Radioactive iodine treatment is commonly recommended by endocrinologists as a “cure” for hyperthyroidism and Graves’ Disease.  While many people who receive this treatment seem to do fine, others regret the decision to have received this treatment method.  And for those who are considering to receive radioactive iodine, there of course is no way to predict who will do well after receiving the treatment, and who will be miserable.  I receive emails from both categories of people, as sometimes I’ll get an email from someone who received RAI and they are very happy with their decision.  On the other hand, every week I receive at least a few emails from people who received RAI and regretted their decision.  And some of these people want to know if following a natural treatment protocol can restore their thyroid health, which I’ll discuss in this post.

The truth is, when someone receives radioactive iodine there really is no way to predict whether or not their thyroid health can be restored back to normal.  This depends on how much damage has been done to the thyroid gland.  And this in turn depends on a few different factors.  One obvious factor is the dosage of radioactive iodine that was used during treatment.  If a very high dose was used then this will increase the chances of the person becoming permanently hypothyroid.  Sometimes what will happen is that a lower dose will be used, and if it doesn’t make the person hypothyroid then the doctor will recommend another session of RAI.  So receiving a very large dose of RAI and/or receiving multiple RAI treatments will decrease the chances of your thyroid gland secreting a normal amount of thyroid hormone.

Why Can’t The Effects Of Radioactive Iodine Always Be Reversed?

In order to understand why the effects of RAI can’t always be reversed, it probably would be a good idea to explain what happens when someone receives this type of treatment.  Radioactive iodine is also known as iodine-131.  When someone receives this treatment, it is taken up by the body as if it were the mineral iodine.  So it will travel through the bloodstream to the thyroid gland.  But unlike the mineral iodine, RAI will destroy the cells of the thyroid gland.  Obviously the larger the dose of RAI that is used, the more thyroid cells that will be destroyed, thus increasing the chance that the person will become permanently hypothyroid.

But isn’t it possible to regenerate the cells of the thyroid gland?  Well, it is thought by many that the thyroid gland doesn’t have the ability to regenerate.  However, not only have I helped patients who sustained significant damage to their thyroid gland through radioactive iodine, but numerous other natural healthcare professionals have had similar experiences.  Obviously there will be people who receive RAI who can’t have their thyroid health restored back to normal, but there also will be some people who receive RAI, and after following a natural treatment protocol they are able to wean off of their thyroid hormone medication.

Plus, remember that even if someone who received RAI can’t have their thyroid health restored back to normal, this doesn’t mean that they can’t benefit from following a natural treatment protocol.  After all, I think most people reading this would agree that hyperthyroidism typically isn’t due to a deficiency of radioactive iodine.  Most hyperthyroid conditions are due to Graves’ Disease, which is an autoimmune condition that affects the thyroid gland.  And as a result, receiving RAI might eliminate the hyperthyroidism, but it won’t do anything for the autoimmune component.

But how about if someone received radioactive iodine due to a non-autoimmune hyperthyroid condition, such as toxic multinodular goiter?  Well, even if there isn’t an autoimmune component, many people with multinodular goiter have other imbalances, such as adrenal weakness, toxic overload, etc.  The point I’m trying to make is that radioactive iodine uses radiation to kill thyroid cells, but in no way does it do anything to restore one’s health.  Whether someone develops Graves’ Disease or multinodular goiter, RAI doesn’t address the underlying cause of the problem.

How Can You Determine If You’d Benefit From Natural Treatment Methods?

So if you have received RAI, how can you find out if you would benefit from following a natural treatment protocol?  Well, being a natural healthcare professional I’m going to be biased, as in my opinion I think most people who receive RAI can benefit from natural treatment methods.  Keep in mind that I’m not suggesting that everyone who has received this treatment method can restore their thyroid health and therefore avoid taking thyroid hormone medication.  Although this without question is possible in some people, there is also the possibility that you will need to be on synthetic or natural thyroid hormone.

With that being said, I still feel that it’s important to address the cause of the condition whenever possible.  While this is true with all chronic health conditions, this is especially true with autoimmune conditions such as Graves’ Disease.  And the reason for this is because the research clearly shows that someone who has one autoimmune condition has a greater likelihood of developing another autoimmune condition in the future.  And since RAI doesn’t do anything to address the underlying cause of the autoimmunity associated with Graves’ Disease it would make sense to do everything you can to address the cause.

In summary, some people who have received radioactive iodine would like to know if their thyroid health can be restored after following a natural treatment protocol.  Although some people can have their thyroid health restored after receiving RAI, there is no way to predict if this will happen, as it depends on a few factors, including how much damage has occurred to the thyroid gland.  If the person has certain nutrient deficiencies then this can also affect the healing process.  But even if someone’s thyroid health can’t be completely restored back to normal, since RAI doesn’t do anything to address the underlying cause of the condition, most people who have received this procedure can still benefit from natural treatment methods.

