There are many natural treatments for hypothyroidism, but there isn’t much evidence that they work. 

INTRODUCTION TO HYPOTHYROIDISM & NATUROPATHIC DIETARY APPROACHES

Hypothyroidism is a disease where the thyroid slows the formation and release of thyroid hormone. What you eat can affect how well your thyroid works and your body uses the thyroid hormones. Naturopathic Doctors use dietary changes as a first-line therapy for supporting and managing thyroid health, following a holistic perspective on diet. When managing hypothyroidism, holistic dietary approaches typically center around anti-inflammatory, functional foods, and are tailored to each individual and their root cause of disease. The following areas are considered when it comes to this approach:

• Gut microbiome health
• Inflammation 
• Autoimmunity
• Food allergies and intolerances 
• Nutritional deficiencies

To help determine a plan of action for dietary modifications, Naturopathic Doctors (ND) use the following: 

• Probiotic and cultured foods that support gut health
• Elimination of refined sugar, refined carbohydrates, and processed foods to address inflammation 
• Testing for food allergies
• Testing for autoimmune markers
• Testing for vitamin and mineral deficiencies

   

It is well established that nutrition is a key component in whole-body wellness — where physical, mental/emotional, and spiritual health encompasses overall health and well-being. These components are integral to integrative wellness. If one piece is missing, you cannot have complete health. The foods we consume can make or break health outcomes, whether or not disease is present. When it comes to hypothyroidism, key nutrients include:

• Iodine
• Selenium
• Vitamin D
• Omega-3 fatty acids
• Vitamin B12
• Magnesium 
• Zinc 
• Probiotics
• Antioxidants 
• Dietary fiber

These nutrients can be obtained with a diet rich in seafood & shellfish, lean meats, eggs, fruits & vegetables. Sea vegetables, like seaweed, nori, and kelp are a great source of natural iodine. Nuts & seeds are a great source of minerals, healthy fats, selenium, magnesium, and omega-3 fatty acids. Brazil nuts are a great source of selenium. Foods like flax, whole grains, and legumes are chock full of healthy dietary fiber. Fermented foods, like sauerkraut and kimchi, are a good source of probiotics.  

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COMPREHENSIVE OVERVIEW OF FOODS TO AVOID

What we eat can be a powerful tool for the prevention and treatment of disease. When it comes to hypothyroidism, nutrient-dense, anti-inflammatory foods can make a huge difference in your ability to manage the disease and your symptoms. Similarly, certain foods may cause your hypothyroidism to become worse. These common foods should be avoided not just for thyroid disease, but for overall health and wellness: 

• Sugar and refined carbohydrates
• Fried, fatty foods
• Processed foods
• Alcohol
• Caffeine 

When it comes to the foods above, they may even be a contributing factor to disease. Research shows the effects of a “modern diet” high in the above foods can lead to many disruptions, which can lead to disease or make thyroid disease worse: 

• Imbalance blood sugar
• Promote inflammation 
• Disrupt gut microbiome
• Weaken the immune system
• Increased blood pressure

IN-DEPTH EXPLORATION OF LESSER-KNOWN DETRIMENTAL FOODS

One of the 6 principles of naturopathic medicine is to use natural substances to restore regenerate and stimulate self-healing, such as through the use of nutrition with whole, natural, organic foods. When you have thyroid disease, good quality, nutrient-dense foods are an integral part of a holistic treatment plan. However, when it comes to hypothyroidism, even some natural foods may need to be kept in moderation, or avoided altogether:

• • Cruciferous vegetables are considered goitrogens, which have been shown to interfere with the production of thyroid hormones by blocking the absorption of iodine, a crucial nutrient for thyroid health. Goitrogens can cause the thyroid gland to swell into a “goiter.”  This is more likely with raw cruciferous vegetables.

     

  • Gluten, a protein naturally found in grains can irritate the gut lining, which can cause nutrient absorption issues. Also, its structure closely resembles thyroid tissue. Studies show a link between gluten intolerance and autoimmune thyroid disease, Hashimoto’s. Eating gluten has been shown to trigger thyroid antibodies, causing the immune system to “attack” the thyroid as a result.  It is generally recommended that people with hypothyroidism, especially Hashimoto’s, follow a gluten-free diet.

