The Role of Immunological Challenges, Oxidative Stress, and Dietary Interventions in Managing Hashimoto's Thyroiditis: A Narrative Review.

Hashimoto thyroiditis (HT) is an autoimmune thyroid disorder characterized by chronic inflammation and hypothyroidism. The current scientific understanding indicates that the development of HT is influenced by a combination of genetic and environmental factors. Nevertheless, oxidative stress (OS) and dysregulated immune processes play a substantial role in HT pathogenesis. Reactive oxygen species (ROS) play a critical role in thyroid hormone synthesis by facilitating iodide oxidation. Since thyroid hormones influence mitochondrial activity and regulate ROS production, the thyroid gland is particularly vulnerable to OS and disruptions in homeostasis. Research indicates that, in HT, the oxidative balance shifts toward a pro-oxidative state. Excessive levels of ROS disrupt cellular homeostasis and induce inflammation, leading to structural and functional damage of thyroid tissue. These processes play a substantial role in the pathogenesis and progression of HT. Among the various environmental factors that can be modulated, dietary nutrients are considered one of the most promising and underappreciated clinical tools in this process. The primary aim was to explore the potential role of dietary interventions in protecting thyroid function, supporting the immune response, and alleviating OS in individuals with HT. According to the literature data, proper nutrition in HT should include sufficient amounts of anti-inflammatory components. These emphasize the role of mono- and polyunsaturated fatty acids (such as omega-3, omega-6), polyphenols, whey protein, soy protein, and isoflavones. Moreover, a well-balanced and varied diet rich in antioxidants, including vitamins C and E, selenium, zinc, and polyphenols, may help reduce OS in HT, simultaneously modulating the immunological processes. Additionally, it is essential to ensure an adequate intake of micronutrients, including iodine, iron, selenium, and vitamins, especially vitamin D, to support thyroid homeostasis. Adopting a balanced and nutrient-rich diet, along with specific dietary patterns, may be beneficial in managing the symptoms and improving the overall well-being of individuals with HT.