In the last blog post I discussed a diet for hyperthyroidism and Graves’ Disease, and so it’s only fair that I take some time to discuss the ideal type of diet for those with hypothyroidism and Hashimoto’s Thyroiditis.  Although many people with Hashimoto’s Thyroiditis do great when following an autoimmune paleo diet, others need to make certain modifications.  If you read last week’s blog post you’ll notice that in this post there is a good amount of overlap in the dietary recommendations, although just keep in mind that everyone is different, and not everyone will respond well to the same exact diet.

Just like I did in last week’s post, I’ll attempt to make this easier to understand, as what I’ll do is go through each category of food, and discuss some of the main foods within each category which can commonly be consumed, and which ones should usually be avoided.

Vegetables.  Most people with hypothyroidism and Hashimoto’s Thyroiditis should eat a wide variety of vegetables each day.  I would try to eat at least five servings of vegetables per day, and more than this would be even better.  This includes vegetables such as artichoke, asparagus, broccoli, carrots, celery, kale, lettuce, onions, spinach, squash, sweet potatoes, and zucchini.  Some people reading this probably are wondering if it is a good idea to eat cruciferous vegetables, such as broccoli, cabbage, and kale. A number of years ago I did recommend for anyone with a hypothyroid condition to completely avoid these foods, but the more research I have done, the more I have realized that all of the research studies on goitrogenic vegetables involve giving large amounts of these foods to rodents.  I’m not suggesting that people with hypothyroid conditions should eat large amounts of raw cruciferous veggies, but these are very healthy foods, and in most cases, eating a few servings per day won’t cause any issues in those people with hypothyroidism and Hashimoto’s Thyroiditis.

Those people with Hashimoto’s Thyroiditis will want to be cautious about eating the nightshades, which include tomatoes, eggplant, white potatoes, and peppers.  And the reason for this is because these foods contain compounds which can have a negative effect on the health of the gut.  I discussed this in greater detail in my article entitled “Nightshades and Thyroid Health“.

You might wonder if it is essential to eat all organic vegetables.  Of course this is ideal, although I realize that in some areas it can be difficult to purchase organic food, and it is also more expensive than non-organic food.  However, you really do want to minimize your exposure to pesticides, and while rinsing your vegetables can help, eating organic is best.  If you don’t have access to organic food, or if you can’t afford to purchase organic food, then I would recommend to obtain the Dirty Dozen list from the Environmental Working Group and avoid those non-organic foods which are on the “Dirty Dozen list”, and try to eat vegetables which are on the “Clean Fifteen” list.

Sea Vegetables.  Kelp and other sea vegetables have some health benefits, although they are also very high in iodine.  Although eating foods rich in iodine is different than taking high dose iodine supplements, some people with Hashimoto’s Thyroiditis don’t do well even when eating iodine-rich foods.  This sometimes can be related to a selenium deficiency, as antioxidants such as glutathione are selenium dependent, and these antioxidants are necessary to offset the oxidation reaction caused by iodine.  And so unless if someone with Hashimoto’s Thyroiditis is certain that they have sufficient levels of glutathione and other antioxidants (i.e. vitamin C) I would recommend for those people with this condition to minimize their consumption of these foods.

Fruit.  Most people with hypothyroidism and Hashimoto’s can have a few servings of low glycemic fruits per day, which include apples, avocados, blueberries, raspberries, blackberries, cherries, grapes, peaches, pears, etc.  But how about other fruits such as bananas, watermelon, and cantaloupe?  It really does depend on the person, as while these definitely have some health benefits, bananas have a high sugar content, and melons have a higher glycemic index.  As a result, if someone has blood sugar imbalances it is best to minimize their consumption of these fruits.

I would also recommend to eat at least twice as many vegetables than fruit.  I bring this up because I commonly see the opposite pattern, as it is common for people to eat four or five servings of fruit per day, and sometimes more than this, yet only eat a couple of servings of vegetables on a daily basis.

Dairy products and eggs.  If someone has Hashimoto’s Thyroiditis and is following a strict autoimmune paleo diet, then they will want to avoid all dairy products and eggs.  And there are a few reasons for this.  With regards to dairy, many people are sensitive to the proteins of dairy, especially casein.  Some people do fine when consuming raw dairy, but not everyone.  And the same is true with regards to milk from a goat or sheep.  However, if someone has a casein sensitivity then they might react to all types of dairy, regardless of whether it is raw or pasteurized, or if it comes from a cow, goat, or sheep.  I discussed dairy in detail in a past blog post entitled “Should People With Graves’ Disease and Hashimoto’s Thyroiditis Avoid Dairy?“.  As for eggs, although eggs are very nutrient dense, egg allergies are common, and egg whites include compounds which can have a negative effect on gut health.  With that being said, many people do fine consuming egg yolks.  My current approach is to have people with Hashimoto’s Thyroiditis avoid these foods for one month, and if they are struggling with the diet then they can try to reintroduce egg yolks.

Fermented foods.  Most people with hypothyroidism and Hashimoto’s Thyroiditis can benefit from eating some non-dairy fermented foods on a regular basis.  This includes kimchi, kombucha tea, sauerkraut, and unsweetened coconut yogurt.  Although fermented dairy products such as kefir and yogurt can also benefit one’s health, since I typically have my patients avoid dairy I recommend for them to avoided fermented dairy products.  If someone has a condition such as small intestinal bacterial overgrowth (SIBO) then they probably won’t be able to tolerate fermented foods until this problem is addressed.

