When someone with hyperthyroidism or Graves’ Disease is following a natural treatment protocol, the goal should be to address the underlying cause of the condition.  However, while this is being accomplished it is important to manage the hyperthyroid symptoms.  While many people choose to do this with antithyroid medication such as Methimazole or PTU, or beta blockers such as Propanolol, others choose to manage their symptoms naturally.  In this post I’ll discuss some of the most common herbs used to manage the hyperthyroid symptoms.

Bugleweed. This herb has antithyroid activity, as it reduces the thyroid hormone levels, which in turn causes a decrease in the cardiac symptoms associated with hyperthyroid conditions.  Lycopus virginicus and Lycopus europaeus are the two main species.  Most of the research studies involving bugleweed which I have come across have involved lycopus europaeus (1) (2) (3).  These studies show that bugleweed is effective in mild forms of hyperthyroidism, although in my clinical experience I’ve had patients with moderate to severe forms respond to a 1:2 extract ratio.  On the other hand, for some people this isn’t potent enough, and in these cases taking antithyroid medication may be necessary to lower the thyroid hormone levels while addressing the cause of the problem.

Dosage: According to master herbalist Kerry bone, 2 to 6 mL of a 1:2 liquid extract should be used, although I have used higher doses than this on some patients.  6 to 18 mL/day of a 1:5 tincture is recommended by Kerry Bone.

Pregnancy and Lactation: According to Kerry Bone, bugleweed is associated with a substantial risk of causing harmful effects on the fetus or neonate, and he suggests that it shouldn’t be taken during pregnancy.  He also says this herb is contraindicated during breastfeeding due to the possibility of both prolactin reduction in the mother and antithyroid constituents passing into the breast milk.

Motherwort. This herb can greatly help with the cardiac symptoms of hyperthyroid conditions.  It can help to reduce the heart palpitations, decrease the heart rate, and also has antiarrhythmic activity.  While bugleweed is specifically used for hyperthyroid conditions, motherwort can be beneficial for other conditions, such as digestive disorders, bronchial asthma, amenorrhea, and even externally in wounds and skin inflammation (4).  So in addition to its effects on the heart and circulatory system, pharmacological studies have confirmed its antibacterial, antioxidant, anti-inflammatory, and analgesic activity (4) (5).  The results of one study showed that motherwort can weaken the generation of free radicals in mitochondria (5), which is one of the ways that it offers cardioprotection.  Another small study looked at the effect of motherwort in patients with arterial hypertension accompanied by anxiety and sleep disorders, and concluded that this herb may help with arterial hypertension and concurrent psycho-neurological disorders, with minimal side effects (6).

Dosage: According to Kerry Bone, 2 to 4 mL of a 1:2 liquid extract should be used, although I have used higher doses of this in some patients.  If using a 1:5 tincture then 6 to 12 mL should be used by most people.

Pregnancy and Lactation. There has been no increase in frequency of malformation or other harmful effects on the fetus from limited use in women.  However according to Kerry Bone there is evidence of increased fetal damage in animal studies, and as a result I don’t recommend motherwort during pregnancy.  Kerry Bone does mention that it is compatible with breastfeeding, and I have had some breastfeeding women take motherwort.

Lemon Balm. In past articles and blog posts I have briefly mentioned the benefits of lemon balm for people with hyperthyroidism and Graves’ disease.  However, I’m admittedly biased towards bugleweed and motherwort since I took those two herbs when I was diagnosed with Graves’ Disease, although I didn’t take lemon balm.  However, lemon balm can benefit many people with hyperthyroid conditions.  It has antithyroid activity, as it may block the binding of TSH to its receptor by acting both on the hormone and receptor itself, and might also inhibit the TSH receptor antibodies binding to the TSH receptors (7).  Lemon balm also has been used as a mild sedative, spasmolytic, and antibacterial agent, and might even have antitumoral activities (8).  I also came across a few studies which showed that lemon balm has inhibitory activity on the herpes simplex virus (9) (10).  Another study showed that lemon balm can decrease elevated liver enzymes due to its strong antioxidant properties and phenolic compounds (11).  Another study conducted on mice showed that lemon balm has anti-diabetic effects, which is probably due to enhanced glucose uptake and metabolism in the liver and adipose tissue, and the inhibition of gluconeogenesis in the liver (12).

Dosage:  Kerry Bone hasn’t listed doses for lemon balm, and so if I recommend this herb I usually will start someone on the recommended dosage provided by the manufacturer.

Pregnancy and Lactation: Even though lemon balm has some antithyroid activity, some consider lemon balm to be safe during pregnancy, while others recommend to avoid it.  It does seem to be compatible with breastfeeding, although it might produce a mild sedative effect in the baby.

Hawthorn. Although I usually recommend motherwort to help manage the cardiac symptoms associated with hyperthyroidism (elevated pulse rate and palpitations), I also will recommend hawthorn at times.  This can also be helpful in those people with cardiac arrhythmias.  Hawthorn also has anti-inflammatory, gastroprotective, free radical-scavenging, and antimicrobial activity (13).  With regards to its antimicrobial activity, hawthorn seems to be most effective against gram-positive bacteria, with no effect on Candida albicans.

