Calling all hypothyroids

October 25, 2010 9:11 AM

Hypothyroid-filter: What can I eat? Please help me eat delicious, healthful, creative meals and snacks without having an anxiety attack because I'm so worried certain foods will interfere with my thyroid medication.

I was recently diagnosed with hypothyroidism and I think my diagnosis is finally starting to hit me. I'm anxiety-prone as it is, so the more I read about my condition, the more confused and overwhelmed and anxious I feel. It doesn't help that the Foods-To-Avoid lists online often contradict each other. I'm already supposed to avoid certain foods to prevent heartburn and facial flushing. Rosacea is one of the main reasons it's so difficult for me to leave the house; I'm scared someone will comment on how randomly red my face is. (I'm also worried the Levothyroxine medication will make the rosacea worse*, but I digress...)

A lot of the foods I'm apparently supposed to avoid (or eat in smaller quantities?) are the only fruits and vegetables I can imagine eating, liking, and/or incorporating into quick-and-easy meals and snacks**: broccoli, spinach, potatos, sweet potatos, corn, cabbage, brussels sprouts, strawberries, peaches, cauliflower, peanuts, etc. I'm especially disappointed at the prospect of avoiding spinach. What would tuna subs and salads be without my beloved spinach? Boring, that's what.

I'm looking for healthful, preferably quick and easy, meal and snack ideas for someone with hypothyroidism. I also want to use this situation as an opportunity to learn how to cook without relying so much on canned foods, and to try new fruits and vegetables regardless of whether there are food restrictions or not. I never learned how to eat healthfully in general beyond filling every not-always-healthful meal with a canned vegetable the rare times my mother bought something that wasn't junk food, pasta, red meat, and potatos.

These are the only meals I've been able to comfortably eat so far without having an anxiety attack:

Eggs (2/3 of the eggs without yolk) and orange juice
Grilled chicken salad (no spinach)
Raw carrots
Canned bean and ham soup
Raisin Bran Crunch


*I already have thousands of itchy, clear and red bumps on my hands and arms from the Ativan I took at the hospital for my anxiety. It's a good thing I noticed this before I started taking the Levothyroxine medication, otherwise I'd be freaking out about that too.

**Besides apples, carrots, canned green beans and black-eyed peas.

posted by Faraday Cage to health & fitness (41 answers total)

I'm really sorry to hear about your anxiety. My only advice is not to worry too much about the food reactions to the Levothyroxine. Almost all the women in my family take that, and they're pretty much omnivores. I think that unless you've been given specific other instructions from your doctor, you can eat those foods in moderation. (Like allowing yourself some spinach on your sandwich.) Again, you should call your doctor for clarification, but I think that most of the food interactions are when you are eating it at the same meal as taking your medicine.

I know that dealing with the anxiety is sort of a tangent to this question, but I wanted to encourage you to put as much time and energy into it as possible, because it will make everything more manageable.

Good luck!
posted by mercredi at 9:19 AM on October 25, 2010 [1 favorite]

Huh. Someone close to me has hypothyroidism, and the foods she was warned to stay away from most were peanuts and products heavy in soy isoflavones (goodbye, Luna bars!). She's mostly vegetarian (eats fish), and did not, in the early days after diagnosis, stay away from spinach, sweet potatoes, etc. and does not do so now. Now that the meds have stabilized things, she also doesn't totally avoid peanuts or soy, but doesn't eat either in large quantities.

I don't know if it appears on your list, but how about subbing arugula in for spinach? I think it's delicious on tuna sandwiches.
posted by rtha at 9:21 AM on October 25, 2010

I think you have some bad information. I don’t have hypothyroid, but every woman in my family does, and they’ve all been on medication forever, and they eat anything and everything. Among those women is one who would certainly change her diet if she was told to do so, or even if she heard some rumors about doing so, as well as one with a PhD in food chemistry with particular interest in nutrition. Seriously, they have never changed their diet because of being hypothyroid.

The Mayo Clinic also debunks the notion of a hypothyroid diet on their website, although they caution people to avoid certain foods for a few hours after taking their medication. Spinach is not among them.

You’re going to be fine. Beware of getting your health information from the internet, unless the site is particularly reputable.
posted by OmieWise at 9:22 AM on October 25, 2010

I'm puzzled - was diagnosed with Hypothyroidism a long time ago and have never been told that I should eat or avoid certain things. May be a gap in my care but taking thyroid hormone and getting the levels checked regularly has worked just fine for me for more than 15 years. What kind of effects are you being told will result from eating the "wrong" stuff? I've never noticed problems. Not discounting what you've been told but I don't know that it should be a source of that much worry. The one thing I have been told is that one metabolizes thyroid hormone better on an empty stomach so one should take it first thing and not eat for a while - I aim to eat as close to an hour later as my schedule permits
posted by leslies at 9:25 AM on October 25, 2010

My mom also has hypothyroidism, and she's taking medication, and she doesn't have a special diet either.

