The Best Diet For An Underactive Thyroid: Splitting Fact From Fiction

Underactive thyroid diet

[Last updated 6th December, 2017]

Our thyroid plays a huge role in metabolism.

Alongside insulin and cortisol, thyroid hormones are a driving factor behind metabolic rate and weight management.

As you would expect, many health problems emerge if our thyroid stops working properly.

Studies show that at the very least 3.7% of American adults have an underactive thyroid, which is likely similar in other developed countries (1).

Rates are on the rise, as are those selling thyroid supplements and giving inaccurate dietary advice.

This article provides an unbiased summary, splitting fact from fiction.

Don’t like to read? Watch the video instead

Closed captions are available.

What is an underactive thyroid (hypothyroidism)?

The thyroid is a butterfly shaped gland on the front of your throat.

TSH instructs it to produces two different thyroid hormones – thyroxine (T4) and triiodothyronine (T3). These are necessary to send instructions to every single cell in your body. Without these hormones, many metabolic processes break down.

What is an underactive thyroid (hypothyroidism)?

An underactive thyroid (hypothyroid in a medical context) refers to when the gland doesn’t produce enough thyroid hormone. Hashimoto’s Thyroiditis (an autoimmune disease) is by far the most common form of hypothyroidism in the Western world.

In almost all cases hypothyroidism is the result of inadequate T4 production, rather than inadequate T3. Conventional diagnosis relies on TSH and T4 blood tests, however there’s good reason to believe those tests alone are inadequate.

Left untreated, an underactive thyroid will lead to a host of health problems including weight gain, hair loss, fatigue, poor memory and feeling unusually cold.

This 3-minute TED-Ed animation is great if you want a bit more detail.

Conventional treatment for an underactive thyroid is with the hormone levothyroxine (LT4 or Synthroid). It works by replacing the T4 that is not being naturally produced, and is the most effective treatment for this condition.

Summary: The thyroid gland is fundamental to many metabolic processes. An underactive thyroid refers to when it doesn’t produce enough thyroid hormone.

Diet alone cannot cure hypothyroidism

Diet alone cannot cure hypothyroidismFood on its own cannot cure or independently treat a diagnosed case of hypothyroidism.

Hormone replacement therapy with prescription medication, such as LT4, is necessary to restore thyroid function. That’s why LT4 is absolutely essential for any health care system.

In saying that, if you have underlying nutrient deficiencies or food intolerance that remains untreated, LT4 becomes a bandaid that doesn’t treat the root problem.

It’s important to note that if you use LT4, take it before or well outside of meal times. Absorption of the T4 hormone is greatly reduced if consumed alongside food, especially soy, high-fibre foods and coffee (2).

Summary: There is no one food or diet that can correct an underactive thyroid on its own. Thyroid hormones must be replaced through medication.

Iodine and thyroid function

iodine and thyroidIodine is an essential trace element that all living organisms need.

Our thyroid gland requires iodine to produce thyroid hormones. For that reason, a deficiency in iodine can lead to an underactive thyroid.

However, a lack of iodine is rarely the cause of hypothyroidism in developed countries where it is abundant in the food supply (3). Nevertheless, including iodine-rich foods in your diet is a good idea to be safe.

Navy beans, potatoes, eggs, cow’s milk and iodised salt are great food sources of iodine, although levels often depend on iodine content in the soil. Seafood is also iodine-rich as marine animals can concentrate iodine from seawater.

Note that if you have Hashimoto’s thyroiditis (strong majority of all hypothyroidism cases) then speak with your doctor before increasing iodine intake. It can be helpful, but in particular circumstances an increase in iodine can actually irritate the thyroid.

Iodine supplements are unnecessary in most cases

The World Health Organization (WHO) deems a population iodine deficient if urine concentration levels are less than 100 microgram/L.

Americans had a median level of 160 microgram/L in 2003-2004 (4), while Australians were at 124 microgram/L in 2011-2012. Most developed nations are also well above the deficiency level, which is why iodine-related hypothyroidism is so uncommon.

To ensure rates remain low, more than 100 countries have adopted mandatory iodization of all food-grade salt or bread. Note this process isn’t mandatory in the US, but more than half of all salt sold there does contain added iodine (5, 6).

Therefore, if you eat a healthy diet that contains some iodine-rich foods, it is highly likely you consume sufficient amounts of iodine. Supplemental iodine is not recommended for the general public, and has actually been shown to cause further thyroid dysfunction in some instances (7).

The big exception to this rule is if you are pregnant or breastfeeding. Iodine requirements increase by more than 60% because the developing fetus or infant requires iodine too. Women who fall into this category should definitely be supplementing with iodine, as per the World Health Organisation’s recommendations.

You can find a good range of iodine supplements on Amazon (disclosure: this is an affiliate link), but please consult with your doctor before you start taking them.

Summary: As iodine is required for thyroid hormone production, ensure your diet contains foods naturally rich in iodine (but if you have Hashimoto’s then check first with your doctor). Unless you are pregnant or breastfeeding, iodine supplements probably won’t be beneficial.

Supplemental selenium is not warranted and can have side effects

selenium and thyroidThere is a theory that low selenium levels contribute to hypothyroidism through different mechanisms related to iodine.

But a 2013 Cochrane review of the research concluded evidence is lacking to definitively support or refute the use of selenium supplements (8).

So the benefits remain unclear, but the known side-effects of selenium supplementation include digestive issues, hair loss, fatigue, and irritability. It may even greatly increase the risk of prostate cancer in men (9).

It’s fair to say the risks outweigh the benefits at this stage.

Additionally, those with a low iodine status who supplement selenium may in fact aggravate hypothyroidism. For this reason it’s best to stick with selenium-rich foods like Brazil nuts, mushrooms, meat and fish, which are far less potent than supplements.

Summary: Be sure to include selenium-rich foods in your diet, but selenium supplements are unproven to help and linked with several health issues.

Cruciferous vegetables as part of an underactive thyroid diet

Cruciferous vegetables as part of underactive thyroid dietGoitrogens are naturally occurring substances that can potentially inhibit thyroid production (10).

Vegetables from the cruciferae family are known goitrogens. They include brussels sprouts, broccoli, bok choy, cauliflower, cabbage, kale and more.

In theory then, eating these vegetables would aggravate an underactive thyroid and should be largely avoided. But this is only the case if you are iodine deficient or you consume ridiculously large quantities.

Raw cabbage was very problematic in rats when it made up a whopping 33% of their diet (11). One lady also managed to put herself into a coma by eating 1-1.5 kgs of raw bok choy daily (12).

Assuming you don’t eat phenomenal amounts of raw cruciferous vegetables, you are most likely safe. Frequent intake will only aggravate issues if your iodine intake is poor or you have a goiter.

Additionally, cooking cruciferous vegetables and other foods containing goitrogens are thought to greatly reduce its potential impact. A small study in 10 subjects showed that 150 g (5 oz)  per day of cooked brussels sprouts for four weeks straight had no negative effects on thyroid function (13).

As cruciferous vegetables are so nutrient dense, it’s certainly not recommended to cut them out of your diet completely. Rather, ensure you cook them well and that your iodine intake is adequate.

Summary: If you don’t have a goiter or low iodine levels, cruciferous vegetables are safe when cooked well and eaten in regular amounts. The risk only outweighs the benefit if they are consumed in ridiculously large quantities and/or raw.

Limit or eliminate gluten for a hypothyroid diet

glutenGluten is a protein found in grain and wheat that is not well-digested by around 6% of people.

While it’s fair to say the “gluten-free movement” has gotten out of hand, those with genuine gluten issues are at an increased risk for many health conditions (such as fibromyalgia) if they continue to consume it.

And numerous studies have shown a strong link between so-called gluten sensitivity (as well as celiac disease) and hypothyroidism.

For those hypersensitive to gluten, it is thought their immune system can confuse components of gluten with thyroid tissue. The immune system then mistakenly attacks and damages the thyroid gland, characteristic of Hashimoto’s thyroiditis. In fact, around 16% of those with celiac disease have antibodies that attack the thyroid (14).

Going by this theory, an individual with Hashimoto’s will not improve unless gluten is removed from the diet.

I explain it here in this video:

Many studies have found that a gluten-free diet reduces the number of antithyroid antibodies, which is favourable for treatment and in preventing new issues (15, 16, 17). However, there are also good studies that found no improvement (14, 18, 19, 20).

It would be reaching to say that gluten definitively aggravates an underactive thyroid, but at the same time it could very well play a part. The honest truth is we don’t know.

Therefore, if you have an underactive thyroid it’s important to get tested for celiac disease first thing. And if you have a family history of autoimmune disease, or you want to play it extra safe, then eliminate gluten from your diet.

Gluten-containing foods do not offer any unique nutrients that you can’t get from other foods sources anyway.

If you don’t have symptoms to gluten and don’t feel any different on a gluten-free diet, then it’s likely not a problem. Weigh up the social aspect vs the health aspect and go from there.

I’d personally only have gluten-foods as a treat.

Summary: There appears to be a link between gluten intolerance (or celiac disease) and hypothyroidism. However, the favourable effects of a gluten-free diet are inconsistent at best, so recommendations depend largely on an individual’s medical history and dietary preferences.

