Dr. Josh Axe is a certified doctor of natural medicine, doctor of chiropractic, and clinical nutritionist with a passion to help people get healthy by using food as medicine. Dr. Axe has created one of the top 10 most visited natural health websites in the world at www.DrAxe.com which has over 15 million monthly visitors. Dr. Axe has been a physician for many professional athletes. In 2009, he began working with the Wellness Advisory Council and Professional Swim Teams. He worked with professional swimmers, including Ryan Lochte and Peter Vanderkaay, providing nutritional advice and musculoskeletal work on the athletes to increase their performance. He also traveled to the 2012 Games in London to work with USA athletes. Dr. Axe has authored several books including his new book Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems and 5 Surprising Steps to Cure It.


Getting enough fiber is good for you, but too much can complicate your hypothyroidism treatment. The government's Daily Guidelines for Americans currently recommends that older adults take in 20 to 35 grams of fiber a day. Amounts of dietary fiber from whole grains, vegetables, fruits, beans, and legumes that go above that level affect your digestive system and can interfere with absorption of thyroid hormone replacement drugs.

You must take synthetic thyroxine every day in the morning on an empty stomach. Wait at least 30 minutes before eating or drinking (with the exception of water). Skipping doses can cause your thyroid to go off balance. If you do miss a dose, be sure to take it the next day according to your regular schedule. Don’t double up on your dose by taking two pills at a time, because this can increase your levels by too much.
Making dietary changes is your first line of defense in treating hypothyroidism. Many people with hypothyroidism experience crippling fatigue and brain fog, which prompts reaching for non-nutritional forms of energy like sugar and caffeine. I’ve dubbed these rascals the terrible twosome, as they can burn out your thyroid (and destabilize blood sugar).
Thyroid scanning is used to determine how active the thyroid is in manufacturing thyroid hormone. This can determine whether inflammation of the thyroid gland (thyroiditis) is present. It can also detect the presence and degree of overactivity of the gland (hyperthyroidism) or, conversely, it can determine the presence and degree of underactivity of the gland (hypothyroidism).
An article published in May 2017 in the journal Endocrine Connections noted that hypothyroidism and celiac disease are often present together, and while no research has demonstrated that a gluten-free diet can treat thyroid conditions, you may still want to talk to a doctor about whether it would be worth eliminating gluten, or getting tested for celiac disease.
When a patient is suspected to have a thyroid disorder a comprehensive thyroid profile is ordered, in the form of a blood test. The test results will give precise measurements of Free T3 and T4 and their ratios to each other. If the results indicate that for example, the patient’s T3 level is too low then the patient will be checked for deficiencies in essential nutrients which are required for hormone production. Many times this will correct the thyroid without the need for prescription hormones.
Hi, Dawn: Yes, there’s definitely a TON of conflicting information out there. When it comes to cruciferous vegetables and the thyroid, it’s all about raw veggies, not cooked. Raw cruciferous veg contains a compound called goitrogens, which might impact thyroid function by impairing thyroid peroxidase, an enzyme normally found in the thyroid gland. I don’t think this means that you should NEVER eat a single serving of raw cruciferous veggies if you have thyroid issues. But just that you shouldn’t overdo it and eat raw daily. Hope that helps!
Thyroid hormone is critical for normal brain development in babies. Infants requiring thyroid hormone therapy should NOT be treated with purchased liquid suspensions, since the active hormone may deteriorate once dissolved and the baby could receive less thyroid hormone than necessary. Instead, infants with hypothyroidism should receive their thyroid hormone by crushing a single tablet daily of the correct dose and suspending it in one teaspoon of liquid and administering it properly.
Exercise and a healthy diet are important for controlling chronic stress and managing hormone-related neurological function. Research shows that people who regularly exercise usually get better sleep, deal with stress better and more often maintain a healthier weight, all of which reduce some of the biggest risk factors and symptoms associated with hypothyroidism.
To ensure that you remain as healthy as possible it is important to eat the right variety of foods in the correct proportions. For example, choose low fat, low calorie spread rather than butter or ordinary margarines, avoid high salt intake and cut down on hidden fats & sugars (cakes, biscuits, chocolate). More information is available from NHS guidance.
Hashimoto’s disease is the most common autoimmune disease linked to hypothyroidism. In fact, the condition in which the autoimmune system targets the thyroid specifically is commonly known as Hashimoto’s Thyroiditis. Hashimoto’s Thyroiditis is when the immune system targets antibodies directly to the thyroid, causing inflammation of the thyroid gland and thus limiting the gland’s ability to produce its delegated hormones.
Some findings suggest that many people with Hashimoto’s disease (the most common type of hypothyroidism) have lower levels of vitamin D compared to the general population . That’s bad news, since low D is tied to higher levels of thyroid antibodies. “The antibodies activate the immune system to attack the thyroid tissue, which creates inflammation and makes it harder for the thyroid to do its job,” explains Lisa Markley, RDN, co-author of The Essential Thyroid Cookbook.
I think most people with hypothyroidism would agree that their condition is not due to a deficiency of synthetic thyroid hormone. Even though this is obviously true, most endocrinologists tell just about all of their patients with hypothyroidism and Hashimoto’s Thyroiditis to take synthetic thyroid hormone medication for the rest of their life without trying to find out why the person developed a hypothyroid condition to begin with. Although some people do need to take synthetic or natural thyroid hormone on a permanent basis, many people can have their health restored back to normal through natural hypothyroid treatment methods.

