EPISODE 4
Hyperthyroid Diet Tips
There are so many different diets out there, and so it’s not surprising that many people with hyperthyroidism wonder which diet they should follow. While there is no perfect diet for everyone, there is no question that eating well is important for anyone looking to improve their health and achieve a state of remission.
During this episode you’ll learn:
- 3 types of diets those with hyperthyroidism should consider following
- How long should you follow these diets for
- What should you eat if you’re a vegan or vegetarian
- Other hyperthyroid tips
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Here is the transcript for this episode:
Welcome back to the Save My Thyroid podcast. This is Dr. Eric Osansky. In this episode, I am going to discuss some hyperthyroid diet tips. Of course, eating well is essential not only for all hyperthyroid conditions but pretty much any health condition. But when it comes to hyperthyroidism, eating well is important in order to improve your health.
In the case of Graves’ Disease, eating well can help you get into remission. With toxic multinodular goiter, inflammation, we all know it’s a hallmark of all chronic health conditions, not just hyperthyroidism. So you want to do everything you can to reduce inflammation in the body. Once again, eating an anti-inflammatory diet alone may not be enough to restore your health. But eating an anti-inflammatory diet is definitely an important piece of the puzzle. It definitely is important to eat a healthy anti-inflammatory diet in order to restore your health, even if doing this alone won’t necessarily… In some cases it will…changing one’s diet alone can have a dramatic improvement of one’s health and may even get the person in remission. But many times, it’s just a piece of the puzzle.
I’ll add that in some people, food can be a trigger. With Graves’ Disease, certain foods can be an autoimmune trigger such as gluten or dairy. But even if this isn’t the case, once again, you still want to eat a healthy, anti-inflammatory diet.
I need to remind everyone that there is no diet that fits everyone perfectly. Regardless of what type of hyperthyroid condition you have, I of course recommend to eat mostly whole foods, which includes plenty of fresh vegetables, preferably organic vegetables. You want to avoid refined foods and sugars. You want to avoid fast food as well as unhealthy oils, which are in the fast food. Avoid common allergens. I mentioned gluten and dairy. Corn and soy are others. This doesn’t mean you can never eat these foods again. While restoring your health, you definitely want to avoid all these allergens I just mentioned.
I also briefly mentioned with vegetables, you want to try to eat organic. Overall, you want to try to eat organic whenever possible. Try to avoid genetically modified foods. If you are eating organic, you will avoid GMOs.
As I mentioned, there is no single diet that fits everyone perfectly. What I will be doing here is discussing three specific diets to consider following if you have hyperthyroidism. Really, it will be four types of diets because I am going to mention a diet for those who are vegan or vegetarian.
Let’s start off with a Paleolithic (Paleo) diet. With a Paleo diet, you will be eating a whole foods diet. As far as what specifically you can eat, of course with just about any diet, you will eat plenty of vegetables and some fruit. There are some exceptions of course. Eggs, nuts, and seeds are allowed on a Paleo diet. If you are not vegan or vegetarian, meat and fish are permitted to eat. Healthy oils such as coconut oil, olive oil, and avocado oil. You do want to avoid common allergens like gluten, dairy, corn, and soy. On a Paleo diet, you want to avoid eating grains and legumes. They can be harsh on the gut, so they are excluded from a Paleo diet.
Next, let’s discuss a modified Paleo diet. With a modified Paleo diet you want to eat plenty of vegetables as well as some fruit, eggs, nuts, and seeds. If you are not a vegan or vegetarian you can eat meat and fish. Healthy oils such as coconut oil, olive oil, and avocado oil. With a modified Paleo diet, properly prepared legumes would be allowed, such as pressure-cooked beans. Also, a small amount of grains are permitted, such as rice or gluten-free grains. Examples include a half cup of rice or certified gluten free oats. Half a cup, twice per week. Quinoa is a pseudo-grain, but it’s probably okay as well to have if you’re following a modified Paleo diet. You still want to avoid common allergens such as gluten, dairy, corn, and soy.
Then there is the autoimmune paleo diet, or AIP diet. It’s the most restrictive diet of the three I’m discussing here. Plenty of vegetables. Some fruit. Meat and fish. Healthy oils. Avoiding the common allergens. Like Paleo, you want to avoid grains and legumes. Unlike Paleo, with AIP, you’re avoiding eggs, nuts, and seeds. You’re also avoiding the nightshades.
Some will say that even with regular Paleo, you want to avoid nightshades. Nightshades include tomatoes, eggplant, peppers, and white potatoes. The reason why you want to avoid these foods is because they have compounds that can cause inflammation and affect gut healing. Even egg whites have compounds that can affect gut healing. Nuts and seeds can also be a little bit harsher on the gut. Everybody’s different of course, so there are people who follow a Paleo diet and do perfectly fine. Some people eventually need to avoid nuts and seeds.