Desiccated thyroid is not always better

Desiccated thyroid is not betterSome alternative health advocates recommend desiccated thyroid (ground up pork thyroid) instead of the conventional LT4 drug because it’s “natural”.

Aside from the huge flaws in assuming natural is always better than artificial, the problem is that desiccated thyroid contains a mix of T4 + T3 hormones. Trials using a mix of T4 + T3 have found it is, at best, equally as effective as LT4 treatment (21, 2223).

Combination treatment is typically used as a backup for those who do not respond favourably or feel unwell with regular LT4 treatment. To be fair, study participants tend to report better tolerance and preference of desiccated thyroid over LT4 (24).

Anecdotally, many desiccated thyroid users swear by it. For many it can treat symptoms effectively without the bad side effects of LT4. So desiccated thyroid has its place as an alternate treatment, but it’s certainly not better than conventional.

Supplements like desiccated thyroid are also not tightly regulated for dose or quality. Even though they are FDA regulated, supplements aren’t subject to the same strict safety and effectiveness requirements that drugs are.

In fact, a study on “thyroid support” supplements found that half of brands contain a low range of T4, while 1 in 10 contained no T4 at all.

In other words, taking desiccated thyroid comes with more risk for potentially no extra benefit than standard LT4. You will need to do some trial and error with your doctor to find out what is best for you.

Summary: Studies show desiccated thyroid supplements have no benefit over conventional LT4 treatment, and pose more risks. However, anecdotal reports indicate that desiccated thyroid is much better tolerated and can still be an effective form of hormone replacement therapy for some.

Is there a particular thyroid diet for weight loss?

is there a thyroid diet for weight lossAn underactive thyroid can make it extremely difficult to lose weight, especially if your diet is poor.

For this reason it’s critical to develop eating habits that are supportive of a healthy weight… not unlike regular weight loss advice (25).

The only difference is the thyroid must first be treated with proper medication. Once your hormone levels have been corrected, you can lose weight just like anybody else.

That means eating plenty of whole foods that you enjoy, increasing protein intake, cutting down on junk food products, and being more active where possible.

To help you get started I’ve created a 6-step guide on how to lose weight with an underactive thyroid, which you can see here.

If you’re certain that a consistently healthy diet and regular physical activity have not helped your situation, you may want to consider trialling the Autoimmune Protocol diet (AIP).

Summary: There is no particular thyroid diet for weight loss, although I have created a meal plan as a guide. Once thyroid levels have been corrected with medication, you can then lose weight like anybody else.

An underactive thyroid diet plan

a thyroid diet planIf you want a set diet/meal plan to follow – including the shopping list – then please see my 14-Day Meal Plan for Hypothyroidism and Weight Loss.

Alternatively, you can download the meal plan from here and then save it to your phone or print it out:

Or click here to download the list.

This brief diet plan below summarises what has been covered for treating an underactive thyroid:

Do eat:

  • Foods rich in iodine such as iodised salt, seafood, potatoes, eggs and navy beans.
  • Cruciferous vegetables in reasonable amounts, as long as they are cooked well.
  • A diet high in protein, which helps to curb appetite and keep you feeling full. That includes dairy foods, eggs, legumes and seafood.

Don’t eat:

  • Any food when you take LT4 medication as this can inhibit absorption.
  • Iodine supplements unless under the guidance of your doctor (especially if you are pregnant/breastfeeding).
  • Selenium supplements unless under the guidance of your doctor.
  • Gluten-containing foods often, if at all. There seems to be a strong link between Hashimoto’s and non-celiac gluten sensitivity. You should always get tested for celiac disease, but this requires you take a gluten challenge.
  • Desiccated thyroid supplements unless synthroid is giving you unpleasant side-effects.
  • Anecdotal reports suggest caffeine intake should be limited to less than 300 mg per day (2-3 regular coffees) as large amounts can aggravate the thyroid

Summary and the next step…

Hypothyroidism can be a serious condition if not managed properly.

Presuming you’ve experienced the symptoms and had your TSH tested professionally, you must be prepared to make some dietary changes (recommend doing this under the guidance of a health professional).

From what current research can tell us, the best diet for an underactive thyroid is one that contains whole foods, is high in protein, and naturally rich in iodine and selenium. That means eating more nuts, vegetables, and seafood, and only using supplements if natural foods are not an option.

Most patients report improvement with a thyroid supplement too, but if you consistently eat a healthy and wholesome diet they are unnecessary. If you still want to try one however (under the supervision of your doctor), see this Thyroid Support Supplement (disclosure: this is an affiliate link). It contains both selenium and iodine for thyroid health, as well as vitamin B12 for improved energy levels. Additionally, it is one of the few available that is 100% vegetarian.

Cabbage, broccoli and other related vegetables are safe if cooked well (and you don’t have goiter), while gluten is best limited or cut out completely- depending on your tolerance.

If you’ve been doing all the right things and still feel your situation is not improving,  you may want to consider trialling the Autoimmune Protocol diet (AIP).

Just keep in mind that what you eat is only one piece of the thyroid puzzle.

Complete management of an underactive thyroid includes hormone replacement therapy (Synthroid or desiccated thyroid), regular exercise (cardio and strength), adequate sleep and reducing stress.

It’s not easy, but it’s doable. One step at a time.

Want more? Get my new Ebook!

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More on hypothyroidism and related topics

The best diet for an underactive thyroid

Comments

  1. I have to disagree. I am not sure what your credentials are Joe, but I work in the medical field and have seen the effects of food on T4 levels, not too mentions complete reversal of hypothyroidism based on diet.

    • Hi Kristy,

      Which part do you disagree with? That it needs to be treated with hormone replacement therapy?
      I am a dietitian.

    • Hhmmm, an educated source??? Not sure but we need to start learning the TRUTH and NOT believe everything that’s on the Internet. BE EDUCATED, Research yourself: visit 2 medical, 2 endocrinologist and 2 naturopaths and do your own calculations -weighing out pros/cons et cetera. Each individual is different and all things posted on net aren’t necessarily valid to all. That being said, having Hashimoto’s for almost 20 years, this article doesn’t completely make sense nor does it apply to what works for me, but some information is valid. Just be sure to always question ALL people, including and especially yourself. Because YOU can be your best doctor.

      • Could you comment on your condition and experience, about which foods you recommend to eat and no to eat? Thanks!

      • Amen! You are your best doctor! Great advice. –Thehypothyroidismchick.com

      • Muriel D Aguiar says:

        This comment is so true. ‘You are Your best Doctor” Only you know how it feels, to have Thyroid problem. The best diet is to stop eating red meats, drink lots of water, Use lots of unscale fish, not much flour. lots of steam vegetables. cook with Iodine salt/turmeric/vegetable oil No much of this. Eat less fries foods.. Lots of fruits. Soursap, grapes, apples, watermelon, bananas. etc etc. lots of fruits. Yogart is good. And most of all and very essential lots of cardo exercise, every day at least for 45mins. Oh yes that helps a lot. It helps relaxes you, mentally and physically. You get a good night sleep. Most import my mother thought me this and I feel this helps me a lot. I have planted a Allos plant in my yard and I swallow a piece of the gel every day.

    • Huma Rasheed says:

      I’m a physician and I totally disagree with you! Joe’s quite right: diet on its own, at least can’t cure hypothyroidism. In fact, reading his articles amazed me that nutritionists possess such an awesome medical knowledge (no more less than doctors).

      • Strength training, cortisol, estrogen, insulin, stress levels etc . Are all a part of the bigger picture of feeLing our best. . Unfortunately many doctors and professionals just say “go exercise” . As a personal trainer , there is a huge stereotype thanks to the biggest looser/crossfit of what exercise is about . Sedentary people have alot to learn in order to mske exercise successful.

        • Alicia Viragh says:

          Sharon just curious what you do not like about crossfit? I currently have hypothyroid disease and I have been doing crossfit for almost two years. Unfortunately I sometimes feel like it’s working against me though. I am not losing weight. In fact, I am gaining weight. Is crossfit bad for people with thyroid problems?

          • If i can chime in, high intensity exercise (including crossfit) is really great for cardio health and increasing muscle mass.
            However, it’s not as useful for weight loss unless you are very overweight.
            90% of weight loss is achieved through diet changes

            • Thank you to that. I tell people all the time, exercise is to keep the body strong and agile (fit). Food, is the support for all functions of the body. The wrong/inappropriate consumption of food matter will have negative effects on the operation of one’s body—unhealthy weight gain is the result of eating wrong/inappropriately. Eat proper, the body will lose the excess weight—the amount of time differs for everyone.

            • Not…

          • Allergic_Vegan says:

            With hypothyroidism, your metabolism is normally slower. HIIT, as mentioned above, can help you lose weight. What you need to do though, is be sure you are drinking plenty of fluids, and also do “double-downs”. What this means is that you do a good High intensity interval training twice a day. Also, the body gets used to a particular exercise routine, which is why we need to change it up.

            With Cross-Fitness, what you’re doing is a wider variety of “President Fitness challenge” exercies. That wil help you bulk up, but not necessarily lose weight. You need a good cardio routine that changes it up every few weeks.
            signed one who tried this, and lost 20 pounds.