The thyroid peroxidase test measures the level of an antibody that is directed against thyroid peroxidase (TPO). A presence of TPOAb in the blood reflects a prior attack by the body's immune system on thyroid tissue. A positive thyroid peroxidase test may signal chronic thyroiditis. Other autoimmune disorders, however, may have a positive TPOAb test.
The normal values for the serum T4:T3 ratio are seldom discussed in the literature because measurement of serum T3 levels is not a recommended outcome in hypothyroidism (1). In a large study of approximately 3800 healthy individuals (4), the serum free T4:free T3 ratio was around 3, as opposed to a ratio of 4 in more than 1800 patients who had undergone thyroidectomy and were receiving l-thyroxine monotherapy. The corresponding serum free T4:free T3 ratio in patients continuing to receive desiccated thyroid is not well-defined, but the serum total T4:T3 ratio is known to be low (28, 50). In one study, the serum total T4:total T3 was about 40 in patients receiving desiccated thyroid and about 100 in those taking l-thyroxine monotherapy (60). Of course, this is affected by the timing of blood collection in relation to the timing of l-triiodothyronine administration, which is not commonly reported. Other key factors are the well-known poor reproducibility of the serum total T3 assay (61) and the interferences with direct measurement of free T3 (5).
“More than 70 countries, including the United States and Canada, have salt iodization programs. As a result, approximately 70% of households worldwide use iodized salt, ranging from almost 90% of households in North and South America to less than 50% in Europe and the Eastern Mediterranean regions.  In the United States, salt manufacturers have been adding iodine to table salt since the 1920s, although it is still a voluntary program.”  [http://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/#h3]
There are some people who say that there is no scientific evidence linking food to thyroid problems or healing. We have a choice to make about how we want to view things and about what we want to believe. Choice is a powerful tool. Let us never forget that. Even if there is supposedly “no evidence” that food is linked to thyroid healing, you could say to yourself, “What if I try something new and different for 3 weeks and just see how I feel.” Because really, what have you got to lose? Especially if you have been sick for a long time… You might learn something new and have fun along the way! You have a choice. You can choose to start a thyroid diet plan and see what happens.
Bone broth — Beef and chicken stock contain the amino acids L-proline and L-glycine, which can help repair the digestive lining and improve hypothyroidism. Bone broth also contains numerous important minerals that nourish the digestive tract and prevent deficiencies like calcium, magnesium, phosphorus and silicon. Bone broth has been shown to help overcome food sensitivities, improve energy and fight fatigue, increase immunity and lower pain of the muscles and joints.
ADHD Bipolar Disorder Brain Health Cancer Carbohydrates carbohydrate sensitivity casein Cholesterol Constipation Crucifers Dairy Depression diabetes Dopamine fasting Fiber Food Sensitivity Fructose Fruits Gout Grains Heart Disease Histamine Hypertension Hypothyroidism IBS insulin insulin resistance iron ketogenic diet ketosis low-carbohydrate diet Meat obesity Omega-3 Processed meat Protein red meat Refined Carbohydrates Sugar Vegan Vegetables Vegetarian Weight Loss whey
Going “natural” is an evolving trend in healthcare. Even hypothyroid patients are exploring their options outside of synthetic thyroid hormone. One such option is a so-called natural thyroid supplement made from dried animal thyroid glands. These are usually derived from pigs (called Armour Thyroid) but are also sometimes made from dried cow thyroids. (3)
Muscle cramps are involuntarily and forcibly contracted muscles that do not relax. Extremely common, any muscles that have voluntary control, including some organs, are subject to cramp. Since there is such variety in the types of muscle cramps that can occur, many causes and preventative medications are known. Stretching is the most common way to stop or prevent most muscle cramps.
Hypothyroidism can be easily treated with thyroid hormone replacement. The preferred treatment for most people with an underactive thyroid is levothyroxine sodium (Levoxyl, Synthroid). This is a more stable form of thyroid hormone and requires once a day dosing.Liothyronine sodium (Cytomel) also may be prescribed to treat hypothyroidism under certain conditions.
These clinical trials also began to define the adverse-effect profiles associated with these agents; thyrotoxicosis was frequently encountered. Patients treated with l-triiodothyronine3 (100 to 175 mcg/d) normalized BMR faster than did those receiving desiccated thyroid (120 to 210 mg/d) or l-thyroxine (200 to 350 mcg/d) but were more likely to experience angina (32). Desiccated thyroid was also associated with adverse symptoms in other studies; muscle stiffness, psychosis, and angina all occurred (33). In a crossover study of l-triiodothyronine monotherapy (75 to 100 mcg/d), l-thyroxine monotherapy (200 to 300 mcg/d), and desiccated thyroid (1.5 to 3 grains/d), all of these therapies restored BMR and serum PBI; with l-triiodothyronine, however, angina and heart failure occurred. Dose reduction corrected these adverse effects, but authors concluded that l-thyroxine monotherapy or thyroid extract was preferred (34). In a trial of l-thyroxine monotherapy at doses of 200 to 300 mcg/d versus l-thyroxine (80 mcg) plus l-triiodothyronine (20 mcg) daily, patients receiving the combination had such symptoms as palpitations, nervousness, tremor, and perspiration (35). Some early proponents of l-thyroxine monotherapy emerged because of less frequent thyrotoxic effects (24), but it is difficult to determine whether such adverse effects were related to the agent used or its high dosage. Thyrotoxic adverse effects were typically remediable by simple dose reduction (36), so desiccated thyroid remained the preparation of choice (37).