Coconut products.  Most people with hypothyroidism and Hashimoto’s Thyroiditis do fine when consuming coconut products, which include coconut butter, coconut milk, coconut oil, coconut flakes, and coconut yogurt.  Plus, there is some evidence that coconut can help to increase the metabolism, which might offer yet another benefit to those with an underactive thyroid.  With regards to coconut milk and coconut yogurt, although you can purchase these at most health food stores, you need to be careful about other ingredients which might be included that you shouldn’t consume, and as a result it might be best to make your own coconut milk and yogurt.  As is the case with fermented foods, if someone has SIBO then they might not tolerate coconut products.

Meat.  Most types of meat are fine to eat, including beef, chicken, turkey, lamb, and pork, although the quality of the meat is of course important. For example, if someone is going to eat beef then ideally they will want to choose 100% grass fed beef.  If someone is eating poultry then organic pasture raised is preferred, although this admittedly is challenging to find in some areas.

Organ meats are very nutrient dense, and so if you like organ meats such as liver and heart then feel free to eat these.  Of course you want to make sure the organ meats are from a good quality source.

Seafood.  There is a lot of controversy over eating fish.  First of all, fish are high in mercury, as well as other toxins.  This is especially true with larger fish, but toxins affect the smaller fish as well, although to a lesser extent.  While some natural healthcare professionals claim that fish which are high in selenium help to offset any adverse effects of mercury, I still recommend to limit one’s consumption of fish to three times per week, and to try to eat fish with a low mercury content.  I’ve discussed this in greater detail in an article I wrote entitled “Seafood and Thyroid Health“.

Nuts and Seeds.  Although nuts and seeds are nutrient dense, they also have lectins and phytic acid, which can have a negative effect on gut health.  As a result, if someone has a leaky gut or another gastrointestinal issue then it probably is best to avoid nuts and seeds.  This is the main reason why nuts and seeds aren’t part of an autoimmune paleo diet, as a leaky gut is common in autoimmune conditions such as Hashimoto’s Thyroiditis, and some feel that a leaky gut is a necessary prerequisite to develop autoimmunity.  If someone is pretty certain they don’t have a leaky gut or other digestive issues, I would still make sure not to eat too many nuts and seeds, although having one or two servings per day is probably fine for most people.  Soaking nuts and seeds will help to reduce the antinutrients and make them easier to digest, although someone with a leaky gut still should be cautious about eating soaked nuts and seeds.  I’m sure some people who add chia seeds and or flax seeds to their smoothies will wonder if this is okay, but if you are dealing with a leaky gut then these should also be avoided, as these also have compounds which can affect the permeability of the gut.

Gluten-Free Grains.  Although some people seem to do fine eating a small amount of gluten-free grains such as brown rice, buckwheat, and the psuedograin quinoa, these also include compounds which can affect the health of the gut.  As a result, anyone dealing with a leaky gut should ideally go grain-free, at least until the gut has been healed.

Legumes.  These should ideally be avoided while trying to restore one’s health since they also have compounds which can affect intestinal permeability.  This includes black beans, lentils, peanuts, pinto beans, and soybeans.

Soy.  This is yet another controversial topic in the world of thyroid health.  Although a small amount of fermented non-GMO soy might be okay depending on the person, one’s overall consumption of soy should be minimized.  I would definitely look to avoid processed soy products such as soy protein powder, soy burgers and chicken nuggets, soy milk, etc.  I’m not too concerned about a small amount of soy lecithin being consumed, as long as it’s from a non-GMO source.  With that being said, some people react negatively to all types of soy, even soy lecithin.

Sugars.  Having a very small amount of natural sweeteners such as honey, pure maple syrup, molasses, or stevia is usually fine, although there are exceptions.  On the other hand, other sweeteners such as agave, corn syrup, high fructose corn syrup, and sucrose should be avoided.  The sugar alcohols are controversial, as while many people seem to do fine with them, they might have a negative effect on gut health, and they usually lead to bloating and gas in those with small intestinal bacterial overgrowth.  For more information on this I’d check out my blog post entitled “Natural Sugars, Sweeteners, and Thyroid Health“:

Herbs and spices.  Some herbs and spices are usually fine to consume, such as cilantro, garlic, cinnamon, ginger, oregano leaves, and rosemary.  Sarah Ballantyne (author of the wonderful book The Paleo Approach) has done a lot of research in this area, and she has put together a comprehensive list of what herbs and spices are fine to eat, which ones you should be cautious about, and which ones should be avoided.

Oils.  With regards to cooking, consider using coconut oil, although if someone has problems with coconut oil then they can use lard or duck fat as alternatives.  Olive oil shouldn’t be used for cooking, but it makes an excellent salad dressing (I personally use an olive oil/garlic combination on my salads).  Although there is some controversy over flax oil, I think adding some organic flax oil (not flax seeds) to your salad or smoothie is fine in most cases.

