The Best Foods for Hypothyroidism

The human Thyroid Gland is shaped like a butterfly and is located just below the Adams’ Apple in the neck.  It requires iodine, which is typically supplied through our diet.  The thyroid is the only organ in the body that uses iodine and it doesn’t really need that much – the average adult only uses around one teaspoon of iodine during their entire life.  Nevertheless, iodine deficiency continues to be the number one cause of hypothyroidism globally predominantly because there are large numbers of people with the disorder in developing countries without adequate access to dietary iodine.  Therefore, ensuring sufficient iodine intake is a primary consideration when it comes to the best foods for hypothyroidism.

Ideally we should have around 15 to 20 mg of iodine stashed away in our body at any one time.  The thyroid stores 70 – 80% of this, which it combines with tyrosine, an amino acid, to produce the thyroid hormones thyroxine (T4) and triiodothyronine (T3).   About 80% of thyroid hormone produced by the thyroid is T4.  The remainder is the much more concentrated T3.  However, the body subsequently converts most of the T4 to T3 in the intestines.

Types Of Hypothyroidism

There are three types of hypothyroidism – Primary, Secondary and Tertiary.

Primary hypothyroidism occurs when the thyroid gland itself malfunctions and produces inadequate amounts of thyroid hormone.  There are a number of conditions that can cause it – iodine deficiency, Hashimoto’s disease, various types of thyroiditis, some treatments and medications, thyroid tumors etc.

Secondary or central hypothyroidism happens when the  pituitary gland doesn’t produce enough TSH (Thyroid Stimulating Hormone AKA thyrotropin) to stimulate the thyroid to produce thyroid hormones.  The cause may be something like a pituitary tumor.

Tertiary hypothyroidism is caused by malfunctions in the hypothalamus, the section of the brain that controls the endocrine system.   In this case, it doesn’t produce enough TRH (thyrotropin-releasing hormone), the hormone that instructs the pituitary gland to produce TSH, the hormone that in turn stimulates the thyroid to produce thyroid hormones.

There Are No Specific Foods For Hypothyroidism

There is little scientific evidence to prove that any specific diet plan or types of foods can cure hypothyroidism but you can certainly help your thyroid by avoiding some foods.  That’s good news for most people with hypothyroidism because it means that you can still eat a wide variety of foods.  It is the opinion of most experts that a healthy balanced diet coupled with necessary thyroid medication is the best treatment for hypothyroidism.

Good Foods For Hypothyroidism That Should Be In Your Diet

When considering what to eat if you have hypothyroidism there are a couple of things to bear in mind.  The first is that some nutrients are very important for maintaining a healthy thyroid.  These are:

  • Iodine
  • Selenium
  • Zinc

Therefore, ensuring you include foods that are rich in these nutrients is essential.  Most health professionals also recommend that you get these via your diet rather than by taking supplements.  If you do want to go down the supplements route, always speak to your doctor first.

Iodine Rich Foods For Hypothyroidism

We’ve already mentioned the importance of iodine to the thyroid.  This means it’s vital you get enough of it in your diet.  Iodine deficiency remains the leading cause of hypothyroidism in developing nations.  In most developed countries however the availability of something as simple as iodized salt along with iodine fortified staple foods has significantly reduced the incidence of iodine deficiency in those countries.  Even so, iodine deficiencies are creeping up again in many countries thanks to largely unwarranted health warnings about the dangers of excess salt.

Foods that are good sources of iodine include:

  • Iodized Salt
  • Seaweed or kelp – this is very high in iodine so exercise caution if using it because excess may damage the thyroid
  • Seafood – notably cod, tuna and shrimp.
  • Dairy products
  • Eggs
  • Prunes

Interesting Questions about Thyroid:

Pregnancy & Thyroid Disease

Why are women more likely to get thyroid disease?

In general, women are much more likely than men to become hyperthyroid or hypothyroid and to get Hashimoto’s thyroiditis. The reason for this is uncertain.

Women are also more vulnerable to autoimmune diseases. Two of the most common thyroid diseases, Hashimoto’s thyroiditis and Graves’ disease, are caused by problems with the body’s immune system. Normally, the immune system defends the body against germs and viruses. In autoimmune diseases, the system attacks the body’s own tissues. Diseases of the immune system tend to run in families.

What about thyroid disease and pregnancy?

Hyperthyroidism or hypothyroidism can affect a woman’s ability to become pregnant. They may also cause a miscarriage if they are not quickly recognized and properly treated.