Dosage: According to Kerry Bone 3 to 7 mL of a 1:2 liquid extract should be used.  If someone is taking a 1:5 ratio then 9 to 20 mL should be used.

Pregnancy and Lactation: According to Kerry Bone, hawthorn has shown no increase in the frequency of malformation or other harmful effects on the fetus from limited use in women.  Just as is the case with motherwort, I typically don’t recommend hawthorn during pregnancy.  According to Kerry Bone, hawthorn is compatible with breastfeeding.

Reminder: The Quality Of The Herb Does Make A Difference

When someone is taking one or more of these herbs and they aren’t helping to manage the symptoms, one needs to consider a few factors.  First of all, the potency of the herb is important.  For example, some people will prepare herbal teas using one or more of these herbs, which can offer some benefit, but many times won’t be potent enough to manage the hyperthyroid symptoms.  If you purchase a liquid herb then the extract ratio is important.  For example, a 1:2 ratio is more potent than a 1:5 ratio.  There aren’t a lot of companies which sell bugleweed, but most that do offer it as a 1:5 ratio.  If you are taking bugleweed as a 1:5 ratio and it’s not helping then you might need to increase the dosage, or switch to a 1:2 extract.

Speaking of dosage, I always get emails from non patients asking what specific dosage of bugleweed or motherwort they should take.  Obviously this depends on the person, as if someone has thyroid hormone levels well outside of the reference range, along with a very high pulse rate, and they’re not taking antithyroid medication, then they most likely will require higher doses of these herbs.  On the other hand, if someone has slightly elevated thyroid hormone levels and a pulse rate which isn’t too high then they most likely will require a lower dosage.

Finally, the quality of the herb does make a difference.  So for example, if you go online and purchase some motherwort to help with the elevated heart rate and palpitations, and it doesn’t seem to be helping, while there’s a chance the dosage isn’t high enough, there’s also the chance that the quality of the herb is poor.  So before coming to the conclusion that motherwort isn’t effective you might want to try a different brand.  If you have been following me for awhile you know that I recommend working with a natural healthcare professional who has experience working with hyperthyroidism and Graves’ disease, as they will have experience dealing with the proper dosing, and they should be able to recommend some good quality brands.

Where Does L-Carnitine Fit In?

L-Carnitine isn’t an herb, but I figured I’d briefly mention it here since it can help to lower thyroid hormone levels when taken in higher doses.  This also isn’t something I personally took when I was diagnosed with Graves’ Disease, but over the years many of my patients have taken this.  For more information on L-carnitine I’d recommend reading my article entitled “How Does L-carnitine Help With Hyperthyroidism and Graves’ Disease?”

In summary, while the goal of a natural treatment protocol should be to restore the health of the person with hyperthyroidism and Graves’ Disease, managing the cardiac symptoms is important.  In many people this can be accomplished with herbs, and four herbs which can play a role in managing the hyperthyroid symptoms include bugleweed, motherwort, lemon balm, and hawthorn.  Both bugleweed and lemon balm have antithyroid activity, while motherwort and hawthorn help with the cardiac symptoms.  Motherwort, lemon balm, and hawthorn also have other benefits as well.  And L-carnitine taken in higher doses also can lower thyroid hormone levels.

In my articles and blog posts I frequently talk about detoxification. It’s quite common for my patients to have followed one or more liver detoxification programs prior to speaking with me for the first time. In fact, I’m sure many people reading this have gone through at least one liver detoxification program over the last few years. And some people have gone through multiple liver detoxifications over the last year alone. However, most people who follow a liver detoxification don’t have a good understanding of the detoxification pathways. As a result, in this post I would like to share some of the basics so that you better understand the different phases of detoxification.

There are two primary phases of detoxification. In the phase one detoxification system, which is known as “biotransformation”, certain toxins are converted into intermediate metabolites which can actually be more harmful than the original compound. In the phase two detoxification system, also known as the conjugation process, these intermediate metabolites are combined with certain molecules and become less toxic and water soluble. And then of course these metabolites are excreted, which is considered as being phase three detoxification. I mentioned how in phase one these toxins can be more harmful, as these intermediate metabolites can cause damage to the proteins, DNA, and RNA if they don’t go through phase two detoxification. As a result, this can be problematic if someone has compromised phase two activity.

What Role Do Cytochromes Play In Detoxification?

Cytochrome P450 enzymes are produced by the liver, and are also found in the kidney, small intestine, lung, adrenals, and most other tissues. They are utilized in phase one. There are 58 different cytochromes, and different cytochromes will play different roles in the metabolism of toxins, which include medications. The cytochrome P450 can be inhibited or induced by certain drugs, as well as by certain nutrients (1). An inducing agent can increase the rate of another drug’s metabolism, whereas an inhibiting agent can inhibit the drug’s metabolism.

