Nutrition Tips for Thyroid Patients

More research is needed to better understand the exact impact of foods and nutrients on thyroid health, but there's some scientific evidence for how a few specific types affect the thyroid in both positive and negative ways.

While certain nutritional deficiencies—like too little iodine and selenium—can be the cause of hypothyroidism, these conditions are uncommon in the United States due to soil quality, diet, and use of iodized salt. Autoimmune disease is, in fact, the impetus for most cases of thyroid diseases in the Americas—Hashimoto's thyroiditis in the case of hypothyroidism (underactive thyroid) and Grave's disease in the case of hyperthyroidism (overactive thyroid).

Despite immune system dysfunction being at the root of these issues, diet nevertheless plays an important role in thyroid management. While specific foods and supplements can't treat or reverse thyroid disease, eating a healthy, thyroid-friendly diet can support your thyroid function and treatment, help you maintain or lose weight, and may even help reduce some of your symptoms like fatigue, constipation, and slow metabolism.

The following dos and dont's are a great place to start when you're looking to make some changes. Consider seeking the help of a nutritionist who can help guide you further.

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Watch Now: 7 Thyroid Nutrition Tips

Limit Dietary Stress

Dietary stress in your body is caused by eating foods that create:

  • Inflammation, sensitivity, or allergic response
  • A spike or rapid fluctuations in your blood sugar

Or contain:

  • Toxins or chemicals that can trigger immune responses
  • High amounts of unhealthy fats

You can help eliminate dietary stress by making some strategic changes.

Eliminate Heavily Processed Foods

Processed foods don't have a direct impact on thyroid function, but when they're heavily processed, as in the case of frozen pizza, microwave dinners, and donuts, they aren't healthy for anyone. Some heavily processed foods even contain certain ingredients that are considered carcinogenic (cancer-causing).

In addition, foods that are heavily processed often have a lot of empty calories that don't support your body at all. It's best to choose fresh fruits, vegetables, whole grains, and foods that have been minimally processed if you can. One way to start adopting a cleaner diet is to try shopping only the periphery of the grocery store.

Skip Table Salt

Stay away from processed table salt too, as it's loaded with chemicals and a processed form of iodine. If you're craving salt, try a healthier, more natural form like an unrefined sea salt or a Himalayan pink salt.

Use common sense. If you can't pronounce certain ingredients or the product contains an enormous amount of fat, calories, sugar, or salt, it's probably best to set it back on the shelf or only indulge very occasionally.

Add Good Fats

Incorporate more good fats like olive oil, avocado, and healthy nuts into your diet. These have anti-inflammatory properties that may help support your immune system. Salmon is also an excellent source of good fat, but choose wild-caught salmon instead of farmed salmon for maximum nutritional value.

Use grass-fed instead of grain-fed organic meats whenever possible. Meat from grass-fed animals is much higher in healthier fats and nutrients and lower in fat overall than meat from grain-fed animals.

Limit Sweets

Eating too much refined sugar can increase inflammation, and having thyroid disease increases your risk of developing type 2 diabetes. To help reduce this risk and lower dietary stress, cut down or eliminate honey, molasses, soft drinks, and other forms of sugar, and cut diet drinks and artificial sweeteners from your diet entirely.

Reduce Caffeine Intake

Caffeine is a powerful stimulant. This means that a high daily intake of coffee, tea, or caffeinated soft drinks can be exhausting to your adrenal glands, raise your cortisol levels, and actually worsen any blood sugar imbalances you have.

Drink in Moderation

Alcohol is often heavy on carbohydrates and sugars. There's nothing wrong with an occasional drink for most people, but overuse of alcohol is a stress on your liver, your immune system, and your blood sugar.

Avoid Eating Too Much in One Sitting

Eating until you're stuffed causes a spike in your blood sugar, typically followed by a dip or crash. This is a dietary stressor that can be avoided by making your meals more balanced in terms of calories and stopping once you feel satisfied. Mindful eating is a helpful strategy for avoiding overeating, as it gives your body time to register that you're full and improves your awareness of those signals. As a bonus, it can also help aid digestion.

Give Your Body a Nightly Food Break

Try to stop eating after 8 p.m. and give your body a 10- to 12-hour break overnight before you eat breakfast. When you sleep, your body starts producing thyroid, adrenal, and growth hormones. It draws the energy for this production from your stored fat, burning it as you sleep.