I’ll tell you a bit of a story. When I was dealing with Graves’ Disease, there was no AIP diet. So I wasn’t following an AIP diet. I was following more of a regular Paleo diet although I have never been a huge egg eater. Same with nightshades. I like white potatoes, but I was never big into tomatoes or eggplant. It was mostly closer to what AIP would have been back then if it existed. But I was still eating nuts and seeds. My health was improving, but on my adrenal saliva test there was a marker called secretory IgA, and it was depressed the first time. Then I ended up retesting, and it was still depressed. I didn’t know why. I decided to avoid nuts and seeds for a couple months, and then I retested secretory IgA. By the way, this marker relates to the gut, and upon retesting it improved. Would it have improved if I had continued eating nuts and seeds? I don’t know. But again, it is excluded from that autoimmune paleo diet.
To be fair and upfront, it’s not as if I properly prepared the nuts and seeds. I didn’t soak them and sprout them. That also might have made a difference if I had continued eating them. AIP for alot of people is a good starting point. Obviously, it is really strict, so some people will choose to follow the paleo diet or the modified paleo diet instead. If you are doing fine on a paleo or modified paleo diet, there is no reason to switch over to AIP. But if someone starts with one of those two and are not receiving optimal results, that is when they might want to consider following an AIP diet.
That is one of the advantages of following AIP initially. Let’s say a few months go by, and you are not improving symptom-wise, or you do some retesting and things aren’t improving. You probably can’t blame the lack of improvement on the diet. Of course there are always exceptions. Someone could have a sensitivity to broccoli or something like that, and that’s why some doctors will bring up food sensitivity testing. I’m not going to go into that here. Maybe in a future episode. But AIP, I realize it’s strict, but sometimes it’s a good idea to start with that. This way if after a few months, if someone is not improving, then you can’t blame it on the nightshades or the eggs or the nuts and seeds.
What should you eat if you are a vegan or vegetarian? I will mention that you don’t need to eat meat to restore your health. Many people who eat meat find an AIP diet to be very challenging. I’m sure you can imagine that this diet would be even more challenging for someone who doesn’t eat meat or fish. For vegans and vegetarians, I would recommend either a Paleo diet or a modified Paleo diet minus the meat or fish. A lot of vegans and vegetarians would probably prefer the modified Paleo diet, so they are able to eat a little bit of grains and the properly prepared legumes.
How long should you follow this diet for? I would say a minimum of 30 days. However, 90 days would be even better. You can go longer than 90 days if you’re thriving and not stressed out about the diet.
When it comes to reintroducing foods, you want to start with one food at a time. Reintroduce one food every three to four days. Let’s say you’re following AIP, and the first food you reintroduce is egg yolks; you would eat egg yolks every day for three or four days in a row. There are so many different variations. Some would say just eat the egg yolk for one day. Others will say to have a bite or two of the egg yolk initially, and then see how you respond. And if all goes well, eat more later in the day. Maybe in the next few days, don’t eat any egg yolk and see how you respond.
My approach is if you want to eat the egg yolk all three or four days, that’s fine. Obviously, if you eat it the first day and you have a reaction then I wouldn’t continue eating it. If you have any type of reaction, stop the food, wait for the symptoms to resolve, and then you would reintroduce the next food.
When it comes to reintroductions, Sarah Ballantyne, who has a website called PaleoMom.com and a few wonderful books, has different stages of reintroductions. It’s not perfect. There is no perfect method. That’s what she chooses. She bases it on reintroducing nutrient-dense foods first and those that are less allergenic initially. It’s a guideline to go by.
Some might wonder, can you eventually reintroduce gluten, dairy, soy, corn, those common allergens? It really depends on the person. There are some practitioners who say never to reintroduce those, especially if you have a condition such as Graves’ Disease or any other autoimmune condition. I’ll say I have been in remission since 2009 and I have not been 100% gluten-free and dairy-free. For the most part, I am, but there are times when I have fallen off the wagon.
It is playing with fire. If you reintroduce gluten and/or dairy or even some other allergens like corn, there is the possibility that you can become inflamed or even relapse. That is ultimately up to you. I did play with fire a little bit when I was first exposed to these allergens. Like I said, I don’t eat them regularly, but I am trying to be upfront by letting you know that I have not completely avoided these foods 100% since being in remission. Thankfully, I have still remained in remission.
I mentioned ideally 90 days, and you can go longer. If someone is following AIP, you can go longer than 90 days even though it’s not meant to be a long-term diet. For some people, Paleo or modified Paleo will be their long-term diet. There is nothing wrong if someone wants to eat paleo or modified paleo for the rest of their lives. I eat probably more of a modified paleo on a wellness basis, but probably closer to paleo because I don’t really eat legumes, and I’ll have grains a few times a month rather than a few times a week. I will eat eggs. Not a whole lot because I’m not a huge egg person. But my wife is a huge egg person, so sometimes she’ll make me an egg or two. I do eat nuts and seeds regularly. More nuts like almonds, pistachios, walnuts, pecans.
