Can you eat bread if you have Hashimoto's disease? A nutritional perspective

October 26, 2025 •

4 min read

For people with Hashimoto's, the relationship between diet and symptoms is increasingly recognized, with a growing number of patients reporting symptom improvements after dietary changes. So, can you eat bread if you have Hashimoto's disease, and what does the science say about gluten and thyroid health? The answer is nuanced, depending heavily on individual factors and potential sensitivities.

Quick Summary

The connection between consuming bread and Hashimoto's depends on individual sensitivity to gluten, an inflammatory trigger for some. A gluten-free diet or alternative breads like sourdough may help manage symptoms, but the decision is personal and should be based on careful observation and medical advice.

Key Points

Gluten and Autoimmunity: Research suggests a link between gluten and increased autoimmune activity in individuals with Hashimoto's, potentially through molecular mimicry and increased intestinal permeability.
Test for Celiac Disease: The risk of Celiac disease is higher in those with Hashimoto's. A strict, lifelong gluten-free diet is necessary if you test positive for Celiac.
Sourdough May Be Better Tolerated: The fermentation process of traditional sourdough breaks down much of the gluten, which some people with mild gluten sensitivities may tolerate better than standard bread.
Elimination Diet is Key: To understand your personal sensitivity, an elimination diet is the most reliable method. Remove gluten, track symptoms, and then carefully reintroduce to gauge your body's reaction.
Focus on Whole Foods: A gluten-free diet should not be a swap for processed alternatives. Prioritize naturally gluten-free whole foods to ensure a nutrient-dense and anti-inflammatory diet.
Professional Guidance is Recommended: Always work with a healthcare professional or registered dietitian when making significant dietary changes to ensure you maintain a balanced nutritional profile.

The Connection Between Gluten and Hashimoto's

Hashimoto's thyroiditis is an autoimmune disorder where the immune system mistakenly attacks the thyroid gland. The link between gluten, a protein found in wheat, barley, and rye, and Hashimoto's is a topic of significant interest within the functional medicine community, though mainstream medical views are still evolving. The core theory revolves around two key concepts: molecular mimicry and intestinal permeability.

Molecular Mimicry: A Case of Mistaken Identity

Research suggests that the body's immune system can sometimes confuse the protein structure of gliadin (a component of gluten) with the molecular structure of thyroid tissue. This phenomenon, known as molecular mimicry, could potentially trigger or exacerbate an autoimmune attack on the thyroid gland when gluten is consumed. In sensitive individuals, this cross-activation of the immune system can increase inflammation and thyroid antibodies, leading to more pronounced symptoms.

Intestinal Permeability and Leaky Gut Syndrome

Another proposed mechanism is related to intestinal permeability, or "leaky gut". In this condition, the gut lining becomes more porous, allowing undigested food particles and toxins, including gluten peptides, to enter the bloodstream. This can trigger a systemic immune response, causing inflammation that can worsen autoimmune conditions. A gluten-free diet is believed to help heal the gut lining, which can in turn calm the immune system's overreaction.

High Correlation with Celiac Disease

It is well-documented that people with one autoimmune disease have an increased risk of developing another. The prevalence of celiac disease—a severe autoimmune reaction to gluten that damages the small intestine—is significantly higher in individuals with Hashimoto's than in the general population. For those with co-existing celiac and Hashimoto's, a strict, lifelong gluten-free diet is essential. However, even without a formal celiac diagnosis, many people with Hashimoto's report feeling better on a gluten-free diet, suggesting a non-celiac gluten sensitivity.

Evaluating Bread Consumption: A Comparative Analysis

For individuals with Hashimoto's, not all bread is created equal. The following table provides a breakdown of different bread types and their potential impact:


Bread Type	Contains Gluten	Potential Impact on Hashimoto's	Considerations
Standard Wheat Bread	Yes	High potential for inflammation and immune response due to modern, high-gluten wheat and additives.	Typically contains refined flour, which can lead to blood sugar spikes and inflammation.
Ancient Grain Bread (e.g., Einkorn, Kamut)	Yes	May be better tolerated by some, as these grains contain a different type and lower quantity of gluten.	Still contains gluten and must be avoided by those with celiac disease or high sensitivity.
Sourdough Bread	Yes	The fermentation process significantly breaks down gluten, making it easier to digest for some with mild sensitivities.	Not suitable for celiac patients or those with severe gluten intolerance. Quality varies; look for traditionally made sourdough.
Gluten-Free Bread	No	Safest option for those sensitive to gluten. Made from flours like rice, quinoa, or buckwheat.	Be mindful of highly processed versions that can be high in sugar and additives. Choose nutrient-dense options.

