweet potato noodles
½ teaspoon salt
1 teaspoon olive oil
2 cups (25 g) basil, packed
½ cup (120 mL) coconut cream
4 Tbsp olive oil
¼ cup (20 g) fresh or frozen coconut meat (optional, for thicker pesto)
2 garlic cloves
½ lemon, juiced
½ teaspoon salt, plus more for topping
½ teaspoon pepper for topping
1) Bring a large pot of water to boil. Add the pasta, a pinch of salt and olive oil, and cook according to instructions (usually 7 to 8 minutes).
2) While pasta is cooking, place all pesto ingredients into a high-speed blender. Blend until well incorporated, about 10 to 15 seconds, or until a creamy consistency is reached.
3) Divide the pasta among bowls, top with the desired amount of pesto and add salt and pepper to taste. Store in the refrigerator three to four days, or freeze in small containers for later use.
Roasted Root Veggies with Watercress
Makes 4 to 6 servings
This is one of my favorite recipes. It's delicious eaten alone or as a side dish. It nourishes and at the same time moves liver qi.
This dish is beneficial for qi-deficient conditions.
4 small carrots, cut in ¼-inch (½-cm) slices
3 small parsnips, cut in ¼-inch (½-cm) slices
3 medium sweet potatoes, cut in ½-inch (1-cm) half-moons
4 small beets, cut in ¼-inch (½-cm) half-moons
4 tablespoons olive oil
½ teaspoon salt
½ teaspoon pepper
¼ cup (8 g) watercress, chopped roughly
1 tablespoon balsamic vinegar
1) Preheat the oven to 400°F/205°C.
2) Place the carrots, parsnips, sweet potatoes and beets in a large baking dish; coat evenly with olive oil and sprinkle with salt and pepper. Bake for about 50 minutes to 1 hour, stirring halfway through to ensure even browning.
3) Once the veggies are tender and lightly caramelized, they are done.
4) Toss the veggies with watercress and balsamic vinegar. Serve on its own or with salad, potatoes or a protein dish.