Processed Foods.  Obviously these should be avoided while trying to restore one’s health back to normal.  While some people are able to get away with eating processed foods, for others it will have a negative effect on their recovery.  After someone has restored their health back to normal they of course should still to eat mostly whole foods, although if someone has a healthy gut then eating some processed foods on an occasional basis probably won’t be a big deal.

Remember That There Is No Specific Hypothyroid Diet For Everyone

Although these are some general guidelines, just keep in mind that everyone is different.  As a result, there might be some people who are unable to eat the “allowed” foods due to food sensitivities, a yeast or bacterial overgrowth, etc.  On the other hand, some people eat some of the “forbidden” foods yet still receive good results.  The problem is that it is impossible to predict who will do fine when straying from the diet, and who won’t show a significant improvement in their health.  And so while I realize the diet is strict, especially for someone who has gut issues, I would recommend to try to be strict in order to achieve optimal benefits.

So if you have hypothyroidism/Hashimoto’s, then hopefully you have a better idea as to what you can eat, and which foods you should avoid while trying to restore your health.  While the overall goal should be to eat whole foods while avoiding the refined foods and sugars, the type of whole foods you eat can be an important factor in your recovery.

As I mentioned, you ideally want to eat at least twice as many vegetables as fruits, and if at all possible try to buy meats, fruits, and vegetables that are organic.  If this isn’t possible then at least try to buy healthier meats while trying to avoid fruits and vegetables that are on the Dirty Dozen List.  Although following these dietary recommendations alone probably won’t be enough to restore the health of most people, making these changes can lead to a huge improvement in your health, and when combined with other factors will greatly increase your chances of restoring your health back to normal.

Although I commonly recommend an autoimmune paleo diet to my patients with hyperthyroidism or Graves’ Disease, not everyone will need to follow the same exact diet.  For example, while someone with Graves’ Disease can usually benefit from following an autoimmune paleo diet, if someone has a condition such as toxic multinodular goiter or subacute thyroiditis without an autoimmune component, then their diet usually doesn’t need to be as strict.  Regardless of what type of hyperthyroid condition you have, hopefully after reading this blog post you will have a better understanding when it comes to the foods you should eat, and which foods you should avoid.

You’ll notice that below I list each category of food (i.e. vegetables, fruits, meats, etc.), and I not only tell you which foods should be eaten in most cases, which foods should be eaten with caution, and which foods should be completely avoided, but I will also explain the reasoning behind my recommendations.

Vegetables.  I look at many food diaries of my patients, and most people don’t eat enough vegetables.  Probably the average person I work with eats two to three servings of vegetables, and I would recommend to at least twice this amount.  It’s also important to eat a wide variety of vegetables.  This includes vegetables such as artichoke, asparagus, broccoli, carrots, celery, kale, lettuce, onions, spinach, squash, sweet potatoes, and zucchini.  Try to eat organic vegetables if possible, although if this isn’t possible then visit the website for the Environmental Working Group and get the Dirty Dozen and Clean Fifteen lists, and make sure to avoid those vegetables (and fruits) which are on the Dirty Dozen list.  If someone has Graves’ Disease and is trying to follow a strict autoimmune paleo diet then they will want to avoid the nightshades, as these include compounds which can have a negative effect on gut health.  And so you might need to avoid tomatoes, eggplant, peppers, and white potatoes.  For more information on this I would read my article entitled “Nightshades and Thyroid Health“.

Every now and then someone with a hyperthyroid condition will ask me if they should eat a larger amount of raw cruciferous vegetables in an attempt to decrease thyroid hormone production.  In most cases, eating a few servings of raw cruciferous vegetables won’t lower thyroid hormone levels.  In some people eating a large amount of raw broccoli, kale, or other cruciferous vegetables might help, although even if it does help this of course isn’t doing anything to address the cause of the problem.

Sea Vegetables.  There is a lot of controversy when it comes to iodine and thyroid health.  Most endocrinologists will recommend for patients with hyperthyroidism and Graves’ Disease to avoid iodine since it’s involved in the formation of thyroid hormone.  However, iodine usually does not lead to an increase in thyroid hormone levels unless large doses are taken, and many people with Graves’ Disease are able to eat some sea vegetables, which are iodine-rich.  On the other hand, some people with hyperthyroidism and Graves’ Disease don’t do well with any iodine, and of course if this is the case then I would avoid these foods while trying to restore one’s health back to normal.

Fruit.  Although I try to eat at least five or six servings of vegetables per day, I’ve always enjoyed eating fruit more than vegetables.  And this describes a lot of people, as I commonly see people eating more fruit than vegetables, although ideally you want to eat at least twice as many vegetables than fruit.  With that being said it’s fine for most people to have a few servings of fruits which have a low glycemic index, although if someone doesn’t have blood sugar imbalances then it might be fine to have some fruits with a higher glycemic index occasionally, such as watermelon and cantaloupe.  But for the most part you want to focus on eating fruits such as apples, avocados, berries (blueberries, blackberries, raspberries, strawberries), cherries, grapes, peaches, pears, etc.  However, if someone has a yeast or bacterial overgrowth then they might need to avoid some of these fruits as well.  And just as is the case with vegetables, make sure you avoid those foods which are on the Dirty Dozen list, and try to stick with fruits on the Clean Fifteen list.

