Diet and Hypothyroidism

When you're hypothyroid, figuring out what to eat can be a confusing process. This can be especially true if you are trying to lose weight or battling symptoms of hypothyroidism, like bloating or fatigue. While you may feel overwhelmed at times, try to relax and take one day at a time. Diet can play an important role in the management of your disease, so embarking and finding your way on your "eating right" journey is worth your efforts.

These tips, and a discussion with your doctor and/or nutritionist, can set you on the right path.

Protecting Thyroid Function

Goitrogens are substances found in foods that may interfere with thyroid hormone production, although this is usually only in people with iodine deficiency (which is rare in the United States). Even so, moderating your intake of goitrogen-containing foods, like raw cruciferous vegetables (for example, broccoli, cauliflower, and cabbage), is a reasonable dietary goal.

Of course, it's best to talk with your doctor about the specific servings of goitrogenic foods allowed for you. Generally speaking, though, a few servings a day is likely harmless.

Keep in mind that cruciferous vegetables are very nutritious food choices, so avoiding them completely is not ideal. One consideration is to cook these delicious vegetables, as heat eliminates most goitrogenic activity.

Soy is another goitrogenic food, but soy consumption is a somewhat controversial issue within the medical community. There is scant medical evidence that soy has health benefits, and it may be detrimental to thyroid function, especially supplements that contain high doses of soy.

It's best to discuss the consumption of soy with your personal doctor, but until that discussion, avoiding high amounts of soy is your best bet.

Losing Weight

Some people with hypothyroidism find it difficult to lose weight, despite optimal treatment of their disease with thyroid hormone replacement medication.

The good news is that under the guidance of a doctor or nutritionist, you can use various dietary strategies to lose those extra pounds.

Two "example diets" your doctor or nutritionist may recommend include:

  • Counting calories and/or restricting calories (for example, the Weight Watchers model)
  • The Zone Diet (a low-carb, protein-enriched diet)

Counting and/or Restricting Calorie Intake

In order to lose weight, you should first write down the number of calories you are consuming each day. Then, based on your resting metabolic rate and daily caloric requirement, your doctor or nutritionist can recommend how many calories to cut back on.

Roughly speaking, sedentary men over 30 years old need about 2,000 to 2,400 calories a day, while active men need about 2,400 to 2,800 calories a day. Sedentary women over 30 years old need about 1,600 to 1,800 calories a day, while active women need about 2,000 to 2,200 calories per day.

As an aside, be sure to not cut your calories back too drastically. Doing so can cause your body to hold onto stored fat, turning to your muscles for energy.

This starvation mode can ultimately slow your metabolism, which translates to a reduction in your daily caloric requirement—creating a vicious cycle of hunger and no weight loss.

Zone Diet 

The Zone Diet, developed by Barry Sears, Ph.D., is a protein-enriched, low-carbohydrate diet that focuses on balancing the body's insulin reaction to food. 

According to the Zone theory, when you consume too many carbohydrates, your pancreas releases excess insulin, which prevents your body from using its stored fat for energy. This can impair your ability to lose weight.

With the Zone Diet, a person sets up their meals to contain 40 percent carbohydrates, 30 percent protein, and 30 percent fat. More specifically, a person consumes carbohydrates that have a low glycemic index, proteins that are lean, and unsaturated fats. This specific pattern of eating allows for the slow release of insulin within the body, which promotes the burning of fat.

Managing Symptoms

In addition to losing weight (or maintaining a normal body mass index), eating nutritiously can also help reduce various symptoms of hypothyroidism.

Bloating

Bloating is a common symptom in people with an underactive thyroid gland. In fact, according to the American Thyroid Association, hypothyroidism can cause as much as five to 10 pounds of weight gain just from excess water alone. Some of that water weight gain can be in the face, causing puffiness around the eyes, as well as fluid retention and swelling in the hands, feet, and abdomen.

Considering what you eat is paramount to managing your bloating. Generally speaking, high-fiber foods may produce gas, which can worsen your bloating. Likewise, salty foods, such as hot dogs, pizza, bread, soups, and processed foods, can worsen fluid retention.  

Research suggests that adhering to a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polypols) diet may ease bloating.

Some High-FODMAP Foods You May Want to Avoid

  • Wheat
  • Onions
  • Garlic
  • Certain fruits (for example, apples, apricots, cherries, mangoes, nectarines, peaches, pears, plums, and watermelon)
  • Certain vegetables (for example, cabbage, cauliflower, artichokes)
  • Beans

Constipation

Another symptom of hypothyroidism that may be eased with diet is constipation. Unlike for bloating, consuming fiber, like beans, whole grains, and apples, can relieve constipation. Drinking lots of water is also good for maintaining a healthy bowel function.

Even so, in addition to dietary changes, some people with hypothyroidism and constipation need to take an over-the-counter laxative, like Milk of Magnesia or Miralax (polyethylene glycol). Be sure to speak with your doctor, though, before trying a laxative, especially if your constipation is worsening. You may need to have your thyroid function rechecked or have your doctor investigate other causes.

Fatigue

Some people with thyroid disease still note fatigue despite optimization of their thyroid hormone levels. After being evaluated by your doctor for other health conditions that may be causing or contributing to your fatigue (for example, anemia or depression), consider these fatigue-easing dietary tips:

  • Drink a caffeinated beverage (coffee, tea) every morning.
  • Take a fatigue-fighting dietary supplement, like co-enzyme Q10, under the guidance of your doctor.
  • Consider an elimination diet; stop eating sugar, dairy, or gluten, for example. Some people find this increases their energy levels.

Getting Proper Nutrition

Since nutritional deficiencies may worsen symptoms of thyroid disease, ensuring adequate vitamin and mineral levels is a good idea. 

Vitamin D

Vitamin D is known as the "sunshine vitamin" because your body makes it when your skin is exposed to ultraviolet rays. Besides sunlight exposure, you can get vitamin D from certain foods, like oily fish, eggs, and fortified milk and cereals. While vitamin D plays an important role in maintaining strong bones, emerging research suggests it also plays a role in immune system health. 

More specifically, a number of studies have evaluated the relationship between vitamin D levels and Hashimoto’s thyroiditis. Research has shown that people with Hashimoto's thyroiditis are more likely to have low vitamin D levels.

The good news is testing for vitamin D deficiency requires a simple blood test. Treatment entails taking a vitamin D supplement, the dosage of which depends on your target level.

Vitamin B12

Research suggests that about one-third of people with Hashimoto's disease are deficient in vitamin B12, which is a water-soluble vitamin obtained by eating fish, meat, dairy products, and fortified cereals. Vitamin B12 is critical for the production for the production of red blood cells and neurologic function.

Like vitamin D deficiency, being tested for vitamin B12 deficiency requires a blood draw. Treatment is also straightforward, requiring either an increase in your dietary intake of vitamin B12, supplements, or shots. 

Selenium

Selenium is a mineral found in foods like Brazil nuts, tuna, lobster, halibut, and grass-fed beef. Early research suggests that selenium supplementation can improve the mood or well-being of those with Hashimoto's thyroiditis. So, along with getting your vitamin D and vitamin B12 levels checked, be sure to inquire about your selenium level. 

Timing Is Key

Taking your thyroid hormone replacement medication at least three to four hours before taking iron or calcium supplements and at least one hour apart from drinking coffee or taking fiber supplements is essential to preventing poor drug absorption. 

Moreover, other prescription medications, vitamins, or over-the-counter drugs (besides fiber and calcium) may interfere with your thyroid medication absorption. Be sure to confirm the timing of your food and medication/supplement intake with your doctor or nutritionist.

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