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Thyroid Pharmacist

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Hashimoto's & Goitrogens

What Are Goitrogens and Do They Matter with Hashimoto’s?

Medically reviewed and written by Izabella Wentz, PharmD, FASCP

Dr. Izabella Wentz / August 16, 2018

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Many people with Hashimoto’s are often given nutrition advice by well-meaning people who intend to help them with their thyroid journey. Unfortunately, not everything you read and hear about supporting the thyroid with nutrition is true — some recommendations are simply myths that can be harmful or unnecessary!

One particular myth claims that those with thyroid conditions should not eat goitrogens. Goitrogens are substances that suppress the thyroid gland by interfering with thyroid hormone production, resulting in an enlargement of the thyroid known as a goiter.

Have you heard this before? This is only partially true, as all goitrogens are not created equally.

In this article, you’ll learn:

  • What are goitrogens?
  • Which substances are considered goitrogenic?
  • What are cruciferous vegetables, and why are they considered goitrogens?
  • How to eat and prepare goitrogens safely
  • The two goitrogens you should avoid at all costs
  • Other reasons you may be reacting to crucifers, and how to address them

Goitrogens 101

Delicious and healthy vegetables belonging to the cruciferous vegetables family are packed with nutrition. For example, cabbage, broccoli, cauliflower, kale, and turnips help increase detoxification in the liver, which is beneficial for individuals with autoimmune thyroid disease and impaired liver detox pathways. (For this reason, I love organic crucifers, especially kale, because kale’s hearty green leaves tend to pick up a lot of toxins from the environment.)

Unfortunately, they have gotten a bad rap due to some old nomenclature and outdated patterns in thyroid disease. These nutrient dense veggies that support the liver’s detoxification have also been identified as “goitrogens”.

The word “goitrogen” refers to any substance that has the potential to interfere with thyroid function. Goitrogens suppress the thyroid gland by suppressing the release of thyroid hormone, changing the way thyroid hormone gets produced in the body, and suppressing the absorption of iodine. As a compensatory mechanism, the thyroid will enlarge to counteract the reduced hormone production. This causes the formation of a goiter, also known as an enlarged thyroid gland.

Which Foods Are Goitrogens?

You may be surprised that some of your favorite greens, grains, and fruits are goitrogens. The following foods are all goitrogenic:

  • Bamboo shoots
  • Bok choy
  • Brassica genus veggies
  • Broccolini
  • Brussels sprouts
  • Cabbage
  • Canola oil
  • Cassava
  • Cauliflower
  • Choy sum
  • Collard greens
  • Horseradish
  • Kale
  • Kohlrabi
  • Millet
  • Mizuna
  • Mustard greens
  • Nitrates (often found in processed foods)
  • Peaches
  • Peanuts
  • Pears
  • Pine nuts
  • Radishes
  • Rapeseed
  • Rapini
  • Rutabaga
  • Soy
  • Spinach
  • Strawberries
  • Sweet potato
  • Tatsoi
  • Turnips

Not all goitrogens are created equally. Not all of them work in the same way. While it’s possible to be sensitive to anything, I like to look at research studies and clinical outcomes before I determine if a food is on the “No” list for Hashimoto’s.

The History Behind The Fear Surrounding Crucifers

Cruciferous vegetables in particular are considered to be “goitrogenic” because they have the potential to block iodine absorption. They contain glucosinolates, which are responsible for this action. Glucosinolates can prevent the absorption of iodine into the thyroid gland when consumed in large quantities.

Since iodine is a crucial nutrient for the thyroid, eating too many goitrogens in the raw state has been reported to cause hypothyroidism in people with iodine deficiency. This could be a major issue in someone who has iodine deficiency induced hypothyroidism.

Crucifers blocking iodine and exacerbating iodine deficiency was a major concern in the 1950’s, as then, the primary reason for hypothyroidism was due to iodine deficiency. So, public efforts have since been made to add iodine to the salt supplies of most industrialized countries. Adding iodine to the salt supply has resulted in lower rates of iodine deficiency.

Research has shown, however, that iodine is a “Goldilocks nutrient”. While a deficiency in iodine can create hypothyroidism due to a lack of building materials for thyroid hormone, an excess of it can also create hypothyroidism.

Today, iodine excess is recognized as a risk factor for developing Hashimoto’s! (In cases of iodine excess, excess hydrogen peroxide can cause oxidative damage to the thyroid gland.) Furthermore, Hashimoto’s has become the primary reason for hypothyroidism, responsible for 90 to 97 percent of cases of hypothyroidism in the United States. (Read more about the history of the iodine-thyroid controversy in my article, here.)

In other words, iodine deficiency is not widespread in people with Hashimoto’s. Most patients with Hashimoto’s do not have an iodine deficiency, so the goitrogenic mechanism and levels of glucosinolates in these healthy vegetables should not be an issue.

Another reassuring fact to note is that you’d have to eat a lot of them for the goitrogenic effect to be a concern. Thus, eating cruciferous vegetables (unless a person is otherwise sensitive to them) is perfectly healthy for people with Hashimoto’s and should not impact thyroid function.

How Each Substance Acts As a Goitrogen

However, it’s important to note that not all goitrogens work in the same way. In the following chart, you can see how the agents of each food act as a goitrogen:

Goitrogen Effects On The Thyroid

Note: Millet is a cereal crop that is not related to wheat, and it is often used in gluten free bread and bakery products. However, millet also contains isoflavones that inhibit thyroid peroxidase (TPO) and should be avoided by people with thyroid disorders.

Eating Crucifers Safely with Iodine Deficiency Induced Hypothyroidism

Even in the case that a person does have hypothyroidism due to iodine deficiency, he/she can still enjoy crucifers as long as they are cooked or fermented, as they are only truly goitrogenic and affect the thyroid’s absorption of iodine in a raw state. Cooking or lightly steaming them will deactivate and break down the iodine-blocking glucosinolates, as will fermenting the vegetables (as in sauerkraut).

The Exceptions: Soy and Canola

While I generally don’t recommend the avoidance of goitrogenic cruciferous vegetables, there there are two goitrogenic foods that I do always recommend avoiding with Hashimoto’s, and they are soy and canola.

Soy is a goitrogen that blocks the activity of the TPO enzyme. As such, it has been linked to the development of autoimmune thyroiditis.

A study conducted in 2006 suggested that by inhibiting absorption, soy may increase the dose of thyroid hormone required by hypothyroid patients. Furthermore, it highlighted a concern based on in vitro and animal data that those with low iodine uptake or compromised thyroid function may increase their risk of developing clinical hypothyroidism with the ingestion of soy-containing foods.

The study recommended that those who eat soy should ensure their iodine intake is adequate. However, as I mentioned above, excess iodine may exacerbate Hashimoto’s.

Additionally, soy may have indirect deleterious effects on the thyroid as well. Soy is often highly processed and American soy is likely to be genetically modified. Some researchers believe that processing and genetic modification may make foods more reactive. I don’t have any specific studies to back up this claim, however, soy protein is a common IgG reactive substance, much like gluten and dairy. In fact, it’s one of the most common reactive foods in people with Hashimoto’s. For this reason, people with underactive thyroid function and Hashimoto’s should eliminate soy from their diet. I often see people with increased anxiety and increased thyroid antibodies due to consuming soy.

In 2015, I conducted a survey of 2,332 readers with Hashimoto’s. 63 percent said they felt better after removing soy, and 34 percent reported a reduction in thyroid antibodies after doing so. On a personal note, I have suffered from a “soy crash”, feeling drained and exhausted the day after eating soy. I feel much better without it, and you may too!