These cytochrome P450 enzymes not only play a role in detoxification, as they are also essential in the metabolism of certain nutrients. For example, the cytochrome P450 enzymes are necessary for the metabolism of vitamin D (2), as well as vitamin E (3). These cytochromes are also necessary for the metabolism of hormones such as estrogen, as the first step in the metabolism of estrogens is the hydroxylation catalyzed by cytochrome P450 (4).

Genetic Polymorphisms Can Affect Detoxification

Polymorphisms are common genetic defects, and these can occur in the Cytochrome P450 (CYP) family, which in turn can affect the detoxification process. This is especially true with regards to the phase one metabolism of drugs, since almost 80% of drugs are metabolized by these enzymes (5). For example, if someone has a polymorphism of CYP2D6 then the individual would be considered to be a “poor metabolizer” (5). And polymorphisms of other CYP genes are also common, such as CYP1A1, 2A6, A13, 2C8, 3A4, and 3A5.

But what’s the significance of these genetic polymorphisms? Simply put, having certain polymorphisms of the CYP enzymes can reduce the person’s ability to detoxify. And some of these polymorphisms have been linked to chronic health conditions. For example, many people with hyperthyroidism and Graves’ Disease will commonly be advised by their endocrinologist to take Propranolol, which is a beta blocker. The cytochrome CYP2D6 is primarily responsible for the metabolism of Propranol (6), along with some other beta blockers, such as metoprolol (7). As a result, if someone were to have a genetic polymorphism of this cytochrome then this can affect the clearance of Propranol. Why is this important? Well, someone who has a polymorphism of CYP2D6 might require a different dosage of these beta blockers when compared to someone who doesn’t have such a polymorphism. Of course most people aren’t tested for these polymorphisms, and so the medical doctor will just recommend what he or she thinks is the appropriate dosage. In the future more and more people are going to be tested for these genetic polymorphisms, which in turn will impact the drug recommendations given by medical doctors.

But even though the focus of this post is on the detoxification pathways, these polymorphisms can cause other health issues. As I mentioned earlier, people who have a polymorphism of CYP2D6 are considered to be “poor metabolizers”. Well, a few studies have linked this polymorphism with Parkinson’s disease (8) (9). This doesn’t mean that everyone with this specific polymorphism will develop Parkinson’s, although it very well might make that person more susceptible to developing this condition. There is also evidence that some of these polymorphisms can increase one’s susceptibility to cancer (10).

Although I’ve been focusing on CYP2D6, there are many other types of polymorphisms of the cytochromes one can have, as I briefly listed some of them earlier. In addition to having polymorphisms of the cytochromes, there are other polymorphisms which can affect detoxification. For example, polymorphisms of glutathione S-transferase M1 (GSTM1) can have a negative effect on detoxification. N-Acetyltransferases (NAT) are key enzymes in the conjugation of certain drugs and other xenobiotics with an arylamine structure (11), and these polymorphisms can also affect detoxification.

How Can Nutrient Deficiencies Affect Detoxification?

Having certain nutrient deficiencies can have a negative effect on detoxification. And the reason for this is because nutrients are necessary for the proper functioning of the detoxification pathways. Some of the more important nutrients required for phase one detoxification include vitamins B2, B3, B6, B12, and folate. Many reading this are familiar with glutathione, which is an important antioxidant that also plays an important role in both phase one and phase two detoxification. The amino acids glycine, taurine, glutamine, cysteine, and methionine are all important for phase two detoxification.

However, when looking back at phase one detoxification, remember that intermediary metabolites are produced, and these can lead to the formation of free radicals. As a result, it is important to have sufficient antioxidants to help neutralize these free radical reactions. This not only includes glutathione, but others such as selenium and vitamin C.

The Complexity of The Phase Two Detoxification System

As I briefly mentioned earlier, phase two involves the conjugation of the intermediate metabolite with another molecule to make it less toxic and water soluble. While this might sound easy enough, it actually can be quite complex, as there are numerous pathways required in this phase. This includes acetylation, acylation, sulfur conjugation, methylation, and glucuronic acid conjugation. I’m not going to discuss these here, but just remember that having problems with any one of these pathways can affect phase two detoxification.

But what would cause these systems to malfunction? Well, there can be numerous factors which cause this. Having a genetic defect such as an MTHFR polymorphism can cause problems. Or having a certain nutrient deficiency can also lead to big issues. For example, if someone has a vitamin B5 (pantothenic acid) deficiency then this can affect acetylation. If they have a deficiency in glycine or taurine then this can affect acylation. If they have a deficiency of vitamin A or niacin then this can affect sulfation, etc. So for example, glutathione synthesis is magnesium-dependent. There are other important nutrients and amino acids required, but if someone has a severe magnesium deficiency, yet they take something such as N-acetyl cysteine to help increase glutathione levels, they won’t be able to accomplish this if the magnesium deficiency isn’t addressed.