Talk to your doctor about this before you go changing your diet.
posted by empath at 9:27 AM on October 25, 2010

A lot of the foods I'm apparently supposed to avoid (or eat in smaller quantities?) are the only fruits and vegetables I can imagine eating, liking, and/or incorporating into quick-and-easy meals and snacks**: broccoli, spinach, potatos, sweet potatos, corn, cabbage, brussels sprouts, strawberries, peaches, cauliflower, peanuts, etc. I'm especially disappointed at the prospect of avoiding spinach. What would tuna subs and salads be without my beloved spinach? Boring, that's what.

I have hypothyroidism. It's not necessary to avoid these foods. Ignore whatever source you got this information from, and warn other people away from it as a public service.
posted by StrikeTheViol at 9:29 AM on October 25, 2010

I've been taking thyroid hormone for five years and have also never been told to change my diet. Like leslies I don't eat for an hour after (or at least 4 hours before) taking the pill.
posted by muta at 9:33 AM on October 25, 2010

There's been some guidance about avoiding foods with soy and cruciferous greens like broccoli and cauliflower because in large quantities they impact thyroid function. But the Levoxyl is providing your body with a regular, steady dose of thyroid hormone. Any impact those foods would have would be regulated.

(IANAD, but I am a vegetarian take Levoxyl.)
posted by lunalaguna at 9:38 AM on October 25, 2010

Another hypothyroid from a long line of hypothyroid women here. I don't think there's a woman in my family who is NOT on some kind of thyroid supplement.

I was told, by my endo, that I can eat pretty much anything I want. In my family we eat whatever we want, yes, including peanuts and cauliflower and strawberries. And we're just fine.

IANAD, of course, but my primary care doc and endo both told me - there is MUCH good from eating cruciferous veggies like cauliflower, for your general health. They are chock full of nutrients. So are strawberries.

The one thing I was told was not to eat dairy products (yogurt, etc.) for about an hour or two after taking my Synthroid, which is taken on an empty stomach anyway. But you have an endocrinologist, I hope! If not, consult with one - they're the ones who are/should be monitoring your thyroid levels and talking to you about how to take your supplements. Your endo - not Metafilter or unregulated internet websites (Mayo Clinic is great, though) - is the one that you should be talking to.
posted by Rosie M. Banks at 9:38 AM on October 25, 2010

Good news so far. Thanks, everyone.

Anxiety sucks. It appears all rationality and skepticism went right out the window the moment I really started to think about the permanence of my condition. I am quite frankly embarrassed.
posted by Faraday Cage at 9:39 AM on October 25, 2010

nth-ing the no-change-in-diet. Diagnosed with hypothyroidism (Hashimoto's) in 2003. I read some things about a "hypothyroid diet," but they seemed to mostly be addressing "how not to gain weight when you're hypothyroid." I haven't changed my diet at all, and of three or four different doctors in the past 7 years, none have mentioned dietary restrictions.

I have been told several times to take levothyroxine on an empty stomach, though.
posted by devotion+doubt at 9:40 AM on October 25, 2010

(And as a fellow anxiety sufferer, I urge you not to be embarrassed...prescription meds always bring out my super-anxiety.)
posted by devotion+doubt at 9:42 AM on October 25, 2010 [4 favorites]

The only foods you really need to avoid are foods high in iron and soy, and only in the hours before and after you take your medicine, at least according tho the informational pamphlet I get with my monthly Levothyroxine. These foods interrupt your uptake of your meds. Finding this out made me sad, because my favorite breakfast granola had delicious toasted walnuts.
posted by Sara Anne at 9:42 AM on October 25, 2010

Don't be embarrassed. No one here thinks you're foolish for asking. Your health care providers won't think so, either. (Well, your providers shouldn't, at least.)