Dairy products and eggs.  I receive a lot of questions about dairy, and although dairy products have some health benefits, many people are sensitive to the proteins of dairy.  As a result, I usually recommend for my patients to avoid dairy products while trying to restore their health back to normal.  Some will ask if it’s okay to eat raw dairy products, or dairy from a sheep or a goat.  The truth is, some people do fine on these other types of dairy, but if someone is sensitive to casein then they still might react to raw milk, or milk from a goat or sheep.  Keep in mind that I’m not suggesting that everyone will need to avoid dairy on a permanent basis, and for more information I would read a blog post I wrote entitled “”Should People With Graves’ Disease and Hashimoto’s Thyroiditis Avoid Dairy?“.

How about eggs?  Although eggs are allowed on a standard paleo diet, if you choose to follow an autoimmune paleo diet then eggs are excluded.  And there are a couple of reasons for this.  First of all, egg allergies are common.  But another reason is because egg whites have compounds which can cause or contribute to a leaky gut.  With that being said, eggs are very nutrient dense, and so I usually recommend for my patients to avoid eggs for at least one month, and after this time if they feel the need to reintroduce other foods I will tell them to reintroduce egg yolks and see how they do.

Fermented foods.  These have numerous health benefits, and as a result, most people with hyperthyroidism and Graves’ Disease can consume fermented foods.  If avoiding dairy then of course I wouldn’t consume fermented dairy such as yogurt or kefir, although non-dairy fermented foods such as kimchi, kombucha, sauerkraut, and unsweetened coconut yogurt are usually fine.  However, there are some people who don’t tolerate fermented foods well, including most people with small intestinal bacterial overgrowth (SIBO), and if someone has a severe yeast infection then they also might not do well with fermented foods.

Coconut products.  This includes coconut butter, coconut milk, coconut oil, coconut flakes, and unsweetened coconut yogurt.  Although some sources claim that coconut can increase metabolism, and thus benefit people with hypothyroid conditions, I haven’t come across anyone with hyperthyroidism or Graves’ Disease who experienced an increase in hyperthyroid symptoms due to consuming coconut products.  However, some people with small intestinal bacterial overgrowth are unable to tolerate coconut products, although this doesn’t describe everyone with this condition.

Meat.  If you’re a strict vegetarian or vegan then of course you can skip this section.  One of the biggest problems with hyperthyroid conditions is that in many people it leads to extreme weight loss, and thus eating nutrient dense foods is important.  Although vegetables and fruits are nutrient dense, meat is one of the most nutrient dense foods. And so feel free to eat beef, chicken, turkey, lamb, pork, and other types of meats.  And if you like organ meats then you can eat this as well, as they are even more nutrient dense than “regular” meat.   Of course  one does need to pay attention to the quality of the meat, and try to eat organic whenever possible.  This will help to minimize the toxins you consume, and ideally you also want to choose grass-fed/pasture-raised meat.

Seafood.  Although fish is nutrient dense and is an excellent source of omega 3 fatty acids, due to the mercury and other toxins I usually recommend to minimize one’s consumption of fish to two to three times per week.  Others argue that it depends on what type of fish you consume, as eating fish high in selenium might help to offset the negative effect of mercury and other toxins.  This remains controversial, and so while I’m not opposed to people eating fish a few times per week, I usually don’t recommend eating fish on a daily basis.  And although I’m focusing on fish, this applies to other types of seafood as well.  I talk more about this in an article I put together entitled “Seafood and Thyroid Health“.

Nuts and seeds.  I mentioned earlier how I like fruit, but I enjoy eating nuts and seeds even more.  While I like all types of nuts and seeds, cashews are without question my favorite.  And while nuts and seeds have a lot of nutrients and are part of a standard paleo diet, eating nuts and seeds aren’t allowed for those following an autoimmune paleo diet.  And the reason is because nuts and seeds have compounds such as lectins and phytic acid, which have a negative effect on gut health.  Although soaking nuts and seeds will make them easier to digest and reduce the antinutrient content, if someone has a leaky gut, or another type of digestive issue, it really is best to avoid the nuts and seeds.  To be honest, I’ve had some people with a leaky gut do fine when eating small amounts of nuts and seeds, but I’ve also had people who didn’t do well until they eliminated the nuts and seeds from their diet.

Gluten-Free Grains.  It’s challenging for many people to give up gluten, and for these people it’s obviously even more challenging to avoid grains altogether.  Although someone who is gluten sensitive might do fine eating some gluten-free grains such as brown rice, buckwheat, and the pseudograin quinoa, these can also affect the permeability of the gut.  In other words, even if someone doesn’t have a sensitivity to grains, these potentially can have a negative effect on gut health.

Legumes.  These also have compounds which can cause or contribute to a leaky gut.  As a result, they should be avoided for anyone who has a confirmed or suspected gut condition.  Some examples of legumes which should be avoided include black beans, lentils, peanuts, pinto beans, and soybeans.