Thyroid Health and Detoxification

Thyroid hormones play an important role in detoxification. Either a hypothyroid or hyperthyroid state can have a negative effect on the cytochrome P450 enzymes, which you now know play an important role in phase one detoxification. For example, one study in mice showed that hypothyroidism can affect the metabolism of xenobiotics by suppressing the CYP3A enzyme, while inducing the CYP2B enzyme (12). Numerous studies also show that a thyroid imbalance can affect the cytochrome enzymes (13) (14) (15).

So what does this mean? Well, it means that having hypothyroidism or hyperthyroidism can have a negative effect on detoxification. And so while it’s beneficial for people with these conditions to do things to detoxify their body, if they have a thyroid hormone imbalance then this can reduce the ability of body to metabolize toxins. And so it is important to correct any thyroid hormone imbalance in order to achieve optimal detoxification.

So hopefully you have a better understanding of the importance of the detoxification pathways. When someone undergoes a liver detoxification, the foods and supplements they are taking should support these pathways. If someone is deficient in one of these nutrients then this will have a negative effect on detoxification. However, having certain genetic polymorphisms can also have a negative effect on the detoxification pathways. In addition, having healthy thyroid hormone levels are also important for proper functioning of the detoxification pathways.

It’s common for people who have thyroid and autoimmune thyroid conditions to have blood sugar imbalances.  Eating a large amount of carbohydrates and refined sugars is the primary factor responsible for this.  However, many people wonder about natural sugars and sweeteners, and so I decided to put together a post which discusses this, including which ones are okay to consume, which ones should be avoided, and which ones are controversial.

One thing to keep in mind as you read this information is that while some natural sweeteners are better than others, regardless of the type of sugar or sweetener, you do want to minimize your overall consumption of these.  Although there are some health benefits of certain sweeteners such as honey and maple syrup, eating large amounts can have a negative effect on one’s health.  This is true not only with the sweeteners I mention here, but even with whole foods which contain larger amounts of sugar, such as fruits.  For most people, eating a few servings of fruit per day is fine, but eating large amounts of fruit on a daily basis can cause health issues in some people.  This is especially true with those who have blood sugar imbalances and/or a yeast or bacterial overgrowth.

I’m not going to talk in detail about fructose in this post, but I wanted to briefly mention it, as when it comes to the different types of “natural” sweeteners, the high levels of fructose in some of these can be an issue.  Of course fruit has fructose, but eating a small amount of fructose won’t cause problems for most people.  On the other hand, consuming large amounts of fructose on a regular basis can impair insulin sensitivity and cause metabolic dyslipidemia (1) (2) (3).  While many people realize that high fructose corn syrup can be detrimental to their health, they might not realize that certain natural sweeteners such as agave syrup also has large amounts of fructose.  Once again, this doesn’t mean you need to completely avoid consuming fructose, but you do want to minimize your consumption of it.

With that being said, let’s go ahead and discuss some of the different forms of natural sugars and sweeteners:

Honey. There are many different health benefits of honey.   Honey consists of mainly fructose and glucose, along with 25 different oligosaccharides, and it has a glycemic index anywhere from 32 to 85 (4).   It also contains small amounts of proteins, enzymes, amino acids, minerals, trace elements, vitamins, aroma compounds and polyphenols (4).  Many studies have shown that honey is more tolerable than most common sugars or sweeteners in healthy subjects, as well as in patients with impaired glucose tolerance or diabetes mellitus (5).  Another study showed that honey caused greater elevation of insulin than sucrose, although it reduces blood lipids, homocysteine, and CRP in normal and hyperlipidemic subjects, and when compared with dextrose and sucrose caused lower elevation of the plasma glucose level in diabetics (6).  However, another study showed that while consuming honey can provide beneficial effects on body weight and blood lipids of diabetic patients, it also raises hemoglobin A1C (7).  Even though honey is high in fructose, most people with thyroid and autoimmune thyroid conditions can have a small amount of raw honey every now and then.

Maple syrup. Maple syrup, along with honey and brown sugar has shown intermediate antioxidant capacity (8).  It has many different phytochemicals, which might lead to numerous health benefits (9).  One study compared the enhancement of plasma glucose levels in type 2 diabetes by oral administration of sucrose or maple syrup, and concluded that maple syrup may have a lower glycemic index than sucrose, which may help in the prevention of type 2 diabetes (10).  Just as is the case with raw honey, many people with thyroid and autoimmune thyroid conditions do fine consuming small amounts of maple syrup every now and then.

Molasses. Molasses can also be used as a natural sweetener, as it the main byproduct of sugar production, and it is high in antioxidants (11).  In fact, one study looked at the total antioxidant content of some of the different alternatives to refined sugar, including raw cane sugar, maple syrup, agave, honey, etc., and found that dark and blackstrap molasses had the highest total antioxidant content (12).  Blackstrap molasses is also a good source of calcium (13).  Small amounts of molasses is fine for many people with thyroid and autoimmune thyroid conditions.

