5 Controversies In The World of Thyroid Health

There are numerous “controversies” when it comes to thyroid health.  And so the goal of this post is to discuss some of the more common controversies.  Although I have my personal biases, and will give you my opinion with regards to each of these “controversies”, my goal isn’t to persuade you to choose one side or the other, but instead is to provide you with some information so you can make an informed decision, or perhaps do some further research on your own.

Controversy #1: Iodine.  This might be the biggest controversy in the world of thyroid health.  Many healthcare professionals will recommend for people with hypothyroid and hyperthyroid conditions to supplement with iodine.  On the other hand, some will advise people with thyroid conditions to stay away from iodine…especially those who have autoimmune thyroid conditions.  I’ve written about iodine numerous times in the past, and I definitely would check out some of my previous articles and posts.

The Case For Iodine Supplementation: Iodine is necessary for the formation of thyroid hormone.  And so if someone has a hypothyroid condition and is deficient in iodine, then it would make sense to correct this deficiency so that the thyroid gland will be able to produce a sufficient amount of thyroid hormone.  But how about those people with hyperthyroidism and Graves’ Disease?  Well, even though this condition involves an excessive production of thyroid hormone, the cause of this is usually an overactive immune system attacking the TSH receptors.  And so in most cases it’s not caused by having too much iodine.  Plus, many years ago iodine in the form of Lugol’s solution was used by medical doctors to treat many cases of hyperthyroidism and Graves’ Disease.

In addition, many people with hyperthyroid conditions have benefited from iodine supplementation.  Besides some of the positive experiences my patients have received when supplementing with iodine, many other people have reported an improvement in their health upon taking iodine supplements.  And while one can make the argument that some of these people were taking numerous other supplements at the same time, many people don’t notice a positive change in their health until they introduce iodine.  In other words, I’ve worked with numerous patients who were taking certain supplements, but once they started taking iodine they began experiencing a big improvement in their health.

For those who question the safety of iodine supplementation, there is no question that a small percentage of people don’t do well when taking iodine.  However, the same can be said with other supplements and herbs as well.  But in most cases, those who have an iodine deficiency and take iodine with the proper precautions experience great benefits.

The Case Against Iodine Supplementation: Although iodine has helped many people with thyroid and autoimmune thyroid conditions, there have been cases when taking iodine has worsened a person’s condition.  There have even been reports of people who didn’t have a thyroid condition until they began taking iodine supplements.  In addition, there is a possibility that iodine can trigger an autoimmune response, thus causing an autoimmune thyroid condition.  While it’s great that many people have taken iodine and have benefited tremendously, what about those people who took iodine and had a negative reaction?

My Opinion About Iodine Supplementation: Those who have been reading my articles and blog posts for awhile know that I’m pro-iodine.  But I also realize that there can be risks with taking iodine, and that iodine isn’t for everyone.  With that being said, most people who react to iodine do so because 1) they take large doses of iodine without getting tested for a deficiency, 2) they don’t take the proper precautions, such as also supplementing with antioxidants such as selenium and vitamin C, as well as magnesium to help with the absorption.   I would encourage you to do some research on your own, and at the same time check out the following two articles I’ve written about iodine:

Can Taking Iodine Cause An Autoimmune Thyroid Condition?

Is Iodine Safe To Take In People With Hyperthyroidism?

Controversy #2: Gluten.  Many people with thyroid and autoimmune thyroid conditions can benefit from avoiding gluten.  Truth to be told, many people without thyroid problems can also benefit from avoiding gluten.  But when should someone avoid gluten?