Canola is another goitrogen that should be avoided in all individuals with Hashimoto’s, as it is highly processed and made from genetically modified crops. The most common source of its consumption is canola oil. It’s obtained from Canola (did you know that the name Canola comes from “Canadian oil”?), which is a variety of rapeseed.

Substitutes for Soy and Canola Oil

To replace soy and canola oil from your pantry, I highly recommend coconut oil, as it is a better alternative that contains healthy fats. Coconut oil is antimicrobial, antiparasitic, antiviral and antibiotic, and can help with weight issues. I find most people with Hashimoto’s can tolerate it.

I also recommend extra virgin olive oil. Studies have shown that extra virgin olive oil lowers “bad” cholesterol, cuts your risk of heart disease and stroke, and can lower blood pressure. It can also reduce inflammation, enable calcium in your food to be better absorbed into your bones, and regulate your immune system, as it’s loaded with antioxidants and polyphenols. Moreover, as a healthy fat, it helps to keep you feeling full longer after meals.

However, I avoid buying olive oil in stores, where the oils can sit on the shelf for months, growing stale, musty, and eventually rancid. Some may even be adulterated with added peanut or canola oils to cut costs! So, I recently became a member of the Fresh-Pressed Olive Oil Club, and now it’s my new favorite way to get pure, unadulterated extra virgin olive oil delivered to my doorstep. (They deliver three bottles to my home, four times a year. One bottle lasts one month, so I can have the freshest extra virgin olive oil on hand for every month of the year.) If this sounds like something you’d be interested in joining, you can try a FREE retail-size bottle of their artisan oil, valued at $39, for just $1, to help cover shipping! Click here for more details.

Why Am I Still Reacting To Crucifers?

Goitrogenic vegetables, except for soy and canola, are generally safe for consumption. That said, some people may not tolerate certain crucifers like broccoli, due to their gassy nature.

There may be other reasons, however, for why someone may be reacting to cruciferous vegetables.

SIBO (Small Intestinal Bacterial Overgrowth) & FODMAPs

SIBO, or Small Intestinal Bacterial Overgrowth, is an overgrowth of bacteria in the small intestine that is present in up to 50 percent of people with hypothyroidism. This condition can be a trigger for intestinal permeability and can be a root cause or exacerbating factor for Hashimoto’s.

SIBO can be exacerbated by eating foods that contain FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols). Some cruciferous vegetables like cauliflower tend to be considered high FODMAP foods, which means they may contain molecules that are not always easily absorbed by everyone.

High FODMAP Foods
If SIBO is not eradicated, a person can be sensitive to whatever foods he/or she is eating. If you suspect SIBO to be at play in your body, be sure to get tested for gut infections ASAP, so you don’t run the risk of losing more foods.

You can view all of the tests I recommend in my article on SIBO. You can also find SIBO protocols in in my new book Hashimoto’s Protocol, which explores SIBO in greater detail.

CBS Gene Mutation and Sulfur Sensitivity

Some people with Hashimoto’s may also be reactive to sulfurs, which are naturally found in high amounts in cruciferous vegetables.

I have found that individuals with CBS gene mutations are more likely to have sulfur sensitivity. In some cases, sulfur toxicity or sensitivity may also be present in people with mercury toxicity, and some of my clients have reported this reaction after treatment with DMSA or high doses of N-Acetyl Cysteine. Symptoms of sulfur toxicity include reactions like skin rashes, breakouts, and skin dryness after eating sulfur-rich foods such as eggs and garlic.

Sulfur requires specific protocols to encourage elimination. Here are some tips to help with sulfur sensitivity:

  • Supplement with butyrate, molybdenum, B12, L-carnitine, and thiamine to help to clear out excess sulfur
  • Avoid DMSA, as it is known to lead to a sulfur sensitivity and can exacerbate this condition
  • Avoid sulfur-rich foods such as eggs, garlic, onions, and cruciferous vegetables, as well as sulfur-containing supplements like NAC, selenium, glutathione, and alpha-lipoic acid, for 4 to 8 weeks as you clear out excess sulfur

If you suspect that you may have a CBS gene mutation and/or a sulfur sensitivity, be sure to test for the CBS gene mutation using a genetic test like the one offered by 23andMe, as well as check out the Sulfur Toxicity Protocol in the Advanced Protocols section of Hashimoto’s Protocol.

The Takeaway

I hope this article has debunked the myth surrounding goitrogens. There are certain goitrogenic mechanisms that I am extremely cautious around and recommend avoiding, like millet, soy and iodine excess, which inhibit the thyroid peroxidase enzyme and thyroid hormone release. That said, kale, broccoli, and other goitrogens (with the exception of soy and canola) are wonderful greens and foods that help our bodies to detoxify!

Remember, most cruciferous vegetables and goitrogen-containing foods are safe for those with Hashimoto’s. However, if you seem to react to them, you may wish to look into SIBO, sulfur sensitivity, iodine deficiency and the CBS gene mutation.

I wish you all the best in your healing journey!

P.S. If you’re looking for a diet that can be beneficial for Hashimoto’s, download my FREE 2-week AIP recipe plan.

P.P.S. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free by signing up for my newsletter. You will also receive occasional updates about new research, resources, giveaways and helpful information.

For future updates, make sure to follow us on Facebook too!

References

  1. Messina M, Redmond G. Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature. Thyroid, 2006;16(3):249-258.
  2. Doerge DR, Sheehan DM. Goitrogenic and estrogenic activity of soy isoflavones. Environmental health perspectives, 2002;110(Suppl 3):349.
  3. Dolan LC, Matulka RA, Burdock GA. Naturally occurring food toxins. Toxins, 2010;2(9): 2289-2332.
  4. Niemi UM, Roine PZ. Ernährungswiss. The effect of rapeseed oil on the thyroid function of rats. European Journal of Nutrition. 1960;1(164).
  5. Bajaj JK, Salwan P, Salwan S. Various possible toxicants involved in thyroid dysfunction: A Review. Journal of clinical and diagnostic research: JCDR. 2016;10(1):FE01.
  6. Zava TT, Zava, DT. Assessment of Japanese iodine intake based on seaweed consumption in Japan: A literature-based analysis. Thyroid research. 2011;4(1):14.
  7. Esposito T, Lobaccaro JM, Esposito MG, et al. Effects of low-carbohydrate diet therapy in overweight subjects with autoimmune thyroiditis: possible synergism with ChREBP. Drug Design, Development and Therapy. 2016;10:2939-2946. doi:10.2147/DDDT.S106440.

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Filed Under: Diet, Gut Tagged With: Elimination Diet, Food Pharmacology, Food Sensitivities, Goitrogens, Iodine, Root Cause Recipe Portal, Soy

Dr. Izabella Wentz

Dr. Izabella Wentz, PharmD, FASCP, is a clinical pharmacist, New York Times Bestselling Author, and a pioneering expert in lifestyle interventions for treating Hashimoto’s Thyroiditis.

She received a Doctor of Pharmacy degree from the Midwestern University Chicago College of Pharmacy at the age of 23, and has worked as a community pharmacist, a clinical consulting pharmacist, as well as a medication safety pharmacist. She is a Fellow of the American Society of Consultant Pharmacists and holds certifications in Medication Therapy Management and Advanced Diabetes Care.

