How can lifestyle and supplementation influence thyroid function?

The role of lifestyle in hypothyroidism and Hashimoto's disease

Etiology indicates that genetic factors are a key determinant of the disease's development. However, for the disorder to develop, environmental factors must be present, factors that are within everyone's control. One such factor is diet. Diet can have a beneficial impact on both the course and effectiveness of treatment for thyroid disorders, including hypothyroidism and Hashimoto's disease. Dietary modifications can reduce the risk of developing disorders resulting from thyroid dysfunction, reduce the severity of inflammation, and increase the effectiveness of pharmacotherapy.

The most important dietary assumptions – diet therapy in a nutshell

According to the current state of knowledge as of 2023, the most important factors contributing to the occurrence and exacerbation of thyroid diseases (hypothyroidism with Hashimoto's) are:

• stress (emotional and physical),
• lack of sleep,
• alcohol abuse,
• smoking cigarettes,
• food poisoning,
• microflora dysbiosis,
• infections (EBV, Helicobacter pylori, SIBO, Candida, other viral, bacterial and/or parasitic),
• malnutrition,
• overfeeding,
• improperly balanced diet,
• use of certain medications (especially chronic ones),
• use of hormonal contraception,
• hormonal disorders (estrogen dominance, progesterone deficiency, low testosterone),
• exposure to heavy metals and other toxins, including endocrine disruptors such as bisphenols (BPA, BPS), phthalates, dioxins, polychlorinated biphenyls (PCBs), flame retardants (BFRs) and others.

Observational and case-control studies, as well as experience from dietetic offices, show that patients with thyroid diseases are people with chronic nutritional deficiencies.

In theory and practice, emphasis is placed on the deficiencies of the following substances:

• selenium,
• potassium,
• iodine,
• copper,
• magnesium,
• zinc,
• iron,
• vitamins A, C, D and B.

It is important to emphasize the need to consume adequate levels of protein, dietary fiber, and omega-3 unsaturated fatty acids, and to preferably reduce the consumption of products containing easily digestible carbohydrates, such as refined grain products, confectionery, and highly processed foods. Consumption of goitrogens, soy, lactose, and gluten should be considered on an individual basis.

Vicious circle

When the thyroid gland is not working properly (especially when there is a deficiency of active fT3), the following occurs:

• slowing down intestinal peristalsis (resulting in constipation, bloating, abdominal pain, overflowing, and consequently SIBO, IBS, inflammatory bowel diseases),
• the rate of stomach emptying decreases (an ideal environment is created for the multiplication of unfavorable bacterial flora, parasites, Helicobacter pylori),
• disturbance of the secretion of digestive enzymes (problems with vitamin and mineral deficiency),
• deficiency of hydrochloric acid (this reduces the ability to digest protein and absorb iron),
• liver function slows down, which translates into disturbed detoxification processes and poorer storage of nutrients such as iron (↓ reduced ferritin in blood tests), vitamins A, D, K, B12, C,
• slowed production of bile (bile is essential in the process of digestion and absorption of fats; its disturbed production by the liver can generate digestive problems manifested by bloating, gas, abdominal pain, indigestion, fatty diarrhea).

All of the above are also factors that worsen thyroid function, i.e. a self-perpetuating vicious circle.

What is the diet for thyroid disorders?

Diet therapy for thyroid disorders is based on proper nutrition of the body and regulation of the immune system through the anti-inflammatory effects of ingredients in food.

What is proper nutrition?

Balancing: protein + fiber + fat + carbohydrates (in each meal)

Where:

protein: meat, fish, seafood, eggs, dairy products, legumes

fiber: vegetables, low-sugar fruits

fat: olive oil, avocado, coconut, cocoa, butter, nuts, seeds

carbohydrates: cereal products, fruits, vegetables, legumes

protein: min. 20-30 g per meal

fiber: min. 10 g per meal

fat: 10+ g per meal

carbohydrates: the rest (to supplement energy; if a reduction in energy intake is necessary, it may turn out that the diet assumptions will not accommodate additional carbohydrates, such as a larger amount of cereal products or fruits other than low-sugar ones)

Food source: as little processed as possible, natural for humans (elimination of highly and ultra-processed foods)

Fluids: Medium-mineralized, low-sodium water 2000-2500 ml/day. Tea or coffee in limited quantities and only between meals (compounds found in these infusions limit the absorption of some micronutrients). If drinking only coffee, do not exceed approximately 4 cups per day. If drinking only tea, do not exceed 2 cups of green tea and 3-4 cups of other teas. If drinking coffee and tea simultaneously, divide the values given above by 2.