The Case For Avoiding Gluten: If someone has a gluten sensitivity this can cause numerous problems if the person continues to eat foods which have gluten.  One of the main problems is that gluten can affect the permeability of the small intestine, thus leading to the condition known as leaky gut syndrome.  And while testing for a gluten sensitivity might sound like a good idea, most of the available testing isn’t completely reliable.  And the more accurate testing, such as Cyrex Labs Wheat/Gluten Proteome Reactivity & Autoimmunity test, is quite expensive.  For those who don’t mind spending $300+ on such testing that’s fine.  But it’s definitely less expensive to go on a gluten-free trial.  And quite frankly, most people should be eating whole, healthy foods, which are naturally gluten free.  Many people who are gluten free eat too much processed food, such as gluten free cereal, gluten free cookies, gluten free bread and pasta, gluten free pizza, etc.  I’m not suggesting that having these foods every now and then will cause problems, but many people eat these foods on a daily basis.

The Case Against Avoiding Gluten: When I first began working with people who have thyroid and autoimmune thyroid conditions, I wasn’t as strict when it came to having people avoid gluten.  And many people still received good results.  And so while some people do need to avoid gluten in order to restore their health back to normal, others might not need to completely avoid gluten in order to receive great results.

My Opinion About Avoiding Gluten: Although it’s true that some people who follow a natural treatment protocol who continue to consume foods with gluten will still be able to restore their health back to normal, the question that you need to ask yourself is whether or not consuming gluten on a regular basis is necessary.  Just because you don’t react to something doesn’t mean it should be part of one’s regular diet.  Keep in mind that this is coming from someone who is not completely gluten free, as while I eat mostly whole foods and minimize my consumption of gluten, every now and then I will eat foods which aren’t gluten free.  So I’m not suggesting that everyone needs to permanently avoid gluten, as I think for many people it’s fine to indulge every now and then.  But I do think those following a natural treatment protocol should make a serious attempt to avoid gluten, and even after restoring one’s health back to normal it’s a good idea to minimize your consumption of gluten-based foods.  And of course some people will need to avoid gluten on a permanent basis.

Controversy #3: Goitrogens.  I work with a lot of people who have hypothyroid conditions, and most of these people have Hashimoto’s Thyroiditis.  And many of these people do everything they can to avoid goitrogenic foods, such as broccoli, kale, cauliflower, spinach, strawberries, etc.  In the past I encouraged people with hypothyroidism to avoid goitrogenic foods, as a few years ago I wrote an article entitled “Goitrogens: Thyroid Inhibiting Foods You Should Avoid“.  So should people with hypothyroid conditions avoiding eating these foods?

The Case For Goitrogenic Foods: Many of the goitrogenic foods are very healthy.  Foods such as broccoli, kale, cauliflower, Brussels sprouts, spinach, strawberries, peaches, and other foods have plenty of nutrients which can benefit our health.  And when it comes to the research which talks about the thyroid-inhibiting effects of certain foods, these were performed on rats and mice, but perhaps more important than this is they involved large quantities of these foods.  I’ve never consulted with anyone with hypothyroidism who had their condition develop by eating too much broccoli or kale.  Remember that most people with hypothyroidism have Hashimoto’s Thyroiditis, which is an autoimmune condition that involves destruction of the thyroid gland.  One can argue that eating goitrogenic foods will only worsen one’s hypothyroid condition, but I haven’t found this to be true.  An exception to this might be if someone has an iodine deficiency, but even when this is the case it is controversial as to whether consuming small amounts of goitrogenic foods will inhibit thyroid activity.  For those who remain concerned, keep in mind that cooking these foods will reduce their goitrogenic activity.

The Case Against Eating Goitrogenic Foods: Even if there is only a small chance of goitrogenic foods inhibiting thyroid function, why take the chance and eat these foods?  After all, there are other foods people with hypothyroid conditions can eat, so why not play it safe and avoid those foods which can potentially cause problems with thyroid function…especially if someone already has a hypothyroid condition?

My Opinion About Eating Goitrogenic Foods: Although I don’t encourage people with hypothyroid conditions to eat large amounts of goitrogenic foods, I do think that in most cases, eating a small amount of goitrogenic foods is fine.  I discussed this in further detail in an article I recently wrote entitled “An Update on Goitrogenic Foods and Their Impact On Thyroid Health“.