Women who become pregnant may not notice signs of thyroid disease because similar symptoms can occur in a normal pregnancy. For example, patients may feel warm, tired, nervous, or shaky. In addition, enlargement of the thyroid (goiter) commonly occurs during pregnancy.

A pregnant woman is treated differently than is a non-pregnant woman or a man. For example, radioactive materials commonly used in diagnosing and treating many thyroid diseases are never used in pregnant women. The timing of a biopsy or surgery for a thyroid nodule and the choice of drugs for hyperthyroidism may be different in a pregnant woman. These issues require careful consultation with your doctor.

What is postpartum thyroiditis?

Postpartum thyroiditis is a temporary form of thyroiditis. It occurs in 5%-9% of women soon after giving birth (postpartum period). The effects are usually mild. However, the disease may recur with future pregnancies.

The symptoms usually last for six to nine months. First, the damaged thyroid gland may release its stored thyroid hormones into the blood, causing hyperthyroidism. During this time, you can develop a goiter, have a fast heart rate, and feel warm or anxious. Then, a few months later, you will either return to normal or become hypothyroid. Hypothyroidism occurs because the thyroid has been damaged and its hormone reserves used up. If this happens, you may feel tired, weak, or cold. The hypothyroidism usually lasts a few months until the thyroid gland completely recovers. Occasionally, the hypothyroidism may be permanent.

How do doctors test for thyroid disease during pregnancy?

As with any disease, it is important that you watch for the early warning signs of thyroid disease. However, only your doctor can tell for sure whether or not you have the disease. Your doctor may examine:

  • your history and physical appearance
  • the amount of thyroid hormones, thyroid stimulating hormone (TSH), and thyroid antibodies in your blood.

How is thyroid disease treated during pregnancy?

Pregnancy places some limits on the treatments which you can receive, because your doctor must also look out for the safety of your child. A common treatment for hyperthyroidism is radioactive iodine, but it must be avoided by women who are pregnant or nursing a baby. Surgery to remove a goiter or cancer may also be delayed until after the pregnancy. However, needle aspiration biopsy of a thyroid nodule may be safely done during pregnancy.

Treatments which may be used for thyroid disease during pregnancy include:

Postpartum thyroiditis may or may not be treated during the hyperthyroid stage, depending upon its severity. If the patient later becomes hypothyroid, her doctor may prescribe thyroid hormone pills.

Anti-Thyroid Drugs

What do antithyroid drugs do?

Antithyroid drugs block pathways leading to thyroid hormone production.

Antithyroid drugs used in this country are Propylthiouracil (PTU) and Tapazole®. Some physicians will recommend antithyroid medication as a first line of treatment to see if the patient is one of the lucky 30% of patients who go into a remission after taking antithyroid medication for one to two years. (Patients are said to be in remission if their hyperthyroidism does not recur after discontinuing the antithyroid drugs.) If antithyroid drugs do not work for the patient, then physicians usually recommend radioactive iodine.

Antithyroid drugs are also used to treat very young children, older patients with heart conditions, and pregnant women. For severe or complicated cases of hyperthyroidism, especially in older patients, PTU or Tapazole® can be given for four to six weeks to bring the hyperthyroidism under better control prior to administering radioactive iodine treatment.

In cases when women are diagnosed with Graves’ disease while they are pregnant, PTU is prescribed. The smallest dose possible is given because the medication does cross over to the fetus. The mother should be checked every three to four weeks during the pregnancy so that the lowest possible dose can be given. Too much PTU can cause fetal goiter, hypothyroidism, and mental retardation.

® Tapozole is a registered trademark of Jones Medical Industries.

Are there any side effects?

Antithyroid drugs cause side effects in about 10% of patients. Reactions can include:

  • skin rash
  • swollen, stiff, painful joints
  • sore throat and fever
  • low white blood count, which can lead to serious infections
  • jaundice (yellow coloring of the skin) and, rarely, liver failure.

Most side effects clear up once the drugs are stopped. If you think you are having a reaction to anti-thyroid drugs, call your doctor immediately.

What can be expected with antithyroid drug treatment?

