The Low-Iodine Diet
The typical amounts of stable iodine found in most diets can interfere with the use of radioactive iodine for the treatment of thyroid cancer.
For radioactive iodine to work, it’s important to starve the cancer cells of the relatively large quantities of nonradioactive iodine in your body so that the radioactive iodine is able to enter them. Your thyroid cancer cells can’t tell the difference between radioactive iodine and stable, nonradioactive iodine. Stable iodine enters your body through your diet. A lot of dietary iodine comes from iodized salt. Additional iodine enters your diet from ﬁ sh, seafood, kelp, dairy products, artiﬁcial red food dye, and multivitamins. If you follow a low-iodine diet prior to receiving radioactive iodine, your daily total iodine intake should be reduced from 500 mcg (the average daily intake) to less than 40 mcg, resulting in more than 12 times the amount of radioactivity being taken into each thyroid cancer cell than if you followed your usual diet. Thyroid cancer experts have noted over the years that patients on a low-iodine diet are frequently more responsive to scans (showing positive uptake) than those not on a low-iodine diet (often showing false negative uptake). Clearly, you don’t want to have a false negative cancer screening, which means your scan does not show cancer when it is actually there.
A Brief History of the Low-Iodine Diet
Thyroid cancer specialists were aware of the value of a low-iodine diet for many years, although many of them could not agree on the composition of the diet. This became easier after a group at the National Institutes of Health (NIH) in Bethesda, Maryland, proposed a simple diet that proved to be effective. See Appendix B for suggested reading and additional resources to help you follow a low-iodine diet.
Strict adherence to this diet will signiﬁcantly enhance the sensitivity of the radioactive iodine scans and the effectiveness of any RAI treatments. The following foods or ingredients must be avoided on a low-iodine diet:
- Iodized salt, sea salt (non-iodized salt may be used) • Dairy products (milk, cheese, cream, yogurt, ice cream, butter)
- Eggs (speciﬁcally egg yolks; egg whites may be used) • Seafood (both fresh and salt-water ﬁsh; shellﬁsh; seaweed; kelp)
- Foods that contain the additives carrageenan, agar-agar, algin, or alginates
- Cured and corned foods (ham, corned beef, sausage, luncheon meats, sauerkraut, pickles)
- Bread products that contain iodate dough conditioners (breads from small bakeries are sometimes safe; better to bake it yourself from scratch)
- Foods and medications that contain red food dyes (speciﬁcally, FD&C Red Dye #3; consult your physician about discontinuing or substituting for any red-colored medicines) • Chocolate (because of the milk content; dark or pareve chocolate is ﬁne)
- Soy products (soy sauce, soy milk, tofu, soy burgers, etc.) Additional Guidelines
- Avoid restaurant foods, since there’s no reliable way to determine what’s in your food.
- Use unsalted matzos (unleavened crackers made only of ﬂour and water) or unsalted tortillas instead of bread.
- Non-iodized salt may be used as desired.
- Read ingredient lists of prepared or packaged foods carefully.
- Do not take multivitamins, since most contain iodine.
- Use olive oil as a condiment or in cooking instead of butter or margarine; nondairy or pareve margarine may also be used.
- Prepare low-iodine meals in advance and freeze them for easy use later.
- Food prepared from any fresh meats, fresh poultry, fresh or frozen vegetables, and fresh fruits should be ﬁne for this diet, provided that you do not add any of the “to avoid” ingredients listed. The diet is easiest when food is prepared from basic ingredients.
Table of Contents
Why a Hypothyroid Diet & How Can a Hypothyroid Diet Help You?
Individuals who are dealing with hypothyroid symptoms can have a harder time with weight control and engaging in a regular exercise program can help with losing or maintaining the ideal weight.
Foods that are high in fiber will provide a more ‘fuller’ feeling and help with bowel function.
Consuming more water will also help, along with adding more vegetables to one’s diet. Getting more vegetables into one’s current diet that is of non starch form like green beans and asparagus are also highly recommended.