Dr. Wentz has dedicated her career to addressing the root causes of autoimmune thyroid disease, after being diagnosed with Hashimoto’s Thyroiditis in 2009. As a patient advocate, researcher, clinician and educator, she is committed to raising awareness on how to overcome autoimmune thyroid disease.

Disclaimer: The information contained herein is for informational purposes only and should not be construed as medical advice. Please consult your physician for any health problems and before making any medical or lifestyle changes.

Lifestyle changes can result in improved thyroid function and/or an increased absorption of thyroid hormone medications, leading to a lower required dose and possible symptoms of hyperthyroidism at a dose that was previously stable. Please discuss lifestyle changes with your physician and ensure that your thyroid function is monitored every 6-8 weeks while making lifestyle changes. Symptoms of overmedication include, but are not limited to: rapid or irregular heartbeat, nervousness, irritability or mood swings, muscle weakness or tremors, diarrhea, menstrual irregularities, hair loss, weight loss, insomnia, chest pain, and excessive sweating. Do not start, change, increase, decrease or discontinue your medications without consulting with your physician.

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Reader Interactions

Comments

  1. Audrey Milotakis says

    July 7, 2013 at 11:01 PM

    What if you do not have a Thyroid? Should I be avoiding these foods completely?
    Reply
  2. Thyroid Lifestyle says

    July 7, 2013 at 11:13 PM

    Great question! The foods block the formation of thyroid hormone inside the thyroid. If you do not have a thyroid and are getting all of your thyroid hormone from a pill like Synthroid or Armour, you do not have to restrict these foods. The exception may be soy, as it can lead to other issues…
    Reply
    • Barbara says

      March 30, 2021 at 4:58 PM

      Thank you Dr Wentz. May I inquire if fermented soy is fine with hypo such as natto and tempeh soy? Also, I ha ve tsh at 7, ft3 slightly elevated and ft4 slightly low, I take 5-6 15 mg armour daily. I have tpo at 76 or so. Endo says my thyroid hardly working,shrunk, rough and bumpy,cannot be healed, have to stay on armour rest of life? is this true in your opinion? i beleive in healing it and that it can work again?
      am taking kelp as was low in iodine, then did 24 hr urine and it was enough. so, should I continue as you had written that too much can worsen hashi? how so? can you explain further and send to my email please? I woudl sooo appreciate your feedback.
      Warm regards,
      Barbara
      ps some docs say if ft3 high then dont need armour?? can you help?

      Reply
      • Dr. Izabella Wentz says

        April 8, 2021 at 7:51 AM

        Barbara – thank you for reaching out. ❤️ Those with Hashimoto’s may be sensitive to soy. It can block the activity of the TPO enzyme and worsen the autoimmune attack on the thyroid. Soy can be hard to avoid, as it’s not only found in foods such as edamame beans, soy milk, tofu, tempeh, miso, and soy sauce, but also in many processed foods and even supplements. Ingredients to look out for include soy lecithin, bean curd, hydrolyzed soy protein, soybeans, edamame, natto, okara, yuba, tamari, olean, gum arabic, carob, and hydrolyzed vegetable protein. Here are a couple article you might find interesting:

        HOW AVOIDING SOY CAN BENEFIT HASHIMOTO’S
        https://thyroidpharmacist.com/articles/soy-and-hashimotos/

        IODINE AND HASHIMOTO’S
        https://thyroidpharmacist.com/articles/iodine-hashimotos/

        Reply
  3. Dawn says

    July 8, 2013 at 11:59 AM

    May I ask what other issues the soy can lead to?
    Reply
  4. debbie says

    March 4, 2015 at 12:41 PM

    I was born without a thyroid gland (rare) yes some of them do interfer with my medicine
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:14 PM

      Debbie- Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically, is ‘dead’, or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to re-balance the immune system to prevent this (sometimes the autoimmunity can be reversed as well). The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.

      HASHIMOTO’S ROOT CAUSE BOOK
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply
  5. ROSALIND MONAHAN says

    March 6, 2015 at 5:01 AM

    What if you have a partial thyroid. Should you avoid goitrogens? What will eating soy and canola do to me with a partial thyroid and taking 1.25 mg of armour thyroid
    Reply
  6. Izabella Wentz @Thyroid Lifestyle says

    July 31, 2013 at 8:21 AM

    Soy can trigger/worsen thyroid autoimmunity and is often associated with food intolerances
    Reply
  7. Michelle says

    August 7, 2013 at 3:37 AM

    I was wondering if you’ve ever come across this issue: When I eat something that seems particularly triggering to me (soy milk was especially bad, I cut it out of my diet completely when this started happening), my thyroid actually swells up. It becomes very painful for a couple of hours before it goes away. The big problem I have is that this also occurs when I exercise.
    My doctor, also a Hashi’s patient, just told me “You have a sensitive thyroid” and moved on. The triggering foods are easy enough to avoid, but I would like to be able to exercise again. Every time I’ve tried to get back into it, even if I do a very light workout, it still happens. I stop before it gets too bad, but do you know what might be causing this, and how I could avoid it? It also seems to happen more often in the summer (I live in Phoenix, so there’s both the heat, and high amounts of pollution in the air), sometimes out of nowhere, though not nearly as badly as when I run (definitely not in the day during the summer!) or eat something triggering.
    Sorry for the long question, and thank you for all your information that you offer. I’ve only just discovered you, but what I’ve been reading so far has provided me with a lot of excellent info I was missing, or curious about. I’ll definitely be buying your book by the end of the month, so I can hopefully start getting somewhere with this disease!
    I was diagnosed with hypothyroidism 4 years ago, and confirmed a Hashimoto’s diagnosis about 2 years ago when I changed doctors. I’m 26 years old now, and from my symptoms, I must have had it since I was at least 14 years old, but no one ever caught it, most likely because I was always UNDERweight in spite of it!
    Reply
  8. Izabella Wentz says

    August 11, 2013 at 7:13 PM

    Hi Michelle, I wonder if it is the environmental pollution or perhaps some environmental allergens are contributing? There are various pollens that cross react with foods, for example grass allergy can cross react with wheat/gluten food sensitivity, etc.
    I think screening the antibodies should be mandatory! So many people are affected and misdiagnosed. I had complete physicals almost annually, but not diagnosed until later in life. I was always underweight as well, so I think I had in probably since puberty, and it worsened during undergrad, finally diagnosed at age 27.
    Reply
    • Laurel Chapdelaine says

      August 19, 2018 at 10:02 PM

      You mention grass in the last comment. I find I have had a problem when the gardeners come on Wednesdays to cut the lawns in my condo community, which has a lot of grass. Is that something that I should consider with Hypothyroidism? I don’t eat it of course, but my nose runs for about 3 days after.

      Reply
      • Dr. Izabella says

        August 21, 2018 at 12:48 PM

        Laurel – thank you for sharing your journey. I know how miserable this can be. When I started my journey with Hashimoto’s I started becoming to allergic to EVERYTHING. I was dependent on eye drops and antihistamines 24/7. At that time, I didn’t know that having all those toxins on board was actually delaying my healing. Here is an article you might find helpful.

        LIVER SUPPORT
        https://thyroidpharmacist.com/articles/support-liver-recover-from-thyroid-disease/

        Reply
  9. Lynn says

    August 11, 2013 at 7:45 PM

    Really??? Strawberries???!!??? Pears??!!!?? 🙁 I’ve been making oatmeal smoothies with strawberries, pears. Is 1/4 c too much, or is on how my body feels?
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 5:42 PM

      Lynn- Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.