            And yes, DIET IS KEY! You need to go higher healthy Vegan proteins (legumes, quinoa, nuts) and lower carbs. I would do 4 oz carbs per meal, half the plate with vegetables, and then the rest with protein. I would also use coconut oil, eat more legumes and greenbeans.

            The reason why Vegan proteins is that red meats are not healthy for our hearts, whatever a pig eats, you eat, and poultry is not necessarily better. Dairy can cause bloating. I read where they found that people with hypothyroidism tend towards dry skin, bloating, gassiness and lactose intolerance. (Like me). Fish tends to have a lot of pollutants in it, And shellfish is never healthy. (Polution, bad farming techniques, plus over fishing of Atlantic Salmon).

            Even going 5 days Vegan and 2 days non-Vegan would be healthier.

            • Humans need to consume some form of animal protein for an overall healthy functioning body. Animal sourced proteins contain nine essential amino acids that the body cannot make, nor does and plant matter carry. An average sized male should consume anywhere between 70-90 grams of total protein. Carbohydrates are not the demon many make them out to be—there are good and bad carbohydrates. Study the difference and understand, carbohydrates are the body’s source of energy and heat.

      • Sonya Bowles says:

        Hello. I just had to jump in and ask about something. I JUST had 3 quarters of my thyroid taken out. On the 28th. Today is the 2nd. Since my surgery, in the hospital, My blood pressure was good, lower than my normal I think, but my heart rate was low. Every time they would give me any pain meds, my heart rate would drop. I have barely slept since my surgery. Actually going more than a day and a half with no sleep at all. I’m scared to sleep. I can’t relax. I’m restless. And I have been anxious. They kicked me loose from the hospital after 24 hours. I got the drains removed yesterday. And I did feel better after that. But after getting back home, I started having the anxiety again. My surgeon keeps no staff or equipment in his Fresno office. So he didn’t take my BP. I took it after getting home yesterday evening. During the mother of all panic attacks. My BP was high, but my pulse was in the 70s. It was closest to normal as I have seen it since the surgery. I called my surgeon and and he told me that I could take an ativan. Mind you, I felt so bad, up all night. Didn’t know how to use my grandpa’s bp machine. And even though my ativan was on the list of meds to quit taking, (though my pain meds that I would have normally taken was left on as is, though I am quartering them now) but the methimazole (anti thyroid ) was on the list of continued meds. And I was desperate so I took it because it was on the list. The surgeon didn’t give it to me in the hospital. So that is the only time I have taken it. And he told me yesterday that I should not need it anymore. So anyways, I am feeling anxious. I did get some broken sleep last night. Though I think that I would have slept all night if my daughter didn’t wake me up. It is what it is though. But with my bp and pulse, could I be hypo? I never had any problems with my heart rate or blood pressure until I went hyper. And then it was high. Idk what is wrong with me. Any ideas or suggestions??

    • Sharon Ricci says:

      I had similar thoughts. One in particular is to point out that the FDA DOES regulate Armour Thyroid, Nature-Throid, and Thyroid USP. I would also like to add that Conventional medications like LT4 have been recalled on several occasions for lack of consistencies in dosages. Armour Thyroid was only recalled one time as a result of a one time miss packaged issue and Nature-Throid has NEVER been recalled for inconsistencies in dosages or quality problems. I also don’t know where you get your information about T4 and T3. There are people who have digestive issues and other issues and have poor conversion to T3 which is actually more potent in the body. When given medications that already have T3 supplied they do better. They are getting what their own body is failing to make. There is also T2 and T1 which almost no one seems to want to talk about. You would think it has no importance whatsoever in the body but the truth is that normally you wouldn’t make it if it did not serve some important purpose. Only Porcine medications supply T2 and T1. Not enough research is done on Thyroid Disease I presume because it’s the number one pharmaceutical used in America and elsewhere. This whole article made me wonder who paid you for it? A pharmaceutical company that makes synthetics?

  2. I agree with joe,the dietitian…after speaking with several people that have an under active thyroid like me and millions of others that are being poisoned by are water our toothpaste that we use.
    First of all I trust your credentials . I have been seen by a doctor, a endocrinologist and I could write a book.
    Joe is absolutely right, it does start with your hormones and by eating right not by going to a doctors office to get a blood draw only to find out with a phone call , this is your number, your range ,you are safe and here is your prescription .

    This is my body and I do not feel well, my hair is falling out, I do not have any energy, I can’t sleep, I am miserable.
    Could you please check my cortisol levels.?
    This was too much for this doctor, she felt that I received this information from a chiropractors office, or a new age practice.
    I was even prescribed a stronger dose of meds that I should have been on, and then my dose was lowered to 50.
    It just seems to be a guessing game with this dr, I am now going to be looking for a dr in Boulder,Co.
    Thank you for letting me vent…
    J.C

    • Good luck with your treatment JC. If you have any questions please feel free to email me through the contact page above.

    • Janet Carter says:

      Wow, this could have been written by me, strangely I am Jan and JC.
      My doctor is clueless I know more about the thyroid than she does & she is very closed minded to all the information available.

  3. I too was prescribed Synthroid…what a nightmare!

    • Car booth says:

      I couldn’t take that stuff either!!! Switched to eltroxin

    • Patsy Lewis says:

      I am 73 and my doctor has prescribed Synthroid 50 MCG for 42 days. My TSH is 4.740, hypothyroidism, unspecified – E03.9. I am not overweight, but have been under a lot of stress in the past few years, caring for my mom until her death last year. Am now caring for my mentally challenged brother, who lives with me. The main problem I have is my hair falling out and my skin is dry, but the dry, fair, thin skin is inherited from my Irish/Scottish ancestors, I always assumed. After reading a lot of information, I am concerned that my doctor is not paying enough attention to my overall condition, but only my thyroid. I eat a lot of vegetables, such as cabbage, broccoli, carrots, squash, field peas, etc. I eat mostly chicken, tuna, turkey, some tilapia, eggs occasionally, multigrain bread, no sodas and decaf tea, black and green.
      drink orange juice, fruits such as blueberries, yogurt, strawberries, applesauce. I drink a normal amount of coffee, but only one cup with caffeine daily.I drink one glass of milk, fat free and cook with canola oil.
      As I have only the problem with my hair loss, dry skin and not as much energy as I had when I was younger, should I go ahead and take the Synthroid as prescribed and see what happens? I don’t want to get myself into a worse condition with this medication and don’t know what is best for my health.

  4. I have gained 16 pounds in less than 2 months. I am 53 years old and could pull suits out of my closet from 2005 and still wear them! I feel awful and look worse. Today, I stopped the meds, I will clear my body and mind of this lie and certainly be better off! I was only border line low, I don’t know how I was stupid enough to ever agree to take something like this. I am on no other meds…now I am on NO meds. I will control my health with what I put in my body. I wonder how many other women this has happened to and we mindlessly obey the doctor. We have to truly be our own advocate for how we feel, what we consume and the results of our own behavior which ultimately determines our health. Please wise us and find will power and conviction to control your life and your health. I am starting today!

    • Hi SP,

      I’m curious, do you attribute the weight gain to Synthroid?
      Are you planning to take a desiccated thyroid instead, or forgo thyroid hormone altogether?

      If you have any questions you can always email me directly via the contact link 🙂

      Joe

    • jane pinder says:

      . how are u getin on withouty takin your meds i want to stop but scared to , i started on 25 then went to 100 then now say say go back to 50 i cant get it right why ?? i hate it and never felt so low

      • Hi Jane,

        Have you asked your doc to try desiccated thyroid (Armor)?

        • i am 58 years old i have been battling thyroid problems my whole life .. when i was living in new york i was seeing a wellness dr who had me on armour thyroid .. i loved it it was working fine & then all of a sudden i couldnt get it anymore bcuz of the corporate greed going on in this country they stopped making it bcuz they werent making money off of people selling something cheaper that worked .. i cant get it anymore .. i have snce moved to florida i feel like crap all the time i asked my dr the last visit i had if i could please get a armour prescription bcuz i heard it is making a come back & she tells me no just flat out no .. & proceeds to tell me no dr will prescribe that anymore they have proven it doesnt work … BULL CRAP I NEVER FELT BETTER THEN WHEN I WAS ON ARMOUR.. however now that the drug companies are in cahoots with drs & insurance companies forget about getting anything thats good or right for you now …..

          • Many Canadian pharmacies carry Armour and ship to the US if you aren’t able to get Armour where you live. Many patients resorted to this when it stopped being available in the US years ago (it is now back on the market). Many US doctors prescribe it so keep looking! Also, you might take a look at NatureThroid and other types of NDT. Armour was reformulated and some patients have reported trouble with it now. Good luck and I hope you will keep looking for a doctor who will support your health!

          • I take Armour and am able to get from a compounding pharmacy. I live in NY

    • Janepinder says:

      Hi
      There will u let me no how u get on , I’m wanting to stop taking meds but scared to do so mines always up and down
      Regards Jane

    • It has been 3/4 of a year…..hhow did it work for you? Thanks

    • I stopped taking Synthroid too. I actually feel better. I have my thyroid and my levels are always normal. I was put on this medicine because I got sick and my levels were up. My levels have been normal since I changed my diet and started being physically active. I agree with Joe. He has good points on his site.