Soy.  While fermented soy products which are not genetically modified might have some health benefits, soy also has compounds which can have a negative effect on gut health, and thus it really is a good idea to minimize one’s consumption of soy products.  While some people do fine eating a small amount of fermented soy, I would make sure not to eat any nonfermented or processed soy products such as soy milk, soy protein powder, soy chicken nuggets, soy ice cream, etc.  For most people, having a small amount of non-GMO soy lecithin isn’t an issue.

Natural Sweeteners.  This is yet another controversial area, as some sources recommend to avoid all sweeteners, even those that are natural.  Many people with hyperthyroidism and Graves’ Disease seem to do okay with small amounts of natural sweeteners such as honey, pure maple syrup, molasses, and stevia.  Some people do okay with small amounts of sugar alcohols, although they might have a negative effect on gut health, and are usually problematic if someone has a condition such as SIBO.  You should try to avoid other sweeteners such as agave, corn syrup, high fructose corn syrup, and sucrose.

Herbs and spices.  Many herbs and spices are fine to use, including garlic, cilantro, ginger, cinnamon, oregano leaves, and rosemary.  Sarah Ballantyne, who is author of the wonderful book The Paleo Approach, has done a lot of research in this area, and she has an article where she listed those herbs and spices which can be safely consumed in those with autoimmune conditions such as Graves’ Disease, and those herbs which should be avoided or used with caution.

Oils.  Coconut oil is usually the best option for cooking, although if someone is unable to tolerate coconut oil then they can instead use lard or duck fat.  I don’t recommend olive oil for cooking, although you can add olive oil to your smoothie, or use it as a salad dressing.  Organic flax oil is usually fine to consume as well.

Refined foods and sugars.  Just about everyone reading this knows that processed foods shouldn’t be consumed when trying to restore one’s health back to normal.  I’d be lying if I told you that I never eat any processed foods, but I still try to eat mostly whole foods, and when trying to restore one’s health you really do want to be strict.  It’s not uncommon to receive emails from my patients asking if it’s okay to cheat every now and then and have a slice of pizza, a piece of birthday cake, some ice cream, etc.  The truth is that some people who are trying to restore their health back to normal cheat every now and then and don’t experience any adverse effects, while others who stray from the diet don’t do well and suffer serious setbacks.  Since it’s impossible to know who will do fine when cheating and who will suffer consequences, I recommend for everyone to be strict and avoid the refined foods and sugars when trying to restore their health.

Reminder: There Is No Specific Hyperthyroid Diet That Fits Everyone

While it would be great if there was a single diet that fit everyone with hyperthyroidism and Graves’ Disease, the truth is that since everyone is different, it is common for people to follow slightly different diets.  For example, after initially avoiding eggs, one person might be able to successfully reintroduce eggs or egg yolks, while another person might need to avoid eggs completely.  Or if someone has a condition such as SIBO they might need to avoid eating fermented foods and certain fruits which are high in FODMAPS.  While many people with Graves’ Disease can benefit from following an autoimmune paleo diet, those with hyperthyroid conditions who don’t have autoantibodies can usually do fine following a standard paleo diet, which means they probably will do fine eating foods such as eggs, nuts, seeds, and the nightshade vegetables.

As I mentioned earlier, it’s common for people to ask if they can reintroduce foods that normally should be avoided.  And of course some of my patients don’t ask, as I’ll have some patients who simply eat foods they know they shouldn’t eat.  Remember that I’ve been through this as well, and so I know from self experience that it is challenging to eat a strict diet.  Just remember that certain foods are forbidden for a reason, and after you have restored your health you should be able to eat a wider variety of foods again.

So hopefully you now have a better understanding of the foods you can and can’t eat while trying to restore the health of your hyperthyroid condition.  Obviously the overall goal is to eat whole foods while avoiding the processed foods and sugars, but this doesn’t mean that all whole foods are allowed.  Certain whole foods can be problematic, which is why some people with Graves’ Disease will need to avoid them while restoring your health.  Also keep in mind that while eating well is essential to receive optimal benefits, other factors are also important such as doing a good job of managing stress, taking quality nutritional supplements, minimizing one’s exposure to toxins, etc.

There are numerous occasions when eating healthy is a challenge. There are birthday parties, weddings, Thanksgiving day, Valentine’s day, and other reasons why people choose to indulge in junk food. And then there’s the challenge of eating well when going out of town on an extended vacation. For someone with Graves’ Disease or Hashimoto’s Thyroiditis who is following a strict diet, having a single cheat day can have a negative effect on their recovery. But when someone goes on a vacation for a few days or longer, and chooses to eat poorly most of the time, it can completely ruin what they’re trying to accomplish. And so the goal of this blog post is to discuss how you can eat well while on vacation, and still have a good time.

Keep in mind that I’m not trying to be a “party pooper”, as I’d be lying if I told you that I don’t eat some bad foods when I’m on vacation. However, while it’s usually not a problem indulging every now and then after someone has restored their health back to normal, if you are in the process of trying to restore your health then you really do want to try to be as strict as possible. An ideal situation would be to either plan your vacation before following a natural treatment protocol, or after you have restored your health back to normal. With that being said, I realize that some people won’t follow this advice and will go on a vacation a few months after starting a strict diet, and I’ll list some tips to help keep you on track while you’re out of town.