      FOOD SENSITIVITIES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply
  10. susan says

    August 12, 2013 at 3:34 AM

    is there a specific diet you can follow if you do have hypothyroidism that helps control weight loss? I can not seem to loose weight at any cost and really getting frustrated.
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:17 PM

      Susan- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply
  11. Stella says

    March 4, 2015 at 5:26 AM

    Have you cut out gluten from your diet? I have been gluten-free for the past 6 months, dairy-free for about 5 months and went completely grain-free about 1.5 months ago. In the past 6 months I have lost nearly 20 pounds. I’m hypothyroid and have switched to natural desiccated thyroid in this time frame; however, I went gluten-free prior to making the transition in medication and started losing weight as soon as I got off gluten. I too could not lose weight before this.
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:18 PM

      Stella- You may be interested in checking out the Root Cause Recipe Portal. It is full of autoimmune paleo and paleo recipes. You’re able to organize weekly shopping lists, meal planning, etc. Hope you check it out.

      http://rootcauserecipes.com/

      Reply
  12. Lauren Appleby says

    August 12, 2013 at 6:30 AM

    I was diagnosed with a goiter at age 12. I have never been put on any medication. I dis always have to watch my weight but was never fat. After I went through menopause at age 52 (I am now 55) my weight has suddenly become a problem & am now steadily gaining weight. I have always been a physical person & run a horse farm, so I’m on my feet all day doing manual labour but I still can’t lose the weight. I’ve gained 40 pounds & am freaking out… What can help me??
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:21 PM

      Lauren- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply
  13. Kim says

    September 11, 2013 at 1:42 AM

    Lauren .. Try the Paleo diet and CrossFit !!! Don’t look at the scale but the inches you will loose ..
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:26 PM

      Kim- You may be interested in checking out the Root Cause Recipe Portal. It is full of autoimmune paleo and paleo recipes. You’re able to organize weekly shopping lists, meal planning, etc. Hope you check it out.

      http://rootcauserecipes.com/

      Reply
  14. Celia says

    August 14, 2013 at 3:36 AM

    Hi Izabella:
    First, you are a God-Send for us Hashi Folks! Can’t wait to get a copy of your book (arriving tomorrow via Amazon, Yay!). Second, which oil alternatives are good for cooking, baking etc (aside from Olive and Coconut)? I did not know about canola and every time I make gluten free brownies, I add organic canola! I had no idea until now that is was a goitergen!
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:27 PM

      Celia- The three oils that are recommended for people with Hashimoto’s
      are coconut oil, extra-virgin olive oil, and cod liver oil. Thank you so much for your support. I’m looking forward to hearing your progress on this page. Make sure to take the book slow, take notes, highlight, and establish a baseline when making changes. 🙂

      Reply
  15. Liz says

    September 11, 2013 at 4:51 AM

    I would also like to know which oils are good to cook/bake with. My copy of your book is on its way 🙂 Can’t wait to start reading… thank you!!
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:28 PM

      Liz- The three oils that are recommended for people with Hashimoto’s
      are coconut oil, extra-virgin olive oil, and cod liver oil. Thank you so much for your support. I’m looking forward to hearing your progress on this page. Make sure to take the book slow, take notes, highlight, and establish a baseline when making changes. 🙂

      Reply
  16. Steven Lilley says

    September 2, 2013 at 5:34 PM

    Hi.
    The photo of broccoli seems to be one I released under creative commons. However, I can’t find attribution to that effect. Please link back to the original at http://www.flickr.com/photos/sk8geek/5478500913/
    Many thanks
    Steven
    Reply
  17. Izabella Wentz says

    September 11, 2013 at 12:44 AM

    Please let me know if I did it correctly 🙂
    Reply
  18. andrea says

    September 11, 2013 at 1:25 AM

    I ran out of my pills I think I feel fine, but iam very sleepy, no energy. I start work around 0430 til 1430. I have 2 kids (7) (1). Should I go back to my doctor?
    Reply
  19. Izabella Wentz says

    September 11, 2013 at 8:10 AM

    Yes. Please go back to your doctor ASAP or an urgent care.
    Reply
  20. Kylie says

    September 11, 2013 at 3:13 AM

    Hi I take 150micrograms of thyroxine daily and still eat soy yoghurt and drink soy milk. Is this a prob?
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:31 PM

      Kylie- Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.

      FOOD SENSITIVITIES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply
  21. Jennifer says

    March 4, 2015 at 11:16 AM

    Yes. You will notice a difference after a few weeks of not eatting this stuff.
    Reply
  22. Cindy says

    September 11, 2013 at 7:03 AM

    I would love to purchase your book… What’s the name of it?
    Reply
  23. Izabella Wentz says

    September 11, 2013 at 8:08 AM

    Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause. http://www.thyroidrootcause.org/book
    Reply
  24. Cindy says

    September 11, 2013 at 7:07 AM

    I would love to purchase your book… What is the name an how can I get it?????
    Reply
  25. Ashley Davis says

    September 13, 2013 at 3:47 AM

    I notice that peanuts are listed. Does this mean that all peanuts should be avoided or can you have cooked peanuts?
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:31 PM

      Ashley- Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.

      FOOD SENSITIVITIES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply
  26. Tom says

    January 12, 2014 at 9:41 AM

    You may want to do an updated research review. A thorough one. There are no human trials that I am aware of linking Hashimotos to cruciferous vegetable consumption. At all. After interviewing multiple cruciferous vegetable researchers, and authors of thyroid disease books, they are coming up with completely different conclusions than you are. In one of my interviews with Dr. Jed Fahey from Johns Hopkins, he stated that “canola”/rapeseed has long been hybridized to contain very low levels of goitrogenic compounds.
    Reply
  27. Izabella Wentz, PharmD says

    March 23, 2014 at 12:53 AM

    Thanks Tom- I agree that crucifers are not going to be an issue for most people with Hashimoto’s, with the exception of soy, which has been considered a trigger for Hashimoto’s. As far as canola, I don’t recommend it for other reasons.
    Reply
  28. connie curtis says

    July 14, 2014 at 4:25 AM

    my dr.peter osborne said that you can eat these if they are cooked . He said no more than 2 a week if raw and its best to not eat fermented.
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:33 PM

      Connie- Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.

      FOOD SENSITIVITIES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply
  29. Lea says

    January 22, 2015 at 2:29 AM

    Hi Izabella,
    Is it ok to take supplements that have cruciferous vegetables such as cabbage in them?
    Thank you,
    Lea
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:35 PM

      Lea- Not everyone will need every single supplement! In fact, I believe that most nutrients should come from the diet, this is why I always list food sources for most of the nutrients, vitamins, minerals and probiotics that are depleted in Hashimoto’s in the book and on the blog. However, some may require/prefer supplements and the supplements on the website are a resource for those that do. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm.