Even without anxiety, sorting through information on chronic health conditions can be confusing and overwhelming.
posted by Uniformitarianism Now! at 9:47 AM on October 25, 2010 [6 favorites]

I've had hypothyroidism for 20 years (as long as I can remember), and as long as you're taking your medication and getting blood tests regularly your diet is not a big factor.
I wait an hour after taking my pill to eat (though my doctor tells me this isn't necessary, it's not hard to do), try not to eat tons of soy (but don't avoid it outright) and wait till later in the day to take a vitamin which has a lot of iron, but I don't notice any difference if I don't do these things.
The only thing that's made me feel any different was learning about a B12 deficiency which can sometimes go along with thyroid problems, so if you're still feeling tired and your thyroid levels are fine, consider getting that checked as well.
posted by waterlily at 9:48 AM on October 25, 2010

Not that it's really necessary at this point but just adding my voice to the chorus - I also have hypothyroidism and I have never been told by my doctors to avoid any of the foods listed above. I'm a "anything and everything" eater and I've never had a problem related to my thyroid & diet.
posted by moxiequz at 9:49 AM on October 25, 2010

When you're first diagnosed, everything seems to relate to your thyroid. My advice: stop looking for information on the internet. Seriously--it will make you crazy and you'll end up more freaked out. (You can read Mary Shomon, but not her commenters, okay?)

Let the meds get a chance to work. You can avoid cabbage, etc. if you want, but you'd have to eat a couple of bushels to really impact your health. I avoid soy, but I don't like it very much, so that's not a hardship.

Take your pill on an empty stomach, no dairy for a while afterwards, and don't stress!
posted by Ideefixe at 9:50 AM on October 25, 2010 [1 favorite]

Don't feel embarrassed, FC. Getting from where you were, to a more healthy state, is a process. Your journey goes one step at a time. Fear is, unfortunately, a natural part of coming to terms with any medical condition. You should have seen how angry I was when I was told I'd have to take pills for the rest of my life. Man, that tantrum I threw - THAT was embarrassing. :)

Some facts: There are some foods that will interfere with your uptake of thyroid hormone, but ONLY if your body is processing them at the same time. So, as long as you don't eat anything an hour after you take the pill, you'll be fine. I manage it by taking my pill first thing in the morning, and waiting an hour to have breakfast. If you do that, the rest of your day is yours to eat whatever you like.

If you *really* need to eat sooner on a given day, you can read the full avoid-this list. Above was mentioned high-iron foods (liver, shellfish, tuna, beans, nuts, seeds, fortified cereals, whole grains), and soy. Add to that high-fiber foods (many of which are on the high-iron list), and, ironically, anything with iodide in it.

It's a lot to remember, so it's probably easiest to just give the pill an hour by itself.
posted by Citrus at 9:59 AM on October 25, 2010 [1 favorite]

I was advised to avoid soy--but prior to my diagnosis I was attempting a high protein vegetarian diet. You can imagine how much soy I was consuming in order to do that. This is the time period when my symptoms got bad enough that I went looking for a diagnosis.

Now I eat soy but in moderation. Little changes like switching from using a soy protein powder to a whey protein powder don't require much effort on my part, so why not?

I did go and see a nutritionist after my diagnosis because my health insurance would cover it. That could be helpful, if it is an option for you.
posted by divka at 10:00 AM on October 25, 2010

I had my thyroid removed for cancer two years ago, so I am completely dependent on Levothyroxine. I was never told of any food restriction by either of my two endos... only to take on an empty stomach, and wait an hour to eat anything, and to avoid any vitamins or supplements (especially iron) for 4 hours after.

So pretty much what everyone else here is saying.
posted by kimdog at 10:02 AM on October 25, 2010

It appears all rationality and skepticism went right out the window the moment I really started to think about the permanence of my condition.

You've already had it your whole life. Things will only get better with the medicine.
posted by empath at 10:03 AM on October 25, 2010

I've been hypothryoid since I was a teenager. Been well over 15 years now, and the *only* thing I've been told to avoid (and this was from the pharmacy, not any one of my docs) was grapefruit, because apparently it interferes with the absorption of the levothyroxine. However, I've been drinking grapefruit juice occasionally anyway, with no ill effects.

Step away from teh google... that is what will make you crazy. Just ask your doc what he recommends, and if it's something off the wall bizarre, change docs.
posted by cgg at 10:19 AM on October 25, 2010

By the way, if you have had an undiagnosed thyroid problem, and you get it corrected - you will feel like a new person. Seriously. Your thyroid impacts on your whole body, including your mental health. I'm not saying your anxiety will go away - I have anxiety, and I still need to mind things - but general well-being, energy levels, etc. - oh my God, it's like night and day! I hear this from friends and family who have had hypothyroid problems corrected, too. Give things a few weeks to work, and allow for some tweaking of the supplement level.