Testing Your Personal Tolerance to Gluten

Since individual reactions vary greatly, the most effective way to determine your personal tolerance to gluten is through an elimination diet.

Steps for a Gluten Elimination Protocol:

Elimination Phase: Completely remove all gluten-containing foods from your diet for a set period, typically 12 weeks or longer. This includes wheat, barley, and rye, as well as products that may contain hidden gluten like certain sauces or processed snacks.
Symptom Tracking: During this phase, diligently record any changes in your symptoms. Pay attention to improvements in fatigue, brain fog, joint pain, or digestive issues, which are common in Hashimoto's.
Reintroduction Phase: After the elimination period, slowly reintroduce gluten into your diet. Reintroduce one food group at a time, allowing several days between each to monitor for adverse reactions.
Assessment: If your symptoms return or worsen after reintroducing gluten, you can conclude that you have a sensitivity and should continue to avoid it. If no symptoms reappear, you may be able to tolerate small amounts, particularly from high-quality sources like true sourdough.

Nutritional Considerations and Potential Deficiencies

While a gluten-free diet can be beneficial, it requires careful planning to avoid nutritional pitfalls. Many processed gluten-free products are stripped of nutrients and fiber. A balanced, nutrient-dense diet is crucial for supporting thyroid function.

Focus on Whole Foods: Emphasize naturally gluten-free foods like fruits, vegetables, lean proteins, and healthy fats.
Choose Nutritious Grains: If you tolerate them, incorporate gluten-free whole grains like quinoa, brown rice, and certified gluten-free oats.
Prioritize Key Nutrients: Pay attention to nutrients vital for thyroid health that can be found in gluten-free foods: selenium (Brazil nuts, seafood), zinc (legumes, nuts), and B vitamins (eggs, legumes).
Support Gut Health: Consider incorporating fermented foods, like coconut yogurt or fermented vegetables, to support a healthy gut microbiome.

Conclusion: A Personalized Dietary Approach

The question of whether you can eat bread if you have Hashimoto's disease has no universal answer. For those with celiac disease, the answer is a definitive no. For others, the response lies in personal sensitivity, and a well-monitored elimination diet is the best way to find out. The potential link between gluten, inflammation, and autoimmunity in Hashimoto's is a strong motivator for many to explore a gluten-free lifestyle. However, the key is personalization and making informed choices based on how your body responds.

Consulting with a healthcare provider or a registered dietitian experienced in autoimmune conditions is highly recommended before making significant dietary changes. This ensures a balanced approach that supports both thyroid health and overall well-being. For a deeper understanding of the functional medicine approach to Hashimoto's and diet, you can explore resources like those offered by Dr. Nikolas Hedberg(https://drhedberg.com/gluten-and-hashimotos-disease/).

Frequently Asked Questions

The theory of 'molecular mimicry' suggests that the immune system can confuse the protein structure of gluten with that of the thyroid gland, triggering an autoimmune attack. Additionally, gluten can increase intestinal permeability (leaky gut), allowing inflammatory substances into the bloodstream.

Celiac disease is a severe, diagnosed autoimmune reaction to gluten that causes intestinal damage. Non-celiac gluten sensitivity (NCGS) is a less defined condition where a patient experiences symptoms from gluten consumption without the intestinal damage seen in Celiac. Both can occur in those with Hashimoto's, and both can be addressed with a gluten-free diet.

Sourdough bread, particularly traditional versions, may be better tolerated by some individuals with mild gluten sensitivity because the fermentation process breaks down much of the gluten. However, it still contains gluten and is not safe for those with Celiac disease.

Safe alternatives include bread made from naturally gluten-free grains and starches like rice, corn, quinoa, buckwheat, sorghum, and amaranth. You should also look for certified gluten-free oats.

Yes, a poorly planned gluten-free diet can lead to deficiencies in important nutrients like fiber, B vitamins, and iron, as many gluten-containing whole grains are good sources of these. Focusing on naturally gluten-free whole foods can help mitigate this risk.

An elimination diet is the most reliable method. Remove all gluten from your diet for a minimum of 12 weeks, carefully track your symptoms, and then slowly reintroduce gluten to see if symptoms return. This should be done under medical supervision.

For those without Celiac disease, some people can reintroduce small quantities of high-quality gluten, like traditional sourdough, after significant symptom improvement and antibody reduction. However, lifelong avoidance may be necessary for others, and any reintroduction should be done with caution.