If you have too short a break between eating in the evening and again in the morning, your body never gets the message that it's time to shift into fat-burning mode. By allowing a break of 10 to 12 hours, you encourage your body to get the message that more food is not coming every several hours, which may help shift you into fat-burning mode overnight.

Eliminate Toxins

Hormones, antibiotics, and pesticides are toxins and they can trigger autoimmune and inflammatory responses. The more you can remove these toxins from your food, the less stress these foods will create in your immune and endocrine systems. Buy organic, hormone-free, antibiotic-free, free-range, wild-caught, and pesticide-free foods whenever possible.

Try a Thyroid-Friendly Diet

Since it produces hormones that affect your entire body, your thyroid is sensitive to what you eat. The more dietary stress you put on yourself, the more likely you are to experience inflammation that can worsen your autoimmune reactions and interfere with your thyroid function. Here are some approaches you can try that are thyroid-friendly and may reduce inflammation.

Gluten-Free Diet

Celiac disease is an autoimmune condition that causes an immune reaction in your digestive system to gluten, a protein in wheat, barley, and rye, leading to damage in your small intestine. Having this disease can cause poor absorption of nutrients that are vital to thyroid health, like iodine and selenium, and lessen your body's ability to absorb your thyroid hormone replacement medication (levothyroxine). Celiac disease is three times more common in people with Hashimoto's thyroiditis and Graves' disease than in the general population.

For those with celiac disease, going on a gluten-free diet may help reduce inflammation and lose weight. If you haven't been diagnosed with celiac disease, but you think you might have it based on your symptoms and/or a family history, be sure to get checked out by your doctor. Even if you simply have a gluten sensitivity, you may benefit from a diet that's low in gluten.

Low-Glycemic Diet

A low-glycemic diet is low in sugar and simple carbohydrates that are quickly absorbed, such as bread, rice, pasta, cereals, potatoes, and corn. The benefit of this diet is that it helps to balance blood sugar spikes, which cause dietary stress. Consistently high blood sugar can be inflammatory as well, so lowering and balancing your blood sugar reduces overall stress on your hormones, including your thyroid hormones.

Low-Carbohydrate Diet

Similar to a low-glycemic diet, a low-carb diet helps keep your blood sugar balanced, but it focuses more on the number of carbohydrates you eat rather than the quality, as the low-glycemic diet does. Examples include the Atkin's diet and the ketogenic diet.

Autoimmune Protocol Diet

The autoimmune protocol diet focuses on reducing inflammation and healing your immune system. It's appropriate for any type of autoimmune disease and involves eliminating specific foods for six to eight weeks, then reintroducing them slowly.

Elimination Diet

Food intolerances and allergens—dairy, soy, and nuts, for example—can cause inflammation and make it harder for you to lose weight. It might be worth it to try an elimination diet and/or get allergy testing to determine if you have any food sensitivities or allergies.

Be sure to talk to your doctor before you try any of these dietary approaches to make sure there aren't any risks for your particular health situation.

Be Aware of Goitrogenic Foods

Goitrogenic foods can slow down your thyroid and promote its enlargement, known as a goiter. Though you don't need to avoid these foods entirely, you should avoid regularly eating large quantities of them in a raw form, particularly if you have hypothyroidism.

Be especially careful about raw smoothies that may include large quantities of raw goitrogens like kale and spinach. Cooking and steaming these foods helps reduce the level of goitrogenic properties, but even then, if your thyroid treatment isn't optimized and you're not feeling as well as you could, it doesn't hurt to avoid eating these foods raw and to reduce your intake of the cooked version too.

Some examples of the most goitrogen-rich foods include broccoli, Brussels sprouts, cauliflower, kale, strawberries, peaches, and peanuts.

how goitrogens disrupt thyroid function
Illustration by Emily Roberts, Verywell

Increase Your Fiber Intake

Many people with thyroid disease struggle with constipation and extra weight. One of the key tactics that can help is increasing your fiber intake. Fiber is important for digestion, heart health, healthy bowel movements, and to enhance your feeling of fullness.

Ideally, you should get 25 to 30 mg a day. It's best if fiber comes from high-fiber foods like beans, whole grains, and apples with skin. But if needed, aim for a combination of food and natural fiber supplements—such as psyllium—to reach higher levels of fiber daily.

Psyllium capsules are also helpful for times when you choose to indulge in low-fiber, high-glycemic foods, like birthday cake. Taking a dose as directed before eating can essentially help transform what you're eating into a higher-fiber, lower-glycemic food that's less likely to spike your blood sugar. Doing this in lieu of regularly following a fiber-rich diet full of healthful foods, however, is not advised.

