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What is the Best Diet for Hypothyroidism?

Foods to eat with hypothyroidism

With Andrew Cunningham MD and Nicole German Morgan RDN

Salmon over spinach and leeks

There’s no one ‘diet’ for hypothyroidism, and food certainly isn’t going to stop or cure the issue — but here’s what you should and shouldn’t be eating to feel your best and manage your symptoms, according to the latest research.

Our tiny but mighty thyroid gland is one of the body’s main powerhouses — and when it doesn’t function properly, we’re at risk for one of many thyroid disorders. These disorders can be frustrating, debilitating, and hard to manage — but you’re not alone in the battle, and it can be done. An estimated 20 million Americans live with a thyroid disorder (many of them unaware of it!). You or someone you love might be one of them. 

One of the most common thyroid issues? Hypothyroidism. It’s a condition that occurs when the body doesn’t make enough thyroid hormone — versus hyperthyroidism, in which your body makes too much thyroxine hormone. 

Thyroid hormones are all-important, playing a major hand in everything from cell repair and metabolism to regulating our energy levels and moods. Without these hormones, people with hypothyroidism end up dealing with a whole range of possibly risky symptoms and complications.

These include — but are definitely not limited to:

  • debilitating fatigue
  • heart issues
  • intolerance to cold
  • mood changes (like depression)
  • weight gain
  • constipation
  • dry skin
  • increasing LDL or ‘bad’ cholesterol
  • joint pain

Unfortunately, the list of side effects goes on. In serious cases, Myxedema coma may occur. This is a life-threatening situation in which severe hypothyroidism can lead to slowed mental function, hypothermia, and organ failure. 

The causes behind hypothyroidism are fairly varied. It could be caused by an autoimmune disease (such as Addison’s or rheumatoid arthritis), thyroid gland surgery, iodine intake issues, radiation, or Hashimoto’s thyroiditis, which is an autoimmune disease that causes inflammation of the thyroid gland — and one of the most common culprits behind hypothyroidism. The pituitary gland itself may cause issues as well. When it doesn’t release enough TSH, the thyroid can’t then make its hormones. 

While medication is necessary to manage healthy thyroid levels, there are also some lifestyle changes and things you can do to support healthy thyroid function — and to reduce some of the intensity of your symptoms. And it starts in your kitchen.

Eating the right foods will not only make you feel better and more energized (we’ll all take an energy boost, right?), they can help combat some of the extra weight gain that comes from a slowed-down metabolism. If you’re feeling cold all the time, it could be a sign that your metabolism has taken a dip (since it controls your body temperature). 

Minerals & nutrients for hypothyroidism

Nutrients play a big role in thyroid function. Remember how we mentioned iodine? There’s a lot of clinical research to support the link between iodine and thyroid function. According to one study, “chronic exposure to excess iodine from water or poorly monitored salt are risk factors for hypothyroidism.” Yep — too much iodine can be a real problem.

To make matters just a bit more complicated, a deficiency in iodine may also lead to thyroid issues, according to another study. This is why it’s so important that you talk to your doctor about testing your iodine levels — especially if you think you’re getting too much or too little of the stuff. If you’re getting too little, make sure you’re using iodized salt in your foods. Eating seafood (see below) can also help, as can iodine supplements. 

Don’t go overboard here, though, warns Nicole German Morgan, RDN, LD, CLT, founder of Your Thyroid Dietitian: “More iodine does not mean more thyroid hormone production when your body already has enough.”

So which other minerals should you be getting? Morgan recommends selenium (tuna, eggs, legumes) and zinc (oysters, chicken) which may support the conversion of T4 hormone to the active T3 hormone, as well as all of the B-vitamins, which “can support energy and the body's stress response, which is supportive for those with hypothyroidism.”

You’ll also want to get enough tyrosine (this can be found in simple cans of tuna), which is also associated with thyroid function. Morgan also recommends vitamin D, “which can support the immune system for those with an autoimmune thyroid condition, and support the production of many hormones in the body.” For all of the above, you can take supplements as well — just be sure to check with your healthcare provider first. 

Foods for hypothyroidism

There are plenty of foods that support healthy thyroid function. According to Sofia Norton, RD, Dietitian Expert and founder of Kiss My Keto, you’ll want to focus on filling your plate with plenty of plant-rich foods. Think leafy greens, whole grains, nuts, seed, and zinc-rich legumes like peas, lentils, chickpeas, and beans. “These foods contain amino acids like tyrosine, B-complex vitamins, minerals like selenium, and antioxidants — all of which support thyroid health,” Norton says.

