Hypothyroidism and diet

[Caker]

Just diagnosed with hypothyroidism, are there any dietary changes I can make that help please?

[Hidden]

Hi Caker I think the most popular bit of advice is to cut out gluten I do this and also I use lactose free milk and I’ve noticed numerous health benefits so that would probably be a good start for you.

I’m sure one of our knowledgable members will point you in the right direction good luck x

[Caker in reply to Hidden]

Thankyou that’s really helpful.

[SlowDragon Administrator]

Always get actual copies of all your thyroid results and ranges on tests

Keep good records of how you feel at each dose of levothyroxine

Standard starter dose of levothyroxine is 50mcg

Is that what you were prescribed?

Bloods should be retested 6-8 weeks after each dose change in levothyroxine

Important to test vitamin D, folate, ferritin and B12 ....ask GP if not been done yet

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

If you have autoimmune thyroid disease diagnosed by high thyroid antibodies, then ask GP for coeliac blood test FIRST before considering trialing changing to a gluten free diet

approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying strictly gluten free diet for 3-6 months

If no noticeable improvement, reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

[Caker in reply to SlowDragon]

This is really helpful, thank you so much, I want to help myself feel better as fast as possible and I’m sure adjusting my diet will help.

I’ve been started on 50mcg Levo and first appt to see GP tomorrow, so feeling a little shell shocked, kind of want to hide myself away until I know properly how to deal with it, so really appreciate a safe place to ask questions and gather info.

Thank you

[SlowDragon Administrator in reply to Caker]

Ask your GP to test thyroid antibodies (if not been tested yet)

Plus vitamin D, folate, ferritin and B12 need testing too

Bloods should be retested after 6-8 weeks. (Often GP can say 3 months ...that’s too long)

NICE guidelines

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

20% of Hashimoto's patients never have raised antibodies and an ultrasound scan can be useful anyway

healthunlocked.com/thyroidu...

[Caker in reply to SlowDragon]

Thank you so much for your help and info, I’m starting to feel much less overwhelmed.

[SlowDragon Administrator in reply to Caker]

Levothyroxine should always be taken empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime (but needs be 2 hours after a meal, an hour after any snack)

verywellhealth.com/best-tim...

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients.

Teva is the only brand that makes 75mcg tablet. So if avoiding Teva when dose is increased to 75mcg ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

healthunlocked.com/thyroidu...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

[Caker in reply to SlowDragon]

I haven’t had a flu jab this Winter, what are your thoughts on this for next winter, does a cold or infection have any diverse effects on people affected by an inactive thyroid?

[SlowDragon Administrator in reply to Caker]

Been several posts on this issue over the years

Everyone has to make up their own view and decision

[Caker in reply to SlowDragon]

Thank you

[greygoose]

The most important thing is to avoid soy: soy protein, soy oil, soy flour, etc. etc. etc. Soy creeps into most things, these days, so that will probably mean cooking everything yourself from scratch. But consuming soy could make you more hypo because it stops thyroid hormone getting into the cells.

[Caker in reply to greygoose]

No probs, thank you, this site is super helpful, I’ll be ok if I can regain a little control hopefully.

[greygoose in reply to Caker]

You're welcome.