10 Tidbits About Hypothyroidism and Your Diet

For the Most Part, Moderation Is Key

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If you have an underactive thyroid gland (called hypothyroidism), what you eat may affect your thyroid disease, including the absorption of your thyroid medication. 

Here are ten tidbits to optimize your overall health, wellbeing, and energy, while minimizing any negative impact on your thyroid function.

Goitrogenic Foods May Slow Down Your Thyroid

Goitrogens are substances found naturally in certain foods that can slow down the production of thyroid hormone—keep in mind, though, this phenomenon occurs typically in people with an underlying iodine deficiency (which is rare in the United States).

Still, even for people without iodine deficiency, experts recommend not over-consuming goitrogenic foods.

The main goitrogenic foods are cruciferous vegetables like broccoli, cauliflower, kale, and cabbage. The good news is that the enzymes involved in forming goitrogens in cruciferous vegetables can be partially destroyed by heat, allowing you to enjoy these foods in moderation, if they are steamed or cooked.

Soy May Be a Problem

Soy acts as a goitrogen and can inhibit your ability to absorb thyroid hormone medication. A general guideline is to avoid overconsuming soy, especially processed and high-phytoestrogen forms of soy, like soy shakes, soy powders, soy milk, and soy supplements. 

If you are having difficulty in maintaining optimal thyroid levels and reducing thyroid-related symptoms, you may want to consider eliminating soy, or limiting your soy consumption to fermented forms, like tempeh, in small quantities as a condiment, and not as a primary protein replacement.

Obtain Sufficient Vitamin and Mineral Levels

Nutritional deficiencies may worsen symptoms of thyroid disease, so ensuring you have sufficient levels of the following nutrients is important:

Vitamin D

Vitamin D is important for immune system health and is made in the skin from exposure to the sun's ultraviolet rays.

Vitamin D is also found in foods like fatty fish, cod liver oil, and fortified cereals. Research suggests that vitamin D deficiency may be linked to the development of Hashimoto's thyroiditis (autoimmune hypothyroid disease), and that vitamin D supplementation may help with the treatment of thyroid disease.  

Vitamin B12

Like vitamin D deficiency, vitamin B12 deficiency is common in people with Hashimotos' disease. Due to its important role in red blood cell formation and nerve function, a deficiency in vitamin B12 may 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 is found in a variety of foods, including fish, meat, chicken, eggs, and milk, and a deficiency is more common in the elderly and those who eat vegan. 

Selenium

Selenium is a mineral found in Brazil nuts, fish, cottage cheese, eggs, and grass-fed beef, among other foods. Research suggests that selenium supplementation can improve the mood or well-being of those with Hashimoto's thyroiditis. 

Coffee Interferes With Your Thyroid Medication

You should not 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 absorption and make your thyroid medication less effective.

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

Iron, Calcium, and Calcium-Fortified Juice Don't Mix With Your Thyroid Medication

It's important to wait at least three to four hours after taking your thyroid medication before drinking a calcium-fortified juice or ingesting any calcium or iron supplements, as they may interfere with the absorption of your thyroid medication.

Likewise, some medications (for example, antacids) may interfere with your thyroid medication. Be sure to keep your doctor up to speed with any changes in the supplements or medications (both over-the-counter and prescription) you are taking. 

Iodine Can Be a Friend or Foe to Thyroid Patients

In some areas of the world, iodized salt is an essential way to prevent iodine deficiency, cretinism, and mental retardation due to iodine deficiency in pregnant women. In the United States however, many people have limited their salt intake or stopped using iodized salt, and you need enough iodine for the thyroid to function properly. An excess of iodine, however, is also linked to increased risk of thyroid disease, so staying in range and avoiding deficiency or excess is essential. 

Be Careful About Celiac, Gluten, and Wheat

A subset of people with autoimmune disease have dietary-triggered autoimmunity, due to celiac disease, or a wheat/gluten intolerance. This means that their thyroid disease (for example, Hashimoto's thyroiditis) was triggered by an underlying autoimmune digestive problem. 

If you have celiac disease or wheat/gluten sensitivity, going on a gluten-free diet may lower or even eliminate your thyroid antibodies and cause an autoimmune thyroid disease remission. If you have not been diagnosed with celiac disease, but are suspicious for it based on symptoms and/or a family history, be sure to get it checked out by your doctor. 

High-Fiber Foods are Essential

Many people with thyroid disease struggle with constipation and extra weight. One of the key tactics that can help is increasing fiber intake, particularly from high-fiber foods like beans, whole grains, and apples with skin. 

Keep in mind, however, that if you switch to 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, as fiber can affect the absorption of thyroid hormone replacement medication. Moreover, a high-fiber diet may worsen bloating (usually temporarily), which is a common symptom in people with hypothyroidism. 

Mini-Meals

You may have heard that to raise metabolism and lose weight, you should eat "mini-meals" and "graze" all day on smaller meals. But now scientific evidence is emerging that fewer meals, spaced further apart, may be more effective for burning fat and obtaining a normal body mass index. 

Drink Enough Water

One of the most powerful things you can do to help your health and metabolism is to drink enough water. Water helps your metabolism function more efficiently and can help reduce your appetite, get rid of water retention and bloating, improve your digestion and elimination, and combat constipation. Some experts even say that we should drink one ounce of water per pound of scale weight.

A Word From Verywell

A wise guideline is to practice moderation. While there are some foods, drinks, and supplements you definitely need to keep apart from your thyroid medication, there is no reason people with thyroid disease should go overboard eating—or completely eliminate—most categories of foods.

Sources:

Collins AB, Pawlak R. Prevalence of vitamin B-12 deficiency among patients with thyroid dysfunction. Asia Pac J Clin Nutr. 2016

Fan Y et al. Selenium supplementation for autoimmune thyroiditis: A systematic review and meta-analysisInt J Endocrinol. 2014;2014: 904573.

Mazokopakis EE, Papadomanolaki MG, Tsekouras KC, Evangelopoulos AD, Kotsiris DA, Tzortzinis AA. Is vitamin D related to pathogenesis and treatment of Hashimoto's thyroiditis? Hell J Nucl Med. 2015 Sep-Dec;18(3):222-7.

View Article Sources
  • Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL/Wolters Kluwer; 2012.