Agave syrup. A lot of people consider agave to be a healthier type of sweetener.  The good news is that agave syrup has a low glycemic index and might contain beneficial antioxidant nutrients, trace elements, or phytochemicals (14).  The bad news is that it is very high in fructose, and depending on the source and how it’s processed, it might actually have higher levels of fructose than high fructose corn syrup.  Consuming agave syrup can potentially lead to elevated serum triglycerides and VLDL (14).  Dr. Joseph Mercola has put together a very interesting and eye-opening article on agave syrup, and explains why you should avoid it.

Stevia. Stevia is a small perennial shrub that has been used for centuries as a bio-sweetener and for other medicinal uses such as to lower blood sugar (15).  It has no calories and is over 100-300 times sweeter than table sugar (15).  Steviol glycosides are the secondary metabolites responsible for the sweetness of stevia (16). One study on diabetic rats showed that stevia consumption not only resulted in a reduction of blood glucose, but also might ameliorate liver and kidney damage (17).  Based on another study on male rats which decreased their fertility, there is a small concern that stevia can have a negative effect on fertility (18).  However, this is yet another controversial subject, and there is no evidence that taking stevia can decrease fertility in humans.  With that being said, if someone is trying to conceive and/or is having a difficult time conceiving then it probably would be a good idea to play it safe and avoid stevia.  In addition, a recent study showed that the stevia glycosides can inhibit the growth of lactobacillus reuteri (19).  This has caused some healthcare professionals to claim that stevia is harmful to the gut flora, although more studies are definitely needed in this area before we can come to such a conclusion.  I’ve had patients with thyroid and autoimmune thyroid conditions consume small amounts of stevia while following a natural treatment protocol without it having a negative effect on their recovery.

Coconut sugar. I have had many patients ask about coconut sugar, also known as coconut palm sugar.  This is lower in fructose than some of the other sugars and sweeteners I’ve listed here.  However, the fructose content is somewhat controversial, as some sources claim that it has less than 10% fructose, while other sources claim it’s closer to 40%.  Coconut sugar does seem to be a good source of certain minerals and inulin.  While inulin can be beneficial to the gut flora, as it can help to stimulate the growth of the Bifidobacteria species (20) (21), some claim that it might cause problems with gut healing.  With that being said, I came across a study which showed that inulin-enriched pasta actually preserves intestinal mucosa barrier functioning and might be used in the prevention of gastrointestinal diseases and metabolic disorders (22).

Luo han. This comes from a Chinese plant, and is minimally processed.  One study conducted on rabbits showed that it not only improves the lipid profile by lowering total cholesterol and triglyceride levels while increasing HDL-C, but it also lowers plasma glucose levels (23).  Another study showed that Luo han can provide a positive health impact on stimulating insulin secretion (24).  Another study showed that Luo han might be beneficial as an antibacterial agent (25).  Small amounts of Luo han are probably fine to consume.

Xylitol and other sugar alcohols. Xylitol is a naturally occurring alcohol found in plants, and is a common sugar substitute.  Xylitol does seem to have some health benefits, as there is evidence it can help with otitis media (26), and also might help to prevent dental cavities by inhibiting the growth of several strains of mutans streptococci (27) (28).  Erythritol is another type of alcohol and also was found to prevent dental caries.

However, some people experience gastrointestinal discomfort and sometimes even diarrhea when consuming sugar alcohols such as xylitol.  A few studies have shown accelerated intestinal transit after xylitol ingestion (29) (30).  Since sugar alcohols are fermented by gut bacteria,  someone with a condition such as small intestinal bacterial overgrowth (SIBO) will want to avoid all sugar alcohols.  There is some concern that some sugar alcohols might cause an increase in intestinal permeability (a leaky gut), although I wasn’t able to find any studies showing this to be the case.  For those who have dogs you will want to make sure that they don’t ingest any foods which contain xylitol, as there is evidence that acute liver failure can occur when they consume xylitol (31).

Which Natural Sugars/Sweeteners Can You Safely Consume?

Now that I have discussed some of the more common natural sweeteners, I’d like to summarize which natural sugars/sweeteners most people with thyroid and autoimmune thyroid conditions can safely consume, and which ones should be avoided.  As I mentioned in this post, sweeteners such as honey, maple syrup, and molasses seem to be fine in very small amounts.  There is some controversy over stevia, although I personally think that it’s fine for most people to have small amounts of this as well.  However, if someone has problems conceiving then it might be best to avoid stevia.  I recommended to avoid sweeteners high in fructose such as agave since it has high levels of fructose.  Luo han seems to be a safe option.  Although coconut sugar is a better option when compared to certain sweeteners such as agave, it probably is best to first choose honey, maple syrup, or molasses.  Small amounts of sugar alcohols are fine for some people, but they can be problematic for someone with SIBO, and there is some concern that they can cause a leaky gut, although more research needs to be done in this area.