      I do have a full supplements chapter in my book. Have you checked it out? Not everyone should be taking every supplement and the book will help uncover your root cause. This will help you figure out your supplementation.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply
  30. Jennifer says

    March 4, 2015 at 11:14 AM

    Take out the soy especially soy milk. It made me cold and foggy . I thought I was going mad. And broccoli will block you up with constipation . No doctor believes me but “i” know its true.
    Diagnosed at 14 yrs old now 47 , after going gluten free and avoiding goitregens. I never felt better. Still on thyroxine … But u have to make lifestyle changes in food to feel great.
    I’m now trim and happy
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:36 PM

      Jennifer- You may be interested in checking out the Root Cause Recipe Portal. It is full of autoimmune paleo and paleo recipes. You’re able to organize weekly shopping lists, meal planning, etc. Hope you check it out.

      http://rootcauserecipes.com/

      Reply
  31. Vinci mills says

    March 4, 2015 at 6:31 PM

    I was tested for food allergies eight years ago, and they found antibodies to all of the brassica veggies, broccoli, cauliflower, all cabbages, etc. I was also tested for iodine deficiency, and was found to be very low. My question is, once allergic, always allergic? And should I be on an iodine supplement ? I have had Hashimoto’s for 13 yrs.
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:37 PM

      Vinci- I’m very hesitant in recommending iodine in Hashimoto’s. Although iodine serves as fuel for our thyroid and is very important in iodine deficiency hypothyroidism, Hashimoto’s is a different mechanism. It’s like pouring gas into an engine that’s on fire… that’s essentially what’s happening in Hashi’s, thyroid inflammation, and adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, animal and human studies. I have spent 4 years researching this and have seen too many people suffering the consequences of adding iodine too soon. My approach is, let’s fix the engine first (usually a gut issue), and then add the fuel once we know that the engine is no longer on fire. Hope that you will check out my book. I have a whole chapter on the iodine controversy that references numerous studies as well as the work of Abraham and Brownstein.

      AMAZON
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply
  32. Enrica says

    March 4, 2015 at 10:09 PM

    have been eating all the above for all the right reasons,and now is all wrong?!?!

    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:38 PM

      Enrica- Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.

      FOOD SENSITIVITIES AND HASHIMOTO’S
      https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply
  33. Ana says

    March 5, 2015 at 8:09 AM

    Hi Izabella, many thanks for the great information.
    Just wondering what your opinions are on fermented soy products, such as tempeh? Are they still as detrimental?
    Thanks
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:39 PM

      Ana- Soy has been linked to the development of autoimmune thyroiditis.

      Reply
  34. Cortnee says

    March 5, 2015 at 6:18 PM

    Hi there. I am currently taking a raw protein powder that is vegan and seems great but I just noticed that under “other ingredients” it says fermented soy. It seems as though this is in a very small dose but I am wondering if I shouldn’t buy it anymore? Trying to find anything supplemental is very hard when my diet is so restrictive. Not only do I have hashi’s but I also have the MTHFR gene which makes detoxing, liver function and digestion almost impossible!
    Any help would be appreciated 🙂
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:41 PM

      Cortnee- Soy has been linked to the development of autoimmune thyroiditis. Here is an article you may find interesting as well! 🙂

      MTHFR
      https://thyroidpharmacist.com/articles/mthfr-hashimotos-and-nutrients

      Reply
  35. Susan says

    March 6, 2015 at 12:56 AM

    Hi Izabella, Thank you for your emails and great information. I take a number of supplements recommended/sold by my functional medicine doctor. He also encouraged me to eat Paleo and I feel it has made differences in how I feel, pain levels and inflammation issues. I had nodules on my thyroid which now are gone. I take 65mg of NatureThroid and was on T3 10 mg until my number went up to 5 and he took me off of it. I’m continuing on the NatureThroid with his recommendation. My question is, I noticed some supplements may have soy lecithin, or natural tocopherols soy, safflower oil, and some soft gels have soybean oil or other ingredients I’ve heard that are in gel caps that are not Paleo approved. How much of this is contraindicated or is the amount very small? I also take olive leaf extract and oil of oregano the latter lists lecithin in “other ingredients” and then says Contains soy at the very end. It’s difficult to sort through all of this. Thank you for any advice.
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:44 PM

      Susan- Soy has been linked to the development of autoimmune thyroiditis. Not everyone will need every single supplement! In fact, I believe that most nutrients should come from the diet, this is why I always list food sources for most of the nutrients, vitamins, minerals and probiotics that are depleted in Hashimoto’s in the book and on the blog. However, some may require/prefer supplements and the supplements on the website are a resource for those that do. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm.

      I do have a full supplements chapter in my book. Have you checked it out? Not everyone should be taking every supplement and the book will help uncover your root cause. This will help you figure out your supplementation.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply
  36. Cynthia says

    March 14, 2015 at 10:27 PM

    Could you please explain why soy is a problem? My daughter is nine, has Hashimoto’s, is a vegetarian and likes tofu and edamame. Her integrative medicine doctor said it should be fine for her unless in very large amounts.
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:45 PM

      Cynthia- Soy has been linked to the development of autoimmune thyroiditis. Recovering from adrenal fatigue and hypothyroidism when following a vegetarian diet is very challenging, as vegetarian diets are often carbohydrate heavy.
      Vegetarian sources of protein such as legumes (beans), dairy, grains, soy and some seeds may be incompatible with trying to heal a leaky gut, which is almost always present with Hashimoto’s. Pea protein is an alternative that may be easier to digest and is less likely to cause food sensitivities (I use NOW Foods brand).

      Eggs, some seeds, and nuts would be the preferred sources of protein for vegetarians, however, some people with Hashimoto’s may be intolerant to those as well, especially in the early stages of starting a healing diet.

      Being a vegan is even more challenging, and nuts and seeds would be the go-to source of protein, which are usually too difficult to digest for many in the beginning of their thyroid healing journeys.

      While vegan and vegetarian diets have been reported to be extremely helpful with autoimmune and chronic conditions, I have not been able to find reports of people recovering from Hashimoto’s by following a vegan diet. Even devout vegans who are nutritionally conscious still struggle with low body temperatures, hypothyroidism and Hashimoto’s.

      Additionally, many former vegans have reported improved symptoms of Hashimoto’s following transitioning to a Paleo diet. Based on this, I believe that animal proteins must play an important role in building back the health of people with Hashimoto’s.

      That said, while meats and fats are important for healing, eating them exclusively will produce an acidic environment in the body; hindering healing, and thus the diet should be balanced with plenty of nutrient rich vegetables (suggested ratio may be 20% meat/80% veggie).

      Additionally, vegan and raw vegan diets can be extremely helpful for cleansing and detoxifying, especially for those with persistent protein digestion issues. A vegan diet can be followed for a few days to a few weeks and may help the body detoxify. B12 and iron or ferritin supplements should be utilized at this time to prevent deficiency.

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply
  37. jen says

    July 21, 2015 at 1:05 PM

    Hi Stella, that is encouraging… I also have an underactive thyroid, and have had it for about 10 years. I have struggled with weight all this time, and seem to lose it and then gain it etc, and have tried all sorts of eating plans…. I will try going gluten free and dairy free.
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:46 PM

      Jen- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      Reply
  38. Barbara G says

    July 21, 2015 at 1:07 PM

    I have the same questions. When cruciferous/goitrogenous vegetables are listed as ingredients in supplements (i.e., particularly “whole food” suppplements”) are they ok to take?
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:47 PM

      Barbara- Not everyone will need every single supplement! In fact, I believe that most nutrients should come from the diet, this is why I always list food sources for most of the nutrients, vitamins, minerals and probiotics that are depleted in Hashimoto’s in the book and on the blog. However, some may require/prefer supplements and the supplements on the website are a resource for those that do. I recommend getting tested for deficiencies to determine your need for a supplement as instructed in the book and blog. I also don’t recommend starting multiple supplements all at once. I recommend starting one at a time and then adding another a week or so later once it has been confirmed that the first supplement is not causing any harm.