     

  • Soy is considered a goitrogen, which is a type of food that can block iodine absorption and cause a goiter. 

INTERACTIONS BETWEEN FOOD, NUTRIENTS, & THYROID MEDICATION

As previously mentioned, the primary focus in naturopathic medicine is the restoration of health through the use of natural substances that minimize the burden on a body that is weakened by illness or disease. NDs are also adept at understanding interactions between herbs, medications, and nutrients. With this in mind, certain foods and medications should not be combined when being treated for hypothyroidism. A systematic review indicated the following foods and supplements can interfere with medications used to treat hypothyroidism: 

• Soy 
• Caffeine 
• Calcium, milk, and supplements
• Iron supplements  

If you are on conventional thyroid medications, such as Levothyroxine, be mindful of your timing between taking the medication and consuming the above. Herbal treatments may also be an effective option for thyroid treatment rather than conventional medications. Research shows that herbal medicine is effective at regulating thyroid hormones and preventing side effects. In particular, the following herbal treatments were shown to be effective in supporting hypothyroid hormone health and symptoms:

• Nigella sativa L (black seed oil) has powerful antioxidant properties. Studies show Nigella sativa improves thyroid hormone levels and relieves increased oxidative stress.

   

• Ashwagandha has been studied for its normalizing effects on thyroid hormones.

   

• Peppermint helped manage symptoms of fatigue and lethargy that come with hypothyroidism 

These herbs are just scratching the surface as to what can be done to support the thyroid. Optimizing diet should always be the number one priority and then working with a Naturopathic Doctor to determine the root cause of your hypothyroidism and specific recommendations for your unique case.

Everyone is different, and foods that work for one person, may not be right for another. Having someone to guide you will help you to determine if there are foods you should avoid, or to find out if there are alternative or supportive treatments for your specific need and current state of health.

Another thing to be mindful of with thyroid medication is consistency: Make sure you are taking your thyroid medication daily, around the same time, and away from food and any of the items listed above.

We had a patient who took their medication right before eating breakfast every day, unbeknownst to his medical doctor. He would eat cereal with milk. His conventional doctor kept increasing his dose because they weren’t seeing the effect they desired in his TSH lab value. Then he started working with Naturally Sue Wellness and stopped eating dairy and therefore was not consuming morning cereal. We also counseled him on when to take his medication so it wouldn’t be hindered by absorption issues. We told him which symptoms to look for in case his hormones were too high. 

Sure enough, he started getting palpitations and we tested his TSH and it was low, meaning he was leaning towards an overactive thyroid.  He was being overmedicated due to his food interaction and timing.  We had him go back to his doctor and lower his dose and he was perfectly fine at a lower dose.

This shows how patient education and dietary information can make a real impact on outcomes. 

IODINE: A NATUROPATHIC BALANCING ACT

Iodine is one of the main nutrients needed for proper thyroid hormone production. Iodine is considered a building block for thyroid hormones, along with the amino acid tyrosine. Studies show that iodine deficiency causes hypothyroidism. Without iodine, T3 (triiodothyronine) and T4 (thyroxine) thyroid hormones cannot be produced, which are required for the entire body’s metabolic processes. If those hormones are not produced because of a lack of iodine, metabolism will be negatively impacted, and in turn, your overall health and well-being.

Naturopathic practitioners are uniquely positioned to utilize diet and alternative treatments to help heal from disease. When your iodine status is taken into consideration, your ND can help make great strides in your hypothyroidism treatment. 

Getting the right amount of iodine can be a balancing act. While iodine is crucial for optimal thyroid hormone function, too much of it can lead to even worse health issues. If you and your ND determine iodine supplementation would work well for your condition, they may recommend more holistic ways to get what you need. Below are some natural ways to improve your iodine levels, should you need to:

• Eat a balanced, nutrient-rich diet. Support thyroid health with the right amount of key nutrients by eating a balanced, nutrient-dense diet, organic diet.
  
