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.

Many people with hypothyroidism and Hashimoto’s Thyroiditis take thyroid hormone medication, and every now and then I’ll get asked if there is a natural substitute for thyroid hormone.  I deal with both hyperthyroid and hypothyroid conditions, and with hyperthyroid conditions there are some pretty good natural alternatives for the medication.  For example, bugleweed is an herb which has antithyroid activity, and many people choose to take this instead of antithyroid medication.  And motherwort can be used instead of beta blockers in some people with hyperthyroidism.  But are there nutritional supplements or herbs which can effectively manage the hypothyroid symptoms while someone is trying to restore their health back to normal?

Most people with hypothyroid conditions are aware that there are natural alternatives to synthetic thyroid hormone, such as Armour and Nature-Throid.  But while many people do better on natural thyroid hormone, this is still a form of hormone replacement therapy.  In other words, natural thyroid hormone isn’t doing anything for the actual cause of the condition.  Then again, neither is the bugleweed or motherwort many people with hyperthyroid conditions take, as I recommend these to manage the hyperthyroid symptoms while trying to address the cause of the condition.  Even so, some people prefer to take supplements and herbs, and would like to avoid taking hormones whenever possible.

Are There Supplements And Herbs To Take Instead of Thyroid Hormone Medication?

If someone has depressed thyroid hormone levels then unfortunately there are no nutritional supplements or herbs which will replace thyroid hormone.  And this is the case with any hormone deficiency.  However, there are nutrients and herbs which can help to increase the output of thyroid hormone, and in some cases these can be taken while the cause of the condition is being addressed.  So what I’d like to do is talk about some of these nutrients and herbs which might be beneficial in some cases of hypothyroidism.

Iodine. Yes, I’m starting with the controversial iodine.  I’m definitely not suggesting that iodine can be taken instead of thyroid hormone medication, and  I realize that many people with Hashimoto’s Thyroiditis don’t do well when taking iodine.  However, iodine is necessary for the formation of thyroid hormone, as thyroxine (T4) consists of four iodine atoms, while triiodothyronine (T3) consists of three iodine atoms.  Although an iodine deficiency can cause hypothyroidism, most cases of hypothyroidism are caused by Hashimoto’s Thyroiditis.  With that being said, if someone has a non-autoimmune hypothyroid condition and tests positive for a moderate to severe iodine deficiency, then it probably would be a good idea to correct this deficiency.  If someone with Hashimoto’s tests positive for an iodine deficiency then eventually this should be corrected, although other factors may need to be addressed first in order to make sure the person doesn’t have a negative reaction to iodine.

Tyrosine. This is an amino acid, and like iodine, this is also necessary for the formation of thyroid hormone.  As a result, many thyroid support formulas will include tyrosine.  However, very rarely is a tyrosine deficiency the primary cause of hypothyroidism.  And so while supplementing with tyrosine usually won’t cause any problems, it also is unlikely to make much of a difference with regards to thyroid hormone output.

Selenium. This mineral is important for the conversion of T4 to T3.  As a result, if someone has normal levels of T4 but low levels of T3, they very well might have a selenium deficiency.  However, there are other factors which can also interfere with the conversion of T4 to T3, such as high cortisol levels.  Some studies have shown that selenium can help to reduce thyroid antibodies, and while this isn’t always the case, when it does help to lower these antibodies this will minimize the amount of thyroid gland damage, which in turn can help with the output of thyroid hormone.

Iron. Iron is another mineral which is essential for normal thyroid hormone metabolism, and a deficiency of this mineral impairs thyroid hormone synthesis by reducing the activity of heme-dependent thyroid peroxidase (1).  Iron deficiency anemia is very common, and while this might not be the cause of most cases of hypothyroidism, if someone has an iron deficiency I think it’s safe to say that it’s not helping with the thyroid condition.  And so I recommend for most of my patients to not only get a complete blood count, but also an iron panel which includes serum iron, ferritin, iron saturation, and TIBC.

Zinc. Studies show a significant correlation between serum zinc levels and thyroid volume, along with thyroid antibodies and free T3 levels (2) (3).  Once again, taking zinc alone probably won’t make much of a difference in someone with hypothyroidism, although if someone is deficient in zinc it could be a contributing factor.

Ashwagandha. There are a few studies which show that ashwagandha can stimulate thyroid hormone production (4) (5).  In fact, one of these was a case study which showed that taking ashwagandha caused thyrotoxicosis in a 32-year old woman.  However, I’ve given ashwagandha to numerous patients with hyperthyroid conditions without a problem, as it doesn’t seem to directly affect the thyroid gland, but instead affects the hypothalamic-pituitary-thyroid (HPT) axis.  It also affects the hypothalamic-pituitary-adrenal (HPA) axis, which can in turn modulate cortisol levels.  Ashwagandha is commonly given to lower elevated levels of cortisol, but in most cases it can also be safely taken with those who have depressed cortisol levels.  Anyway, some people with low or depressed thyroid hormone levels might benefit from taking ashwagandha.