If you like seafood, you’re in luck. Again, tuna can be exceptionally beneficial for those with a thyroid disorder. Explains Norton, “Tuna is rich in selenium, iodine, and tyrosine, all nutrients needed for the production of thyroid hormones. Selenium helps convert T4 into T3, but it also protects the thyroid gland from free radical damage since it is an antioxidant mineral. The thyroid needs both tyrosine and iodine to produce thyroid hormones.”

Grossed out by the thought of tuna? You’re still in luck. Morgan also recommends spinach and sweet potatoes to her patients with hypothyroidism. “Spinach is a great source of many vitamins and minerals, including iron and some B-vitamins. Sweet potatoes are an excellent source of vitamin A, which supports thyroid hormone. Sweet potatoes, although a carbohydrate source, absorb more slowly and do not raise blood sugar as much as other starchy foods like the grains or sweets categories.”

According to Dr. Andrew Cunningham, an integrative health MD, you’ll want to load up on fruits and vegetables, “as these are a great source of phytosterols to reduce cholesterol, polyphenols to reduce inflammation, and micronutrients for a healthy immune system.” Think blueberries, olive oil, nuts, green tea, cloves, and apples. 

Avoid Soy

There are also some foods you’d do well to eat less of — or chat with your doctor before adding to your plate. Plant estrogens, also known as phytoestrogens, are one one of them. The big one? Soy. “Research shows that plant estrogens may inhibit the activity of enzymes that help in the production of thyroid hormones. Researchers also believe that soy may block iodine uptake and interfere with the absorption of thyroid medication,” Norton says. Soy foods include tofu, soy milk, and soy sauce.

There’s also some controversy around goitrogens, which can inhibit the function of the thyroid gland. These include cruciferous vegetables such as bok choy, broccoli, brussels sprouts, cauliflower, collard greens, and fruits like peaches, pears, plums, raspberries, and strawberries. But aren’t fruits and veggies good for us? Yes, but in moderation when it comes to hypothyroid patients, says Dr. Cunningham.

“For those whose diets contain adequate iodine,” he says, goitrogens can be safely consumed — in reasonable amounts, especially when cooked. Try keeping these foods to one serving per day, says the Kresser Institute.  

Dr. Cunningham adds, “People with Hashimoto's, not unlike the general population, should limit added sugars and highly processed foods. These foods are typically high in saturated fats, which may increase your cholesterol and decrease the integrity of your gastrointestinal system. Those with Hashimoto's run a higher risk of developing diabetes, obesity, or heart diseases than those without a thyroid condition.”

He also notes that there is an association between celiac disease and Hashimoto's. “The research is inconclusive, but a gluten-free diet may benefit those with Hashimoto’s.”

So is there one kind of diet that works best for hypothyroid patients? Not exactly, unfortunately!

There is some evidence that plant-based diets are a smart choice for people with thyroid disorders. In fact, both vegetarian and vegan diets may be smart options, but more research is needed. According to one study, “Vegetarian diets were not associated with increased risk of hypothyroidism. Vegan diets, which may be expected to lack iodine due to complete exclusion of animal products, tended to be protective.” 

Because so many hypothyroid patients experience weight gain, you’ll want to eat a diet tailored to your specific needs. According to Dr. Cunningham, “As metabolic functions slow down, many people experience difficulty maintaining their average body weight, even if they keep the same healthy movement or eating habits as before their diagnosis. Eating a thyroid-friendly diet tailored to your specific needs may help minimize your symptoms and maintain a healthy weight.” 

You should be working with your doctor or a registered dietitian to determine what foods might work best for you — and then fill your plate with those. 

Oh, and some foods may contraindicate medications. If you take hormone replacement medication, like synthroid, Dr. Cunningham recommends you swallow the pills with just water. “Avoid grapefruit or its juice, coffee, and foods containing soy or cottonseed meal for at least four hours after you take your medication, as these foods can impact how your body absorbs the medication.” Walnuts or dietary fibers can also decrease the potency of your medication, he says.

Just make sure to clear any major dietary or supplemental changes with your doc. “There are foods that may lower the effective dosage of thyroid medication when eaten within four to five hours of taking thyroid medication. These foods are those that are high in fiber, high in calcium, or high in iron,” Morgan says. 

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Causes of Hypothyroidism