Keep in mind that there are some people who have problems tolerating honey and maple syrup, and if this is the case then of course it’s best to avoid these.  With regards to stevia, if you do take this I would recommend pure organic stevia, and avoid processed types.  But every now and then there will be someone who doesn’t seem to do well even with organic stevia, and thus should avoid it.

In summary, many people with thyroid and autoimmune thyroid conditions have questions about which natural sugars and sweeteners they can safely consume.  Many people with these conditions are able to consume small amounts of honey, maple syrup, and molasses.  In my opinion stevia is also okay to consume by most people, as long as it’s not processed.  Luo han is probably safe to consume in small amounts.  There is controversy over coconut sugar and the sugar alcohols.  And sweeteners high in fructose such as agave should be avoided.

In the last blog post I spoke about 5 power foods for hyperthyroidism and Graves’ Disease, and so it’s only fair that I put together a blog post where I discuss 5 power foods for hypothyroidism and Hashimoto’s Thyroiditis.  Remember that this list isn’t all-inclusive, as there are other foods which are nutrient dense that can benefit people with hypothyroid conditions.  Also, keep in mind that while I intentionally left off cruciferous vegetables because of the stigma they receive by many people with hypothyroidism due to their goitrogenic properties, many people with hypothyroid conditions can eat normal amounts of cruciferous vegetables.

Keep in mind that not everyone with hypothyroidism and Hashimoto’s Thyroiditis will be able to eat all of these “power foods”.  For example, the first power food I listed is coconut oil, and while most people do fine when eating this, if someone has a condition such as small intestinal bacterial overgrowth then they might not be able to consume coconut oil, along with other coconut products.  Obviously everyone is different, and while most people with hypothyroid conditions can eat the foods I’ve listed, there are always exceptions.  So with that being said, let’s go ahead and talk about these power foods.

Power Food #1: Coconut Oil. Because coconut oil is a saturated fat, many people still try to avoid this oil out of fear that saturated fats can cause heart disease.  Of course this isn’t proven in the latest research, and the evidence actually shows that coconut oil can lower lipid levels in serum and tissues and LDL oxidation by physiological oxidants (1).  Another study demonstrated that coconut oil has anti-inflammatory, analgesic, and antipyretic (can reduce fever) properties (2).  The anti-inflammatory properties can be especially beneficial for those with autoimmune thyroid conditions.  Coconut oil is also one of the fats you can safely cook with.

Lauric acid is the main ingredient of coconut oil that offers some wonderful benefits.  In addition to the benefits I already listed above, coconut oil also has antimicrobial properties due to lauric acid, which converts into monolaurin (3) (4) (5).  Lauric acid also has insulinotropic properties (6), which means it helps stimulate the production of insulin.  Another study showed that lauric acid present in coconut oil might protect against diabetes-induced dyslipidemia (7).

There are some sources which demonstrate that coconut oil can speed up the metabolism, and thus benefit people with hypothyroidism.  In fact, a few sources claim that coconut oil can cure hypothyroidism.  Although coconut oil might have a positive benefit on the metabolism, keep in mind that most cases of hypothyroidism have an autoimmune component, and just taking coconut oil isn’t going to address this.  But with that being said, due to some of the other health benefits I mentioned earlier, coconut oil should be consumed by most people with thyroid and autoimmune thyroid conditions.  I recommend for most people with thyroid and autoimmune thyroid conditions to consume at least one tablespoon of coconut oil per day.

Power Food #2: Avocados. Avocados are one of most nutrient dense foods, and so eating an avocado per day can help to provide many nutrients, and comes with other health benefits as well.  Current research has shown that avocado seeds may improve hypercholesterolemia, and can be useful in the treatment of hypertension, inflammatory conditions and diabetes (8). Seeds have also been found to possess insecticidal, fungicidal, and anti-microbial activities (8).  Avocado oil consists of 71% monounsaturated fatty acids (MUFA), 13% polyunsaturated fatty acids (PUFA), and 16% saturated fatty acids (SFA), which helps to promote healthy blood lipid profiles and enhance the bioavailability of fat soluble vitamins and phytochemicals from the avocado or other fruits and vegetables, naturally low in fat, which are consumed with avocados (9).  A recent study showed that avocado consumption is associated with improved overall diet quality, nutrient intake, and reduced risk of metabolic syndrome (10).  If you are unable to purchase organic avocados, the good news is that avocados are currently on the “Clean Fifteen” list of the Environmental Working Group, which means that non-organic avocados are lower in pesticides when compared to other fruits and vegetables.

Power Food #3: Bone Broth. Bone broth involves boiling the bones of animals, and it is very nutrient dense.  In addition, bone broth includes amino acids which can help to reduce inflammation and heal the gut.  This can be essential for someone who has Hashimoto’s Thyroiditis, as many people with this condition have a leaky gut.  And some researchers feel that everyone with any type of autoimmune condition has a leaky gut.  I’m not sure if this is true, but regardless of whether or not someone has a leaky gut, drinking bone broth can be beneficial.  And if someone does in fact have a leaky gut, then drinking a few cups of bone broth can help with the healing process, assuming the trigger which caused the leaky gut in the first place has been removed.

