HDiet plays an important role in the maintenance of thyroid function. Hypothyroid patients need to pay attention to what they consume because there are foods that have been proven to hinder thyroid function such as estrogenic and goitrous, as well as foods that improve function such as selenium-rich. In addition, patients with hypothyroidism are at risk for weight gain so making proper food choices is essential for maintaining a healthy BMI. Nutritive deficiencies such as low B-12 are common among patients in this group and can lead to co-morbid conditions such as anemia. Foods high in nutrients should be chosen over empty calorie foods.

Foods to enjoy 

Proteins: It is recommended that hypothyroid patients have one serving of protein at every meal. Lean meats such as chicken, turkey, lamb, pork, fish, as well as beans, nuts, and cheese are all good sources of protein.

Vegetables: 5-6 serving per day. Using the plate method, vegetables should make up half your plate. Make sure if you are eating goitrogenic vegetables like kale and broccoli that you are cooking them.

High fiber foods: Hypothyroid patients often suffer from constipation. High-fiber foods not only keep patients regular but also keep them full which promotes weight loss.

Iodine rich foods: Studies are contradictory when it comes to iodine. Too little and you can get hypothyroidism, too much and you can inhibit thyroid hormone production. Source of iodine include table salt, seaweed, medications, nutritional supplements, and drinking water.

Daily allowance iodide is 150 mcg per day. Toxicity may develop when intake is over 900 mcg per day. Iodine deficiency leads to developmental delays, mental retardation, goiter, and other health problems. Iodine supplementation, such as universal salt iodization (USI) has been successful in controlling iodine deficiency disorders (IDD).

Excess consumption of iodine can also lead to hypothyroid. A number of epidemiological studies have acknowledged the association of excess iodine with the development of thyroid autoantibodies, hypothyroidism, hyperthyroidism, cancers, and autoimmune thyroid disease.

Foods that have Selenium: Selenium is an essential element required for the normal functioning of the thyroid gland and thus its beneficial effects in hypothyroidism have been suggested. However, more studies are needed to further evaluate these findings.

Sources of selenium; Brazil nuts, sunflower seeds, fish, shellfish, beef, pork, chicken, eggs, grains. Daily allowance 50-55mcg per day. Toxicity may develop when intake is over 350-400 mcg per day.

Highly desirable micro-nutrients and their sources:

• Organ meats such as liver and kidney
• Egg yolks due to the amount of selenium
• Seaweeds because they contain iodine
• Shellfish because they contain iodine
• Fermented vegetables because they contain natural properties and probiotics that aid with digestion
• Bone broths for their gut healing properties and high nutrition values 

Foods to avoid or limit

Goitrogens: foods that block iodine uptake into the thyroid, which is needed to create thyroid hormone. In addition to blocking iodine, goitrogens can block the absorption of thyroid medications. Goitrogens also have the potential to enlarge the thyroid tissue and create a goiter.

• Raw kale, spinach, cabbage
• Raw cruciferous vegetables such as broccoli, brussel sprouts, bcauliflower, turnips, radish, etc
• Raw strawberries and peaches
• Soy and its derivatives

***Many of the foods on this list are rich in nutrients so avoiding them completely may not be beneficial. The vegetables and fruits in these groups when cooked are much less likely to cause harm because heat inactivates goitrogenic compounds.

Gluten: many patients with hypothyroidism have a gluten sensitivity or celiac disease. Gluten molecules mimic the antithyroid molecules and thus eating gluten can act as a trigger the attack of the thyroid by the immune system. Gluten can also irritate the lining of the intestines and lead to decreased absorption of thyroid medication and nutrients.

• Wheat, barley, oats, rye, farro, etc

Dairy products: like gluten, dairy molecules can trigger an attack on the thyroid leading to further damage to the tissue.

• Milk
• Cheese
• Yogurt

Artificial sweeteners: these sugar substitutes are linked to insulin resistance, weight gain, and even cancer.

• Splenda, aspartame, sweet and low, etc. Stevia is a somewhat healthier option as it is more natural, but still linked to weight gain and insulin resistance.

High-fat foods: patients with hypothyroid are at risk for high cholesterol and should limit foods with high fat and saturated fat content. Ideal is to stay under 12g of saturated fat per day. 

• Red meat, processed foods, fried food, butter

High sugar foods:

• Pastries, candies, desserts, ice cream

Interactions of medication and food:

• Its best to take when your medication when you first wake up with a large glass of water. Take thyroid medication 1 hour before meals and drinks or 2 hours after the last meal or beverage.
• The milk in coffee will inhibit the absorption of thyroid medication if consumed together 
• Eggs contain high amounts of iron while will also block absorption if consumed together 
• Citrus fruits and juices decrease absorption if consumed together