Controversy #4: Soy.  I realize that soy is also a goitrogenic food, but there is so much controversy over soy and thyroid health that I figured it deserves special attention.

The Case For Eating Soy: There is some evidence that soy can help to prevent certain types of cancer. And eating some organic fermented soy might have other health benefits as well.  For example, there is evidence in animal studies that soy can prevent osteoporosis, although this is inconclusive.

The Case Against Eating Soy: First of all, most soy in the United States is genetically modified.  And so if you are going to eat soy, please make sure it’s GMO-free.  While there might be some health benefits of consuming some organic, fermented soy, this is controversial.  Soy is a goitrogen, and so it can potentially can inhibit thyroid activity, although someone probably will need to eat a large amount of soy for this to happen.  Soy also has antinutrients, such as lectin and protease inhibitors.  And so eating soy can make digestion difficult, and potentially interfere with the absorption of certain nutrients, such as iron.  While there is some evidence that the phytoestrogens of soy has certain health benefits, there is also evidence that it can cause problems, such as infertility.

My Opinion About Eating Soy: Without question, I am opposed to people eating non-organic soy, since most of the soy is genetically modified.  However, I’m also not in favor of people eating large amounts of soy, even if it is organic and fermented.  As for eating small amounts of fermented, organic soy, I think doing this on an occasional basis is fine for most people.  I personally try to avoid soy-based foods, although I do occasionally eat some foods which have organic, fermented soy, and I don’t think having very small amounts of soy will lead to major health problems in most people.  For example, if someone takes a nutritional supplement with organic, fermented soy I think that in most cases this will be fine.  On the other hand, I would be cautious about eating soy-based foods on a regular basis, even if the soy is organic and fermented.

Controversy #5: Fluoride. Although many people (including myself) avoid fluoride, from time to time I’ll have a patient ask whether they should use toothpaste with fluoride, or if it’s okay to drink water that has fluoride.

The Case For Using Fluoride: This honestly will be tough to defend, as I really do feel strongly about intentionally using products which have fluoride.  But I’ll give it a shot.  First of all, millions of people use toothpaste with fluoride and drink fluoridated water, yet many of these people don’t have a thyroid problem.  Plus, even though fluoride can affect thyroid health, it’s probably safe to conclude that most people with hypothyroid conditions didn’t develop this condition due to fluoride exposure.  In addition, thousands of dentists recommend fluoride in order to prevent the formation of cavities.

The Case Against Using Fluoride: There is strong evidence that fluoride can have a negative effect on thyroid health.  In fact, in the past, fluoride was used as a treatment for hyperthyroid conditions by numerous medical doctors.  Even if it really does help to prevent the formation of cavities, one always needs to consider the risks and benefits.  In my opinion we don’t need to use fluoride-based toothpaste and have fluoride in the water to have healthy teeth, and many other healthcare professionals would agree with me.

My Opinion About Using Fluoride: My wife and I have used a fluoride-free toothpaste for many years, and so have our two daughters.  And so I do recommend not using fluoride-based toothpastes, and recommend drinking water without fluoride.  This might mean drinking reverse osmosis or distilled water, or perhaps buying a separate fluoride filter.

In summary, there are numerous controversies in thyroid health, but these are five of the biggest ones.  Although I revealed my personal opinions for each of these, other natural healthcare professionals will argue with my viewpoints.  Many will tell all of their patients with thyroid and autoimmune thyroid conditions to avoid iodine, while others will tell all of their patients to never eat gluten, not to consume any goitrogenic foods, etc.  Some also won’t agree with my perspective involving fluoride, and of course many dentists and numerous other healthcare professionals feel that some fluoride use is beneficial.  The frustrating part is that if you do research on PubMed, or another source, there will be no clear cut answers.  Clinical studies are definitely lacking in these areas, and so ultimately it is up to you to do your own research and decide what is best for your health.