A complete list of dietary taboos for hypothyroidism

First, don’t eat large amounts of raw cruciferous vegetables for a long time； Second, don’t blindly supplement iodine or completely quit iodine. Adjust it according to your own type of hypothyroidism. ； Third, don’t eat processed foods high in oil, salt and fat for a long time. The rest of the so-called "no seafood, no soy products" and other rules are mostly one-size-fits-all, regardless of the situation, and there is no need to shackle yourself.

Last week, a 28-year-old Hashimoto girl with hypothyroidism came to me for consultation. She said that she had not touched broccoli or kelp for half a year, and even the salt at home was specially replaced with iodine-free. As a result, her TSH spiked to 12 during the retest, her hair loss was worse than before, and her whole body was swollen. To put it bluntly, I have fallen into the trap of "blind food taboos" and have not even understood the most basic dietary logic.

Let’s first talk about the most frequently asked question about cruciferous vegetables, which is also the most controversial point at present. The traditional clinical view is that the glucosinolates in the cruciferous family will decompose into thiocyanates, inhibit the thyroid's absorption of iodine, and long-term consumption may easily induce goiter, so patients are advised to avoid all foods. But now the latest nutritional research and clinical follow-up show that this inhibitory effect will only occur if you eat more than 2 pounds of raw cruciferous vegetables every day and your own iodine intake is insufficient. I have met a patient who ate raw cabbage every day in order to lose weight. He ate it for two months and went for a review. His thyroid was really swollen. Later he cooked the vegetables and ate them, and most of the glucosinolates were decomposed. Normally, he ate three or four times a week, half a catty each time. After three months, the swelling disappeared. Of course, some conservative doctors will advise Hashimoto patients to avoid exposure as much as possible, mainly because they are afraid that some patients with insufficient iodine intake will suffer even worse. Everyone should just follow the advice of their attending doctor. There is no need to argue about right and wrong.

When it comes to iodine intake, this is definitely the hardest hit area where patients with hypothyroidism are most likely to go to extremes. Seriously, stop listening to the nonsense that "you need to supplement iodine for hypothyroidism" or "you need to avoid iodine for hypothyroidism". They are completely different things. If your hypothyroidism is caused by iodine deficiency - for example, you live in an iodine-deficient area, you have had endemic goiter before, or you have transient hypothyroidism caused by iodine deficiency during pregnancy, you should not avoid iodine, but also supplement it appropriately. It is okay to eat iodized salt normally, and occasionally eat kelp and seaweed. On the contrary, iodine deficiency will make thyroid function worse and worse. However, if it is hypothyroidism induced by Hashimoto's thyroiditis, which accounts for more than 90% of hypothyroidism, then iodine must be restricted. It is not that you cannot touch it at all, but you should not eat high-iodine foods such as kelp, seaweed, and wakame. It is perfectly fine to eat iodized salt normally and occasionally eat some marine fish and shrimp. I met a retired aunt last year. I heard from my neighbor that Hashimoto should avoid iodine. After eating iodine-free salt for three years, her urine iodine was only 1/3 of the normal range. Her TSH soared to 27. Instead, she had to take extra iodine supplements to bring it back. There is also hypothyroidism after treating hyperthyroidism with iodine 131. As long as the urinary iodine level is within the normal range, just eat iodine normally. There is no need to deliberately supplement more or deliberately avoid dietary restrictions.

In addition to these two most controversial points, there is another category of dietary minefields that the industry has basically reached consensus on. The metabolic rate of patients with hypothyroidism is about 30% lower than that of ordinary people, and their ability to metabolize blood lipids and uric acid is poor. If they continue to eat braised pork, fried chicken, pickled vegetables every day, or often eat foods high in sugar, oil, and many additives such as prepared dishes, processed meats, and sweet drinks, they will not only be prone to obesity, but will also aggravate dyslipidemia. Over time, the risk of cardiovascular disease will be much higher than that of ordinary people. I have a 35-year-old male patient. After he was diagnosed with hypothyroidism, he still drank iced Coca-Cola from takeaways. Within two years, his blood lipids were so high that he needed to take medicine. Later, he adjusted his diet and the indicators slowly came down.

As for the myths spread on the Internet about not eating soy products, drinking milk, and eating eggs, they are really a bit outrageous. There are currently no studies proving that normal amounts of soy products and dairy products will affect thyroid function. Unless you are allergic to these foods, you can eat them normally. Some people say that you cannot eat seafood. In fact, except for kelp and seaweed, which are high in iodine, the iodine content of ordinary marine fish, shrimps and crabs is about the same as that of eggs, so there is no problem at all if you eat it normally.

In fact, I have come into contact with hundreds of patients with hypothyroidism. To be honest, the dietary control of this disease is really not that strict. Most people can basically control their thyroid function very well as long as they don't engage in extreme operations - either eating raw vegetables every day to lose weight, or completely avoiding iodine and even iodized salt, or eating haise, heavy oil and salt every day, eating a normal and balanced diet, being less anxious and staying up late, and taking Euthyrox on time and having regular reviews. There is really no need to list dozens of taboos for yourself, and you don’t dare to eat this or touch that. On the contrary, anxiety has a much greater impact on your nail function than eating two more bites of broccoli.