Studies have shown that certain foods can interfere with the absorption of thyroid medications and should be eaten only when thoroughly cooked and either before or after a three hour period after one has taken their thyroid medication. For example goitrogenic foods like broccoli, cabbage and cauliflower can still be eaten but cooking or steaming them will counteract the goitrogens.
Consuming foods that are high in antioxidants and Vitamin B can help with symptoms of hypothyroid. It has been universally agreed upon with health professionals that gluten can be an issue with individuals who have hypothyroid issues and many who have removed this from their diets have experienced a better lifestyle with fewer issues.
With the internet at our disposal it is easy get some research done on all the different types of foods and exercises that are vital to controlling this kind disease. It is always a good idea to keep informed about all the different ways that one can keep healthy while on this medication. There are also support groups for people that share the same kinds of issues that can be very helpful.
Some individuals find that talking to other individuals who share the same kind of issues helps with stress levels and also new ideas on how to handle these kinds of symptoms. From cooking recipes to how each individual has responded to their particular dosages can be shared and many times and can give insight as to how successful they become in dealing with these kinds of issues. As each individual will respond differently to the different types of thyroid controlling medications each will have their own interesting stories. In some cases it is very helpful to the newly diagnosed on what to expect and how to overcome these symptoms effectively. To date there is no cure for hypothyroid symptoms but studies have shown that we can control the issues with maintaining a positive attitude, getting plenty of rest and eating properly.
Most individuals are instructed to take their daily thyroid medication on an empty stomach and free of other medications an after eating. Vitamins that contain iron and calcium should be taken at least four hours after one has consumed their thyroid medication. Studies have shown that some individuals have a low Vitamin D count and will recommend a supplement that can be beneficial.
With some patients calcium is also prescribed as well.
Doctors also recommend that individuals take their medications during the same time everyday to reap the full benefits. Most will suggest that early morning would be the best time to consume their thyroid medicines and to put it in a place that they regularly visit from the moment they get up. We all get terribly busy and sometimes forget to take our normally scheduled medicines but in this case doubling up should not be the solution. One missed dosage will generally not affect the individual so taking it the next day would be recommended by most doctors.
Doctors have also recommended eating five to six smaller meals a day rather than the normal three square meals a day for those who suffer from hypothyroid issues. This method helps to provide the body with the ultimate levels of energy and helps regulates the thyroid gland. Professional weight loss experts also recommend this for their clients who don’t have thyroid issues and want to lose those extra pounds. Diets that are high in sugary substances should be adjusted if one wanted to concentrate on losing the extra weight. Fruits like apples or blueberries can help with satisfying sugary cravings. Fish, chicken and even lean red meats can be a great staple food along with lots of green vegetables.
Concentrating on fish like salmon can help and consuming those with the lesser amounts of mercury would also be beneficial. Going organic is one of the best choices along with farmed raised foods. Keeping in mind that organic food will spoil much quicker due to the absence of pesticides so eating these items within the three to five day period would be best. Adding beans and nuts for protein is also a great way to get in the much needed healthier types of snacking foods versus cakes and pastries which can weight one down and also most will suffer from the ‘sugar crash’.
Individuals who have these kinds of symptoms will need to stay on course with regular visits to an endocrinologist who can monitor and adjust the medication if needed. He may administer tests on a regular basis to determine the thyroglobulin levels. In most cases the dosage amount generally does not change too much as it is determined by one’s weight and height. This is a very treatable condition that does not have to interfere with everyday life if managed correctly. There are many individuals who have these kinds of issues that have a perfectly normal and successful life.
How to Modify the Diet to Treat Hypothyroidism
Today, the Western diet, also known as the American or “sweet-meat” diet, does not have a very good nutritional reputation. Critics say this dietary habit, which features excessive intakes of fatty and sugary refined foods, is linked to many serious health problems ranging from obesity to cancer (particularly cancer of the intestines). Research has produced plenty of evidence to substantiate these critics’ claims.
For people with hypothyroidism, the Western diet can be especially problematic. As they experience early symptoms of weight gain, consuming the Western diet rich in red meat, processed grains, sugar-sweetened drinks and fatty dairy products will only make this problem even worse. Compared to fully healthy people with a Western diet habit, hypothyroid patients are at even greater risk for unhealthy weight gain if they regularly consume, for example, the typical fatty and sugary fast food meal (hamburgers and soft drinks).
