It is doubtful that nutritional deficiencies are the sole cause of an underactive thyroid, but not having enough of these micronutrients and minerals can aggravate symptoms of low thyroid function. Increasing the intake of; vitamin D, iron, omega-3 fatty acids, selenium, zinc, copper, vitamin A, the B vitamins, and iodine can help in natural hypothyroid treatment.
Vitamin B12 and thiamine are important for neurologic function and hormonal balance. Research shows that supplementing with thiamine, also known as thiamin or Vitamin B1, can help combat symptoms of autoimmune disease, including chronic fatigue. In one clinical study, when patients with Hashimoto’s were given 600 milligrams per day of thiamine, the majority experienced complete regression of fatigue within a few hours or days.[6] Vitamin B12 is another important nutrient for fighting fatigue since it benefits the central nervous system in many important ways: maintaining the health of nerve cells (including neurotransmitters), protecting the covering of nerves called the cell’s myelin sheath, and turning nutrients from food into useable energy for the brain and body. Designs for Health B-Supreme has an array of B vitamins (including thiamine and Vitamin B12) and additional co-factors that help the body utilize the B vitamins.
A clinical trial investigating symptoms found that patients receiving l-thyroxine monotherapy, even with a normal TSH, displayed substantial impairment in psychological well-being compared with controls of similar age and sex (3). Because some hypothesized that this phenomenon came about only after adoption of l-thyroxine monotherapy, a study assessed combination therapy with l-thyroxine and l-triiodothyronine. Remarkably, the latter study showed that psychological measures improve in patients receiving combination therapy until serum TSH level is normal (6). In another study comparing l-thyroxine monotherapy versus desiccated thyroid, in which both groups had a normal TSH, many patients preferred desiccated thyroid and lost weight (60). Unfortunately, the solution to this complex problem is not as simple as reverting to combination therapy; the more than a dozen clinical trials on the subject have not shown benefit of superiority and preference for combination therapy, as previously reviewed (1, 3, 70).
“Excess iodine is generally well tolerated, but individuals with underlying thyroid disease or other risk factors may be susceptible to iodine-induced thyroid dysfunction following acute or chronic exposure. Sources of increased iodine exposure include the global public health efforts of iodine supplementation, the escalating use of iodinated contrast radiologic studies, amiodarone administration in vulnerable patients [amiodarone is a drug used to treat heart rhythm problems], excess seaweed consumption, and various miscellaneous sources.”  [Leung]

Constipation is a common symptom of hypothyroidism. Whole-grain foods such as cereal, bread, pasta, and rice are high in nutrients in addition to fiber, which can help with bowel regularity. However, fiber can interfere with synthetic thyroid hormones, cautions Turner. Some people with hypothyroidism choose to avoid whole-grains altogether, but if you do choose to eat them, "the recommendation is to take your thyroid medication several hours before or after eating foods rich in dietary fiber," she says.
Iodine intake often isn’t readily apparent on a dietary recall since the amount in foods is largely dependent on levels in the soil and added salt. However, Schneider says, “Clients taking iodine tablets are a red flag. Frequent intake of foods such as seaweed or an avoidance of all iodized salt may serve as signs that further exploration is needed.”
When it comes to thyroid medications, it’s important for RDs to know the medications can interact with common nutritional supplements. Calcium supplements have the potential to interfere with proper absorption of thyroid medications, so patients must consider the timing when taking both. Studies recommend spacing calcium supplements and thyroid medications by at least four hours.21 Coffee and fiber supplements lower the absorption of thyroid medication, so patients should take them one hour apart.22 Dietitians should confirm whether clients have received and are adhering to these guidelines for optimal health.
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.
You may have read that green, leafy veggies like kale, bok choy, broccoli, and Brussels sprouts can make hypothyroidism worse. But before you keep reading, ask yourself a question: Do you live in the United States? That’s key — because if you do, you likely don’t need to worry about these cancer-fighting veggies messing with your hypothyroidism management. (7)

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