Two things to keep in mind: First, iron is tough for the body to absorb, but you can boost your absorption of iron-rich foods by pairing them with a source of vitamin C, Markley says. (Like tossing white beans with lemon vinaigrette, for instance.) And second, iron can make thyroid drugs less efficient. So be sure to take your thyroid meds at least four hours before or after eating an iron-rich meal .


When the hypothalmus decides we need more thyroid hormone in circulation (cold weather or increased activity level for example) it sends a chemical messenger called thyrotropin-releasing hormone (TRH) which goes to the pituitary gland.  The pituitary than sends thyroid stimulating hormone (TSH) over to the thyroid.  TSH activates the production of a protein called thyroglobulin.
Seaweed has a high concentration of iodine, an essential nutrient for thyroid function. "Iodine is the precursor for the production of thyroid hormone," Dr. Dodell explains. Seaweed, packaged as nori, wakame, and dulse, can be used in sushi, soups, and salads. Another plus: Seaweed offers nutritional benefits of fiber, calcium, and vitamins A, B, C, E, and K.
Exercise: Many patients with hypothyroidism have reported benefits from practicing a yoga pose called the Shoulder Stand, or sarvangasana, which increases circulation to the thyroid. Lie on your back with your arms (palms up) along your sides. Raise your legs at a right angle to the floor. Then raise your hips so your chin rests on your chest, supporting yourself with your elbows and upper arms on the floor and your hands on your hips. Keep your neck and shoulders flat on the floor, and stretch your torso and legs as straight as possible. Hold as long as comfortable, slowly working up to 5 minutes a day. Don’t do this pose if you are pregnant or menstruating, nor should you try it if you have glaucoma, sinus problems or high blood pressure. The Shoulder Stand may be more effective if you use visualization practices, imagining the thyroid gland waking up from a long period of inactivity and producing more thyroid hormone.
The most common treatment I use is Armour thyroid, (9) a prescription drug made from desiccated (dried) porcine thyroid. It contains the full spectrum of thyroid hormones, including T4, T3, and T2 (10). That last one – T2 – is a little-known product of thyroid metabolism that actually may be very important. The right dose ranges from 15 to 180 milligrams, depending on the person.