Keep in mind that if you start eating a high-fiber diet, you should get your thyroid stimulating hormone (TSH) rechecked in eight to twelve weeks to see if you need a dosage readjustment since fiber can affect the absorption of your thyroid hormone replacement medication.

Drink Enough Water

One of the most powerful things you can do to help your health is to make sure that you're drinking enough water. Staying hydrated helps your metabolism function more efficiently and it can also reduce your appetite, get rid of water retention and bloating, improve your digestion, and combat constipation and fatigue. If you need to lose weight, try drinking water right before you eat. It may help suppress your appetite so that you eat less.

The bulk of your daily fluid intake should be water. Experiment with the type, form, and water temperature that allows you to stay well-hydrated. You may find it easier to drink more water if it's at room temperature instead of chilled, carbonated instead of still, filtered rather than tap, or by adding a fresh lemon, lime, or cucumber slice.

Work up to drinking .5 to 1 ounce of water for each pound of your body weight. So, for example, if you weigh 150 pounds, you need to drink 75 to 150 ounces of water every day. You can stay on the lower side if you aren't very active, but if you sweat a lot or you're fairly active, aim for the higher end.

If you work up to this goal slowly, after a few days, your body will adjust to the new level of fluid intake and you won't be making as many trips to the bathroom.

Maintain Sufficient Vitamin and Mineral Levels

Nutritional deficiencies can worsen symptoms of thyroid disease. And though they're not the reason autoimmune thyroid disease comes about, they are common in people with Graves' disease and Hashimoto's thyroiditis. Ensuring you have sufficient levels of certain nutrients is very important to your wellness.

Before You Buy Supplements

While it doesn't hurt to increase your intake of foods rich in these nutrients, before you rush out and buy a bunch of supplements, ask your doctor to test you for any deficiencies. If your levels are good, taking supplements can lead to toxicity, which can worsen your thyroid symptoms and cause other health issues.

Vitamin D

Vitamin D is crucial for your immune system health. It's made in your skin as the result of exposure to the sun's ultraviolet rays, and it's also found in certain foods. Scientific studies have found that vitamin D deficiency may be linked to the development of autoimmune thyroid diseases and is more common in people with these conditions. Research has also shown that vitamin D supplementation may help decrease both thyroid peroxidase (TPO) and thyroglobulin (Tg) antibodies in people with autoimmune thyroid disease.

Vitamin D's Benefits

  • Helps your body absorb calcium to keep bones healthy

  • Regulates your immune system

  • May lower blood pressure

  • May reduce the risk of developing heart disease and diabetes

Foods High in Vitamin D

  • Fatty fish such as tuna, mackerel, and salmon

  • Cereal

  • Cheese

  • Egg yolks

  • Fortified orange juice

Vitamin B12

Vitamin B12 deficiency is also more common in people with autoimmune thyroid disease, as well as the elderly and people who follow a vegan diet. Due to its important role in red blood cell formation and nerve function, a deficiency in vitamin B12 can cause fatigue, loss of energy, and shortness of breath from anemia (low red blood cell count), as well as numbness and tingling from impaired neurologic function.

Vitamin B12's Benefits

  • Helps your body make DNA

  • Keeps red blood cells healthy

  • Prevents anemia

Foods High in B12

  • Meat

  • Chicken

  • Fish

  • Dairy products

  • Eggs

Selenium

Selenium is essential for thyroid health, especially since the thyroid contains the most amount of selenium in the body. Low levels of selenium are linked with an increased risk of hypothyroidism, goiter, and both Hashimoto's thyroiditis and Graves' disease.

Scientists have found some evidence that people with autoimmune thyroid disease who take selenium supplements can significantly decrease TPO and Tg antibodies after 12 months, as well as improve mood and a sense of well-being.

Again, selenium deficiency is fairly uncommon in the United States, but if you have a low selenium level, which is more likely if you have digestive or absorption issues, you may benefit from supplements. Too much selenium can be toxic over time, however. Experts recommend no more than 400 mcg per day of selenium from all sources, including food, vitamins, and supplements, in order to avoid toxicity.

