Keep in mind, however, that if you switch to a high-fiber diet, you should get your thyroid-stimulating hormone (TSH) rechecked in eight to twelve weeks to see if you need a dosage readjustment, as fiber can affect the absorption of thyroid hormone replacement medication. Moreover, a high-fiber diet may worsen bloating (usually temporarily), which is a common symptom in people with hypothyroidism. 


Whether you take these minerals in a multivitamin or alone, calcium and iron supplements may counteract the medication you take to treat your underactive thyroid. These supplements may affect your ability to absorb levothyroxine, the synthetic thyroid hormone found in medications such as Synthroid and Levothroid, according to the Mayo Clinic. “There’s a very strict way to take thyroid medication,” Blum says. You take it the same way every day, at least one hour before food and never with calcium, iron or other minerals. Blum recommends taking your thyroid medication as soon as you wake up and consuming the mineral supplements with food at dinnertime or before bed.
Although relatively low serum T3 levels could contribute to these residual manifestations, the higher serum T4:T3 ratio should also be considered. This has been well-established for 4 decades (28, 50, 59), but only recently has it been recognized as a relevant measure given that higher serum T4 levels will impair systemic T3 production via downregulation of a deiodinase pathway (9). Thus, some emphasis has recently been directed toward establishing the clinical significance of this ratio (1, 5).
It’s commonly believed that hypothyroidism is due to insufficient iodine, but this isn’t true. Dr. Kharrazian states that if you have Hashimoto’s, taking supplemental iodine is like throwing gasoline on a fire, so eschew iodine supplements and iodized salt. Primary sources of iodine: sea vegetables and seafood. Secondary sources: eggs, asparagus, lima beans, mushrooms, spinach, sesame seeds, summer squash, Swiss chard, and garlic.
When it comes to thyroid medications, it’s important for RDs to know the medications can interact with common nutritional supplements. Calcium supplements have the potential to interfere with proper absorption of thyroid medications, so patients must consider the timing when taking both. Studies recommend spacing calcium supplements and thyroid medications by at least four hours.21 Coffee and fiber supplements lower the absorption of thyroid medication, so patients should take them one hour apart.22 Dietitians should confirm whether clients have received and are adhering to these guidelines for optimal health.
“The effects of fluoride on various aspects of endocrine function should be examined, particularly with respect to a possible role in the development of several diseases or mental states in the United States. Major areas of investigation include . . . thyroid disease (especially in light of decreasing iodine intake by the U.S. population).” (National Research Council, 2006)
Whether you take these minerals in a multivitamin or alone, calcium and iron supplements may counteract the medication you take to treat your underactive thyroid. These supplements may affect your ability to absorb levothyroxine, the synthetic thyroid hormone found in medications such as Synthroid and Levothroid, according to the Mayo Clinic. “There’s a very strict way to take thyroid medication,” Blum says. You take it the same way every day, at least one hour before food and never with calcium, iron or other minerals. Blum recommends taking your thyroid medication as soon as you wake up and consuming the mineral supplements with food at dinnertime or before bed.
Thyroid patients can’t manage their condition through diet. However, eating the wrong foods or taking the wrong supplements can cause trouble. Advertising Policy Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy Among the foods that thyroid patients … Read More
Selenium:   Selenium is one the MOST IMPORTANT when it comes to healthy thyroid function!  It is incorporated into key enzymes involved in several metabolic pathways implicated in thyroid hormone metabolism; additionally, it plays an antioxidant role in the regulation of the immune system.   There are strong links between selenium deficiencies and auto-immune thyroid problems (48, 49).
Although I’m a fan of getting what you need from real food whenever possible, herbs, supplements, and vitamins can still have a place in the thyroid diet plan. It’s hard to give tips here as many people over-medicate and only feel worse later. Hopefully these tips will help; they apply to most auto-immune conditions (This advice was given by my naturopath who focuses on hormonal and thyroid health.):

Correcting these problems requires an integrative approach. It involves more than simply taking a thyroid pill. As you’ll see, it involves nutritional support, exercise, stress reduction, supplements, reducing inflammation, and sometimes eliminating certain foods and detoxification from heavy metals (such as mercury and lead) and petrochemical toxins (such as pesticides and PCBs).

T4 circulates through to the liver where 60% of it is converted into T3 through the glucoronination and sulfation pathways.  If the liver is sluggish it will cause a problem in T4-T3 conversion (6).  Another 20% is converted into reverse T3 which is permanentely inactive.  The final 20% is converted into T3 sulfate and T3 acetic acid which can then be further metabolized by healthy gut bacteria to produce more active T3 (6).

Giving appropriate doses of T3 is trickier than appropriately dosing T4. T4 is inactive, so if you give too much there is no immediate, direct tissue effect. T3 is a different story, though, as it is the active thyroid hormone. So if you give too much T3, you can produce hyperthyroid effects directly—a risk, for instance, to people with cardiac disease. 

First things first, you must consider food to be your medicine and get off all processed junk food, sugar (which sends you on a hormonal rollercoaster ride) and gluten. The Daily Living Eating Plan is a great place to start. In addition, l-glutamine is a key amino acid that reduces cravings for high-glycemic carbohydrates and helps kick the sugar habit. If you have already done that and are looking to go deeper, here are some tips to heal the thyroid:

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Gluten is the common protein found in wheat, barley, & rye. Gluten is a sticky, storage protein that is challenging for the digestive tract because it binds to the small intestinal wall where it can cause digestive and immune system disorders. Gluten sensitivity is an epidemic that is a major contributing factor with inflammatory and autoimmune diseases (61, 62).

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.


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.
Think milk, butter, cheese, and meat. If you buy the cheap, conventionally raised versions at the supermarket, those types of deliciousness can also disrupt all your thyroid’s hard work. You omnivores (like us) can avoid this dilemma by choosing organic, or at least antibiotic-free and hormone-free meats and dairy. It’ll save you in the end, with fewer medical costs down the line.
1. Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, et al. American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24:1670–1751. [PMID: 25266247] [PMC free article] [PubMed]

High-fiber foods – People with hypothyroidism may have digestive difficulties, so aim for 30–40 grams of fiber daily. In addition to a high-fiber diet helping with digestive health, it improves heart health, balances blood sugar levels and supports a healthy weight by making you feel fuller. Some easy ways to increase fiber intake include eating more fresh vegetables, berries, beans, lentils and seeds.
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.

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Please Note: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.

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