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 most common thyroid condition is hypothyroidism, or underactive thyroid. In the United States, hypothyroidism usually is caused by an autoimmune response known as Hashimoto’s disease or autoimmune thyroiditis. As with all autoimmune diseases, the body mistakenly identifies its own tissues as an invader and attacks them until the organ is destroyed. This chronic attack eventually prevents the thyroid from releasing adequate levels of the hormones T3 and T4, which are necessary to keep the body functioning properly. The lack of these hormones can slow down metabolism and cause weight gain, fatigue, dry skin and hair, and difficulty concentrating (see table).2 Hashimoto’s affects approximately 5% of the US population, is seven times more prevalent in women than men, and generally occurs during middle age.3
Symptoms - Hypothyroidism doesn’t have any unique characteristic symptoms - all of its symptoms could potentially present as symptoms of a different illness. One way to differentiate whether your symptoms are a product of hypothyroidism is to consider whether you’ve always had the symptoms (in which case hypothyroidism in unlikely) or whether the symptom is a departure from the way you used to feel (which means hypothyroidism is more likely).
Iodine: Iodine is critical for thyroid hormone production in the body. A true iodine deficiency will cause hypothyroidism (43). In western culture we often see subclinical iodine deficiencies which contribute to hypothyroidism (44). I typically don’t recommend high doses of iodine as it could be problematic with individuals with Hashimoto’s – especially with TPO anti-bodies.
The foods listed above do not contain any thiocyanate when they are in their living, intact state, because thiocyanates do not form until the plant is cut, crushed, or chewed. For example, fresh broccoli contains a harmless substance called glucosinolate, which turns into a thiocyanate called sulforaphane when the vegetable is damaged (see my broccoli blogpost for more information).
Postpartum thyroiditis: Five percent to 10 percent of women develop mild to moderate hyperthyroidism within several months of giving birth. Hyperthyroidism in this condition usually lasts for approximately one to two months. It is often followed by several months of hypothyroidism, but most women will eventually recover normal thyroid function. In some cases, however, the thyroid gland does not heal, so the hypothyroidism becomes permanent and requires lifelong thyroid hormone replacement. This condition may occur again with subsequent pregnancies.
Thyroid scanning is used to determine how active the thyroid is in manufacturing thyroid hormone. This can determine whether inflammation of the thyroid gland (thyroiditis) is present. It can also detect the presence and degree of overactivity of the gland (hyperthyroidism) or, conversely, it can determine the presence and degree of underactivity of the gland (hypothyroidism).
Major diagnostic and therapeutic advancements in the early 20th century dramatically changed the prognosis of hypothyroidism from a highly morbid condition to one that could be successfully managed with safe, effective therapies. These advancements dictated treatment trends that have led to the adoption of l-thyroxine monotherapy, administered at doses to normalize serum thyroid-stimulating hormone (TSH), as the contemporary standard of care (Figure). Most patients do well with this approach, which both normalizes serum TSH levels and leads to symptomatic remission (1).
Hypothyroidism Medication: Conventional doctors almost always put their patients on either Synthroid® (a synthetic thyroid hormone pill that contains only T4; sometimes called Levothyroxine, Levothroid, Unithroid, and Tirosint) or Armour (Natural Desiccated Thyroid derived from the thyroid glands of pigs). Both are tablets that patients will have to take daily for the rest of their lives. In some cases, these medications might help, but there are all kinds of side effects and issues that arise. So I recommend two other medications over these two instead.
In effect, there is no single, specific diet or vitamin/mineral supplement that has been proven to eliminate thyroid disease, according to the National Center for Complementary and Alternative Medicine. If you would like more guidance on the right diet to meet your individual needs, you can consider working with a registered dietitian who has a specialty in thyroid health, or an integrative medicine physician.
Trials of the first pharmacologic strategies included intravenous or subcutaneous (12) or oral (15) administration of thyroid extract, in addition to “thyroid feeding,” the consumption of raw or cooked thyroid gland (16), with sustainable successes. Oral replacement strategies quickly won favor, although “alarming symptoms” associated with treatment were noted; however, the details were not fully described (17). Thyroid transplant may one day reemerge as a viable treatment option given that functional thyroid tissue can be generated from stem cells (18).
Soy? If you have hypothyroidism, yes. Eating too much soy causes problems only for those with hypothyroidism, which occurs when your thyroid gland does not make enough thyroid hormones, Dr. Nasr says. The main problem is that soy hinders absorption of the hormones such patients are taking. “Some studies show that if you eat a lot of soy, or drink a big glass of soy milk, within one hour of taking a thyroid hormone, it might affect absorption,” he says. “A lot of people depend on those hormones to achieve a steady state.
An article published in May 2017 in the journal Endocrine Connections noted that hypothyroidism and celiac disease are often present together, and while no research has demonstrated that a gluten-free diet can treat thyroid conditions, you may still want to talk to a doctor about whether it would be worth eliminating gluten, or getting tested for celiac disease.
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Please Note: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.
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