For those who have toxic multinodular goiter, what type of diet should you follow? Just keep in mind that this is typically caused by insulin resistance or problems with estrogen metabolism or sometimes both of these. With insulin resistance, you always want to follow a low-sugar, low-carbohydrate diet. This doesn’t mean you have to follow a ketogenic diet, but you want to minimize sugars and carbs. With insulin resistance, there is usually an inflammatory process. You would want to address this. Many times changing your diet alone often won’t resolve the insulin resistance state.
With estrogen metabolism, you want to do things to support phase two detoxification pathways. This includes methylation, sulfation, and glutathione. I won’t go into detail on these here. Eating plenty of cruciferous vegetables also can be beneficial. Some sources say don’t eat cruciferous vegetables because they inhibit thyroid function. Most people do fine with them, especially those with hyperthyroidism. They are very healthy, very nutrient-dense. I would encourage you to eat a good amount of those vegetables. That doesn’t mean you have to eat five cups of raw cruciferous vegetables per day. You could have some steamed broccoli or some raw cruciferous vegetables. Broccoli sprouts are also good for supporting estrogen metabolism.
Let’s briefly discuss a few other hyperthyroid diet tips. I mentioned earlier that you want to eat mostly organic. There is something called the dirty dozen and clean 15 lists from the Environmental Working Group. Visit their website, EWG.org. These lists are updated each year. With the dirty dozen list, this lists the top 12 fruits and vegetables with the greatest amount of pesticides. The clean 15 lists the top 15 fruits and vegetables with the least amount of pesticides. They are definitely not perfect lists. For example, strawberries have been on top of the dirty dozen list for the last few years, so I would avoid eating non-organic strawberries. Avocados have been toward the top of the clean 15. If you absolutely have to eat a non-organic avocado, it’s not as big of a deal. But if you are out and about eating at a restaurant, I would try to avoid foods that are on the dirty dozen list. If organic is not an option, try to eat foods on the clean 15 list.
I also mentioned you want to avoid eating genetically modified foods.
Also, there is a little bit of a debate when it comes to gluten versus glyphosate. Some will say the problem isn’t with gluten but with glyphosate. That is the active ingredient in the herbicide roundup. It is toxic. People might be reacting more to the glyphosate than the gluten. There are stories about people going to a different country and eating wheat and doing fine. When they eat wheat in the United States, they don’t do fine.
Another hyperthyroid tip is don’t eat a lot of sugar. This doesn’t just apply to hyperthyroidism, but in general.
Also, salt. I do recommend some sea salt, like Celtic sea salt. Most people, when they think of high salt intake, they think of things like high blood pressure. But there is some evidence that salt can also increase TH-17 cells, which are associated with autoimmunity. You do want to be cautious when eating salt and not load up on it, even sea salt. If you are going to have sea salt, maybe half a teaspoon, maybe up to a teaspoon per day. Everybody is different, too. Some people might do better with a lower amount, maybe a quarter to a half teaspoon of sea salt. I definitely wouldn’t flood your food with salt.
A question that sometimes comes up is whether people with hyperthyroidism should eat foods low in iodine. I would say to avoid foods really high in iodine such as seaweed, kelp, so the sea vegetables. Other foods such as seafood or eggs are good sources of iodine. I can’t say I tell people to avoid those foods. If someone is following AIP, they will be avoiding eggs, but it’s not because they are higher in iodine. When it comes to foods, I would say mainly the sea vegetables. But everybody is different. You could always experiment with avoiding other food sources of iodine and seeing if that makes a difference. If you are eating foods like fish and eggs, and you are not improving, although in the case of eggs, it might not be the iodine. It could be the compounds in egg whites. Also, people could have an egg allergy, so you need to consider that as well.
Just a final reminder that eating a healthy diet alone might not be enough to restore your health. But if you eat an inflammatory diet, you won’t receive optimal results.
With that being said, I’d like to give a few action steps to wrap up this episode. First of all, you want to eat whole, healthy foods with plenty of vegetables, which will help to increase the diversity of the gut microbiome. Choose one of the diets I discussed. I mentioned the Paleo diet, modified Paleo diet, and autoimmune Paleo diet. Follow this diet for at least 30-90 days. In the case of the Paleo diet or modified Paleo diet, you might decide to follow this type of diet permanently. After this period, begin reintroducing one food at a time.
That’s all I want to discuss with regards to hyperthyroid diet. I hope you learned a lot. I look forward to catching you in the next episode.