Action Plan – The Thyroid Diet

by Nikolas Hedberg, D.C., D.A.B.C.I. on March 4, 2011

If you have a thyroid problem, the way you should eat is very similar to that of an individual who does not have a thyroid issue.  Organic foods contain fewer amounts of chemicals and pesticides which, as you know from the thyroid-disrupting chemical chapter, can have a negative effect on the thyroid gland.  The main goals of a thyroid diet are those which remove any stress from the thyroid gland itself and any systems that may be affecting the thyroid gland. 

The first major priority in eating to have a healthy thyroid is to make sure you do not have blood sugar swings.  This requires consistent eating throughout the day of high-quality protein at every meal without eating too many carbohydrates.  Remember that blood sugar swings not only affect the thyroid gland itself but also indirectly affect adrenal gland function which, as previously discussed, is highly connected to thyroid physiology. 

The ideal protein/carbohydrate intake for someone with thyroid gland dysfunction is to eat a moderate- to low-carbohydrate diet with the exception of post-exercise carbohydrate consumption.  The food you consume after you exercise and the meal following your post-workout meal can contain more carbohydrates than you would normally eat.  You can do this because your body is much better at handling carbohydrates and blood sugar after you have participated in exercise.

The next important step in optimizing thyroid function is to alkalize your body.  Your body contains approximately sixty trillion cells which are involved in six trillion chemical reactions every second.  Your cells work best to carry out these chemical processes in an alkaline environment versus an acidic environment.  The machinery in your cells that produce energy and burn fat can most easily do their job when the pH is alkaline. 

Eating foods that drive you into an acidic environment will put undue stress on your cells leading to sub-optimal energy production and function.  The best way to find out if you are in an acid or alkaline state is to do a first morning pH test with Hydrion pH strip paper.  You should be aiming for a pH of 6.5-7.5.  A pH below 6.5 indicates an acidic cellular environment that could be contributing to a decrease in your metabolism.  At the same time, you should not be too alkaline which would be a pH above 7.5.  This would indicate a catabolic state meaning your body is breaking down its tissues rapidly due to some kind of metabolic or chemical stress.  Start by taking your first morning urine pH for five days consecutively.  Eliminate the highest and the lowest of the five readings and then average the middle three to attain your pH. 

So how do you become more alkaline?  The first thing you must do is eat a vegetable or fruit or both at every meal.  Produce contains alkaline-forming substances including calcium, magnesium, potassium and zinc.  These are “buffering” agents meaning they help to reduce acid by-products of metabolism.  The way foods are designated as acid or alkaline is based on the “ash” that is left over when they are burned:  the more buffering minerals in the ash, the more alkaline the food.  In addition, the protein content of a food will also determine its acid/alkaline status.  The presence of more amino acids (protein) in a food leads to more acidity in the body due to amino acid metabolism in the liver resulting in acidic by-products.

Adding sweet potatoes and yams as well as lentils will enhance your alkalinity.  In addition, try to eat at least two cups of alkalinizing greens such as kale, mustard greens, turnip greens, or collard greens each day.  Lean towards the three most alkalinizing grains:  oats (gluten-free if you have Hashimoto's or Graves’), quinoa and wild rice.

There are many other strategies you can use to become more alkaline.  Taking an alkalizing bath of one-cup epsom salts and a half-cup of baking soda will aid in alkalizing your body.  The epsom salts contain magnesium which is a buffering mineral that will assist in the elimination of acid residues that result from metabolism and detoxification.  The baking soda is also extremely alkaline and will aid in neutralizing acidic compounds that the skin is eliminating.  Take one of these baths every day, and if you are an athlete, take one at the end of your training day to enhance healing of acidic muscle tissue that has been broken down. 

The next thing you can do to alkalize is to drink a morning cocktail of a quarter- to half-teaspoon of unrefined Celtic sea salt, a juiced half-lemon or lime, a greens supplement and a half-teaspoon of buffered vitamin C powder.  This cocktail will flood your system with alkalizing agents that mop up acid residues in the body.  Please be sure to use unrefined Celtic sea salt which is extremely alkaline as opposed to table salt or sodium chloride which is extremely acidic.  Table salt has been stripped of its alkaline minerals resulting in a toxic and acidic product.

Your evening ritual should consist of taking 200 mg of potassium bicarbonate and 100 mg of magnesium glycinate before bed.  Increase by one of each until you achieve an alkaline first morning urinary pH.