Many doctors who treat people with hypothyroidism strongly recommend that their patients, if they have a Western diet habit, should switch to regularly consuming foods much lower in fats, sugars, dairy and processed foods in general. Modifying dietary intake will, these doctors say, improve their hypothyroid patients’ general health and could, in some cases, also help the body heal.
With one potential exception, there is no known diet or food that will cure or lessen the effects of hypothyroidism. This one very specific food that could have a positive effect on hypothyroidism is iodine. Your thyroid gland does need a certain amount of iodine to do its job of manufacturing the hormones your body uses to regulate heartbeat, enable you to get a good night’s sleep and have a positive attitude, among other things. Not having enough iodine in your diet could start causing hypothyroid symptoms because your thyroid gland is not able to uptake enough iodine to do its job right. In that case, you could reduce or eliminate your hypothyroid symptoms by simply increasing your iodine intake.
Doctors recommend that you should be careful about ingesting any dietary supplements containing iodine. Of course, there are many benefits to maintaining optimum levels of iodine in the diet.
People take iodine supplements for many reasons from promoting thicker, more healthy hair growth to preventing cancer (iodine can actually help remove damaged cancer cells from the body), general toxic cleanup, and ramping up energy. Doctors also recommend that pregnant women should ensure they are getting enough iodine in their diet and take supplements if they are not. However, too much iodine in the diet could cause development of a hyperthyroid condition (the opposite of hypothyroidism). In that case the excessive iodine has the same effect as throwing gasoline on a fire, the thyroid will produce too many of its hormones and kick the body’s metabolic rate into overdrive.
The best way to promote healthy thyroid activity is to get regular checkups and let your doctor know if you are experiencing any unusual symptoms. They may be associated with a thyroid problem. Hypothyroidism may be characterized early on by such symptoms as feeling tired all the time, having a negative attitude or irregular bowel movements. The thyroid gland needs iodine to manufacture its hormones your body needs. Including foods that include iodine in your diet can help reduce or eliminate these symptoms.
Along with supplements that come in pill form, iodine is also present in significant amounts in such foods as iodized salt, fish, eggs, seafood, dairy products or vegetables that have been grown in soil containing iodine. Depending on his diagnosis your doctor may recommend eating more of these foods or taking iodine supplements.
Cases where simply increasing iodine intake and curing or eliminating major symptoms of hypothyroidism are relatively rare however, people with hyperthyroidism can reduce their symptoms and their long-term health by cutting down on the fat and sugar habit and switching to a more “holistic” diet containing more fresh fruits and vegetables.
There are, however, certain foods that people with or at risk for hypothyroidism should definitely avoid. This would be members of the goitrogen family of vegetables–broccoli, cauliflower, cabbage and kale–actually target and decrease the amount of hormones your thyroid gland is able to manufacture. This is, of course, the cause of all hypothyroid symptoms. But this could be a good thing–if you don’t like broccoli.
On the other hand, fish, chicken and turkey breast, low-fat yogurt, low-fat milk avocado, bananas, lima beans, pumpkin seeds, sesame seeds and lentils all are good for people with hypothyroidism.
All these foods contain tyrosine, the amino acid that works with iodine in the thyroid to produce hormones the body needs. Iodine is useless without Tyrosine.
People with hypothyroidism may take L-Tyrosine, which replaces the tyrosine their system may not be sufficiently supplying. Taking selenium supplements could also help the thyroid produce its hormones. But please note: the thyroid is an amazing gland which normally maintains an optimum balance of a very complicated mix of hormones–make sure you consult with your doctor before ingesting supplements.
If you weigh too much and don’t get enough exercise you thyroid function may get bogged down.
So get and stay in shape while eating healthy.
Hypothyroidism doesn’t happen overnight. Its symptoms may not be identified for months. People with hypothyroidism can reduce or eliminate their symptoms by talking to their doctors and working to improve their overall health over the long haul. Carefully and consistently modifying diet helps meet this challenge.