Coleus. Coleus (Coleus forskohlii) is a member of the Lamiaceae or Mint family.  While it can help with numerous conditions such as cardiovascular disorders, abdominal pain, and constipation, it also is commonly used for hypothyroidism, as it can potentially stimulate thyroid hormone production.

Thytrophin PMG. Some think of this as a glandular, although it’s actually referred to as a protomorphogen.  I have been using this in my practice for many years.  This product doesn’t contain any thyroid hormone.  In fact, many people with Graves’ Disease are able to take this, as its main purpose is to help neutralize the effects of the thyroid antibodies.  Thytrophin PMG isn’t meant to be a replacement for thyroid hormone medication, although every now and then I’ll receive an email from someone who is taking this instead of synthetic or natural thyroid hormone.

Thyroid glandulars. There are numerous types of thyroid glandulars, some of which don’t have thyroid hormone, and other products which do include thyroid hormone.  Obviously if someone is looking to completely avoid taking any type of thyroid hormone then they probably will also want to avoid taking thyroid glandulars which have thyroid hormone.  On the other hand, since these usually have a smaller amount of thyroid hormone, along with some of the nutrients and herbs I listed above, many are willing to take a thyroid glandular instead of levothyroxine, Armour, or Nature-Throid.

So these are some of the supplements and herbs which might benefit people who are looking to avoid taking thyroid hormone medication.  Unfortunately there is no natural substitute that can be taken in place of thyroid hormone, and having sufficient levels of thyroid hormone is very important.  While some people might do fine taking some of the nutrients and/or herbs I discussed in place of thyroid hormone, most people with overt hypothyroidism will need to be on some type of thyroid hormone medication, although they might be fine taking a thyroid glandular which has a small amount of thyroid hormone, along with other nutrients and herbs to support the thyroid gland.

I think it’s safe to say that we’re in a “smoothie era”, as millions of people consume smoothies on a daily basis.  There are a number of positive benefits of consuming green smoothies.  I personally have a green smoothie every morning for breakfast, and many of my patients do the same.  But while there are some great health benefits of drinking green smoothies on a daily basis, there are also some potential downsides of drinking these.

Before I discuss some of the potential “risks” of drinking green smoothies on a daily basis, I’d like to briefly mention a few of the primary benefits of green smoothies:

Benefit #1: Green smoothies can make it easier to start the day with a few servings of vegetables.  I look at the food diaries of patients all of the time, and to no surprise, most people don’t eat enough vegetables on a daily basis.  And most people who eat a few servings of vegetables per day don’t eat any during breakfast, but instead eat them during lunch and/or dinner.  Obviously this doesn’t apply to everyone, but it does apply to most people. It definitely applied to me growing up, as for the first few decades of my life I usually had a bowl of sugary cereal with cow’s milk for breakfast.

Benefit #2: Smoothies offer “instant hydration”, as they allow you to start the day off with a couple of cups of water.   To be fair, many people don’t add water to their smoothies, but instead add something else such as cow’s milk, almond milk, coconut milk, etc.  But many people don’t drink enough water, and so I would encourage you to at least add one cup of water to your smoothie.  For example, if you currently add two cups of coconut milk to your smoothies, try adding only one cup of coconut milk and one cup of purified water.  On most days I personally add 1/4 cup of organic almond milk to my smoothies, and 1 3/4 cups of purified water.

Benefit #3: You of course can include other healthy ingredients to your smoothies.  In addition to green leafy vegetables you can add carrots, avocados, and berries.  Many people can also add raw egg yolks and/or coconut oil to their smoothies.  Some people add a type of protein powder to their smoothie, which usually is fine, but just remember that these powders shouldn’t take the place of whole healthy foods.  I know some people have smoothies which consist of almond or coconut milk, strawberries and bananas, some type of protein powder, and nothing else.  While this is healthier than the bowl of sugary cereal I mentioned earlier, you should also add some vegetables and a healthy type of fat such as an avocado or coconut oil.  I can understand not wanting to add a raw egg yolk, although when combined with the other ingredients I mentioned, most people won’t even taste the raw eggs.  But besides the fact that some people find adding a raw egg to be disgusting, if someone is following a strict autoimmune paleo diet then they probably won’t be adding eggs to their smoothies.

So these are some of the health benefits of drinking smoothies.  But there are also some potential risks of drinking smoothies:

Risk #1: Green smoothies are typically goitrogenic. This of course depends on which green vegetables are added to the smoothie, but two of the most common green leafy vegetables added to smoothies are kale and spinach.  And while both of these have healthy nutrients, eating large amounts of raw kale and spinach can potentially inhibit thyroid activity.  Although there might be some risks with those people who have a hypothyroid condition with regards to eating large amounts of raw goitrogenic vegetables, adding 1/2 cup to one cup of these vegetables to a daily smoothie usually won’t cause a problem with most people, even those with hypothyroidism and Hashimoto’s Thyroiditis.  On the other hand, adding a few cups of raw goitrogenic vegetables to your smoothies and having one or two of these on a daily basis might cause problems in some people with hypothyroid conditions.  I spoke about goitrogens in greater detail in an article I wrote entitled “An Update On Goitrogenic Foods and Their Impact on Thyroid Health“.