Acids and bases in the body are also controlled by your breath.  Each time you inhale fresh oxygen into the system, your body is preparing to exhale carbon dioxide which, if too high, creates an acidic environment in the blood.  Many people in this society are hyperventilators, not taking in full breaths of oxygen and fully exhaling carbon dioxide.  The way to remedy this is to engage in deep-belly breathing for five minutes in the morning and five minutes at night.  Breathe deeply into the abdomen as if filling your stomach with air and then passively exhale the air without effort.  This is how a baby breathes.  Concentrate on your breath without thinking about anything else.  In time, this will become second nature and you will enjoy doing this twice a day.  You can also incorporate this into your meditation practice which you may already be doing.  Those of you who do not meditate will reap some of the benefits of meditation as this is a great starting point to learning how to meditate.  Focusing on your breathing will focus your thought only on this one task instead of the multitude of things that you think about.

In addition to buffered vitamin C powder, there are a few supplements that can aid in alkalizing the body.  Magnesium, potassium bicarbonate, calcium, zinc, fish oil, probiotics and virtually all medicinal herbs will have an alkalizing effect.  Herbs and spices that you use for cooking such as turmeric, thyme, oregano, etc. all help to alkalize.  In general, meat, dairy and grains are acidic but fruits and vegetables are alkaline.  Remember that it is extremely important to eat protein at every meal so do not underconsume protein in fear of becoming too acidic. 

As long as you are eating vegetables and fruits with each meal, you will become more alkaline.  Use the other strategies I have outlined to enhance this process.  You will notice many health benefits as you become more alkaline such as an improved sense of well-being, increased energy, fat loss, improved sleep, clearer/sharper mind, improved digestion and a reduction in allergies.  Your pH is a sign of your alkaline mineral reserves so be patient in this process.  You didn’t become acidic overnight so it will take time to reverse an acidic state.  It may take you a few months to reach a consistent alkaline state. 

How Much Protein Should You Consume?

In addition to developing an alkaline pH, adequate protein intake is a major fundamental aspect of achieving optimal thyroid health.  According to the vast majority of nutrition textbooks, healthy individuals should ingest a minimum of 0.8 g of protein per kilogram body weight every day.

Unfortunately, this calculation is not accurate for everyone, because we all have different activity levels, stress levels, and genetics.  Another flaw in this calculation is that some of the scientific literature shows that one must ingest 1.2-1.8 g of protein per kilogram body weight every day if there is a protein deficit.  Therefore, on average, I prefer for those who are chronically ill to consume 1.2 g of protein per kilogram body weight every day as a minimum.  The one exception to this rule is the patient who is producing high amounts of C-reactive protein which is a marker of inflammation.  Eating protein will further feed its production by the liver possibly exacerbating your condition. 

Another important factor in these calculations is the quality of protein.  Not all protein is created equal.  So, the amount of protein consumed is heavily dependent on protein sources.  Sometimes it can be difficult to get adequate protein intake from diet alone.  This is where protein and amino acid supplements come into the picture.  Before beginning any kind of protein supplementation, you should be sure that you are eating the highest-quality protein from food sources.  These include:

  • Eggs (ideally organic and free range)
  • Types of fish known to be relatively low in heavy metals.
  • Chicken (ideally organic and free range)
  • Non-commercial forms of red meats such as grass fed, locally raised beef; grass fed buffalo; and grass fed lamb. 
  • Dairy products (ideally organic from locally raised dairy cows)
  • Nuts and seeds, particularly almonds, pecans and walnuts (ideally organic)
  • Legumes (ideally organic)
  • Soybeans

Since soy allergies are very common, this may be one of the foods on the list that you will need to avoid.  In addition, soy products tend to be highly processed.  Only soy products that are fermented such as tempeh and miso should be consumed as protein sources from soy.

Dairy is also problematic because of the high allergenicity, processing, and reliability of sources.  Dairy can also be very hard to digest and is often contaminated with antibiotics, hormones and toxins from the cows.  Dairy is of course an excellent source of protein, but I recommend that the amount of protein consumed from dairy should be minimal.

People are most willing to follow a dietary plan when there are a variety of food choices.  This is why I recommend both animal and vegetable-based protein sources eaten in rotation.

Vegan diets can also be a concern regarding protein for a few reasons.  If we review the primary protein source of a typical vegan diet in the United States, it is found that soy is the main protein source.  Unfortunately, soy is low in sulfur-based amino acids.  This is important, because sulfur-based amino acids are required for optimal liver detoxification, the building of glutathione (a powerful antioxidant) and tissue repair.  In addition, plant-based foods contain virtually all of the nutrients necessary for optimal health with the exception of vitamin B12.  I find that many, many patients are deficient in B12 and therefore require supplementation.  Vegans must have a tremendous amount of knowledge for proper food-combining and supplementation in order to achieve optimal protein and amino acid intake for a healthy body.