  5. Hypothyroid is forever?

  6. Very informative article!

  7. Please help me in hypo and I’m gaining lots of weight .I’m using levothyroxyl at the moment and my thyroid my doc said it’s normal with these grams I’m taking but i can’t seem to loose weight

    • Hi Yondz,

      Have you tried to make changes that can improve your diet? Email me hello AT dietvsdisease.org with more details and we can come up with a plan for you

      Joe

  8. Enid Jones says:

    Hi Joe – I am to have radioactive iodine for a megamassive goitre, hopefully on 9 December. I weigh about 17 stones and want it off! Not too worried about the RAI but quite worried about putting more weight on. I hope to get the weight off and a volunteer from the British Thyroid foundation told me yesterday (she had exactly the same conditions as me) she had gone from a size 20 to a size 12 after having the RAI and eating to lose weight! She told me how I was feeling and was spot on. Said she had become ‘a new woman’ after the RAI so I am hopeful about feeling better as well. I read somewhere that 5 small well balanced meals a day would help and at the moment (pre RAI) am trying to do this. Any help you and anybody could give would be very gratefully received. Thanks.

  9. Viral article! Thank you Joe for sharing your thoughts and researches!
    I have even printed Do eat and Don’t eat graphs.

  10. Hi Jo
    Intersting question and answers as I’m scouring the net….
    I’ve just been diagnosed with borderline under active thyroid.
    I have been carrying the symptoms until diagnosed.
    I thought I was loosing the plot.
    I feel better in myself knowing it’s not something sinister. I could never understand for all I tried to eat well, I an now weighing 11 stone and 10 pounds of which mortifies me as I’m on 4ft 10″ I’ve always been around the 9.half stone mark
    Only meat I eat is chicken hmmmn….il be clucking soon!
    Could you suggest foods to eat with regards to this
    Regards
    Tracy
    .

  11. Hi Joe – your diet includes walnuts and high calcium foods – everything I have read says to eliminate walnuts completely, and the Rx bottle says no calcium within 4 hours of taking and you show calcium filled foods for breakfast? It’s confusing! Joyce

    • Hi Joyce,
      Thyroid hormone must be taken on a fasting stomach, and 2 hours before any other foods. I will make sure to emphasize this point better in the meal plan, thanks.
      So actually it is better to have a late breakfast, or for some it suits better not to have breakfast at all (generally speaking, only children need breakfast).
      Have you considered skipping breakfast?
      Calcium is a known binder of thyroid hormone, as is iron. But 4 hours is overly conservative.
      A lot of people recommend avoiding goitrogen-containing foods, such as cabbage, broccoli, peanuts and walnuts falls into this too. But there is no evidence in humans they harm the thyroid. The concern is more about goitrogens inhibiting thyroid hormone absorption- again this is addressed by taking it fasting and waiting 2 hours. Roasted nuts especially should be fine.
      Happy to to work with you to create some individualised recommendations for yourself, just email me.

      • I’ve never heard of waiting 2 hours to eat after taking thyroid hormone. Please know I’m not saying you’re wrong, it must be what you were told. I recently started levothyroxine following a half-thyroidectomy. Both my endochrinologist and primary doctor said to wait 30 minutes to an hour before eating. I wait an hour just to be sure.

        • My doctor said to wait at least an hour after taking my thyroid medication to eat, but two hours is ideal. I am fairly certain you can you can look up your medication or call a pharmacist to verify.

        • Theresa says:

          That’s what they told me to half an hour to 1 hour . I have only been takeing mine for 25 days now and really still don’t feel any better. I have been reading it takes a long time to feel better.

  12. Hello Joe, I have had my blood drawn and the doctor says I do not have a Thyroid condition. But I have every symptom that was posted, what do I do? I have recently been taken off my high blood pressure (Atenolol) and cholestrol meds (Atorvastatin) because I now have mild fatty liver. She told me to change my diet I did but now I feel worse. I am exhausted all the time, when I eat certain foods, pasta, pizza(even two bites) I get sick. I stopped eating all the junk but I know I have to have a thyroid issue. Suggestion?

    • Hi Maria, did that same doctor take you off those meds? I would not stop meds unless your doctor specifies it.
      I recommend you seek the opinion of a second doctor re thyroid issues, just to be sure. Do you have your blood test results at home by any chance?

    • You mentioned pasta and pizza make you sick – both very high in gluten content. Try knocking out gluten for a week and see how you feel.

      I used to wake up with flat belly and go to bed with pregnant belly and felt so bloated. Turned out I just needed to eliminate most gluten. I am not completely gluten free, but I eat no bread, pasta, cereals, etc or anything that has wheat or barley. My life has changed for the better.

    • Have them test you for Nash disease.

  13. Dear Joe, I came across your webpage when looking for advice on a healthy diet for a (dare I say it) a 58 year female old who was diagnosed with hypothyroidism 30 years ago. I try to maintain a steady weight, although every now and again I put on 7lbs then diet to lose it again. My thyroxine Rx varies between 75-125, dependent on blood results. However, I now find my finger nails becoming extremely brittle and I am experiencing other nutrient deficiency associated problems, which brought me to your page-and I am so glad that it did. I have found out so much more about this ‘condition’ (I refuse to call it an illness or disease) than at any time since diagnosis. I am certainly going to give your diet advice in the hope that the changes will make a difference to these problems.

    • Hi Gerry,

      I’d love to follow along and hear about what works or does not work for you. Likewise, if you have any specific questions please feel free to email me hello AT dietvsdisease.org and I will try to help 🙂

  14. I would suggest fluoride free toothpaste as fluoride blocks iodine receptors, and I find coconut water greatly helps get me through the day and not put on any extra weight at all, I also sometimes use coconut cream (thick) with a bit of milk, in my oats and banana and nuts for breakfast. Also can use coconut butter for cooking and try to stay away from hydrogenated oils. Apart from being hydrogenated the veg oils we have been encouraged to use have too much omega 6’s in them and not enough omega 3’s. You can also take flax oil to help with this balance, and reduce brain fog. Lots of omega 6’s and sugars in processed foods, so try to home cook. I’m a nutritional therapist.

    • Sandra Woolsey says:

      There is so much information to take in here. I’m 58 year old female. On levothyroxine for 10 plus years. Have noticed some foods are causing me to clear my throat a lot. I feel as if there’s something stuck in my throat all the time. Last examination showed I had an enlarged thyroid. It’s wearying. Interesting comment about the toothpaste, I.ll stop the flouride. What about our tap water.. I am also on a beta blocker and high blood pressure tablets. Probably half a stone over weight. Have had some scary palpitations this past few years, hence the beta blocker. Soya milk is a big no no for me. I’m trying lactose free, but i think I’ll have to quit dairy altogether. Had a feed of chocolate one evening over Christmas, my swallow was affected big time. My swallow was very tight. Anyone else have this problem.

      • Hi Sandra, curious what happens when you have soy milk?
        Do you eat gluten?
        Considering the beta-blockers, I think longer periods of low-intensity exercise (like long walks) would do you a world of good. (although you have to ask your doc if you are going to change or start any exercise).
        That type of exercise will help lower blood pressure and manage weight.

      • Hi, I was recently diagnosed a few months ago…I was losing my hair and could barely get out of bed. I have been taking my meds and have noticed an improvement but not all my symptoms are gone. I thought your article was really informative and I’m going to try the diet plan. I’m not looking to lose weight but I hope eating better will help with the rest of my symptoms.

  15. I have u deactivated thyroid and my weight is increasing, even though I’m trying to eat a well balanced diet. However my thyroid medication has had to be raised, how can I start loosing weight ?

  16. I have u deactivated thyroid and my weight is increasing, even though I’m trying to eat a well balanced diet. However my thyroid medication has had to be raised, how can I start loosing weight ? Any advice please. (I am a vegetarian so don’t eat meat and other foods)

    • Hi Jennie,

      I wish I could give you a simple straight forward answer.
      Do you manage to fit in regular exercise to your days?

      Are your symptoms well-managed with current med? Eg not feeling fatigued

  17. Underactive thyroid **

  18. I am rather active as my job demands alot of up and down and active activities (as i work with children)I also enjoy alot of swimming and as well as walking to and from college regularly, I have used a pedometer lately and I average just over 10,000 steps a day as recommended. My meds I’m not 100% sure with however I’m due another review in the next few weeks. I did have it all under control a year and half agoand I lost 3 stone then, but as my thyroid worsened the weight seemed to pilet on and I’m now at my heaviest. I have tried alsorts.

    • It may be a thyroid med problem, common if you have been on it for over 5 years.
      Either the dose is still not high enough, or you should try an alternative. In this case dessicated thyroid (Armour).

      Ask your doctor about that, it is definitely worth a try because you are very active and presumably eating well also.

  19. HI Joe, thanks for the article. You sound well-informed, balanced and reasonable. I had a total thyroidectomy in May 2013 due to a very small cancerous area. Since then, I have had significant weight gain (+50 pounds in under 3 years while on low carb WW and various exercise 5x/week) and fatigue/hair loss/fuzzy brain/etc. Do you have any good information about diets for those of us WITHOUT a thyroid? I understand from my endo that those without the thyroid gland are doomed to stay underactive forever. But I’m always looking for a better way to eat.