Risk #2: Green smoothies can be high in oxalates. Oxalates are substances which bind to calcium, and this interferes with its absorption.  Eating foods high in oxalates can therefore lead to a decrease in bone density.  Another risk is that large amounts of oxalates can cause kidney stone formation.  I actually spoke about this in a post entitled “Should Spinach Be Avoided In Those With Thyroid Conditions?“, as I discussed the risk of loading smoothies with foods high in oxalates, such as spinach and swiss chard.  But it’s not just green leafy vegetables which are high in oxalates, as blackberries, blueberries, and raspberries are also high in oxalates, and of course many people add berries to their smoothies.  Once again, I’m not suggesting that people shouldn’t add berries to their smoothies, or other foods high in oxalates.  But it might be a good idea to minimize the amount of these foods you add to your smoothies.

Risk #3: Smoothies prepared the wrong way can spike up your blood sugar levels. Although I do think it’s fine to add some fruit to your smoothies, some people add too much fruit.  Bananas are one of the most commonly added fruits to smoothies, and while many people do fine adding a small banana to their smoothie, some people will add a few bananas, along with a few servings of other fruits to their smoothies.  This can especially be problematic for someone who has blood sugar imbalances, or an underlying yeast infection.  It’s not uncommon for people to prefer fruit over vegetables, and this definitely describes me.  When I first began making smoothies I probably added too much fruit, but I currently add 1/4 cup of organic berries to my smoothies and in my opinion it tastes fine.  Adding a healthy source of protein or fat will minimize the impact that the fructose will have on your blood sugar levels.  I would recommend adding an avocado, one tablespoon of coconut oil, and/or one or two raw egg yolks.

Risk #4: Some people include unhealthy ingredients in their smoothies. Although I’m fine with most people adding some type of “healthier” protein powder to their smoothie, doing so isn’t required.  And even if you do add a small amount of protein powder, you want your smoothie to consist primarily of whole foods.  Add a small amount of fruit, a few servings of vegetables, a healthy type of fat, etc.  But if you do add a protein powder you want to make sure it’s of good quality, and you also want to carefully read the ingredients and make sure it doesn’t include any artificial colorings or flavorings, as well as other unhealthy ingredients.

So What’s The Final Verdict?

I think most people with thyroid and autoimmune thyroid conditions can have green smoothies without a problem.  Just like anything else, the key is having a “balanced” smoothie.  Some people add too much fruit, while others add excessive amounts of green leafy vegetables.  But most people will do fine adding a small amount of fruit, while adding a few servings of vegetables, making sure to add a variety of different vegetables (i.e. 1/2 cup of arugula, 1/2 cup carrots, 1/2 cup broccoli, etc.).

Some healthcare professionals are opposed to smoothies because they feel it’s better to eat your food rather than drink your food.  In other words, rather than consume some or all of these ingredients in the form of a smoothie, they would recommend to simply have one or two eggs for breakfast, a few servings of vegetables, a serving of berries, a healthy type of fat, some meat, etc.  I can’t argue with this, as I admit that it’s better to sit down and eat a meal rather than drink a smoothie.  However, we live in an “era of convenience”, and whereas most people aren’t going to take the time to individually prepare all of these foods, many people are willing to add them to a smoothie.  Of course it can also be time consuming to make a smoothie, as I know it takes me awhile to make my morning smoothie.  In any case, for those people who are preparing a healthy breakfast I’m not suggesting to replace it with a smoothie.  On the other hand, for those people who aren’t eating a healthy breakfast and/or aren’t consuming a sufficient amount of vegetables each day, then having a daily green smoothie might be a good idea.

Something else to keep in mind is that even if you have a morning smoothie, you obviously still want to eat vegetables throughout the day.  I recommend eating a combination of raw and cooked vegetables.  Some healthcare professionals don’t recommend any raw veggies, but I think having a few servings of these are fine, along with having a few servings of cooked vegetables.  But there are some people who will overdo it with the raw vegetables, as they might have a green smoothie for breakfast, a big salad for lunch, another smoothie as an afternoon snack, and another salad for dinner.  I’m not opposed to people having salads, but they also should try adding in a few servings of steamed veggies each day.

In summary, millions of people consume green smoothies on a daily basis, and there are both benefits and risks of drinking these.  Some of the primary benefits of green smoothies are that they allow you to add some extra vegetables, along with some purified water, and other healthy ingredients, such as healthy fats and protein.  However, green smoothies are usually goitrogenic, can be high in oxalates, and might spike up the blood sugar levels.  You of course want to make sure not to add unhealthy ingredients, which can easily be avoided by sticking with whole foods, and organic foods whenever possible.  Overall I think green smoothies are fine for most people with thyroid and autoimmune thyroid conditions to drink on a daily basis, but you want to make sure not to load it up with too much of a single ingredient, such as green leafy vegetables, fruit, protein powder, etc.