When it comes to protein and amino acid supplementation, there are a variety of healthy choices.  I recommend whey protein for those who are not sensitive/allergic to dairy.  Rice, pea and hemp protein sources can also provide high quality protein and amino acids.  Protein powder products are the most beneficial to those who have good digestive function.  For those who have impaired digestive function, I like to use free-form amino acid products for direct delivery of protein building blocks into the system.  Some people require HCl or digestive enzymes in order to optimize digestion and absorption of amino acids.

Gluten
If you have been diagnosed with Hashimoto’s thyroiditis or Graves’ disease, you must avoid gluten indefinitely.  One of the ways to test for gluten intolerance is the anti-gliadin antibody test which measures an immune response to gliadin, the main protein portion of gluten.  A negative anti-gliadin antibody test in saliva, stool or blood does not rule out gluten intolerance.  You can still have gluten intolerance and have false negatives on these tests.  If the test is positive in saliva, stool or blood then this is a very strong indicator that you are gluten-intolerant.  In most cases, there has to be some damage to the lining of the small intestine for the test to be positive in blood or saliva. 

It is very important to understand that traditional medicine only recognizes blood testing or small intestine biopsy as diagnostic of gluten intolerance.  Your traditional physician will have you go through a “gluten challenge” diet for four to six weeks and then test your blood to see if the gliadin antibody is elevated.  This is the worst possible way of detecting gluten intolerance for two reasons.  The first is that if someone is gluten-intolerant and you force her to eat gluten for four to six weeks, you are significantly harming her body.  The second reason is that this test can be negative even if the person is gluten-intolerant making this test a poor method of diagnosis.

Your traditional doctor may want to order a biopsy of the small intestine to look for damage to the lining of the small intestine.  He is looking for what is known as “villous atrophy” meaning the villi that line the gut have been damaged and are worn away from the immune system attack on the dietary gluten intake.  The problem with this test is that you can have gluten intolerance but not have villous atrophy.  Seventy percent of the negative effects of gluten occur outside of the intestine.  This can result in only mild inflammation of the intestine but extra-intestinal damage to organs such as the thyroid, bones, pancreas, brain, adrenals, etc.  I would not feel comfortable having a piece of my small intestine cut out just to perform a test that is not completely accurate.

The best thing you can do is to fill out our gluten questionnaire and have the blood, saliva or stool test done to see if there is a positive antibody in any of these.  If only one is positive and you have many of the indicators of gluten-intolerance, then you should avoid gluten indefinitely.  Most people avoid gluten for a few months and then sneak something in such as a piece of bread and they end up feeling horrible after eating it.  Remember –  it is estimated that up to 40 percent of Americans are gluten-intolerant so it is very important to know if you are as well.  It can mean the difference between a major autoimmune attack on your thyroid or none at all.

The following grains contain gluten:

  • Wheat
  • Oats (not in nature but 99 percent of oats in the US are processed in machinery used for other gluten-containing grains)
  • Rye
  • Barley
  • Spelt
  • Kamut
  • Triticale
  • Bulgar
  • Semolina
  • Couscous
  • Durum flour

*Gluten can be hidden, so read labels carefully. Be wary of modified food starch, dextrin, flavorings and extracts, hydrolyzed vegetable protein, imitation seafood, and creamed or thickened products such as soups, stews, and sauces.

The following grains do not contain gluten and are acceptable for gluten-intolerant individuals and of course those who are not:

  • Corn
  • Millet
  • Rice
  • Taro
  • Teff
  • Arrowroot
  • Wild Rice
  • Tapioca
  • Buckwheat
  • Quinoa
  • Amaranth
  • Wheat Grass
  • Barley Grass
  • Barley Malt

Goitrogens
Goitrogens are compounds in certain foods that inhibit the uptake of iodine into the thyroid gland.  Goitrogens can be neutralized by lightly steaming, fermenting or cooking these foods.  Foods that contain goitrogens include:  kale, cabbage, turnips, rape seeds, peanuts, cassava, sweet potatoes, soybeans, kelp and Brassica vegetables such as broccoli and brussels sprouts.  All of these foods eaten in their raw state could have goitrogenic activity on the thyroid gland. 

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