  
• Increase your intake of iodine-rich foods, such as: 
  • Seafood
  • Meat & Poultry (including liver)
  • Edible seaweed (nori, kelp, dulse, algae, spirulina, chlorella)
  • Eggs
  • Sea salt or Iodized salt
  • Prunes
    
    
• Avoid refined sugar and carbohydrates, processed foods, fried & fatty foods, and inflammatory foods. These foods will destroy your gut lining and disrupt the balance of healthy gut microbes.
  
  
• Replenish and restore your gut microbes with beneficial bacteria through the use of probiotics. 
  
  
• Ensure selenium levels are adequate. Selenium is required for iodine to do its job in thyroid health. Studies show selenium also prevents iodine from becoming too toxic.  

THE NATUROPATHIC VIEW ON ALCOHOL, CAFFEINE, & THYROID HEALTH

A naturopathic approach to health takes the whole person into account, as well as how all systems of the body are interconnected to create a patient-centered approach to care. When it comes to substances like caffeine and alcohol, NDs take into account how each individual’s body may use, respond, and metabolize these substances. Everyone is different in how they may respond based on physiology, the presence of disease, family history, emotional health, and more. 

Other factors to consider include one’s gut health, liver health, hormone health, and lifestyle, such as nutrition, exercise, sleep, and stress management. Based on all of these factors, NDs will tailor recommendations for the consumption of caffeine and alcohol accordingly. 

When someone has a disease, like hypothyroidism, many of the body systems are already compromised since the thyroid is responsible for metabolism. Both caffeine and alcohol add fuel to the fire and should be moderated (this is the case even in someone without hypothyroidism). Both caffeine and alcohol negatively affect your health in the following ways:

• Rob the body of essential nutrients
• Compromise the gut microbiome by irritating the gut lining, but also feeding the bad bacteria
• Cause blood sugar imbalances, leading to cravings and weight gain
• Disrupt hormone function
• Wreck your sleep
• Inhibit the effectiveness of treatments and medications for thyroid. 

If you are going to imbibe caffeine and alcohol, below are a few things you can consider with both substances. 

CAFFEINE

You can reduce your toxic load from caffeine by ditching coffee and energy drinks and going for an alternative instead:

• Matcha Tea is a finely ground powdered form of green tea which is packed full of antioxidants and nutrients. While it does have some caffeine, it also contains an amino acid called L-theanine, which is beneficial for reducing anxiety and stress and promotes relaxation. It effectively cancels out the negative side effects of caffeine. The coupling of l-theanine and caffeine has been known to improve focus and attention. 
  
  
• Turmeric Latte, also called, “golden milk” is a combination of turmeric, ginger, cinnamon, cardamom, and vanilla in a tea. It has powerful antioxidant and anti-inflammatory properties. 
  
  
• Chicory Coffee, is made with ground chicory root and has a similar look, feel, and smell to coffee without the negative effects. It is caffeine-free, and an excellent source of fiber, which may help support digestion by acting as a prebiotic for healthy gut flora. It also can help keep blood sugar in balance, reducing cravings and appetite that may lead to weight gain. 
  
  
• Mushroom tea or coffee, and medicinal mushrooms such as Chaga, reishi, lion’s mane, and cordyceps have become popular for their positive effects on energy, cognition, focus, and attention. These mushrooms are highly anti-inflammatory as well. 

DEEP DIVE INTO GOITROGENS & THYROID HEALTH

Goitrogens are chemicals that naturally occur in certain plants and interfere with the production of thyroid hormones by inhibiting the uptake of iodine. Over time, if you have a thyroid problem, goitrogens can cause a big enough iodine deficiency and hormone disruption to cause a goiter. A goiter is a swelling of the thyroid gland, which is where the term goitrogen comes from. According to research, the thyroid may become enlarged when the thyroid gland has difficulty making thyroid hormones and overcompensates for the lack of hormones. 