Dietary changes: For those who have existing thyroid conditions, excess consumption of soy may affect thyroid function, but this is probably a concern only in those already taking Synthroid or other thyroid replacement medication. If you consume soy on a regular basis, you may require a slightly increased dosage of replacement therapy. You should also know that if you eat soy foods at the same time that you take thyroid hormone, they may interfere with its absorption. To be safe, do not eat soy within three hours of taking your medication. Moderate soy consumption (one serving daily of whole soy foods) should not be a problem. Adequate iodine from dietary sources is also important – iodized salt, fresh ocean fish and seaweed are good sources.
Follow a Thyroid Diet: The consumption of sea food, shellfish and organic vegetables and fruits, rich in iodine content has proven beneficial in overcoming iodine deficiency. It is better to eat small meals rather than three large meals. Non-starchy fruits and vegetables and low-fat proteins should be consumed. Sugary and starchy food items like, pasta, desserts, sodas, white bread, rice, etc. must be avoided completely. An intake of at least 64 ounces of non-fluoridated water is necessary.
People should take T4 on an empty stomach to prevent the absorption of the medication from being erratic. Moreover, doctors usually recommend taking the medication first thing in the morning, then waiting at least an hour to eat breakfast or drink coffee. Taking the medication at bedtime, several hours after the last meal, also appears to work and may be a more convenient approach for some people.
Autoimmune disease - Autoimmune disorders occur when the body’s immune system produces antibodies that attack its own tissues. Scientists aren’t sure why the body produces these antibodies and why it would attack itself. Some think that a virus or bacterium might trigger this, while others believe that genetic factors cause autoimmune disorders. It could also be a combination of the two factors. Regardless of the cause of autoimmune diseases they are thought to be a cause of hyperthyroidism. When the immune system attacks the body, it often targets the thyroid. This limits the thyroid’s ability to produce hormones and results in hyperthyroidism.
The thyroid is a small, butterfly-shaped gland found near the base of the neck. It produces hormones that regulate vital metabolic processes throughout the body. A deficiency in the production of thyroid hormone, known as hypothyroidism, causes these processes to slow down or stop. Receptors for thyroid hormone are found throughout the body, and disturbance in thyroid functioning can cause problems in almost every system of the body from the heart and GI tract to sleep, mood, even the growth of hair, skin and nails.
If you absolutely must have both your thyroid medication and coffee at the same time, talk to your physician about the liquid capsule form of levothyroxine called Tirosint, which research shows is not affected by coffee. You may also consider taking your thyroid medication at bedtime, instead of in the morning; although, again, be sure to discuss this with your personal physician. 
An unhealthy gut environment can contribute to nutrient deficiencies and raise autoimmune activity in the body. Food sensitivities or allergies, including those to gluten and dairy, can trigger gut inflammation. Other causes of a damaged gut are high stress levels, toxin overload from diet and the environment and bacterial imbalances. When leaky gut occurs, small particles that are normally trapped inside the gut start to leak out into the bloodstream through tiny openings in the gut lining, which creates an autoimmune cascade and a series of negative symptoms.
Thus, neither desiccated thyroid nor l-thyroxine monotherapy recreates a biochemical state of euthyroidism as defined by the serum T4:T3 ratio. l-Thyroxine and l-triiodothyronine combination therapy theoretically could be titrated to restore this measure, but such a method would be challenging because of the frequent dosing schedule needed to achieve stable serum T3 levels (5). New technology is needed to allow for steady delivery of l-thyroxine; only then would high-quality clinical trials best investigate the utility of the serum T4:T3 ratio as an outcome measure in hypothyroidism.
A neck lump or nodule is the most common symptom of thyroid cancer. You may feel a lump, notice one side of your neck appears to be different, or your doctor may find it during a routine examination. If the tumor is large, it may cause neck or facial pain, shortness of breath, difficulty swallowing, cough unrelated to a cold, hoarseness or voice change.
Essential fatty acids found in fish oil are critical for brain and thyroid function. DHA and EPA omega-3s found in fish oil are associated with a lower risk for thyroid symptoms, including anxiety, depression, high cholesterol, inflammatory bowel disease, arthritis, diabetes, a weakened immune system and heightened autoimmune disease. Omega-3 fish oil such as cod liver oil can also help balance levels of omega-6s in the diet, which is important for ongoing health.

When the hypothalmus decides we need more thyroid hormone in circulation (cold weather or increased activity level for example) it sends a chemical messenger called thyrotropin-releasing hormone (TRH) which goes to the pituitary gland.  The pituitary than sends thyroid stimulating hormone (TSH) over to the thyroid.  TSH activates the production of a protein called thyroglobulin.