    • Hi Jessica.
      Thanks for the feedback 🙂
      For you it is a complete reliance on the thyroid meds.
      Described by your symptoms, your med dose is not high enough. Have you discussed this with your doctor?
      Assuming you’re on levothyroxine.

      • Hello,

        I am 150 lbs and 5ft 5 inches. I am not overweight, although I would like to lose a few pounds.
        For a few years now I have been noticing my hair falling out. I did a tyroid test and the dermatologist said it was fine. I visited another dermatologist and I did another test. The results came back that my thyroid is underactive. The doc prescribed 25mcb of levothyroxin to be taken for one month.
        The side effects are endless. I have not started taking it.
        As I read on here I’m seeing persons are overweight dealing with this or are gaining weight.
        Will I be able to use an alternative instead of the levothyroxin?
        Results:
        T3: 2.85
        T4: 0.78L
        TSH: 2.32

        Please advise.
        Thanks

  20. Hi Joe,

    I’m so glad I discovered your blog! It’s hard to find blogs that sort fact from hype. I would love it if you would consider providing the sources for your research too, so we can benefit from those resources too. My fav blogs are the ones that list all their sources to back their assertions.

    I’ve deal with hypothyroidism since 1995, & discovered I have hashimoto’s a few months ago (antibodies over 500). I’m in my mid 50s & post menopausal — I hit menopause in my early 40s. My mom, sis (who also has lupus) & brother have thyroid issues.

    My FT3, FT4, TSH & RT3 are all low or in the low end of “normal” ranges. My SHBG, ferritin, and leptin are normal. My saliva cortisol was on the low end of “normal” at noon, a little high in the evening, & in normal ranges otherwise according to STTM. I have blood pressure is typically around 100/ 80. Not sure how to get my FT3, FT4 & RT3 up without keeping my TSH really low (0.06). I feel better at higher Armour doses (less fatigue, anxiety, wt gain, & brain fog; & more motivation & joyful), but it seems like my skin on my face gets super dry & rough when TSH is really low –I can scrape off layers of skin every 2-3 days once moistened. I know it’s complicated, but seeing so many conflicting suggestions by the “experts” on how to handle this gets so frustrating & makes my head spin sometimes. I’d consider paid services, but just not sure whose advice to trust. Suggestions?

    Also, I’ve heard the stories about kale causing comas, but have never heard about the amount. So thanks for clarifying that.

    One question that still wasn’t clarified for me. I’d like to include spinach or kale in my morning yogurt/protein smoothies (which I use unsweetened almond mild for). I make smoothies 5-7 days a week. I’ll also sometimes have things on a lightly cooked bed of spinach with garlic & ghee as well as a large salad. I’ve heard some cooking destroys the enzymes in the raw veggies. I also have been trying to use veggies with dips instead of chips & crackers (i.e. my favs are blanched broccoli, raw cauliflower, celery & cucumbers with cold or hot spinach/artichoke dip).

    So I’m wondering, should I be cooking the kale & spinach b4 using in my daily smoothies? And could you clarify how much I should cook things like spinach, kale, broccoli, & cauliflower?

    Best of luck with your blog & business. I hope my sharing your articles on Pinterest will help you. 🙂

    • Hi Lisa,

      Glad you found it useful and thanks so much for sharing my articles on Pinterest!
      I appreciate the available information is very overwhelming, which is why I am trying to bring a bit of clarity.

      Am not sure about the skin hydration, have you tried really strong pharmaceutical grade moisturizers?
      Can only recommend you see a dietitian in your area specialising in thyroid health and/or autoimmunity.

      To my knowledge a handful of kale or spinach in your morning smoothies is no problem, even if raw. The goitrogen effect only comes in when you eat ridiculously huge quantities, morning noon and night for months on end. Plus if you regularly check thyroid hormone with your doctor, you will be able to see if it is changing.

      Celery and cucumbers raw is fine. Cook broccoli, cabbage, cauliflower etc first, even if just a quick fry or microwave.

      Just to be cautious make sure your diet is rich in iodine foods.

      Oh and all sources for my research are linked by numbers in parenthesis () after certain statements.

      Hope that helps 🙂

  21. Hi Joe

    Thanks for an interesting article. My wife has been on Altroxin for a few years and has become concerned that her doctor has her on a very high dose which she feels could negatively effect her thyroid in the long run. She has gone off the medication a week ago after going to a homeopath and is trying a homeopathy treatment. I have the following questions:

    1. Can long term use of thyroid hormone replacement medication negatively effect the thyroid by replacing the function of the thyroid rather than stimulating it?

    2. Have you had any experience with homeopathic remedies or heard any positive feedback regarding this method of dealing with hypothyroidism. And if so, do you know what is in that medication or how it works?

    Thanks
    Greg

    • Hey Greg,

      Great questions.
      1. To my knowledge long-term Levo use does not damage the thyroid further. Generally with Hashimoto’s the thyroid can not be stimulated or repaired to the point where it functions normally. Hence the replacement therapy. There are always exceptions to the rule, at least from what I’ve heard anecdotally.
      2. I always take an evidence-based approach, although I appreciate the gaps in what we know about autoimmune diseases. Can you be more specific on this homeopathic remedy she is going to trial.?
      Has she spoken to her doctor about going off the meds?

  22. Hi,
    No I haven’t tried it. Looking to start on March 1. Is there a possibility that taking the levo for a month will normalize it? Together with dieting?

    • Yes because the Levo is replacing what your thyroid would have produced if it was functioning at optimal levels. So give that one month and see if you notice some changes.
      Together with a healthy diet and active lifestyle is important. Aim to eat more vegetables at lunch and dinner each day

      • Donna Marie says:

        What are good veggies, please? I am a 47 yr old female with an under active thyroid. I take 150mcg of Levothyroxine daily. I still battle with fatigue, restless nights , some nights I have insomnia, cold spells, sweating, etc. I seriously want to change my way of eating, to gluten free, dairy free. I really enjoy all veggies & fruits and chicken but need to know of things not to eat. Please help!!!

  23. Hey Joe. Am 32 year old female i was diagnosed when I was 17. Started off on 50mg was stable up until Oct 2014. Was gaining weight rapidly 40 pounds in a year feeling a lack of energy and depression. my doctor put me on antidepressants to help with depression unaware that my thyroid was playing up. Easy to throw out pills. Well anyway I got bloods taken waited 6 weeks to be told they were unstable increased to 150mg. A slight improvement in myself at this stage. Decided to go off antidepressants has I found tat it was due to my thyroid that I was in low mood. Doctor advised against it. I found they were not helping with my thyroid at all. Best thing I done going off them cold turkey. My depression gone within weeks. Started exercising regular and eating a well balanced diet. Not much weight lose as yet but feeling fantasic in myself. Always had problems with bloating and my digestive system regards if my thyroid was stable are not this has gone. Would be interested in hearing anymore advice. Thanks marie

    • Hi Marie that’s nice to hear your improvements.
      Regular exercise is really under-appreciated when it comes to mental health issues. Same goes for anxiety and stress as well, as they are all closely related.

      Bloating would be a separate issue to thyroid health, and it may be a symptom of FODMAP sensitivity, especially if you commonly get other digestive problems. You can read more here: dietvsdisease.org/diy-low-fodmap-diet/

      As for other advice, well first thing is that your Levo dose is improved and that seems to have happened and helped. Getting into the habit of preparing your meals ahead of time so you eat healthy foods as much as possible. Regular exercise is important too.
      SLEEP is a big one, you must consider your sleep quality and if that is optimal- can it be improved. Get on top of these things first, and your weight will come down without you even thinking about it.

      Can I also recommend you download a free app called headspace, which is guided meditation. I use it to help with anxiety, it is so important to give our mental health some time of day. It is free for a 10-day trial, so even just to do that and see what you get out of it. You will be surprised 🙂

  24. Thank you you Joe some very good advice Definitely be taking it on board. I will Definitely download APP worth a try.. Every little will help ☺great thanks Marie

  25. I’ve had Hashimotos for many years but I was experiencing symptoms for at least a decade before diagnosis. I’ve always felt better on levothyroxine but am experiencing great difficulty in getting to sleep, my nails are ridged and I do suffer from brain fog. The foggyness could be a result of the insomnia. I exercise daily. I’ve been reading that gelatine aids sleep. Do you know anything about this? I’ve always had problems sleeping but never like this. Any suggestions. Thank you

  26. Marie chavis says:

    Aloha Joe,
    I am a soon to be 52 year old woman with a degree in health education fitness and promotion and a masters degree. I was a college athlete and have always been fit and active with good nutition practices. 3 years ago I began having work impaired anxiety (could not take a deep breath and was beginning to feel fatigue like I hadn’t experienced before). I treated it with yoga and exercise as best as I could then my father was diagnosed with pulmonary fibrosis and while working full time I moved in and took care of him so that he could pass at home. Needless to say there are stressors. So went to the doctor and got bioidentical hormone therapy including armor thyroid and levothyroxine (in the lowest dose available). I think it’s important to note that my father also suffered from low thyroid production but was not diagnosed with hashimotos. 3 weeks ago my doctor passed away unexpectedly and the new doctor I went to had no problem refilling my estrogen and progesterone but said she did not think I needed the thyroid and did not refil my prescription. Since that time I have had increasing muscle aches, fatigue, digestive issues, blurry vision, and nausea. I can’t exercise without being bone weary exhausted for the next 48 hours. What is your take on this? I have made an appointment with a different doctor and am seeking the advise of a registered dietician as well as an acupuncturist. I’d like to get off the thyroid and bioidentical but am concerned about the aftermath. If you can provide any professional input I would gladly receive it. Looking to treat my body with all the love and respect I can but it is honestly baffling me.
    Yours in health,
    Marie

    • Hi Marie,

      Not uncommon when people see a new doctor, unfortunately. But I don’t hold it against them, they receive so much training on pharmaceuticals and then other aspects of health do not receive the time/attention they deserve.

