Key nutrients drive thyroid hormone production. Because the thyroid gland is highly nutrient-dependent, poor nutritional status is one of the root causes of thyroid dysfunction. Nutrient deficiencies can worsen symptoms or prevent thyroid medication from doing its job.
While specific foods and supplements can't treat or reverse thyroid disease, supplements and a thyroid-friendly diet can support your treatment.
So, how to know which supplements can benefit your health? How do you know how much to take? Is more better? How do you know you are getting a quality supplement? Can you cause yourself harm?
The world of supplements is pretty complicated, and many options are more hype than science. It can be tough to decide if you need a supplement and what that supplement should contain.
The Food and Drug Administration (FDA) regulates dietary ingredients and dietary supplements. The FDA's regulation of supplements bases itself on the Dietary Supplement Health and Education Act of 1994 (DSHEA). The definition of a dietary ingredient is a vitamin, minerals, herb, amino acid, or any other substance naturally found in foods that can supplement the diet by increasing intake. Supplement makers cannot make any claims regarding their supplement's ability to "treat, diagnose, prevent or cure any disease."
Under DSHEA, the company manufacturing any dietary supplement takes on the responsibility for ensuring that the product is safe before marketing. The FDA is responsible for monitoring post-market supplement safety. The FDA can remove any supplement found to be unsafe—but that may only be after complaints or serious safety issues have been noticed.
Of course, this means that there are products on the market that may be unsafe or ineffective. To ensure that the products you buy are safe and effective, make sure you:
The thyroid uses iodine to make the thyroid hormones. The numbers associated with thyroxine (T4) and triiodothyronine (T3) represent the number of iodine atoms attached to each. If you don't have enough iodine, you can't make thyroid hormone.
Many years ago, iodine was added to salt (iodized salt) to ensure everyone got enough iodine. However, with so many people reducing their salt intake, now some may need to supplement iodine through diet or supplements. Fish, dairy products, poultry, eggs, kelp, and other seaweeds are excellent sources of iodine.
The RDA for iodine in adults is 150mcg while the UL is 1,100 mcg. Iodine is probably best usually supplied as either potassium iodide (KI), as about 96% of the iodine is absorbed. However, excess iodine may be one cause of hypothyroidism. Consult with your healthcare provider regarding whether you need additional iodine for your thyroid health.
Selenium supports thyroid hormone synthesis. The thyroid gland primarily makes the inactive hormone T4, but our tissues can only use the active hormone T3. These tissues include the brain, bones, kidney, mitochondria, muscles, skin, heart, hair, gut, and liver. So, T4 needs to convert into T3 in our tissues. This conversion from T4 to T3 requires an enzyme that requires selenium.
Although the Recommended Dietary Allowance (RDA) for selenium is 55 micrograms (mcg) per day, research suggests that higher intake may support optimal health, particularly in patients with Hashimoto's. Aim for ~200 mcg daily from food and/or supplements, as this may help reduce thyroid peroxidase antibodies and improve symptoms associated with the condition.
Selenium is found naturally in many foods such as grains, meat, poultry, fish, and eggs, but amounts depend on the selenium concentration of soil and water. Selenium is also available in many multivitamins or as a stand-alone supplement. Look for supplements containing selenomethionine, which is better absorbed than other forms like selenite and selenate.
Selenium can worsen symptoms of hypothyroidism in those with an iodine deficiency. Consider taking selenium along with iodine, especially if you live in an area with selenium-deficient soil.
Keep in mind that consuming too much selenium can cause toxicity. Symptoms of selenium toxicity include garlic breath, nausea, diarrhea, and skin rash, as well as hair and nail loss.
Zinc fights free radical damage, helps prevent poor concentration, and assists in hormone production. This mineral helps with the efficient conversion of T4 to T3. You need enough zinc to convert T4 to the active T3, and you need enough thyroid hormones around to absorb enough zinc.
The RDA for adults is 11 mg for men, and 9 mg for women. The UL is 40mg for both. Good food sources of zinc include shellfish, meat, nuts, lentils, and other legumes like peas and beans. While the "best" form of zinc is still up for debate, zinc picolinate, gluconate, or acetate rank near the top.
Many minerals are better absorbed in a chelated (linked) form. These minerals say "chelated" in the description, or have glycinate, picolinate, acetate, citrate, gluconate, or "___ate" in the name.
Magnesium is an essential mineral that helps our bodies by keeping our bones strong, regulating blood pressure, calming the nervous system, and increasing energy. It is also critical that magnesium is present for thyroid hormones T4 to convert to T3.
Not only are most people deficient in magnesium, but caffeine can also cause magnesium loss. Many hypothyroid patients have extreme fatigue, which can make an exhausted body turn to coffee for a quick pick-me-up. So begins a vicious cycle, because as we increase caffeine intake, magnesium is lost.
Excellent sources of magnesium include dark leafy greens, almonds, sunflower seeds, black beans, and bananas.
Magnesium can impair the absorption of thyroid medications. Talk to your doctor before adding this supplement to your routine.
Besides being an essential component in building red blood cells, iron is necessary to synthesize thyroid hormones. Iron also plays a role in moving oxygen and creating energy within our body.
Beef, chicken, salmon, apricots, white beans, and spinach are all rich sources of iron.