Is Eating Unhealthy Necessary To Enjoy Your Vacation?

Different people will perceive this question differently. Many people eat unhealthy all of the time, but eat even worse when they are on vacation. Other people eat healthy while at home, but eat a lot of junk food while out of town. Other people will try to have some healthy meals while on vacation, although they will eat more junk food while away from home. And some super healthy people will eat the same regardless of whether they are at home or on vacation.

Most people can have an enjoyable vacation even when eating healthy. After all, I think it’s safe to say that the main reason people go on vacation isn’t so they can eat unhealthy foods. They usually go on vacation to relax, spend time with friends and family, do some type of activity, etc. And in most cases, poor planning and the inconvenience of the situation is a big reason why most people eat poorly while on vacation. Keep in mind that I’m not trying to be critical of those who indulge on vacation, as remember I admitted earlier that I don’t eat a perfect diet when I’m on vacation. But I eat better than most people while traveling, and the reason has nothing to do with greater willpower, but instead has to do with proper planning. When I eat junk food of some type, usually I know ahead of time that I’m going to indulge, although I admit that this isn’t always the case. So what are some of the things you can do in order to improve the chances of eating well while on vacation?

1. Stay somewhere with a refrigerator and kitchenette. If you plan on eating healthy most of the time while on vacation it usually is best to prepare most of your meals. But wait, doesn’t this defeat the purpose of going on vacation? If you consider cooking to be hard work then I understand that you might not want to cook while on vacation. And I’m not suggesting that you have to spend hours preparing meals. At the very least you can buy healthier pre-made options at a local health food store for some of the major meals, and if you bring some of your own pots and pans and/or a blender (or stay somewhere that already has these) you can start the day with a healthy smoothie or some eggs, both which aren’t too time consuming.
2. If you plan on eating out, do some research to find restaurants with healthier options. This is best done beforehand, as you can visit some websites to find some restaurants which have healthier options. Some examples include www.urbanspoon.com and www.findmeglutenfree.com.

Another thing you can do is to simply visit Google and do some searching for specific keywords involving healthy foods. So for example, if you’re taking a vacation to Orlando Florida you can type in “grass fed beef restaurant Orlando”, or “gluten free restaurant Orlando”. Something else you can do is look up a few of the local health food stores and contact them, as the people who work there hopefully will have some ideas about healthy places to eat.

3. Bring healthy snacks. While driving or flying to your destination, make sure you bring your own healthier snacks. And if it’s going to be a long drive or flight which involves you eating meals, I once again would try to do some planning to see which restaurants along the way or at the airport have healthier choices, gluten free options, etc. Obviously I would try to avoid fast food, but if the only options are common restaurant chains such as Chili’s, Applebees, etc., then I would eat something such as a grilled chicken salad without the croutons, perhaps a turkey burger without the bun with a side of steamed broccoli, etc.
4. Try to go on vacation with immediate family members. If you are trying to stick to a strict diet it can be challenging going on vacation with friends, unless if they have a more natural mindset. Truth to be told, it sometimes can be challenging going on vacation with immediate family members as well, as they might be fine eating well while at home, but plan on indulging when on vacation. If this is the case then at least try to convince them to eat a few healthy meals, and I would still try to plan ahead when it comes to eating out at restaurants. Once again, if you end up at a restaurant which doesn’t have healthier food choices I would at least try to stick to eating whole foods. And if you haven’t already done so I would visit the website for the Environmental Working Group and download the “dirty dozen” and “clean fifteen” lists, as the “dirty dozen” lists the fruits and vegetables with the greatest amount of pesticides, while the “clean fifteen” lists the top fifteen foods with the least amount of pesticides.
5. If necessary, postpone your vacation. I realize this isn’t always possible, and even when it is possible it is not desirable. After all, life is short, and you have a right to get some rest and relaxation. With that being said, if postponing one’s vacation will improve your chances of restoring your health, and therefore will result in you being better able to enjoy future vacations, then it probably is worth it. But once again, if you plan ahead and are flexible with regards to where you go and where you can stay, then it is possible to eat healthy.

In fact, when deciding to go on vacation perhaps you can use this as an opportunity to visit a city where there are plenty of health food stores and healthier restaurants. In other words, instead of just randomly choosing a location due to the proximity, or based on an attraction you want to visit, do some searching for cities which have numerous health food stores and healthier restaurant options. This combined with a hotel/motel which has a refrigerator and small kitchenette will make eating healthier. And rather than calling it a vacation, refer to it as a “healthy retreat”, or something similar.

Keep in mind that the above tips are mainly for when you are following a strict natural protocol to restore your health. Of course this doesn’t mean that you shouldn’t try to eat somewhat healthy while on future vacations as well, but as I’ve mentioned in past articles and blog posts, there is more room to indulge after someone has restored their health back to normal. On the other hand, if you are currently dealing with weak adrenals, a leaky gut, and/or other compromised areas of your body, it really is a good idea to be as strict as possible while trying to get healthy again.

