What Does Nutrition Counseling for Hashimoto’s Look Like from a Weight-Inclusive Approach?
Hashimoto's thyroiditis is an autoimmune condition in which the immune system attacks the thyroid gland. Over time, this can damage the thyroid and lead to hypothyroidism, meaning the gland doesn't produce enough thyroid hormone. Thyroid hormones play an important role in metabolism, energy, temperature regulation, and many other bodily functions.
This diagnosis can leave people searching for answers, especially when they're experiencing fatigue, changes in energy, or other symptoms. And it's easy to find nutrition advice suggesting that the solution is to eliminate gluten, dairy, or entire categories of food.
Some people have specific medical or nutritional needs that benefit from dietary changes. But Hashimoto's doesn't automatically mean you need to follow a restrictive diet. Treatment of thyroid dysfunction, when present, requires appropriate medical care, and nutrition recommendations should be individualized.
As a weight-inclusive Registered Dietitian, I want to understand the whole person sitting across from me so we can collaborate in creating the most effective treatment plan.
In general, during an initial intake session, I’ll ask questions like: What is a typical day of eating like for you on work-/school days. Does eating look different on free-days. Are you spending more time thinking about food than you'd like? What's happening with your energy? What is your relationship with exercise? How are you sleeping? What are the sources of stress in your life and how do you deal with them? We even talk about pooping!
When I work with someone who has Hashimoto's or other medical conditions, we address related nutrition concerns, dive into lab values, review medications and supplements, coordinate with medical providers when appropriate, and evaluate dietary changes in the context of the person's symptoms, nutritional adequacy, and overall health.
You deserve care that takes your physical health seriously without assuming that weight loss is the answer to every health concern.
What Does This Look Like in Practice?
Here's an adapted example of the kind of nutrition and well-being treatment plan I might develop collaboratively with a client.
Our areas of focus might include:
Nourishment and flexibility: Building a reliable repertoire of satisfying meals and snacks that work in everyday life, including busy days and travel.
Food peace: Exploring food rules, guilt, and preoccupation that can make eating feel unnecessarily complicated.
Movement and strength: Supporting enjoyable, sustainable movement that contributes to strength, mobility, and quality of life.
Body image and safe embodiment: Working toward a more compassionate relationship with the body, including (but not limited to) surface-level appearance
Medical nutrition and energy: Addressing relevant concerns such as thyroid management, iron status, fatigue, and whether a dietary trial is warranted, while avoiding unnecessary restrictions.
Creating more margin: Considering how supportive relationships, pleasure, play, and rest fit into a full life.
Yes, Sometimes We Actually Make Food!
Or, take a trip to the grocery story.
During our sessions, we make time to get creative and come up with several meal and snack ideas to try. Sometimes we're building a recipe from scratch. Other times, we're combining prepared ingredients, grocery-store staples, or restaurant options to make nourishment more accessible.
For example, in the On The Brink Food Lab (aka kitchen) we might put together a North African-inspired protein bowl with prepared meatballs, lentils, quinoa or brown rice, greens, feta, hummus, vegetables, olive oil, and lemon.
Or we might adapt a favorite pre-made wrap or salad into a more satisfying meal or turn a collection of foods from the refrigerator into what we affectionately call a snack plate that is actually a meal.
We also talk about convenience. Could a pre-made protein shake be paired with toast, nut butter, and fruit to make a more substantial meal? Could groceries be delivered before you get home from a trip? Could prepared foods from the grocery store or your favorite local restaurant help you nourish yourself on an especially busy day?
These aren't shortcuts we need to apologize for. They're practical tools.
The goal isn't to create another set of food rules or a rigid meal plan. It's to develop a flexible repertoire of options that makes nourishment easier, more enjoyable, and more consistent with the life you're living.
What Does Progress Look Like?
It might mean having more energy, feeling stronger, eating with greater flexibility, spending less time worrying about food, or feeling more comfortable responding to your body's needs.
It might mean having convenient meals available without feeling that you've failed, enjoying a meal with friends without anxiety, or traveling without organizing your day around food rules.
These goals don't require abandoning medical care or ignoring health concerns. We’re still monitoring lab values and vital signs. But our markers of progress can expand the standard definition of what good care can accomplish.
My goal isn't to help you follow the perfect set of nutrition rules. It's to help you find an approach to nourishment that supports your health and makes room for your life.
Ready to care for your new or existing diagnosis and build a healthier relationship with food? Reach out today. I’m here to support you with weight-inclusive, compassionate care.