All the B-complex vitamins can play a role in thyroid disease, and it is usually sufficient to use a quality multivitamin that contains all the B vitamins. Extra Vitamin B12 and folates may improve the response to thyroid hormones and can overall help boost your energy levels.
Low levels of B12 may lead to anemia, inflammation, or impaired digestion. Supplementing with vitamin B12 could help get your energy back. Good sources of B12 include nuts, animal proteins, and dark leafy greens.
Myoinositol is a B-vitamin substance that appears to be quite useful in promoting thyroid health in people with Hashimoto's thyroiditis, especially when combined with selenium. The recommended dose is 600 mg myoinositol plus 16.6mg selenomethionine.
Vitamin C helps to maintain proper blood pressure levels, reduces the risk of certain cancers, and helps fight heart disease. Citrus fruits, berries, cherries, and tomatoes are all great choices to boost vitamin C levels.
Vitamin D deficiency is commonly found in those with Hashimoto's disease and is associated with the presence of TPO antibodies. Vitamin D supports immune balance by building resilience against infections and maintaining gut health.
Adults up to 70 years old should have at least 600 IU (15mcg) daily, while older adults should have at least 800 IU (20mcg) daily. The best sources of Vitamin D are through food (salmon, tuna, mackerel, liver, eggs, and fortified foods) and by moderate sun exposure (15-20 minutes a day on the arms, chest, legs, and face).
Supplements of D3 are useful to maintain Vitamin D levels, especially during the winter months. D3 is also known as cholecalciferol, not to be confused with D2, ergocalciferol.
Probiotics are combinations of beneficial bacteria. These good bacteria exist in the gut to help:
Probiotics are recommended for those with autoimmune thyroid disease and support overall health in those with hypothyroidism. Probiotics are in foods like yogurt, kefir, unpasteurized sauerkraut, tempeh, miso, and some cheeses. Sources of prebiotics (food for these beneficial bacteria) include garlic, onions, asparagus, bananas, and leeks.
Intestinal permeability (commonly referred to as leaky gut) may be caused by an imbalance of good and bad gut bacteria and can affect autoimmunity. Those with autoimmunity may have lower amounts of Lactobacillus and Bifidus (good bacteria) and higher amounts of E. coli and Proteus (harmful bacteria). The harmful bacteria can become pathogens, or microorganism that can cause disease. Taking probiotics can help reintroduce good gut bacteria to balance out that which is detrimental.
Probiotics are not recommended for critically ill or severely immunocompromised patients, those with short-bowel syndrome or for those who have central venous catheters.
When it comes to herbal thyroid support, formulation matters. Traditionally, the delivery of herbs has been with teas or tinctures, often combining a blend of 2-3 herbs. With concentrations of 2-3 herbs, these traditional delivery systems offer a relatively potent dose.
In modern times, the potency of herbal supplements has declined significantly. You can buy over-the-counter supplements that contain a blend of 8-10 herbs, possibly in combination with vitamins and minerals, too. While each of the ingredients may act positively on the thyroid, cramming them all into a small capsule, limits their effectiveness.
Herbs tend to work best as an extract, a mixture that contains hundreds of plant constituents. Modern drugs can be given in small quantities because they are single substances. However, herbs need to be delivered in higher doses and tend to work synergistically with other plant components.
If you want to support your thyroid with herbal supplements, we recommend you:
You should note that herbs have can interact with many different medications. Follow your healthcare provider's advice for safety. Take only the recommended amounts.
Which herbs have the best evidence for supporting thyroid function? Several herbs come from Traditional Chinese Medicine (TCM), Ayurvedic, and Western herbal traditions. These herbs are from a class of botanicals called "adaptogens," which support the thyroid by helping the body respond to stress.
Ashwagandha or Withania somnifera comes from Ayurvedic traditions. Ashwagandha supports the adrenal glands and can reduce high cortisol levels. Ashwagandha should not be used during pregnancy and may worsen autoimmune thyroid disease (and other autoimmune disorders). A recent study indicated that Ashwagandha might boost T4 synthesis and T4-T3 conversion and improve thyroid function in hypothyroid disorders, increasing T3 and T4 levels and decreasing TSH levels. Ashwagandha may be used with thyroid replacement therapy when used cautiously. Please consult your healthcare provider.
Eleutherococcus seniticosus is also known as Siberian ginseng, eleuthero, and Devil's shrub. Eleuthero is used to moderate the stress response and may help relieve fatigue and anxiety. It may also support energy metabolism, liver function, and can help promote restful sleep.
Centella asiatica, also known as Gotu kola, comes from Traditional Chinese Medicine (TCM). It may be useful in relieving some of the fatigue and depression often associated with hypothyroidism. Gotu kola should be used cautiously with sedatives.
Schisandra sinensis (Schisandra) is another adaptogen used in TCM. The Schisandra berry is used to support the thyroid and liver functions and has anti-inflammatory effects.
Anti-inflammatory herbs may also be useful for those with Hashimoto's thyroiditis or other autoimmune thyroid disorders. Anti-inflammatory herbs include turmeric, garlic, and ginger. These herbs are good for cooking.
Many nutritional factors play a role in optimizing thyroid function, and this information is not intended to diagnose, treat, cure, or prevent any disease. We recommend you work with a Paloma Nutritionist to determine your specific nutritional needs to optimize your thyroid health.
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