  • Several pills are taken from one to four times a day, every day for six to 24 months.
  • Some patients complain that the pills have an unpleasant smell and taste.
  • There is usually some symptom relief within one to two weeks. In some cases, it can take several months to relieve symptoms.
  • Antithyroid drugs have a relatively low success rate. While PTU or Tapazole® may correct the problem temporarily or for a few years, the chances of a permanent remission are about 30% once the drugs are stopped.
  • The likelihood of achieving a permanent remission is increased if the patient takes the medication for one to two years.
  • There are side effects in 10% of the people treated with Tapazole® or PTU. These are:
    • skin rash over most of the body swollen, stiff, painful joints
    • sore throat and fever — if this happens, the antithyroid drugs should be stopped immediately and the physician contacted
    • jaundice
    • liver damage, which is fatal in rare cases
  • Because antithyroid drugs pass into breast milk, only PTU in a dosage less than 200 mg a day is advised if the baby is not weaned.
  • Within 15 years, the thyroid gland may burn out, resulting in hypothyroidism, and the patient will need thyroid hormone replacement.
What About Women and Thyroid Disease?

Hyperthyroidism

  • means too much thyroid hormone
  • affects 2.5 million people in the United States
  • affects 2% of all women in the United States
  • affects women 5 to 10 times more than men
  • can cause infertility and miscarriage

Graves’ disease

Hypothyroidism

  • means too little thyroid hormone
  • affects 5 million Americans
  • affects women 10 times more than men
  • affects 1 out of every 4,000 infants born
  • can cause infertility and miscarriage

Hashimoto’s thyroiditis

Postpartum thyroiditis

  • occurs in 5% – 9% of women after giving birth
  • is usually temporary but can recur with future pregnancies

Thyroid nodules

  • affect 4% – 7% of the population
  • are benign 90% of the time
  • are less likely to be cancerous in women

*Autoimmune diseases run in families and are 5 times more common in women than men.

Have more questions? Need more answers? Check our Full Thyroid FAQ

Selenium Rich Foods For Hypothyroidism

Selenium deficiencies are a problem in some countries (China is a good example) and according to this report it could get worse as global warming affects our climate.  Therefore fruit and vegetables grown in selenium deficient soils in these countries may likewise be selenium deficient.  In addition to being the only organ that can absorb iodine, the thyroid also contains more selenium on a weight for weight basis than other organs.

Selenium has several roles in thyroid function.  First of all it’s involved in the process that converts T4 to T3, the more metabolically active thyroid hormone which the body requires.  Not having enough selenium inhibits this process and reduces the amount of thyroid hormone available to the body.  Secondly, selenium is an antioxidant.  The thyroid produces hydrogen peroxide as part of the process of manufacturing thyroid hormones, a process that also produces free radicals.  Selenium limits the amount of oxidative damage these free radicals do to the thyroid.

Selenium is found in foods like:

  • Brazil nuts (one of the densest sources of selenium)
  • Tuna, sardines, shellfish
  • Lean meats
  • Eggs
  • Legumes ie beans
  • Soy products

Zinc Rich Foods For Hypothyroidism

Zinc is another of those essential minerals we require for multiple purposes throughout the body.  In the thyroid it helps selenium convert T4 to T3.  There is evidence to suggest that zinc may also be needed to help regulate TSH.  Fortunately zinc deficiencies are uncommon in developed countries but if you have hypothyroidism it’s important to ensure you’re getting enough of it.

Zinc is found in foods like:

  • Oysters – the highest natural source of zinc
  • Crab, lobster and some other seafoods
  • Red and white meat
  • Legumes
  • Nuts
  • Whole grains
  • Dairy

Other Important Vitamins And Minerals

You also need to ensure you’re getting enough of the following:

  • Iron
  • Copper
  • Vitamin E
  • Vitamin D
  • Vitamin B12

What Are Not Good Foods For Hypothyroidism?

As mentioned above there are some types of foods and medications that should be avoided if you have hypothyroidism as they can interfere with absorption of thyroxin.  These include:

Goitrogens – so called because of their known ability to potentially cause goiter:

  • soy products
  • cruciferous vegetables like kale, cabbage, spinach, broccoli
  • fruits like pears, strawberries, peaches etc
  • starchy fruits and vegetables
  • some types of nuts and seeds like peanuts, pine nuts, millet

If you do eat these they should be cooked to reduce the goitrogens and only eaten in moderation.

Gluten products

  • bread
  • cereals
  • pasta
  • anything made from wheat and other flours that contain gluten

Other Things To Avoid If You Have Hypothyroidism

Some drinks can also irritate your thyroid notably coffee, green tea and alcohol.  Highly processed foods are another one to take off your list because they will exacerbate your weight gain.

What is necessary is a healthy life style with a balanced nutritious diet that is rich in vitamins and minerals.   It should compromise vegetables, whole-grain foods, fruits, lean-meat and healthy fats in moderate quantities.

Donna Morgan

Donna Morgan

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