You are what you eat. We’ve all heard that phrase. Well, I could be in trouble then, based on that picture. That was a pumpkin spice waffle, complete with all the things I’m pretty sure I’m not supposed to eat. My husband and I shared it on Halloween, and I’m not going to lie – it was delicious – truly amazing. As much as I try to eat healthy, I give in from time to time.
I’ve been asked a lot lately what foods I eat to help boost thyroid function. I’ve also been asked whether I alter my diet at all or my children’s diet. The answer is yes (pumpkin spice waffle splurges aside). The biggest change that I made was to follow the directions in the prescribing information to maximize absorption of the thyroid hormone replacement (Levothyroxine in my case). The prescribing information has a lot of information about the drug and how it should be administered. To read more about the fine print, check out my blog post:
The prescribing information for thyroid medication tells us that we need to pay attention to what and when we eat:
1) T4 (like Levothyroxine) is best absorbed on an empty stomach. Take your medicine 30-60 minutes prior to eating breakfast.
2) Wait at least 4 hours after taking your thyroid medication before taking calcium or iron supplements or antacids, as they can interfere with the absorption of your medicine.
3) Limit or avoid soy as it can interfere with the absorption of the medication.
Soy seems to be a bit of a hot topic lately. Should thyroid patients limit or avoid soy? To me, the answer seems to be yes. The prescribing information for the medication advises that soy can interfere with the absorption of the medication. That includes infant formula containing soy. If it’s mentioned in the prescribing information, it’s worth paying attention to, because from what I have learned, drug manufacturers don’t put anything like that in the prescribing information voluntarily. My endocrinologist said it’s not as crucial for adults, and that being consistent and letting your doctor know about major dietary changes is key. Occasionally having soy is not going to have a major effect, but a diet change that includes significantly more soy could have an adverse effect. For example, she said that if I decided I just had to switch to soy milk and started drinking it every day for breakfast, she would want to closely monitor me for a while to be sure that the increased soy intake didn’t necessitate an increase in my dose.
When discussing infant formula, our doctors have been more strict and have advised against using soy formula. The rationale is that infants are at a much more crucial stage for mental and physical development and having their medication absorbed without any hurdles is important. In a recent article on World Health Foods, they came to the same conclusion. The article states that “…despite the fact that biochemical changes can be triggered in the thyroid by soy isoflavones, the health consequences for adults do not appear to be automatic or guaranteed, and seem to be contingent on the involvement of additional factors like iodine deficiencies, selenium deficiency or other health problems.” (See http://www.whfoods.com/genpage.php?tname=george&dbid=250 ) The article does carve out an exception, though, for soy-based infant formulas stating: “several studies on infant feeding show greater rates of autoimmune thyroid problems in infants who are exclusively fed soy formula”. The article goes on to say: “Part of our concern in this area involves the use of soy protein isolate (SPI) in most infant soy formulas. SPI is a highly process form of soybean, and it is likely to expose an infant’s digestive tract to unexpected proteins and protein components.” The article recommends that if you are considering exclusive soy-based feeding for an infant, you should discuss it with your physician. I’d add that you should discuss it with your pediatric endocrinologist.
For us, it isn’t worth the chance. If there are things we can do to minimize interference with the absorption of the medication, particularly for the kids, then we do them (at least as much as possible/practical). I breastfed my children, but occasionally had to supplement with formula. When we used formula, we chose formula without soy. We are vegetarian, so we do have soy in our diets, but we keep it at a minimum. We also give our kids their vitamins at dinner instead of at breakfast – again to minimize interference with their thyroid medication.
Now on to another hot topic: goiterogenic foods. Do I avoid them? Not really. Should I? I’m not convinced that I should.