Could kale, that superstar among superfoods, actually not be quite so awesome? Kale is a mild goitrogen -- in rare cases it prevents the thyroid from getting enough iodine. But kale shouldn't be a problem for you unless you get very little iodine in your diet and you’re eating large amounts of kale. This is also the case for cabbage, broccoli, cauliflower, and Brussels sprouts.  
Radioimmunoassays for measurement of serum T3 (48) and T4 (49) were soon developed, and it was observed that l-thyroxine monotherapy could normalize both T4 and T3 levels at the expense of a high T4:T3 ratio. In contrast, l-triiodothyronine, desiccated thyroid, thyroglobulin, and l-thyroxine/l-triiodothyronine combination all typically resulted in low or low-normal serum T4 values with usually elevated serum T3 levels, and thus a low T4:T3 ratio (28). Desiccated thyroid resulted in a T3 peak about 2 to 5 hours after administration that corresponded to thyrotoxic symptoms in some patients (50). That a single daily dose of l-thyroxine resulted in stable blood levels of T4 and T3 throughout the day (48) was understood to result from a steady rate of conversion of T4 to T3 (51).
According to Dr. Datis Kharrazian, 90% of people with hypothyroidism have Hashimoto’s, an autoimmune hypothyroid condition, whereby the immune system attacks thyroid tissue. Therefore, to cure thyroid disease, or any autoimmune condition, you have to get to the source of the imbalance; focusing on suppression of symptoms with medication is simply barking up the wrong tree.
If that’s not enough to calm your concerns, some experts suggest that eating cruciferous vegetables may actually be beneficial if you have autoimmune hypothyroidism since the thiocyanates may slow the absorption of iodine in people getting too much, which is possible if you are eating a typical Western diet of fast foods, French fries, and other processed products, that contain iodized salt, and you are heavy-handed with the salt shaker.
90% of all hypothyroid conditions are autoimmune in nature. In other words, most people with hypothyroidism have the condition Hashimoto’s Thyroiditis. But what causes this condition? Numerous factors can trigger an autoimmune response and result in the elevated thyroid peroxidase (TPO) and/or thyroglobulin antibodies you see with Hashimoto’s Thyroiditis. These antibodies will damage the thyroid gland, which is what leads to the decreased production of thyroid hormone. And while taking synthetic or natural thyroid hormone might be necessary for someone who has low or depressed thyroid hormone levels, this won’t do anything to improve the health of the immune system. So the goal is to detect and then remove the trigger which is causing the autoimmune response, get rid of the inflammation, and suppress the autoimmune component of the condition.
Probiotic-Rich Foods — These include kefir (a fermented dairy product), organic goat’s milk yogurt, kimchi, kombucha, natto, sauerkraut and other fermented veggies. As part of your hypothyroidism diet, probiotics help create a healthy gut environment by balancing microflora bacteria. This reduces leaky gut syndrome, nutrient deficiencies, inflammation and autoimmune reactions.
Typically we obtain the iodine we need from a normal healthy, balanced diet. Table & cooking salt in the UK contains little or no iodine. Too little iodine can result in thyroid swelling (a goitre). Goitre in the UK is not due to iodine deficiency Too much iodine can be dangerous and cause either under activity of the thyroid (hypothyroidism) or, in some cases over activity (hyperthyroidism).

Dr. Josh Axe is a certified doctor of natural medicine, doctor of chiropractic, and clinical nutritionist with a passion to help people get healthy by using food as medicine. Dr. Axe has created one of the top 10 most visited natural health websites in the world at www.DrAxe.com which has over 15 million monthly visitors. Dr. Axe has been a physician for many professional athletes. In 2009, he began working with the Wellness Advisory Council and Professional Swim Teams. He worked with professional swimmers, including Ryan Lochte and Peter Vanderkaay, providing nutritional advice and musculoskeletal work on the athletes to increase their performance. He also traveled to the 2012 Games in London to work with USA athletes. Dr. Axe has authored several books including his new book Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems and 5 Surprising Steps to Cure It.


Muscle cramps are involuntarily and forcibly contracted muscles that do not relax. Extremely common, any muscles that have voluntary control, including some organs, are subject to cramp. Since there is such variety in the types of muscle cramps that can occur, many causes and preventative medications are known. Stretching is the most common way to stop or prevent most muscle cramps.
Before you read on, it’s key to know that 90% of hypo- and hyper-thyroidism results from an autoimmune disorder. (Most people do not realize this, as doctors often don’t take time to explain things.) Most hypothyroid conditions are Hashimoto’s and most hyperthyroid conditions are Graves’ Disease, which means that your immune system is attacking your thyroid. Since the immune system resides in the gut or our intestine (Did you know that?!) a lot of what you will read here is about rebuilding the digestive system.

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