How much bone broth should someone drink on a daily basis?  If someone has received a positive test for a leaky gut then drinking at least 2 or 3 cups of bone broth daily would be a good idea.  If someone has an autoimmune condition and doesn’t know if they have a leaky gut, I would recommend drinking at least one or two cups per day, although more than this would be fine.  Of course the quality of the bone broth is important.  For example, if you are drinking beef bone broth then I would make sure the bones are from cows which were 100% grass fed.

Power Food #4: Asparagus: Asparagus possesses a variety of biological properties, as they are rich in antioxidants, plus they are anti-inflammatory, antihepatotoxic, antibacterial,  and antioxytocic (11).  Asparagus can also protect the liver cells against toxins and might even help to alleviate alcoholic hangovers (12).  This plant also contains vitamins A, B1, B2, C, E, magnesium, phosphorus, calcium, iron, and folic acid (11). Other primary chemical constituents of Asparagus are essential oils, asparagine, arginine, tyrosine, flavonoids (kaempferol, quercetin, and rutin), resin, and tannin (11).  Just as is the case with avocados, asparagus is also currently on the “Clean Fifteen” list from the Environmental Working Group.

Power Food #5: Garlic. Garlic has many different health benefits, and while some people are unable to tolerate garlic, for those who are able to eat garlic I recommend doing so on a frequent basis.  With regards to autoimmune conditions such as Hashimoto’s Thyroiditis (as well as Graves’ Disease), garlic can help to decrease proinflammatory cytokines and suppress nuclear factor kappa B (13) (14), which are both factors in autoimmune conditions.  In addition, many people are aware of the antimicrobial properties of garlic, as garlic can help to eradicate bacteria such as H. Pylori, and in some cases can even be effective against strains which are antibiotic resistant (15).  Garlic also has antifungal and antiparasitic activities (16) (17), and of course pathogens can play a role in thyroid autoimmunity.

How much garlic should you eat on a daily basis?  Well, it really does depend on the person, as if someone has a known infection then they should be eating more garlic than someone without an infection, and probably should also consider taking a garlic supplement on a daily basis.  Eating one or two cloves of garlic when having an infection would also be wise, and eating a clove of garlic per day would benefit those without an infection, as garlic can help to prevent infections as well.

So if you have a hypothyroid condition then I would consider incorporating most, if not all of these power foods.  Avocados and coconut oil are healthy types of fats, and both have anti-inflammatory properties.  Bone broth can benefit those who have a leaky gut, which is a component in many people with Hashimoto’s Thyroiditis.  And some sources claim that everyone with an autoimmune condition has a leaky gut, which would make bone broth even more important.  Asparagus has numerous properties which can be beneficial, and garlic is one of the most beneficial foods.

One of the most common questions I get asked from people with thyroid and autoimmune thyroid conditions is “what foods should I eat?”  A general answer I commonly give is to eat whole foods, minimize the refined foods and sugars, and to avoid common allergens such as gluten, dairy, corn, etc.  When it comes to choosing specific foods for thyroid and autoimmune thyroid conditions, one of the challenges is that some healthy foods can cause problems.  For example, if someone tries to avoid all foods with antinutrients such as lectins, phytic acid, saponins, and oxalates, this will greatly minimize the amount of foods they can eat.  On top of this you might decide to avoid eating eggs and the nightshades.  After doing this you will be left with a very small category of foods.

So when putting together this list, I realize that there are some foods which fall within the categories I listed above.  And I’m not suggesting that everyone should eat these foods.  For example, one of the power foods I listed below is eggs.  Eggs have a lot of good nutrients and are a pretty good source of protein.  The problem is that it’s not uncommon for people to be sensitive to eggs.  Of course it’s possible to have an allergy or sensitivity to any food, although some food allergies and sensitivities are more common than others.  The point I’m trying to make is that the “power foods” I listed below represent an excellent source of nutrients and can benefit many people with hyperthyroidism and Graves’ Disease.  However, this doesn’t mean that everyone with these conditions can eat these foods.  And of course there are other nutrient dense foods which I didn’t include on this list.  While this blog post focuses on power foods for hyperthyroidism and Graves’ Disease, for those with hypothyroidism and Hashimoto’s Thyroiditis, in the next blog post I’ll discuss some of the power foods for hypothyroid conditions.