It's natural to feel anxious when you are first diagnosed with any medical condition, especially if you haven't before. And if you haven't been put on any long-term medication before there is some anxiety in dealing with that, getting the dosage adjusted, etc. But soon, taking the thyroid pill will be automatic, like brushing your teeth, and you won't think twice about it.
posted by Rosie M. Banks at 10:23 AM on October 25, 2010

Do not be embarrassed, new health issues bring out the anxiety in me as well. I take Levothyroxine and have taken something for thyroid since 1994. No food restrictions (though I don't eat a lot of soy anyway, but I do enjoy spinach.) Thyroid issues might also be affecting your emotional reactions, as mine contribute not only to my metabolism health and my ability to fend off respiratory infections, but also to my levels of anxiety or my vulnerability to depression. In all of those cases, getting my thyroid issues treated and my levels of T-3 and T-4 brought into alignment also had positive affects on my mood, sleep, etc.

You might be very pleased with the results of your diagnosis on your health improvement overall in the long run. Don't be afraid to ask questions of your health care providers. Enjoy your spinach quiche. :)
posted by jeanmari at 10:25 AM on October 25, 2010

I'm hypothyroid and have been on medication for 41 years now (!). No changes in diet that I know of except for two things: if you are taking iron or calcium supplements, they are to be taken at least 4 hours after you take your thyroid medication. Good luck!
posted by Lynsey at 10:28 AM on October 25, 2010

Hello! My mom and I (and a lot of other women in our family) take Levothyroxine for hypothyroidism. Like you, I was worried about eating soy and calcium-rich foods. However, I have made no efforts to control my diet and my thyroid has been sufficiently controlled for years now. I've never eaten that much soy, but I also haven't given up spinach (and I eat a fair amount), peanuts, or anything at all. My mom was having problems when she drank a glass of soy milk at the same time as taking her pill.

And Faraday Cage, I was also very upset when I first got my diagnosis, so I think that's normal (or at least you aren't alone!) I've been living with it for 8 years now and it rarely, if ever, effects my life. Hang in there, this will get easier!
posted by i_am_a_fiesta at 10:28 AM on October 25, 2010

I'm another person chiming in to say that I've had hypothyroidism for years and years and never given any consideration to a thyroid specific diet. I know it's easy for us to say don't stress out about your thyroid, but really, don't stress out. Once you get the right dose you won't have to think about your thyroid all the time.
posted by crankylex at 10:33 AM on October 25, 2010

Holy crap... You actually got me quite worried with this question. I, too, have hypothyroidism AND anxiety (generic synthroid and lexapro here) and was only told to take it in the morning and to wait 1-1.5 hours after taking my pill to eat. I'm glad the diet is unnecessary... I was really freaking out for a moment.
posted by two lights above the sea at 10:38 AM on October 25, 2010

IANA Health Care Professional. You should not eat anything for an hour after taking your thyroid meds, as some foods bind w/ it and limit the effectiveness. I believe protein is the biggest problem. I take my Lev. with my coffee, and have eaten breakfast 1/2 hour later and it hasn't caused anything terrible to happen.

Your thyroid may produce less after you start supplementing, but thyroid meds are cheap, have low side effects and are pretty effective, so this was a minor issue for me.
posted by theora55 at 10:51 AM on October 25, 2010

I was diagnosed with hypothyroidism at the hospital while I was there for unrelated reasons. The physician at the hospital wasn't particularly helpful or informative, hence the googling and eventual freak-out. She actually left me with the impression that it was an easily reversible condition. By the time I was discharged, I honestly didn't think I would be taking medication for the rest of my life.

I apologize for the public freak-out (especially to you, two lights above the sea!). But I really did need some peace of mind, so I'll try not to be too embarrassed or apologetic.

I have yet to see a doctor/endocrinologist since my discharge. I'm not sure when I'll be able to see one either. Maybe I'll feel a lot better once that happens. I'm still waiting on my Shands card.

Step away from teh google
Will do!
posted by Faraday Cage at 11:01 AM on October 25, 2010

No worries! Do your best to see an endocrin as soon as you can, as they're best equipped to answer your questions and give you reassurance. It may take some time (weeks) to figure out exactly what dose works best for you, so don't be surprised if you're taking your meds as you should but you still don't feel quite...right. The dose may need to be raised or lowered a little, and a visit to your endocrin for bloodwork should be able to sort that out.
posted by rtha at 11:07 AM on October 25, 2010

yeah, I've been on Synthroid for more than a year, and the only thing anyone ever told me is "don't take it at the same time as you eat something with a lot of calcium." My TSH has come down from 8.9 to 1.4 with no restrictions in diet, so I don't think you need to worry.

