10 Things to Know About Thyroid Disease and Your Diet

Are There Foods to Avoid With Hypothyroidism?

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If you have thyroid disease—whether you are hypothyroid (underactive thyroid) or hyperthyroid (overactive thyroid), whether you Hashimoto's, Graves' disease, or other thyroid conditions—what you eat can have an impact on your health. Here are ten things to know about thyroid conditions and your diet, food, beverages, and their impact on your health and thyroid medications.

1. Goitrogenic Foods Can Slow Down Your Thyroid

Goitrogens are substances—occurring naturally in certain foods—that can cause your thyroid gland to enlarge.

This enlarged gland is called goiter. Goitrogenic foods can also function like an antithyroid drug and actually slow down your thyroid and make it underactive, known as hypothyroidism.

The main goitrogenic foods are cruciferous vegetables like broccoli, cauliflower, kale, and cabbage, among others, as well as soy foods. Here is a more detailed list of common goitrogens.

If you still have a functional or semi-functional thyroid gland and are hypothyroid, you should be careful not to overconsume raw goitrogenic foods. If you are hyperthyroid, you may want to talk to a nutritional practitioner about incorporating more goitrogenic foods into your diet.

If you are hypothyroid, you don't need to avoid goitrogenic foods entirely. The enzymes involved in forming goitrogenic materials in plants can be at least partially destroyed by heat, allowing you to enjoy these foods in moderation if they are steamed or cooked.

If you are hyperthyroid, a goitrogen-rich diet may actually help slow your thyroid and help you lower your dosage of antithyroid medication. 

2. Coconut Oil is Not a Thyroid Treatment

You may hear coconut oil recommended for thyroid patients, and while it can be a healthful option, it's not a cure-all or treatment for thyroid disease and does not substitute for thyroid hormone replacement medication in any situation.

It can, however, be a healthy, thyroid-friendly option to replace other fats and oils in your diet.

3. 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 reduction of 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.

If you are hyperthyroid, you may want to talk to a nutritional practitioner about incorporating more soy into your diet.

4. 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. Otherwise, the 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.

5. Iron, Calcium and Calcium-Fortified Juice Don't Mix with Your Thyroid Medication

You should not take calcium-fortified orange or other calcium-fortified juices with your thyroid medication. Wait at least three to four hours after taking your thyroid medication before taking calcium-fortified juice, calcium supplements, or iron supplements, as they can interfere with your absorption of thyroid medication.

6. 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 U.S., however, many people have limited their salt intake or stopped using iodized salt.

Keep in mind that about one-fourth of the U.S. population is now somewhat deficient in iodine, and that percentage appears to be on the rise again, after years of stable iodine levels, due to iodized salt intake.) 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 are essential. 

7. Be Careful About Celiac, Gluten, and Wheat

A subset of autoimmune thyroid patients has dietary-triggered autoimmunity, due to celiac disease, or a wheat/gluten intolerance. 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. Even if you do not have celiac disease, you may find that going on a gluten-free diet may reduce your antibodies, reduce bloating, and help with your energy and weight loss.

8. High-Fiber Foods are Essential

Many thyroid patients struggle with constipation and extra weight. One of the key tactics that can help is increasing fiber intake, particularly from foods. Here is a list of high-fiber foods for thyroid patients.

Keep in mind, however, that if you switch to a high-fiber diet, you should get your thyroid rechecked in 8 to 12 weeks to see if you need a dosage readjustment, as fiber can affect absorption of the medication.

9. Mini-Meals

You may have heard that to raise metabolism, you should eat "mini-meals" and "graze" all day on smaller meals. But this may be exactly the wrong thing to do for thyroid patients who are trying to lose weight. Fewer meals, spaced further apart, may be more effective for you than mini-meals/grazing in helping to manage your leptin and insulin levels.

10. 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 thyroid patients should go overboard eating—or completely eliminate—most categories of foods.

Source: 

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

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