      I do have a full supplements chapter in my book. Have you checked it out? Not everyone should be taking every supplement and the book will help uncover your root cause. This will help you figure out your supplementation.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply
  39. Joanna says

    July 12, 2015 at 5:58 PM

    Hi there, I am a Hashi’s patient and have just read this chapter in the book. I am confused by the message. One of the last paragraphs says “most people with Hashimotos should be able to eat most goitrogens, even in their raw state.” Does this mean “it probably won’t affect you but might as well err on the side of caution?” What is too much raw cruciferous vegetables, I.e. how many cups a week? I would like to have some clearer guidelines before making these lifestyle changes as we eat cabbage, kale, and spinach regularly. Thank you.
    Reply
    • Dr. Izabella Wentz says

      December 20, 2016 at 6:49 PM

      Joanna- The gold standard, or the most accurate test for uncovering reactive foods and individual food sensitivities is actually the Elimination Diet.

      It works better than trying a recommended dietary approach (i.e. gluten-free, Paleo, etc.) and even better than food sensitivity testing (which may be helpful in many cases, but may not be affordable for many people). The elimination diet can work as a stand-alone or in symphony with food sensitivity testing.

      In contrast to other diets that simply exclude common problematic foods, an elimination diet is done to determine what particular food intolerances the individual may have. This allows us to tailor the diet to the person, not to the dietary philosophy! Going though an elimination diet will help you figure out your own individual food triggers and your specific response to each trigger food. Here is an article you may find interesting! 🙂 ELIMINATION DIET FOR HASHIMOTO’S
      https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos

      Reply
  40. Megan says

    August 7, 2017 at 5:22 PM

    Hi! Do you have references for this article?
    I was diagnosed with hashimotos about 9 months ago and in addition to medication my doc recommended gluten free diet with avoiding excessive amounts of cruciferous veggies and soy. I have found this to be a challenge because I am vegan. Recently had blood work done to reveal, surprise surprise, I have iron deficiency anemia.
    In my own searching I have found it very difficult to find scientific based research articles related to hashimotos and food choices…. so I am looking for some resources…. to better understand the science behind these suggestions and how to make them best work for my body.
    Thank you!

    Reply
    • Dr. Izabella says

      August 14, 2017 at 10:56 AM

      Megan – thank you for following this page. Recovering from adrenal fatigue and hypothyroidism when following a vegetarian diet is very challenging, as vegetarian diets are often carbohydrate heavy.

      Vegetarian sources of protein such as legumes (beans), dairy, grains, soy and some seeds may be incompatible with trying to heal a leaky gut, which is almost always present with Hashimoto’s. Pea protein is an alternative that may be easier to digest and is less likely to cause food sensitivities (I use NOW Foods brand).

      Eggs, some seeds, and nuts would be the preferred sources of protein for vegetarians. However, some people with Hashimoto’s may be intolerant to those as well, especially in the early stages of starting a healing diet.

      Being a vegan is even more challenging, and nuts and seeds would be the go-to source of protein, which are usually too difficult to digest for many in the beginning of their thyroid healing journeys.

      While vegan and vegetarian diets have been reported to be extremely helpful with autoimmune and chronic conditions, I have not been able to find reports of people recovering from Hashimoto’s by following a vegan diet. Even devout vegans who are nutritionally conscious still struggle with low body temperatures, hypothyroidism and Hashimoto’s.

      Additionally, many former vegans have reported improved symptoms of Hashimoto’s following transitioning to a Paleo diet. Based on this, I believe that animal proteins must play an important role in building back the health of people with Hashimoto’s.

      That said, while meats and fats are important for healing, eating them exclusively will produce an acidic environment in the body; hindering healing, and thus the diet should be balanced with plenty of nutrient rich vegetables (suggested ratio may be 20% meat/80% veggie).

      Additionally, vegan and raw vegan diets can be extremely helpful for cleansing and detoxifying, especially for those with persistent protein digestion issues. A vegan diet can be followed for a few days to a few weeks and may help the body detoxify. B12 and iron or ferritin supplements should be utilized at this time to prevent deficiency.

      AUTOIMMUNE PALEO DIET
      https://thyroidpharmacist.com/articles/autoimmune-paleo-diet

      Reply
  41. Rose-Marie says

    August 14, 2017 at 10:42 AM

    The green smoothie sounds fabulous.
    Thank you Isabella for all your wonderful and helpful post
    All the Best
    RoseMarie

    Reply
    • Dr. Izabella says

      August 15, 2017 at 2:18 PM

      Rose-Marie – thank you for following this page and for your kind words! I am so happy you enjoyed it. 🙂

      Reply
  42. Jeannie says

    August 15, 2017 at 10:35 AM

    can a person with hashimoto’s have an almost immediate reaction to eating a few strawberries? I’m trying to figure out why my upper back aches for no apparent reason and have been wracking my brain. I did have a few strawberries about 2 hours before this started again. Ugh trying to figure out this disease is HARD work

    Reply
    • Dr. Izabella says

      August 15, 2017 at 1:46 PM

      Jeannie – Please, understand that due to liability issues, I am unable to answer specific medical questions, but I highly recommend that you work with a functional medicine clinician. It’s an entire medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.

      FUNCTIONAL MEDICINE APPROACH TO THE THYROID
      https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid

      CLINICIAN DATABASE
      http://www.thyroidpharmacistconsulting.com/clinician-database.html

      FIND A FUNCTIONAL MEDICINE CLINICIAN
      https://ifm.org/find-a-practitioner/

      Reply
  43. Jeannie says

    August 15, 2017 at 10:38 AM

    p.s. I just had my most recent thyroid tests done. Could these numbers be a factor in the backache?
    T3 1.47 (2-4)
    T4 1.25 (.80-1.80)
    TSH 1.51 (.27-4.20)

    Reply
    • Dr. Izabella says

      August 15, 2017 at 1:45 PM

      Jeannie – thank you for following this page. These are the recommended labs from my book, page 32.

      RECOMMENDED THYROID FUNCTION TESTS
      TSH
      TPO Antibodies
      Thyroglobulin Antibodies
      Free T4
      Free T3
      Reverse T3 (Optional)

      Have you read my book, Hashimoto’s The Root Cause? Here’s the link in case you’re interested.

      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
      
      HOW TO GET ACCURATE LAB TESTING WHEN TAKING MEDICATIONS
      https://thyroidpharmacist.com/articles/how-to-get-accurate-lab-tests-when-taking-thyroid-medications

      Reply
  44. sandra says

    September 25, 2017 at 1:26 AM

    Hello Dr Izabella!! the fermented soy (like tempeh) is a problem if I have subclinical hypothyroidism? I can eat tempeh or hatcho miso one time of week? I have other question, the sauerkraut (Chucrut) is a problem too? Thanks very much!!

    Reply
    • Dr. Izabella says

      September 25, 2017 at 11:01 AM

      Sandra – In general, most people with autoimmunity need to find their food sensitivities, heal from infections, and eat organic; however, bioindividuality is important, not everyone will respond to the same interventions. The foods that heal one person, may not be the same for another. An elimination period of at least 2-3 months is a good starting place, but you may want to continue if you feel that you still have more healing to do. Then you can trial a new food every 4 days and monitor yourself for reactions. Going though an elimination diet will help you figure out your own individual food triggers and your specific response to each trigger food. Here are some articles I hope you find interesting!