In summary, eating healthy is a challenge for many people, but is even more challenging when going on vacation. However, most people can enjoy their vacation even when eating healthy foods. The key to eating healthy while away from home is to do some proper planning, which might include choosing a place to visit which has plenty of health food stores and restaurants with healthier food choices. Just remember that I’m not saying that you should never indulge when on vacation, but for those people who are following a natural treatment protocol, being strict with your diet is important to receive optimal benefits, and as a result you don’t want to wreck your diet while on vacation.

Many people with hypothyroidism experience a significant improvement in their symptoms upon taking thyroid hormone medication.  However, some people actually feel worse when taking thyroid hormone medication.  Some people feel worse when taking synthetic thyroid hormone and feel better when taking natural thyroid hormone, although there are some people whose symptoms worsen when taking natural thyroid hormone.  There are numerous reasons why someone can experience a worsening of their symptoms when taking thyroid hormone, and in this blog post I’ll discuss some of the more common reasons.

Fillers and other ingredients.  One of the main reasons why someone might feel worse upon taking synthetic or natural thyroid hormone is because they are reacting to one of the fillers or other ingredients.  For example, many brands of synthetic thyroid hormone include ingredients people can react to.  Synthroid is probably the most well known brand of synthetic thyroid hormone, and it includes corn starch, lactose monohydrate, as well as artificial coloring.  And so if someone has an allergy to corn or dairy, or if they have a reaction to the artificial colors, then they probably will feel lousy when taking Synthroid.  There are also fillers in some brands of natural thyroid hormone, such as Armour.  I discussed the ingredients in greater detail in an article I wrote entitled “Synthetic vs. Natural Thyroid Hormone: Breaking Down The Ingredients“.

But what can someone do if they are reacting to one or more of these ingredients?  Well, there are a few different options.  One option is to ask your medical doctor to switch you to a different brand of synthetic or natural thyroid hormone medication.  For example, Tirosint is a brand of synthetic thyroid hormone that doesn’t have all of the fillers and artificial colorings that Synthroid has.  As a result, someone might do poorly when taking Synthroid, but do well when taking Tirosint.  With regards to natural thyroid hormone, some people don’t do well when taking Armour, but do fine when taking Nature-Throid.  Another option is to visit a compound pharmacist, as they should be able to put together a hypoallergenic form of synthetic or natural thyroid hormone medication.

Conversion problem.  If someone has a problem converting T4 into T3 then they might not do well when taking certain forms of thyroid hormone medication.  Remember that most people are told to take thyroxine, which is T4.  And so if someone is taking levothyroxine, which is synthetic T4, and they are unable to efficiently convert this into T3 then they will most likely continue to experience hypothyroid symptoms.  Switching to a natural form of thyroid hormone very well might improve the symptoms since this form includes both T4 and T3.  However, taking natural thyroid hormone won’t do anything to address the cause of the conversion problem, which can be due to high cortisol levels, a selenium deficiency, gut dysbiosis, or other problems.  I discussed this in greater detail in a blog post I wrote entitled “6 Factors Which Can Affect The Conversion of T4 to T3“.

Autoimmune Response To Thyroid Hormone.  If someone takes natural thyroid hormone (i.e. Armour, Nature-Throid) and feels significantly worse, this might be due to an autoimmune response to thyroid hormone.  In other words, your immune system can produce antibodies towards T3 and T4.  This is one reason why some doctors won’t prescribe natural thyroid hormone to any of their patients.  I find this to be rare, although over the years I have had a few patients feel horrible when taking natural thyroid hormone and I suspected their immune system might have been reacting to it.  While in most cases I still prefer natural thyroid hormone over synthetic thyroid hormone, this is something to be aware of.

Adrenal Problems.  Although an elevated TSH usually is related to a hypothyroid condition, in some cases it can be due to problems with the adrenals.  One study examining three case reports linked adrenal insufficiency with subclinical hypothyroidism (1), while another study showed a relationship between the TSH and cortisol (2).   As it result, if someone has subclinical hypothyroidism (high TSH and normal thyroid hormone levels) and the thyroid antibodies are normal, then it probably would be a good idea to address any adrenal problems before the person takes thyroid hormone medication.

Thyroid Hormone Resistance.  Thyroid hormone resistance is when the thyroid receptors are not responsive to the actions of thyroid hormone.  If someone has this condition then taking thyroid hormone medication probably won’t cause their symptoms to worsen, although they most likely won’t notice an improvement in their symptoms when taking thyroid hormone.  I discussed this condition in greater detail in a blog post entitled “Thyroid Resistance and Natural Treatment Methods“:

In summary, when someone with hypothyroidism has a worsening of symptoms after taking thyroid hormone medication there can be numerous reasons for this.  Some of the most common reasons include the person reacting to fillers and other ingredients, having a conversion issue, an adrenal problem, or perhaps thyroid resistance.  In addition, for those taking natural thyroid hormone it is possible to experience an autoimmune response to the thyroid hormones.  Sometimes it can be challenging to determine why someone is having a negative reaction to thyroid hormone medication, and while there can be causes other than the ones I listed in this post, initially it’s a good idea to look into these factors I discussed.