      So hard to say about your symptoms without your med history. Could be thyroid related, how long have you been without thyroid meds?
      Here is some common symptoms: http://www.dietvsdisease.org/13-signs-of-hypothyroidism/

      My next advice was get a second opinion, which you have already organised 🙂

  27. I have been to 6 Endocronoligists ans been on 5 different thyroid meds. All the NDTeds give me anxiety and terrible rashes and all
    The T4 only drugs give me weight gain , depression , high cholesterol and stomach issues. Everytime I go on synthroid my dr wants to put me on a statin drug .My TSH is 12 at this point and I feel better off thyroid replacement but I have BAV and my cardiologist is worried about my heart if I don’t get my thyroid levels normal . I haven’t been able to lose weight in years and I am
    just at a loss and very frustrated .

  28. Marie chavis says:

    Thank you. Still waiting for blood work (Hawai’i really does move slow:). I have many of the hypothyroid systems, which stands to reason, the baffling piece is that I’m LOOSING weight (7lbs in 4 weeks). Adrenals? I’m mystified.

  29. CHRISTINE Sutherland says:

    Crickey Joe, see what you’re up against? Good luck trying to bring science to people who think ”research” equals ”Google” or ”anecdote”.

  30. catherine day says:

    Hello

    Thank you for sharing.

    I would appreciate your comment on the other goitrogen listed foods on the Wikipedia page you shared. Things like strawberries, peanuts and pinenuts etc. We often hear of the green leafy vegetables as being the culprits over and above the other sources listed above and on the Wiki pg.

    I suspect that strawberries, peanuts and pinenuts etc. don’t contain as much goitrogen as the cruciferous vegetables? Either way we could roast nuts and make reduced sugar berry coulis to get rid of the goitrogens but it would be interesting to have an actual list of goitrogen content so that one can compare foods to one another. Restricting raw strawberries and nuts seems silly if the goitrogen content is low as we know these are generally good food choices.

    Looking forward to your reply.

    • The wikipedia article is not very good actually.
      These foods do contain goitrogens but in very very low levels.
      Nuts are roasted/cooked before eating anyways.

      Cruciferous contain the most, and even they are fine if you cook them.

  31. Maureen says:

    Just read some of the comments and was recently diagnosed with slow gut issues. All tests pointed to low thyroid. I am on the medication now and I just started. Do you think it will help me? Have a good diet and exercise. Was eating many small meals a day but was recommended breakfast and dinner with smoothies inbetween to give the stomach a rest. Weigh 125 at 5’2″. I have been following the new diet. Have struggled with losing weight. I would like to lose 5 lbs. Will the medication help?

  32. Dana Puhl says:

    Hello! I have been suffering for so many years with hypothyroidism. Five years ago, they found a tumor in my thyroid and after a biopsy was done, diagnosed me with thyroid cancer. I asked for a second opinion which also came back positive for cancer. I had the surgery to remove my thyroid. Half way through my surgery, the surgeon emerged from the operating room to speak with my husband. He said they had a look at the tumor after removing it and and didn’t believe it to be cancerous. They asked if I would like the other half to be left in and then they would send the tumor to be looked at for further assessment. My husband said he knew I would want it left in, thank God! Further study of the tumor revealed that it was in fact, NOT cancer, thank God! In any case, my life has never been the same since!!! So very many problems, never being able to stabilize my medication (T3 and T4), not being able to lose weight, major hair loss, gut issues, hormone issues and the list goes on. There is soooo soooo very much info. On line for those who are hypo or hyperthyroid and very very little for those with only half or no thyroid!! We really do need to hear much more about those of us who are in this position! How does one go about dealing with half a thyroid and all the issues that go along with that?? Help please!

  33. I’m a 45 yet old women who was recently diagnosed with sub clinical hypothyroidism my Tsh was 6.99. I was prescribed 0.25 Levothyroxine. After taking it for a month I had gained 10 lbs, had dry skin, foggy brain, was extremely fatigued so I stopped taking it and decided to try diet and exercise. I started a gluten free and refined/artificial sweetener free diet. After 6 weeks had my Tsh rechecked and it had gone down to 5.7 (my T3 and T4 are within normal limits). But since 5.7 TSH is still considered above normal my doctor wants me to try the Levothyroxine again with a lower dose of 0.125 I’m very hesitant to restart the Levothyroxine because of all the bad side effects I had on it before, the actual only benefit I had was less headaches. My doctor does not agree with Armour treatment so at this point not an option. Since changing my diet and exercising I feel great only a few episodes of fatigue and low energy and hair thinning. In your opinion is it really necessary for me to have to be on medication at this point? She is worried without treatment my levels will get worse. She said next step would be to check my antibodies if my levels don’t go down on the Levothyroxine. I’m just so confused – I feel like the medication that is suppose to make me feel better is actually making me feel worse. Thoughts?

  34. I am 19 and I have hypothyroidism. I am eating a good diet. I am avoiding soy and dairy products. I also eat gluten free and 95% organic. Most of the meat that I eat is grass fed and organic. I try to exercise, but it is hard when you don’t feel good. I have low energy, no motivation, headaches, sometimes I get brain fog, sensitive to cold (always have cold hands and feet), I feel weak a lot and have body aches. I have also experienced hair loss and I have dry skin. I have gained about 7 pounds and have struggled with hypothyroidism for about 8 months now. I also experience a lot of stomach pains because it’s runs in my family. I am currently taking armor thyroid 15mg and when I first started it my body reacted horribly. I was in bed for a week. I felt awful. I also take a multi vitamin, selenium, kelp, iron, omegas, and a probiotic. I always check to make sure im not taking too much. I am currently going to school to become a Dietitian. I just want this to go away. It makes being a student really tough. Plus I will be working two jobs this fall. I currently work a part time job two days a week. I am currently doing iodine skin patch testing. I found out that I am extremely deficient even though I take some kelp. I am hoping this is my problem. We will see. If you have any other tips Joe I would love to hear them.

    • I also watch my sugar and I have secondary hypothyroidism, but they checked my pituitary gland and it is just fine. My cortisol level, dhea and antibodies all came back normal when they were checked too. I am desperate to feel good.

    • Hi Noelle I don’t recommend selenium supplementation, too many side-effects, even hair loss.
      Zinc supplementation however may be beneficial in your case. Speak to your doctor first.
      It is very uncommon to be iodine deficient in the western world, so I wonder how that happened.

  35. I am diagnosed to have low thyroid. I am currently consuming Levathxoryn 75mcg. I am on good diet plan and do eat small meals. But my thyroid is not letting me lose weight. I do lot of walking , biking still my weight is same as what I was 10 years before.

    • You say your on a good diet. it is gluten , soy & dairy free? Some people also have an egg allergy and don’t know it. You also could be over exercising. Having hypothyroidism already has your cortisol levels higher than normal. Do you get a headache easily after working out? If so, you need to cut back. Slow it down. Try yoga. Have you had a complete thyroid panel done? Not just TSH! You could be needing more than just Levathxoryn. You might need both T3 & T4. Have you been checked for Thyroid antibodies? You might have Hashimoto’s and not even know it. That alone will put you in a entirely different ballgame.

  36. Sophie Walfish says:

    Hi Joe!
    Great article!
    At this moment I am on Levothyroxyl but don’t see any improvements
    in my weight, my sensitivity for low temperatures, my hair…
    What kind of diet you would suggest for me to improve my health condition?
    Sophie

  37. Hi Joe!
    Great article!
    Right now I am on Levothyroxyl but don’t see any improvements
    in my weight, my sensitivity for low temperatures, my hair…
    What kind of diet you would suggest for me to improve my health condition?
    Sophie

  38. Hi. I recently was in the hospital and found out I’m hypo- which makes since as I’ve had all the symptoms, except that instead of being sensitive to cold I’m extremely sensitive to heat. Any ways over the last year I’ve gained about 90lbs, I’m tired all the time, nauseous all the time and have aches and pains all over ( I’m only 28 and I feel 90!). The doctor set me up with a medication while I was there but my primary care dr wouldn’t continue it without doing her own tests…. So while I’m waiting for her to get the tests back ( I don’t go back til sept 19) can anyone give me advice on how to alleviate the symptoms of hypo??? I’m miserable.