What is a goiterogenic food? Well, a goiter itself is an enlarged thyroid gland. Something that is goiterogenic is something that causes or contributes to goiter. Goiterogenic foods themselves don’t actually cause goiter but in some people can contribute to issues if consumed in large quantities by someone who already has an existing thyroid condition. I found an article on World Health Foods (“WHF”) website that I feel summarizes this issue very well. In this article, WHF points out that broccoli, cabbage, kale and cauliflower all fall into this category of being called goiterogenic, but that from a practical standpoint, broccoli would only be “bad” for your thyroid if you ate large amounts of raw broccoli and had a history of thyroid problems. (See Up to Date Look at Goiterogenic Foods http://www.whfoods.com/genpage.php?tname=george&dbid=250 ). There is not much research on this, but the research done seems to indicate that cooking inactivates the compounds that make these vegetables troublesome. At my house, we eat broccoli and kale on a regular basis, but they are usually cooked and we don’t consume large quantities (raw or cooked).
Debbie Whittaker, the Herb Gourmet, wrote for Mother Earth Living that other keys to improved thyroid function are:
1) Use iodized salt.
2) Cook goiterogenic foods
3) Eat tyrosine-rich foods (fish, dairy, oats, sesame seeds, bananas, avacados, and almonds).
4) Use cold-pressed olive oil and nuts for vitamin E and nuts for some B vitamins
5) Consider including shellfish, dairy, eggs or meat for zinc and vitamin B12.
6) Eat nuts, whole grains, and whole-wheat breads for naturally occurring B vitamins and zinc
7) Garnish cooked foods with raw culinary herbs such as parsley for Vitamin C.
8) Include vegetables rich in beta-carotene, such as winter squash, in your diet.
9) Consider switching to purified water for both cooking and drinking to reduce fluoride consumption – fluoride has been implicated by some sources in reduced thyroid function. Black and green teas also contain fluoride. (Read it Here)
You will see many of these same recommendations in most articles on thyroid function and foods. We follow many of these recommendations.
Other articles on thyroid function boosting foods:
Okay, so now for the last hot topic: gluten. I have been repeatedly asked about whether we eliminate gluten or casein. The answer is no, we are not entirely gluten free. However, our diet already contains many foods that are naturally gluten free, like fish, fruits, vegetables, eggs, dairy, brown rice, flaxseed, and quinoa. Thyroid patients need foods high in fiber, iron, B vitamins and other minerals, which gluten free diets can sometimes lack. If you choose to go gluten free, consult a nutritionist who can help you find other ways of finding the fiber and vitamins/minerals you may be missing. If you suspect you have Celiac’s Disease or gluten intolerance, discuss that with your doctor and ask to be tested.
Here are some links to articles on going gluten free:
Those are my thoughts on thyroid issues and diet, and a general explanation of what we do at our house. In general, we do well, I think, but we aren’t perfect. We are open to healthier options when they seem reasonable for our family. We have incorporated many of these suggestions into our diets, but honestly most of these tips would benefit most people. We eat fish and eggs, but no other meats. We try to create balanced meals with fresh vegetables and herbs whenever possible. We take vitamins and supplements. However, we have not eliminated fluoridated water from our diets, nor have we stopped drinking black or green tea. We have not totally eliminated gluten from our diets, yet much of our diet is naturally gluten free. We have eliminated artificial food dyes (as much as possible) because we feel they are unnecessary and are worried about their impacts on our health and behavior (a decision for us that was totally unrelated to thyroid function). We also splurge on pumpkin spice waffles, cookies and other fun stuff from time to time. I guess you could call us moderates in the food world.
Foods and diets are intensely personal choices for you and for you family. I have been told I’m nuts for being vegetarian and for consuming dairy. You may be told you are nuts to do the opposite. No matter what choices you make, if you discuss them with family and friends, you are likely to get lots opinions (some that agree and probably many that disagree). To that, I say: read, research, and talk to doctors and nutritionists, then make the best decisions for you and your family. Remember that no food or diet is the magic pill. There is no magic fix for losing weight and there is no magic fix for treating thyroid disorders. Treating thyroid disorders involves a combination of finding the right medication (along with the right doctor prescribing them), the right exercise plan and the right foods and supplements for you. Finding those “rights” will involve plenty of trial and error, but I encourage you to try. You never know what may work for you.
By Blythe Clifford