Diet taboos for children with hyperthyroidism

There are only three core dietary taboos for children with hyperthyroidism - strict avoidance of high-iodine foods during the uncontrolled period, prohibition of ingestion of stimulating drinks containing caffeine/taurine, and avoidance of large amounts of high-sugar and high-oil foods in a short period of time. The rest of the requirements spread online such as "no food" and "no cold food" have no clear evidence-based basis, and there is no need to blindly avoid foods to avoid affecting the normal growth and development of children.

Last week I just met a 10-year-old girl in the outpatient clinic. After taking medication for hyperthyroidism for 3 months, her thyroid function has basically returned to the normal range. However, she has lost 6 pounds than when she was diagnosed. She is always sleepy and unable to concentrate in class. After asking, I found out that her mother heard from relatives in her hometown that people with hyperthyroidism should avoid "eating food". She not only stopped eating milk and eggs, but also refused to touch beef and chicken. She only gave her vegetables and a small amount of lean pork to eat every day. The child was just growing up, so of course she couldn't bear this kind of food. I have encountered more than a dozen similar cases of excessive dietary taboos in the past six months. Many parents think about the dietary taboos for hyperthyroidism too complicated, and instead step into a trap.

Let’s first talk about the issue of iodine intake that everyone is most concerned about. The current consensus in the industry has indeed been adjusted. In the early years, many guidelines required patients with hyperthyroidism to eat a complete iodine-free diet. However, in recent years, the field of children's endocrinology has tended to focus on staged control: if the child is still in the unremitting period of hyperthyroidism, and the symptoms of palpitation, hand shaking, and excessive sweating are still obvious, and the thyroid function index has not dropped to normal, then high-iodine foods must be strictly avoided, and the family must first Switch to non-iodized salt. Ingredients such as kelp, seaweed, seaweed, and wakame that contain dozens or hundreds of times the iodine content of ordinary foods must not be touched. Especially seaweed slices that many children love to eat as snacks and seaweed mixed with rice. If you accidentally consume iodine intake more than ten times the normal requirement, it can easily aggravate thyrotoxicosis. However, whether or not to continue the strict iodine-free diet after thyroid function has stabilized for more than 3 months depends on the advice of different doctors: some doctors will recommend continuing an iodine-free diet to reduce the risk of recurrence, and many doctors will recommend switching to ordinary iodized salt. After all, during the growth and development of children, thyroid hormone synthesis itself also needs iodine. Long-term iodine deficiency may affect thyroid function. Low-iodine marine fish such as salmon and hairtail are perfectly fine to eat occasionally once or twice during the stable period, and there is no need to be overly anxious.

Let’s talk about pungent foods that are easily ignored by everyone. It really doesn’t mean that you can’t touch anything spicy. If your child is used to eating mildly spicy dishes at home, his thyroid function is stable, and he doesn’t feel flustered or irritable after eating, there is absolutely no need to stop eating. What you really need to keep an eye on are those drinks containing caffeine and taurine: milk tea with strong tea base, cola, energy drinks, sports drinks, and caffeinated sparkling water that is now popular on the Internet. These ingredients will directly aggravate sympathetic nerve excitement. Children with hyperthyroidism have fast heartbeats and poor sleep quality. Drinking these ingredients can easily induce acute symptoms of palpitation and hand tremors. Two months ago, I met a junior high school boy. He drank two bottles of energy drinks in order to run a relay in a sports meeting. His heartbeat reached 140 beats/min that day and he was sent to the emergency room by the teacher. A test of his thyroid function directly reversed the effect of more than half a year of treatment, which was not worth the loss.

There is another misunderstanding that many parents are prone to: they think that children with hyperthyroidism are thin and consume a lot of energy, so they arrange fried chicken, milk tea, and cream cakes to replenish their health. This is actually wrong. In the state of hyperthyroidism, the body's glucose metabolism is much faster than that of ordinary people. Eating too many high-sugar foods in a short period of time can easily cause blood sugar fluctuations, or even temporary abnormal glucose tolerance. Moreover, once the thyroid function is under control, the metabolic rate will suddenly slow down. Previously, I was used to eating a diet high in oil and sugar, and my weight can easily increase in a short period of time. I once had a 12-year-old patient who gained 15 pounds from eating in 3 months during the period of hyperthyroidism. After the thyroid function became normal, it took more than half a year to lose weight. He also felt low self-esteem because of being fat for a long time, which affected his mood and was not conducive to the stability of his condition.

Finally, let’s talk about the most frequently asked question about the “fat food” controversy. Many elderly people will say that beef, mutton, seafood, eggs, and milk are “fat foods” and eating them will aggravate hyperthyroidism. We have to look at this objectively: from the perspective of modern medicine, these foods are the core sources of high-quality protein. Children in the hyperthyroidism stage consume a lot of food, and they need to supplement more high-quality protein to sustain the consumption. Complete taboos will lead to malnutrition and affect height and development. Currently, there is no evidence-based research to prove that these foods will aggravate the condition of hyperthyroidism. However, in the field of traditional Chinese medicine, there is indeed a saying that "eat less warm and dry foods during the acute stage of hyperthyroidism." If the child is prone to getting angry, dry mouth, and dry stools, he can eat less warm and dry foods such as mutton and durian, but it is not completely untouchable.

To be honest, some parents usually ask me, "Every restaurant outside has iodized salt, so children can't go out to eat." I really don't need to be so nervous. Iodine intake depends on the long-term average level. Eating out for one or two meals occasionally will not have any impact at all. When buying snacks, just take a quick look at the ingredient list and avoid products with kelp powder, seaweed powder, and crushed seaweed. You don't have to make the whole family feel overwhelmed when eating. The children's psychological stress will be detrimental to endocrine stability.

In the final analysis, the dietary control of children with hyperthyroidism really does not need to be too strict. The core is to avoid those clearly harmful minefields and try to ensure balanced nutrition. The fastest way to recover is if the child can eat, sleep and be in a good mood. After all, the growth and development of the child should be the first priority compared to eating one more bite.