Selenium's Benefits

  • Essential for thyroid hormone production

  • Helps prevent cell damage

  • Boosts your immune system

  • May lower your risk of heart disease

  • May reduce your risk of cancer

Foods High in Selenium

  • Brazil nuts

  • Seafood like shrimp, tuna, halibut, and oysters

  • Sunflower seeds

  • Chicken

  • Eggs

  • Meats like ground beef, beef steak, and ham

Ferritin/Iron

Ferritin is a protein that stores your body's iron and releases it when you need it. Your ferritin levels need to be adequate in order for your cells to be able to properly absorb and process thyroid hormone and iron. If they're insufficient, your iron levels also decrease, which can result in fatigue and possibly anemia. It's also possible to have an iron deficiency without anemia.

Iron deficiency may also contribute to developing hypothyroidism. Because many of the symptoms of iron deficiency are similar to those found in hypothyroidism or occur at the same time, you may not even realize you have a problem. If you're taking Synthroid (levothyroxine) and still not feeling well, ask your doctor to test your iron level.

Iron's Benefits

  • Critical for making hemoglobin, which carries oxygen throughout the body

  • Necessary for making myoglobin, which transports oxygen to the muscles

  • Essential to the production of thyroid stimulating hormone (TSH)

Foods High in Iron

  • Red meat

  • Organ meat like liver and giblets

  • Fortified cereals

  • Poultry

  • Seafood like oysters, salmon, and tuna

  • Dried beans

  • Dried fruit

  • Whole grains

Zinc

Zinc is one of the minerals that's required for the production and processing of thyroid hormone, but it serves a number of roles in the body. Low levels of zinc can be a trigger of hypothyroidism, though as with the other nutrients, deficiencies are uncommon in the United States. Because your body has no way of storing zinc, it's important to consume it on a daily basis.

Zinc's Benefits

  • Aids in thyroid hormone metabolism

  • Boosts your immune system and helps fight off colds and infections

  • Supports wound healing

  • May decrease your risk of age-related diseases like macular degeneration

Foods High in Zinc

  • Seafood like oysters, crab, and lobster

  • Red meat

  • Poultry

  • Whole grains

  • Beans and nuts

  • Dairy products

  • Fortified cereals

Understand Proper Iodine Intake

Iodine is crucial for the production of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). An iodine deficiency can impair your thyroid function because then your body doesn't have enough raw materials to produce the necessary thyroid hormone. At the same time, getting too much iodine can also be problematic, contributing to goiter—thyroid enlargement—and potentially causing autoimmune thyroid disease to flare up and worsen.

When Americans have low levels of iodine, they are typically due to an iron deficiency, following a restricted diet, or taking certain medications.

If your doctor tests you and finds that you have an iodine deficiency, you'll likely take iodine supplements temporarily to get your levels back up. However, keep in mind that simply taking iodine supplements because you have thyroid disease is not recommended since it can make your condition worse, so don't do it without your doctor's direction.

Watch for Absorption Issues

You shouldn't drink coffee, including decaffeinated coffee, until at least an hour after you've taken your thyroid hormone replacement medication. This is because coffee can affect the absorption of your medication and make it less effective.

If you absolutely must have both your thyroid medication and coffee at the same time, talk to your doctor about the liquid capsule form of levothyroxine called Tirosint, which research shows is not affected by caffeine. You may also consider taking your thyroid medication at bedtime instead of in the morning, but again, discuss this with your doctor first.

It's also important to wait at least four hours after taking your thyroid medication before drinking a calcium-fortified juice, eating soy products, taking calcium or iron supplements, or taking certain other medications like antacids, as these also may decrease the absorption of your medication and make it less effective.

Be sure to keep your doctor up to speed by communicating any changes in the supplements or medications that you're taking, both over-the-counter and prescription, to avoid absorption issues.

Consider Probiotics

Probiotics are foods and supplements rich in a good kind of live bacteria that help you maintain a balance of your intestinal bacteria. The right probiotics can help enhance your immune system, improve digestion, combat diarrhea and constipation, and fight infections.

With so many health benefits for thyroid patients, ensuring that you're getting a diet rich in probiotics—or supplementing with them when necessary—is a safe and healthy way to help your health.

A Word From Verywell

It's always wise to practice moderation when it comes to your diet. While there are some foods, drinks, and supplements you definitely need to avoid taking with your thyroid medication, there's usually no reason that you need to completely eliminate any particular foods. Remember to discuss any major dietary changes with your doctor first and to let him or her know if you're concerned about any nutritional deficiencies.

If you're trying to lose weight and you don't know your leptin level and fasting blood sugar, finding out is an important step. Leptin is a hormone that regulates how hungry you are, also known as the "satiety factor." If your leptin levels or fasting glucose levels are imbalanced, you'll need to use diet, supplements, or medications to get them back on track.

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