  39. Joe, Good article you hit the nail on the head with most of this thread. People just have to be their own health advocate. Hypothyroidism isn’t a one size fits all. You may have it for a different reason than me. People need to find the root cause of their disorder. It could be adrenal fatigue and they were misdiagnosed with having hypothyroidism but once you start that thyroid pill, your on it. Your body will stop over time producing what it was already. ( adrenal fatigue and hypothyroidism have many of the same characteristics. You must go to a knowledgeable doctor at least 2-3 times to be correctly tested for adrenal fatigue.) P.S. your never cured of hypothyroidism but you certainly can put it in remission. Check out my face book group. Healing Hypothyroidism…. Good stuff. —-Thehypothyroidismchick.com

  40. That’s a great article, Thanks! One of my, and my family’s favorite veggie dishes is marinated broccoli (http://cooking.nytimes.com/recipes/1016146-broccoli-salad-with-garlic-and-sesame) where the acid “cooks” the veggie. As a nutritionist, do you know if this is sufficient for reducing the impact of the goitrogens?

  41. Hi Joe, in the don’t eat section – should you not be recommending that people get themselves tested for coeliac disease BEFORE they stop eating gluten containing foods, otherwise they will get a negative result?

  42. Hello I had my thyroid checked a few days ago again for the second time as we wanted to make sure it was correct. The fist time she told me its was 27. I had no what that meant. she asked me if I was cold, constipated, fatigued. After researching I came to the conclusion that I had hypothyroidism. These are my numbers after my second test:

    TSH 7.58 ml/U/L
    Free T4: 9.0 pmol/L
    Free T3: 4.4 pmol/L

    Female, 26, 129 pounds
    Exercise: 3 to 4 times a week: Cardio, Weights, High Intensity Interval Training

    Here is the interesting part. I have no symptoms: not tired, actually lost a a pound or two, not constipated, don’t feel cold, been more active. Is it normal to not experience any symptoms at all?

    So here is my questions. Is 7.58 high, very high?
    Even with meds, is it possible to gain weight?
    My cholesterol came a little high, Doc said it was probably due to thyroid. Is that normal?
    Should I be asking for any other tests? Or is this my fate now, Having hypothy.

  43. Allergic_Vegan says:

    The two hour wait is the minimum recommended before taking a vitamin tablet. They actually prefer four hours. Otherwise, it is at least 30 minutes before eating, but they really do prefer an hour. Except the hospitals will insist on giving you that med WHEN you food arrives and then making you wait. I got my doctor to sign off on a direct order for my levothyroxin to be delievered at exactly 4am. It was the best thing ever. For once, I didn’t have to go up on my med after getting out of the hospital.

    I personally found it best to take they synthyroid med at 4am and then go back to bed. That way, if I wake up with low blood sugar, I can eat right away. Incidentally, I found that my blood sugar does not crash if and only if I avoid the Paleo diet and instead eat strict Vegan. My doctor does not agree with the paleo diet either because it is not good for the heart at all. Lets same the thyroid but destroy the heart. And he doesn’t really see true evidence that avoiding so-called “goiter vegetables” is really good. Broccoli and cauliflower really help lower the chances of breast cancer. He thinks that its better go whole foods diet, with an emphasis on Vegetables, legumes and quinoa.

  44. Had thyroid removed 8 years ago due to thyroid cancer. Have tried levoxyl, armor thyroid and currently on synthoid. Still don’t feel right. Fuzzy brained, achy, gaining weight and constantly tired. Exercise regularly, don’t eat sugar, eat lots of vegi’s and protein. Don’t know what else to try. Just want to feel good again.

  45. Hi There,

    I just got these labs from my endocrinologist and I wanted a different perspective on them.

    Can you tell me your thoughts?

    I am a 47 year old Lebanese female who is “5” ‘4 3/4″ and weighs 169 lbs. I have lost 46 lbs since last December 19, 2015.

    I have PCOS and genetically inherited high cholesterol and high blood sugar. Besides genetics I am a sugar addict and have binge eating disorder.

    I have been pre diabetic off and on for at least 5 years. I have never been diagnosed with diabetes as I have never reached diabetic numbers through a self induced OGTT, A1c tests, fructosamine and fasting blood sugars.

    I am working on my diet and exercise to reduce certain blood markers.

    My blood sugar has come down and I am still working on my cholesterol. The cholesterol was measured by my primary care doctor and cardiologist.

    The blood work below was from last week at my Endocrinologists office.

    My last total cholesterol was 360 but my hdl and triglycerides were in normal range. Taken about a couple months ago.

    Last spring my total cholesterol was 259 coming down from 312. Prior to 312 it was 344.

    When it was 259 my hdl and trigs had also improved.

    I think it went high again because I started eating sugar again. I was still losing weight and monitoring my caloric intake but I went Paleo almost sugar free from December 2015 to April 2016 and that’s when my cholesterol came down from 312 to 259.

    I am back to minimizing sugar intake.

    I also suffer from depression, anxiety and ocd.

    I started gaining weight when I hit puberty and developed PCOS. I have lost and gained weight many times since then.

    I carry most of my weight in my belly.

    I am having a hyperoscopy done on Dec 15. Some hyperplasia was found in my uterus.

    I have never had kids. My period has been regular since my early thirties.

    Please let me know if you need any more information.

    I appreciate your insight!!

    Thank you very much.

    Sincerely,

    Vivian

    T4, FREE, NON-DIALYSIS: 0.9

    T3, Free: 2.6

    TSH: 2.33

    THYROGLOBULIN ANTIBODIES <1

    THYROID PEROXIDASE ANTIBODIES <1

    Fructosamine: 243

    A1C: 5.4

    TESTOSTERONE,TOTAL,LCMSMS: 20

    TESTOSTERONE, FREE: 2.7

    Insulin: 3.8

    DHEA SULFATE: 62

    C-PEPTIDE: 1.31

    Vitamin D: 25

    SODIUM 137

    POTASSIUM 4.2

    CHLORIDE 103

    CARBON DIOXIDE 27

    GLUCOSE 92

    UREA NITROGEN 10

    CREATININE 0.71

    BUN/CREATININE RATIO N/A
    Bun/Creatinine ratio is not reported when the BUN
    and creatinine values are within normal limits.

    CALCIUM 9.9

    PROTEIN, TOTAL 7.1

    ALBUMIN 4.2

    GLOBULIN, CALCULATED 2.9

    A/G RATIO 1.4

    BILIRUBIN, TOTAL 0.4

    AST 12

    ALT 13

    ALKALINE PHOSPHATASE 40

    Fasting reference interval

    NON-AFRICAN AMERICAN EGFR 101

  46. Have you ever considered creating an ebook or guest authoring
    on other sites? I have a blog centered on the same
    information you discuss and would love to have you share some stories/information.
    I know my readers would appreciate your work. If you’re even remotely interested, feel free to send me
    an email.

  47. Thanks to big pharma if you are cursed with hypothyroidism you have to do endless research yourself to stand any chance at getting better. Hypothyroidism can be complicated to treat because of underlying adrenal issues, T4 to T3 conversion problems and many other complications. Most doctors admit they find thyroid issues a “boring subject” and other than the basics mentioned in medical school most admit getting all their info from a pharmaceutical company. After being overdosed on T4 meds I quickly learned you are on your own to learn about the proper treatment. I found a gold mine of information on the Stop The Thyroid Madness website. Don’t assume you can be referred to a endo and finally get the help you need. You can easily go from the frying pan to the fire. The key to proper diagnosis and treatment is to EDUCATE yourself and have an OPEN MINDED doctor. In the the treatment of hypothyroidism most doctors and endos are anything but open minded. FIND ONE THAT IS ! Trust me, I learned all of this the hard way.

  48. My wife is hypo and been struggling as long as I can remember.

    Most Doctors recommend taking meds in the morning and starving for 60mins, however I’ve seen a couple of studies/research that suggests taking meds before bed have produced better results than morning.

    Just wondering if you or your readers had any experience or input on this?

  49. F, Prosper says:

    Hi Joe, thanks for your article, I believe all that you said. I take L- Thyroxine tabs 100 mcg 1Tablet daily. And I try my best to eat the best things daily. Some times I feel like having some ice cream and I cheat a little, but that’s every two months or so. But you are right, what you eat is the most important thing to me, and your exercise. I check myself a lot, and when I do the right thing as eating and exercising, I have no problem, but when I get lazy and go off of my good eating, then I see the difference in my body and my behavior. The last visit to my doctor was good, he said that my thyroid was good,whatever that means Lol? I guess he meant that it was low. But for the most part I don’t feel bad only problem is my BP get high, it’s up and down all of the time, am really fed up with it. But I love your article, and I agree with all that you said. Peace.

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  51. I used to weigh 135+ at 5 ft and took 3 yrs of balanced everything to get back to my normal 105 frame. I’m in the gym 5-6 days a week, cardio 30 min 4-5 days a week, weight lifting. Then took on a body building show. (at age of 39.5) After that I gained 20 lbs (only 5 of it would be normal weight). I was diagnosed about 3 wks ago w/hypothyroidism. I continued to eat somewhat regular competition diet of measured meals, pre prep, with the weekends as my cheats and be reasonable with pizza or some snacks. I don’t know where to go diet wise w/this new diagnosis until I can get this extra 15 lbs off me. Do I continue to eat every 2 hrs? Do I keep w/my routine until the med starts to work? I eat low carb, high protein and try to do as much clean eating as I can. I have had to tweak it and go back to a mix of competition diet and prior to that diet which did me well until the diagnosis. I am struggling right now w/the holidays and junk and no will power. I went from one extreme to another and I’m lost. If anyone can give me any advise or direction as I’m afraid to rely on internet info only and research. I do not go back to Dr. until February in which he’ll test me again and adjust. thanks 🙂

  52. Hello,

    My test results for TSH shows 9.090 as of 06/2016, I am gaining weight, my feet and hands are cold.
    I do not get good sleep of 8 huors, I am 49, Male. I am using levathyroxin 10 mg. Is this the right medicine, is my thyroid under active. What foods should I avoid eating ?