Goitrins are released from certain produce when they are eaten raw. NIH has classified the following foods as goitrogenic:  

• Bok choy
• Broccoli
• Brussels sprouts 
• Cabbage 
• Cassava root
• Cauliflower
• Collard greens 
• Kale 
• Kohlrabi 
• Lima beans
• Rapeseed
• Sorghum
• Sweet potato
• Turnips

Flavonoids typically have potent antioxidant benefits. However, research shows that flavonoids may also convert to goitrogens during the digestive process and could harm thyroid health. Foods that contain flavonoids include:

• Fruits, like berries, apples, and cherries
• Onions
• Soy, like edamame, tofu, soy milk and soy isolates
• Teas
• Red wine

This does not mean that someone with a thyroid condition who has fruit, berries, apples, and teas for example is not able to support and heal their thyroid. The above information is for educational purposes and this is where the help of your naturopathic doctor would come in to decipher the correct plan for you.

As Naturopathic Doctors, we would more so look at the wine and large consumption of soy isolates as culprits that could affect their healing, than fruit and onions. Perhaps if a patient were consuming exorbitant amounts of each of all of these, that could become problematic. 

If you have hypothyroidism, there are ways to prepare and consume these foods to minimize their goitrogenic effects and benefit from the vitamins and nutrients available in these foods:

• Choose organic and naturally grown produce to avoid pesticides that contribute to goitrogenic properties. 
  
  
• Eat in moderation and avoid consuming large quantities. 
  
  
• Cook your goitrogenic foods. Research shows that steaming, roasting, sauteing, grilling, or fermenting will reduce the levels of goitrogens. 
  
  
• Ensure adequate iodine and selenium levels. Iodine deficiency is known to be a cause of thyroid issues. Selenium is necessary for iodine to synthesize thyroid hormones. 

Most goitrogenic foods offer a lot of nutrient benefits. If you have hypothyroidism, it may make sense to eat these foods in moderation. When you do choose goitrogenic foods, choose the best quality, organic foods, and cook them. If you have concerns about whether these foods are right for you, your naturopath is trained in clinical nutrition and will be able to help you come up with a personalized plan that covers your needs.

FATS, OILS, & THEIR NATUROPATHIC IMPLICATIONS FOR HYPOTHYROIDISM

Healthy fats are essential for proper cell health, for satiety and blood sugar stability, mood stability, for brain and heart health, and to keep inflammation at bay. But getting those fats from the right sources is key. NIH research shows that diets high in oils, nuts, seeds, seafood, vegetables, and low-fat protein tend to protect against hypothyroidism due to their antioxidant and anti-inflammatory properties, and can lessen the risk of nutrient deficiencies.  

• Omega-3 fatty acids from wild-caught oily fish, 
• flaxseeds and chia seeds
• Nuts & seeds
• Avocado
• Olive Oil
• Coconut oil
• Olives
• Ghee

Not all fats are created equal. Avoiding the wrong types of fats and oils is just as important as what you choose, whether you have thyroid disease or not. Industrial seed oils, trans fats, and refined or overheated oils are dangerous to our health. They promote inflammation and put us at risk for heart disease, cancer, and other chronic health issues. When you have hypothyroidism, consuming these types of fats will only add fuel to the fire. Avoid refined cooking oils, as they become toxic when heated. Fats and oils to avoid include:

• Margarine
• Fried fast food
• Oils and fats in commercial baked goods
• Peanut oil 
• Corn oil
• Soybean oil
• Canola oil
• Grape seed oil
• Sunflower oil
• Generic “vegetable oil”

When selecting dietary fats sources, choose organic fats and oils, as those conventionally grown may contain unwanted chemicals and pesticides. If you’re looking for a stable, high-heat oil to cook with, coconut oil and avocado have stability when heated. When cooking at lower temperatures, extra virgin olive oil is a good option. When choosing oils to drizzle, such as on a salad, look for cold-pressed oils like flaxseed oil, walnut oil, and extra virgin olive oil.

CONCLUSION: EMPOWERING NATUROPATHIC CHOICES FOR THYROID HEALTH

While the quality of foods we consume is essential to overall health and well-being, when it comes to thyroid health, the foods to avoid are equally important.

Many foods and substances that are common in the Western diet have a toxic effect on the body, causing deterioration of the microbiome, increased inflammation, and destabilizing hormone function, adding to an already burdened system.

As part of their holistic training, naturopaths are experts in clinical nutrition. They are taught to address the root cause of disease and understand food as medicine. NDs tailor nutrition recommendations for each patient using evidence-based nutritional recommendations so that each patient gets the most benefit from nutrition possible.