Recommended cooking techniques : steaming, boiling, baking in the oven, in a bag, using parchment paper, fat-free frying.

Goitrogenic compounds
Foods containing goitrogens (goitrogenic substances) should be limited in the diet. This group of active compounds that inhibit thyroid activity includes thioglycosides, found in cruciferous vegetables, and isoflavonoids in soy. These substances are present in soy, as well as in vegetables such as broccoli, Brussels sprouts, cauliflower, cabbage, and turnips. Goitrogens are found in smaller amounts in millet, pears, strawberries, and spinach. The adverse effects of goitrogens occur when large amounts of these substances are consumed in combination with iodine deficiency. Cooking cruciferous vegetables reduces the content of goitrogens by approximately 30%. Moderate consumption of these foods is permitted after heat treatment.

To remember:

Limit consumption of cabbage, broccoli, Brussels sprouts, cauliflower, kale, kohlrabi, turnips, rutabagas, peas, beans, lentils, soybeans, mustard (mustard) + cook these foods (avoid eating them raw) and peanuts.

Take care for sufficient iodine intake or supplementation.

Soy
Research does not clearly demonstrate its adverse effect on thyroid hormone secretion. It can be consumed in limited quantities – at least 4 hours after taking the medication. Soy protein may inhibit the drug's absorption.

To remember:
You can eat soy (low-processed form, i.e. cooked, tofu, sugar-free soy drink, and preferably fermented form, i.e. tempeh, natural soy yogurt, soy sauce), but maintain a time interval of at least 4 hours after taking a drug commonly used for hypothyroidism.

Gluten and lactose
It is often noted that patients with hypothyroidism/Hashimoto's disease should eliminate lactose due to food intolerance (lactose) and interactions with levothyroxine and gluten (gluten) due to possible interactions of gliadin (from gluten) with thyroid antigens.

A gluten-free and/or lactose-free diet may reduce immune system stimulation and alleviate autoimmune processes (the immune system is linked to Hashimoto's disease and hypothyroidism) in individuals with celiac disease (gluten), non-celiac gluten sensitivity (gluten), wheat allergy (gluten), cow's milk protein allergy (lactose), or lactose intolerance (lactose). A gluten-free and/or lactose-free diet is not recommended for healthy individuals who do not experience negative symptoms after consuming products containing gluten or lactose.

However, despite the lack of diagnosed gluten- or lactose-related symptoms, eliminating gluten and/or lactose from the diet can result in clinical improvement. To do this, you can assess your response by performing tests (TSH, FT3, FT4, anti-TPO, anti-TG), implementing a well-balanced gluten-free diet for at least 4-6 weeks, then repeating the tests and analyzing whether the test results have improved and whether your well-being has improved. If either or both are present, you'll know whether a gluten- and lactose-free diet is beneficial or not.

To remember:
Eliminating gluten or lactose is not a one-size-fits-all approach. Individual circumstances should be considered, preferably in consultation with a specialist (elimination diets for thyroid disorders require appropriate and meticulous balancing).

Supplementation
As we've written, a proper diet is crucial for this issue. If we're not getting enough essential nutrients through our diet, supplementation may be a good idea.

An example of a supplement to complement the lifestyle hygiene described in this article could be: N°1 Thyro PROTECT . This preparation contains 9 active ingredients with supportive properties, including plants used in traditional Indian and Chinese medicine:

• Selenium – helps in the proper functioning of the thyroid gland
• Guggul – supports the proper balance of thyroid hormones.
• Schisandra – improves the ability to adapt to stress; useful in maintaining physiological cleansing functions.
• Ashwagandha – helps maintain physical and mental abilities in cases of weakness, fatigue and loss of concentration.
• Burdock – helps maintain normal blood glucose levels.