With that being said, let’s go ahead and list five power foods that can benefit those people with hyperthyroid conditions:

Power Food #1: Kale. Kale has some wonderful health benefits.  First of all, it is very nutrient dense.  Second, it has antiproliferative effects (1), and so it can help with the prevention of cancer.  There is also evidence that it can favorably influence serum lipid profiles and thus reduce the risk of coronary heart disease (2).  As for whether you should eat kale raw, or if you should cook it, one study showed that the cooking process of kale resulted in lowering of the activity of its antioxidants (3).  However, you still will get many of the benefits of kale if you lightly steam it.  As for how kale can specifically benefit people with hyperthyroidism, kale is considered to be goitrogenic, which means that when consumed in larger amounts it can potentially inhibit thyroid function.  Cooking might reduce the goitrogenic activity, and if you have hyperthyroidism or Graves’ Disease feel free to eat a few servings of raw kale per day.  Bone density is an issue with hyperthyroidism, and kale is one of the best sources of calcium, and unlike spinach it exhibits excellent absorbability for its calcium (4).

Power Food #2: Organ Meats. Although I still can’t get over the “mental barrier” which has prevented me from eating organ meats, this category of food is very nutrient dense.  And while eating nutrient dense foods is important for everyone, one can argue that it is even more important for someone who is dealing with hyperthyroidism.  One of the biggest problems many people with hyperthyroid conditions have is losing a large amount of weight.  This of course is due to the increased metabolic rate caused by the elevated thyroid hormone levels.  And while it is important to normalize the thyroid hormone levels, while one is trying to accomplish this it is important to eat nutrient dense foods.

In addition, Coenzyme Q10 (CoQ10) is high in organs with high rates of metabolism such as the heart, kidney, and liver (5).  And numerous studies show that CoQ10 is low in people with hyperthyroid conditions (6) (7).  Although one can of course supplement with CoQ10, since organ meats have high amounts of this then this presents another option.

Power Food #3: Eggs. As I mentioned earlier, eggs are a common allergen.  As a result, not everyone is able to eat eggs.  However, even if someone doesn’t have an egg allergy, the egg whites have certain compounds which can cause problems in those people with autoimmune thyroid conditions, as well as those with other types of autoimmune conditions.  On the other hand, although I do have most of my patients initially avoid eggs, I’m not opposed to some people reintroducing eggs.  And this is especially true with those people who have hyperthyroid conditions, as many people with hyperthyroidism have a voracious appetite and are struggling to gain weight.  I know this described myself when I was diagnosed with Graves’ Disease.  Eggs are another nutrient dense food, and if someone doesn’t have an egg allergy it might be fine for them to eat egg yolks without much of a problem.

Some people are concerned that eating eggs will increase their cholesterol levels, even though research clearly shows that this isn’t the case (8) (9) (10).  In fact, one study showed that people who reported eating four or more eggs per week actually had a lower serum cholesterol concentration when compared with those who ate one egg or less per week (8).  In those with metabolic syndrome, eating eggs (including the yolks) improves lipoprotein profiles and insulin sensitivity (11).  Ideally you want to eat organic, pasture-raised eggs.

Power Food #4: Almonds. Almonds are rich in monounsaturated fat, fiber, α-tocopherol, minerals such as magnesium and copper, and phytonutrients (12).  Other cardioprotective nutrients unique to almonds include arginine, manganese, calcium, and potassium (13).  One study showed that incorporation of almonds into a healthy diet could ameliorate inflammation and oxidative stress in patients with type 2 diabetes mellitus (14).  There is also evidence that almond and almond skin ingestion may lead to an improvement in the intestinal microbiota profile and a modification of the intestinal bacterial activities (15).  One potential problem with almonds, as well as other nuts and seeds, is that it has antinutrients such as lectins and phytic acid.  As a result, you don’t want to eat large amounts of almonds, and if someone has a leaky gut then it probably would be best to avoid eating almonds while repairing the gut.  Because some researchers speculate that everyone with an autoimmune condition has a leaky gut, almonds are excluded from most autoimmune paleo diets, which means that those people with Graves’ Disease who are following this diet would want to avoid eating almonds.

Power Food #5: Berries. Consuming different types of berries can be beneficial to one’s health.  This includes blueberries, raspberries, blackberries, strawberries, and cranberries.  All berries have different phytonutrients, and the phenolic compounds are responsible for their antioxidant properties (16) (17).  In addition, numerous studies have shown berries of different kinds to have anti-inflammatory properties, and can potentially modulate inflammatory cytokines which are found in different types of autoimmune conditions (18) (19) (20) (21) (22).  Berries are typically high in oxalates, and so you want to be cautious about eating too many of these.  Growing up I never was much of a berry eater, as I frequently ate a lot of apples, grapes, and bananas.  But I currently have a smoothie on a daily basis, and I’ll always include some organic berries, as I usually rotate between blueberries, blackberries, raspberries, and strawberries.

So these are some of the “power foods” which can benefit people with hyperthyroidism and Graves’ Disease.  Of course there are other foods I didn’t include on this list which are also nutrient dense.  For example, while kale is without question a “power food”, so are other cruciferous vegetables such as broccoli and cabbage.  And although organ meats are very nutrient dense, other types of meat are nutrient dense.  For those people with hypothyroidism and Hashimoto’s Thyroiditis, in the next blog post I’ll discuss power foods which can be beneficial for people with these conditions.