      WHAT’S CAUSING YOUR LEAKY GUT
      https://thyroidpharmacist.com/articles/whats-causing-your-leaky

      https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos

      Reply
  45. Angela says

    October 15, 2017 at 9:57 PM

    Is Tempeh ok when one has hypothyroidism and nodules?

    Thank you

    Reply
    • Dr. Izabella says

      October 17, 2017 at 10:59 AM

      Angela – thank you for following this page. Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Have you read my books?

      Hashimoto’s Root Cause
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Hashimoto’s Protocol
      https://www.amazon.com/Hashimotos-Protocol-Reversing-Thyroid-Symptoms-ebook/dp/B01HXK6GVQ/ref=sr_1_1?ie=UTF8&qid=1505933035&sr=8-1&keywords=hashimotos+protocol+izabella+wentz

      Reply
  46. Jon says

    October 17, 2017 at 9:21 AM

    Hello-
    I was wondering about cassava as a highly goitrogenic food. Normally I boil it for 25-30 minutes before eating to remove the goitrogens.
    Does frying remove the goitrogens as well, even if you don’t soak or boil? I am really interested in the Artisan Tropic Cassava Strips product (http://artisantropic.com/artisan-products/). Should I be concerned that there is no soaking/boiling, but rather simply frying? Does any form of cooking remove the goitrogens?

    Reply
  47. Sara says

    August 18, 2018 at 6:23 AM

    This is way too much explanation. Just tell me what to eat and not to eat, what to do and not to do. I don’t have time to swim through seas of words.

    Reply
    • Dr. Izabella says

      August 18, 2018 at 4:09 PM

      Sara – thank you for reaching out. I understand how overwhelming this can be. I’ve developed a streamlined approach to help you strengthen your body and start eliminating symptoms! I lead you through self-directed protocols that are beneficial to you, regardless of your root cause. I also walk you through the maze of identifying your individual triggers to autoimmune thyroid disease.

      It took working with 1000+ clients, dozens of functional medical trainings, reviewing thousands of scientific articles and consulting with over one hundred health experts over the course of 7 years to put the protocols contained in the book together for you:

      Hashimoto’s Protocol: http://amzn.to/2B5J1mq

      Reply
  48. Grace says

    August 18, 2018 at 3:14 PM

    Thank you Dr. Wentz for all that you are sharing with us here and in your books. I was so excited to see that you wrote an article about goitrogens and Hashimotos! I just discovered that many goitrogens seem to hurt me. I was on a strict ketogenic diet for over a year. I started Intro Stage 1 of the GAPS diet a week ago.

    I understand that I was born with severe food intolerances. I spent all of my life learning to identify suspects, rotate them, and avoid most foods. I was diagnosed with rapid cycling bipolar disorder, which I think was the result of actually having Hashimoto’s. Most recently (2 months ago), I eliminated goitrogenic foods including crucifers, bamboo shoots, and strawberries, and alfalfa sprouts. Within a day or two, my daily severe, crippling anxiety attacks stopped. Completely. Gone. Except once when I ate a little cauliflower, and the next morning the familiar anxiety returned for a few hours. And after I ate a strawberry or two. And then when I had alfalfa sprouts on a salad.
    But dulse seems to have no such affect. Your chart helps me understand the difference. Thank you.

    My TSH level has been monitored and fluctuating for the past couple decades, within the “normal” limits, but outside the “optimal” limits used by functional medicine practitioners. A few weeks ago, my doctor agreed to order the additional blood tests that I requested. The big news was that I tested positive for ANA (titer 320), TPO AB (17 IU/ML), and TG AB (4 IU/ML without considering anti-TG antibodies, which were present); and low for Free T3 (2.4 pg/ml). My other thyroid levels were within optimal limits.

    So, I think that I am sensitive to most goitrogens because they trigger Hashimoto’s hyper-thyroid symptoms. What do you think?

    Reply
    • Dr. Izabella says

      August 19, 2018 at 4:24 PM

      Grace – thank you for reaching out. Cruciferous vegetables are only goitrogenic in the raw state. Cooking or lightly steaming will deactivate the glucosinolates, as will fermenting the vegetables (as in sauerkraut), thus diminishing the goitrogenic activity. While consuming fermented and cooked cruciferous vegetables is preferred, occasionally eating small amounts of these foods in the raw states should not aggravate autoimmune thyroid conditions but everyone is different. Steaming is a great option ?

      Reply
  49. j says

    August 21, 2018 at 1:00 PM

    Dr. Wenz:

    Fifteen years ago, I was diagnosed with hypothyroidism. Is it okay to eat fermented soy products, such as natto, miso, and soy sauce?

    Reply
    • Dr. Izabella says

      August 23, 2018 at 3:59 PM

      J – thank you for reaching out! Vegetarian sources of protein such as legumes (beans), dairy, grains, soy and some seeds may be incompatible with trying to heal a leaky gut. We know that intestinal permeability (aka leaky gut) is present in every case of autoimmunity and often precedes the development of Hashimoto’s. Symptoms of leaky gut may include bloating, diarrhea, constipation, stomach aches, acid reflux and irritable bowel syndrome. According to the Institute of Functional Medicine, many people develop IBS 5-10 years before an autoimmune diagnosis. I was one of them and didn’t take my gut health as seriously as I should have. Gut problems are often caused by infections like H. pylori, parasites like Blasto, SIBO, an imbalance of bacteria, and enzyme deficiencies or food sensitivities (especially to gluten, dairy, and/or soy). Even stress can be a factor in gut permeability. Here is an article you might find interesting.

      6 DIFFERENT ROOT CAUSES
      https://thyroidpharmacist.com/articles/6-different-hashimotos-root-causes/

      Reply
  50. Melisa Johnston says

    August 22, 2018 at 7:46 PM

    Dr Izabella,
    That you for caring and helping others.
    I have been receiving your emails and trying my best through the ((FOG FOG FOG)) to understand them. They make sense but I can’t take much away ((FOG)).
    I was recently diagnosed with Hashimatos’s three months ago. My family members also suffer with it severely, my mother’s scan showed her thyroid all shriveled up but partially functions, My brother also gained so much weight he’s in the danger zone. My Dr ran all the usual blood tests plus a few unique ones and found my TPO was 277 & my thyroid globulin was 7.4 on the higher end and my weight for 5’8″ is 211-240 (Uugghh).
    After refusing to take a chemical thyroid pill (synthroid, etc) since my family had extreme reactions to them, she put me on my request of Nature Thyroid 32.5. Short story- it was too strong & caused me to sleep every free moment while upright. So she reduced it to 16.3 – still feels to strong – sleeping 4hr deep nap in the middle of the day but able to function some of day. Considering cutting these in half to give me 8. I have been supplementing (I know not the best choice) with GNC Women’s Ultra Mega Energy & Metabolism and MenoXcel for menopausal relief even though I am thru Menopause, I still get extreme sweats upon physical exertion in a house temp set at 76-74 degrees. Willing to try any suggestions.
    Please help me ((FOG)) what do you recommend I start?
    If it is reading a book ((FOG)) do you have it in Audio version?

    Much Thanks and Love for all your research & emails.

    Reply
    • Dr. Izabella says

      August 27, 2018 at 4:03 PM

      Melisa – thank you for reaching out and sharing your journey. <3 Brain fog is a very common symptom of Hashimoto's. Often we are told that being confused and forgetful is part of normal aging or that we need less stress. Really, much of our symptoms including brain fog can be attributed to low thyroid hormones and food sensitivities. There are quite a few options for thyroid medications. In my experience, what works for one person may not work for another. If your doctor will not prescribe the medication which you are looking for, ask your local pharmacist for doctors in your area who prescribe the medication you are looking to try. Have you read these articles?