  53. Had Graves’ disease which resulted in my having my thyroid radiated with iodine. Now on thyroid supplements, but surely not enough. The moment I had my radiation completed I gained 25 pounds. I wish I had known that I would have zero metabolism afterwards. I might have chosen to not go through with it. Do I follow your guidelines for low thyroid rates, even though I have zero thyroid hormone?

  54. I have Congenital Hypothyroidism.
    I’ve had good endocrinologists and bad. I’ve had good habits and bad ones too (missing doses)!
    Just *recently* was informed about the importance of diet and thyroid conditions. Only took 30 years!! What the heck?!
    — Makes all the sense in the world. —
    I’m used to synthroid medication (name brand only). Always have had concerns about armour.
    For what it’s worth, Crossfit 2-3 days a week and decent diet put me in the best shape of my life.
    Still working out my energy levels.
    Didn’t know that coffee along with medication could be troublesome.
    Looking forward to changing my diet a bit to see if it helps! Goodbye gluten 🙁

  55. I seem to have error come up when sending post.

  56. Thank you so much for putting this article together! There are so many extremely adamant people making claims all over the web about what helped them without a shred of scientific evidence to back them up. And then they knock what professionals told them. If what they happened to do helped them, great! But I really wanted to start from the base of what is really known so far vs. what we don’t know, and the nuances that effect it – a perfect example is how I’ve read a bunch of sites saying to stop eating broccoli and such, meanwhile you point out that’s if you have an iodine deficiency or goiter to begin with. I’m very interested in the effects of nutrition on health, but I get tired of seeing every armchair “expert” or people claiming they are in the “medical field” (which can mean they are a tech somewhere rather than a physician, dietitican, or nurse anyway, having been in the “medical field” myself). Sorry that I sound very frustrated, but I am – the internet is littered with people’s opinions being blasted as truth, it muddles everything – this article at least gives a solid basis for what professionals are thinking, based on scientific evidence, vs. what we don’t know, and what factors can influence it.

  57. Please add coffee to the list of “foods/supplements” to not take with your thyroid medication. Folks may swallow their Rx with a cup of coffee and think they are taking it “on an empty stomach” only to be rendering it ineffective. 2 hours -that’s a long time for some folks to go without coffee in the morning- is the recommended wait time between taking Levothyroxine and coffee. https://www.ncbi.nlm.nih.gov/pubmed/18341376/

    Solutions include taking the medication at night or 2 or more hours before rising, if one is in the habit of waking in the middle of the night.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139142/

    I’ve personally had great success eliminating all hypothyroid symptoms due to Hashimoto’s by eating a gf whole food vegan diet, exercising regularly and taking desiccated thyroid (naturethroid and armour equally successfully)… Just one anecdote to balance the predominant view on this website.

  58. Cheryl Matthews says:

    Hi Jay,
    I am.55 and have underactve thyroid diagnosed Jan. 2016. I started then taking levothyroxine 50mcg now I am taking half of 75 mcg daily.
    I also was diagnosed in Feb. 2016 with
    Throat Cancer. I have Lupus, F-myalgia, Arthritis, Osteoporosis, Depression, Panic/Aniexty Attacks, TMJ, ADHD, Digenetic Bone/Disk Disease, Menapause(started at 40). On and On but nothing has or still makes my life miserable than my Thyroid!!! So Tired and why I couldn’t get to Dr before last Jan. I stayed in MISC/Hollings Cancer Hospital for 2 months after surgery to remove my epiglottis. I ended up with pneumonia and a feeding tube before leaving to not go home but NHC Rehab for 2 more months to learn how to talk, drink and eat again. Came home for 2 months and one morning woke up and I had no feeling in my left side and extreme headache on right side. My home health nurse took me to ER as I thought I had a stroke. My son came the Dr did a CT scan and came in to telly son and I that I had a Brain Tumor the size of a golf ball with infection the size of ping pong balls. So I had Brain surgery and spent 3 more months in Hosp/rehab. I have been home since Jan. and no more feeding tube. I try to eat not no apatite unlike before increase in levothy. One week I have apatite the next week I don’t. I am so hungry I get nausea. I drink Boost to help kill the hunger? I am so tired and I do coffee to get me to something important but the crash is so bad. How long does it take for meds to show me they are working? I use coconut oil on my hair and skin so not sure if that’s why my skin looks better because none of my other symptoms are better. Not eating can’t be good eithe…How often should I check my Thyroid and can thyroid be up one week and not the next?

  59. I was recently diagnosed with Hypothyroidism. I am on my first round of Levothyroxine. What a difference it has made!! I’ve also given up Gluten, Soy, and some dairy. I am on a Low FODMAP diet for severe IBS-D. I get in at least 10,000 steps daily. Joe is spot on with this web article. For the first time in my life I’ve experienced no allergies, I have more energy, no headaches, no moreV Vertigo, no osteoarthritis, and I’ve had no more IBS-D triggers since going Gluten and Soy free and Low FODMAP. I also do not eat anything with High Fructose Corn Syrup in the ingredients. I do have one day a week where I will just feel “blah” and I sill experience memory fog, but I feel so much better. And there are apps out there that will help you with Gluten free and Low FODMAP grocery shopping. This med, changing my eating habits, and walking every day has helped so much. I am still having a hard time losing weight, but I know it doesn’t happen overnight.

  60. Bhawna Arya says:

    I have come to know that i have hypothyroidism, just few days back and i haven’t consult a doctor yet but due to gaining more wait i am following a 7 days GM diet plan and its already my 4th day, i want to know if it will be beneficial or not due to my thyroid..?

  61. Hello world,
    Im writing here in complete confussion and I hope there is someone who can help. I have had an abnormally weird looking neck pretty much my whole life. While at my primary care provider appointment she says she dosnt like it and sugguests we need to do a thyriod test and scheduel a thyriod ultrasound. so long story short doctors office call to tell me i have HYPOthyroidism. My TSH level is at .18 and they are putting me on synthyroid at 0.025 mg. The medication will be coming in the mail in a week or so. During the phone call I was given so much information I could not comprehend at the time. I have just call my doctors office so I can ask my questions that ive written down but doctors and hospitals have never been a trustworthy bunch for me. With protocols and the daily going through the motions i like to really research whats going on. Unfortunatly all the research i’ve done over the past week since the diagnosis has really confused me. This past year from october 2016 up to the diagnosis I had a fall from 25-40ft. it fractured my acetebular and also had multiple sacram fractures that put me through so much trauma and rehabilitation. i finished physical therapy in march and was feeling great until I had what i didnt know then a minor back spasm in april. Followded a few weeks later by symptoms of what a “urgent-care” type doctor told me was some type of stomach ulcer, which after a month of omneprezol seemed to be ok. All was good for awhile until July of this year when I had two severe back spasms and since i have never been the same. I have constant back and all over body pain. Mostly with my back. I am mostly always cold. Also, every now and then I am having heart palpitations that get very scary. I am unable to get over 3 hours of sleep uninterrupted. And most recently to add my eyes twitch very regulary. weather I have gotten sleep or not. It started with my right eye, and now both of them do it all through out the day. I have been having so much trouble with concentraiting and remembering things. I cannot remember much. I am confused all the time. I have also been having sharp pains under the left side of my rib, in the stomach area which sometimes radiates from the center back to the left side. Its sharp and when it happend it was severe and lasted about 3 days. since then Ive had some discomfort. I did mention it to my doctor and about the ulcer they claimed I had in april so she put me on omneprezol again. But my sypmtoms were completely different the first time. My apt with my primary care provider went well but i definintly forgot a lot of what i wanted to tell her . I cant remember If i mentioned all I have mentioned here. I wish I had a better way of explaining everything. At first I thought all of this had to do with my fall accident and just recovering from that. A lot of things line up with having hypothyrionism and I cant deny that.. but could it also be anything else?

    I also wanted to ask about DIET. I am completely blown away about how confusing all the information is out there on the internet. I consider myself a very healthy and active person and just want to know what im supposed to be eating and if I really have to let go of my two favorite foods: spinach and kale. some websites mention they are bad for hypothyroidism….Have i been secretly killing myself the last 3 years?

    I am a 29 year old female. I have no children and was still hoping to have a family someday, upon reading I found out a lot of information about infertility and retardation of children with this condition. Im scared about that and also im scared about the medication chosen by the doctor. Is synthroid a good medication? Will it cause my body more harm then good? also is anyone else having the stomach issues I have?
    this is all so crazy. Just feeling very overwhelmed and scared. If anything, thank you for listening and Ill try and write again if the doc or nurse calls back with a diet. I have a thyroid ultrasound Dec 7th, when I get the results I will write back here as well.

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