(Boy do I sympathize, though. When I took Prozac, I think I suffered every side effect listed in the first 20 minutes after I took the pill, just through sheer anxiety and suggestibility. So, yeah, don't be embarassed.)
posted by KathrynT at 11:40 AM on October 25, 2010

Take it one hour before or two hours after a meal. Don't change your diet.
posted by candasartan at 4:17 PM on October 25, 2010

Gonna chime in also. I have hypothyroidism and have been taking levoxyl for 5 or so years now. I see a top-notch endocrinologist, and my father is also an endocrinologist, and I've never heard anything about a specific diet. Don't worry about it.

Where did you get the list of foods to avoid?
posted by radioamy at 5:44 PM on October 25, 2010

Coming back in the thread to add that once you've got hypothyroidism it's pretty much a given that you'll be taking thyroid hormone forever but it's not a big deal. I get my levels checked annually now - was more frequent for the first year or two and that's it.
posted by leslies at 6:49 PM on October 25, 2010

radioamy: Here are some of the lists that come up when you google "hypothyroid foods to avoid":

http://www.suite101.com/lesson.cfm/18912/2313/3
(the following foods are considered goitrogenic: cabbage, broccoli, turnips, rutabaga, mustard greens, kale, spinach, Brussels sprouts, peaches, pears, strawberries, and radishes cauliflower, millet, and African cassava.)

http://www.umm.edu/altmed/articles/hypothyroidism-000093.htm
(Avoid foods that interfere with thyroid function, including broccoli, cabbage, brussels sprouts, cauliflower, kale, spinach, turnips, soybeans, peanuts, linseed, pine nuts, millet, cassava, and mustard greens.)

http://searchwarp.com/swa95859-P2.htm
(Cruciferous vegetables – broccoli, cauliflower, Brussels sprouts, cabbage, mustard, rutabagas, kohlrabi, and turnips. Isothiocyanates are the category of substances in cruciferous vegetables that have been associated with decreased thyroid function. They appear to reduce thyroid function by blocking thyroid peroxidase, and also by disrupting messages that are sent across the membranes of thyroid cells. Cooking these vegetables does make the isothiocyanates less available.)

http://en.wikipedia.org/wiki/Goitrogen

"Um... look at the sources..."

*hides face* I know!

I'm only linking because you were curious.
posted by Faraday Cage at 7:20 PM on October 25, 2010

I wouldn't think about avoiding broccoli, cauliflower, or cabbage over this. Their nutritional value far outweighs any danger to you, they won't prevent your thyroid pills from working, and besides that, you'd probably have to eat something like 10 pounds of this stuff in a sitting to have any side effects, anyway. (At which point, you'll be more concerned about a stomachache than anything else!)
posted by Citrus at 7:39 AM on October 26, 2010

Another hypothyroid veggie eater chimes in! 25+ years now. Totally fine.
posted by judith at 10:45 PM on October 27, 2010

A dermatologist prescribed Finacia and Metrogel - they work brilliantly- to me for hypothyroid rosacea.
posted by nickyskye at 11:46 PM on October 27, 2010

My sister has hypothyroid, which actually was a major contributing factor to her anxiety. It took spending a month in a mental health facility before it was properly diagnosed. She is now on some type of synthetic thryoid meds (among others) and is doing MUCH better on all fronts. The only thing she was told to stay away from was brussel sprouts due to the interaction with the thyroid (and I think due to the possibility of developing a goiter, which she had started to develop a little).
posted by 1000monkeys at 11:59 PM on October 28, 2010

I'm coming in late here, but my 2 cents . . . my doc told me not to load up on the spinach and soy but that some is just fine. He also told me that the hormone is something your body makes anyway (or should make), so it's not really a drug that will have side effects or interact with other drugs. And you'll know if something's wrong and you're not getting enough of an effect from it; you'll feel tired, cold, and listless, and you'll gain weight for no reason. So you can easily monitor it. When I was told by my doc 15 years ago that "you'll be on this for the rest of your life," it freaked me out, too, but compared to any other chronic illness I can think of, hypothyroidism is super easy to manage.

As for learning to cook healthy, I would start by getting a vegetarian cookbook (just because they're veg heavy and usually stress nutrition). I really like Mollie Katzen's cookbooks because the recipes aren't too difficult, they use fresh ingredients and they're really reliable. And she has such a friendly, non-threatening tone that her books are especially good for beginners.

What I did when I was working on trying new vegetables was to just get some of whatever vegetable was on sale at the grocery store that week, then come home and look up recipes for it online (Epicurious has a ton of good recipes, though some are pretty labor-intensive or require some advanced skills; also try Simply Recipes). I also joined a CSA, which got me trying all kinds of new things.
posted by WorkingMyWayHome at 10:06 PM on November 26, 2010