      WHICH THYROID MEDICATION IS BEST?
      https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/

      TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
      https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/

      HOW THE DOSE OF YOUR THYROID MEDICATION CAN UNCOVER YOUR ROOT CAUSE
      https://thyroidpharmacist.com/articles/the-dose-of-your-thyroid-medication-can-uncover-your-root-cause/

      HOW TO GET ACCURATE LAB TESTING WHEN TAKING MEDICATIONS
      https://thyroidpharmacist.com/articles/how-to-get-accurate-lab-tests-when-taking-thyroid-medications/

      Reply
  51. Rehana says

    November 4, 2018 at 5:23 AM

    Thank you Dr.Wentz for sharing the valuable information for all of us.
    I would like to know your take on consuming Kodo, Foxtail, Barnyard, Little & Brown Top Millets alternatively ,along with veggies to avoid rice wheat oats not other gluten containing foods.
    I have been diagnosed with hashimoto thyroiditis with reactive hypoglycemia fructose intolerance and other food sensitivities. I m on gluten free, diary free, egg free almond free sugar-free diet having rice with other veggies n meat. I want to eliminate rice too as it is a cereal I m little skeptically to choose those millets since I found some information claiming them to be goitrogenic . Please help

    Reply
    • Dr. Izabella says

      November 4, 2018 at 4:32 PM

      Rehana – you are very welcome! Millet is goitrogenic. Not all goitrogens are created equally. Not all of them work in the same way. While it’s possible to be sensitive to anything, I like to look at research studies and clinical outcomes before I determine if a food is on the “No” list for Hashimoto’s. Here are some articles you might find helpful.

      https://thyroidpharmacist.com/articles/what-are-goitrogens-and-do-they-matter-with-hashimotos/

      https://thyroidpharmacist.com/articles/new-study-shows-that-this-type-of-diet-is-helpful-for-hashimotos-2/

      Reply
  52. Alisa says

    December 6, 2018 at 11:31 AM

    Amazing information, you are helping so many people!!!!

    Reply
    • Dr. Izabella says

      December 7, 2018 at 5:52 PM

      Alisa – thank you so much for your support! <3

      Reply
  53. Bob LISTECKI says

    January 14, 2019 at 12:38 PM

    Interesting when I cross checked the foods creating inflammation from the ALCAT test with the list of foods considered goitrogens I had about a 30% match. Sweet Potato which is a staple of the Okinawa diet as a low glycemic index food but it made my list. So ya just have to listen and learn.

    Reply
    • Dr. Izabella says

      January 15, 2019 at 9:08 AM

      Bob – thank you for sharing!

      Reply
  54. Daniel says

    December 4, 2019 at 9:02 AM

    Thanks for this article!
    I have 2 questions:
    1. “For this reason, I love organic crucifers, especially kale, because kale’s hearty green leaves tend to pick up a lot of TOXINS from the environment.”
    So…these are toxins from the environment who we eat then? Are the positive effects from kale for the body outline the toxin load from kale? And do you have source for that “detoxing” effect?
    2. “Avoid sulfur-rich foods such as eggs…”
    Are egg yolks ok to eat or do you mean the whole egg?

    Thanks again for your work.
    Daniel

    Reply
    • Dr. Izabella says

      December 10, 2019 at 6:36 AM

      Daniel – thank you for reaching out. <3 The gold standard or the most accurate test for uncovering reactive foods and individual food sensitivities is actually the elimination diet. In contrast to other diets that simply exclude common problematic foods, an elimination diet is done to determine what particular food intolerances the individual may have. An elimination period of at least 2-3 months is a good starting place, but you may want to continue if you feel that you still have more healing to do. Then you can try a new food every 4 days and monitor yourself for reactions. Going through an elimination diet will help you figure out your own individual food triggers and your specific response to each trigger food. Here is an article I hope you find interesting!

      https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos

      Reply
  55. Marine says

    November 3, 2020 at 4:24 AM

    hello,
    I thank you for your work, it is comforting for me.
    in your recipe book you use a lot of cassava flour. is it really goitrogenic? how often can you eat it with hashimoto disease?
    thank you

    Reply
    • Dr. Izabella Wentz says

      November 5, 2020 at 8:08 AM

      Marine – thank you for reaching out. <3 I'm so glad you are enjoying my book! While all this info may seem confusing, the big takeaway here is that most goitrogens are okay, with the exceptions of soy and millet as I mention in the article above on goitrogens, as most people with Hashimoto’s are not iodine deficient, especially those in developed countries. So, cassava should be fine in moderation for you if you have Hashimoto’s. However, if you are sensitive to cassava then you would want to use another flour instead. Hope this helps

      Reply
  56. Krista says

    April 28, 2021 at 11:51 AM

    Hi I have hashimotos vitamin D & A deficiency that I take supplements for to keep my levels within range. I have very high selenium levels and I don’t eat Brazil nuts or take any supplements with selenium. My doctor doesn’t have any explanation for this as they said people usually have lower selenium levels. What could be the cause of higher selenium level without supplements containing selenium?

    Reply
    • Dr. Izabella Wentz says

      May 11, 2021 at 11:51 AM

      Krista – thank you for reaching out and sharing. ❤️ Those with a CBS mutation have difficulty breaking down selenium. (Research has found that selenomethionine needs to be converted into its active form via the CBS gene. So, if this gene is mutated, the body cannot break down selenomethionine properly.) Thus, those with a CBS gene mutation will have more selenium circulating in their body, compared to those without this mutation. Here is an article you might find helpful: https://thyroidpharmacist.com/articles/selenium-deficiency-and-hashimotos/

      Reply
  57. Krista says

    April 28, 2021 at 11:52 AM

    My vitamin D supplement is my garden of life it’s all natural vegetables and fruits inside. It contains cruciferous vegetables. Should I not take this type and switch to another D formula?

    Reply
    • Dr. Izabella Wentz says

      May 11, 2021 at 10:39 AM

      Krista – thank you for reaching out. ❤️ There is a myth that foods known as goitrogens, such as cruciferous vegetables, are not good for those with Hashimoto’s. Iodine deficiency is not widespread in people with Hashimoto’s, and so eating cruciferous vegetables (unless you are sensitive to them) is perfectly healthy for people with Hashimoto’s and should not impact thyroid function. In the case that a person does have hypothyroidism due to iodine deficiency, he/she can still enjoy crucifers as long as they are cooked or fermented. Cooking/fermenting will break down the iodine blocking content. That said if you have concerns about the supplement you are using or are sensitive to look into another option and discuss with your practitioner.

      Reply

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Lifestyle changes can result in improved thyroid function and/or an increased absorption of thyroid hormone medications, leading to a lower required dose and possible symptoms of hyperthyroidism at a dose that was previously stable. Please discuss lifestyle changes with your physician and ensure that your thyroid function is monitored every 6-8 weeks while making lifestyle changes. Symptoms of overmedication include, but are not limited to: rapid or irregular heartbeat, nervousness, irritability or mood swings, muscle weakness or tremors, diarrhea, menstrual irregularities, hair loss, weight loss, insomnia, chest pain, and excessive sweating. Do not start, change, increase, decrease or discontinue your medications without consulting with your physician.


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