Diet taboos for thyroiditis

There are no 100% universal absolute dietary taboos for thyroiditis. The core principle is to "adjust your diet by type and stage, and avoid foods that will aggravate your own inflammatory response or metabolic burden." Statements posted online such as "all avoid iodine and cannot eat cruciferous vegetables" are too one-sided and cannot be directly applied to everyone.

Let’s start with the most common question about iodine, which is also the most controversial point at present. I have met no less than ten patients in the outpatient clinic. As soon as they were diagnosed with thyroiditis, they immediately changed the iodized salt at home to non-iodized salt. They did not even dare to touch kelp, seaweed or even iodized soy sauce. As a result, their thyroid function was messed up. At present, there are indeed different schools of academic advice on iodine intake for different types of thyroiditis: For subacute thyroiditis induced by viral infection, because the course of the disease is mostly transient, there is no need to adjust iodine intake during the normal thyroid function stage. Only when short-term hyperthyroidism symptoms occur, it is enough to avoid high-iodine foods, and you can eat normally after the inflammation subsides. ； For Hashimoto's thyroiditis, which accounts for the highest proportion, the functional medicine school believes that excessive iodine will aggravate the thyroid autoimmune reaction. It is recommended that patients with significantly elevated TPOAb and TGAb control their daily iodine intake to 100-150 μg, and try not to eat foods with high iodine content such as kelp, nori, and wakame. ； The mainstream view of endocrinology departments in domestic tertiary hospitals is that as long as thyroid function is within the normal range, it is perfectly fine to consume iodized salt normally and occasionally eat seafood. Excessive avoidance of iodine will lead to insufficient thyroid hormone synthesis and induce hypothyroidism. Both views are supported by clinical data. There is no absolute right or wrong. You can choose based on your own antibody level, iodine intake in your living area and the advice of your attending doctor. There is really no need to go to extremes.

Let’s talk about the mythical “cruciferous vegetable death theory”. I don’t know when broccoli, cabbage, radish and other common vegetables have become “poison” for thyroid patients. Last year, I met an aunt who hadn’t eaten any cruciferous green leafy vegetables for half a year. As a result, she was deficient in several vitamins during the review, and her constipation became more and more serious. In fact, the premise of this statement is that "eating more than 2 pounds of raw food every day" will affect the iodine absorption efficiency of the thyroid gland. We usually eat a cooked meal and eat half a plate, which does not reach the disease-causing amount at all, so there is no need to eat it. On the contrary, the antioxidants in these vegetables can also help reduce inflammation, and eating them has only benefits.

There is also the "gluten taboo theory" that has become very popular in recent years. It is true that a small number of Hashimoto patients with celiac disease and gluten intolerance have significantly reduced antibody levels after quitting gluten, but these people account for less than 10% of all thyroiditis patients. If you have not been diagnosed with a clear gluten allergy, there is no need to spend a lot of money to buy gluten-free bread and gluten-free soy sauce. It is expensive and can easily lead to an unbalanced diet, which is not worth the gain.

There are several types of food. No matter what kind of thyroiditis you have or what stage you are in, it is recommended to eat less. This is not to say that eating one bite will cause trouble, but long-term consumption will indeed increase the burden of inflammation: such as milk tea and cakes with excessive added sugar, fried chicken and margarine desserts with high trans fatty acid content, and things that are so spicy that you can't sleep after eating them and your neck will feel swollen. Especially during the hyperthyroidism stage, the symptoms are characterized by panic, insomnia, and hypermetabolism. Exposure to these symptoms can easily aggravate the symptoms. I met a young man in the acute stage of subcutaneous thyroiditis before. He went to eat spicy hot pot just as he was about to turn around. That night, his neck hurt so much that he couldn't even sleep, so he went back to the hospital and was prescribed painkillers.

In fact, you really don’t need to treat thyroiditis as a big problem, and you don’t need to follow a list of taboos every day. I often tell patients that your body’s feelings are more accurate than anything else: if you feel uncomfortable, have a swollen neck, or feel flustered after eating something, then don’t eat it recently.； If you have no reaction after eating something, you should eat whatever you should. After all, a good mood and good nutrition are the keys to helping inflammation subside, and they are more effective than any taboos. If you are really unsure, ask your attending doctor during your next check-up, which is much more reliable than searching for messy information online for a long time.