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Important nutrients for Hashimoto’s and hypothyroidism
As the master of metabolism, the thyroid gland regulates digestion, energy production, mental sharpness, fat burning, and heart rate.[1] Even the suppleness and strength of the skin, hair, and fingernails are significantly affected by thyroid function. All of these metabolic processes require fuel, making the thyroid a particularly “hungry” part of the body with respect to nutritional demands. When the thyroid is deprived, or “starved” of certain nutrients, however, the risk of subclinical hypothyroidism, frank hypothyroidism, and even Hashimoto’s disease (the autoimmune form of hypothyroidism) increase.
Thankfully, we can show our thyroid some love by eating a balanced diet and focusing on the nutritional factors that support the function of this very important gland. Here are some of our favorite nutrients that support thyroid function.
Iodine
Iodine deficiency has long been known to cause thyroid issues, with the most dramatic effect noted in babies born to iodine-deficient mothers.[2] In fact, iodine deficiency is among the most prevalent (and preventable) causes of mental impairment to this day, worldwide.[3]
Although congenital hypothyroidism (once troublingly known as “cretinism”) is rare in the developed world, the World Health Organization (WHO) nevertheless estimates that over 30% of the world’s population – some two billion people – have insufficient iodine intake.[4] Even when congenital hypothyroidism is avoided, sub-optimal iodine levels may still limit a child’s cognitive development: even moderate iodine deficiency in a mother can lower her baby’s intelligence quotient (IQ) up to 16 points.[5],[6] For this reason, much attention is given in particular to pregnant and lactating women with regard to iodine intake.[7]
Even moderate iodine deficiency in a mother can lower her baby’s intelligence quotient (IQ) up to 16 points.
Pregnancy and childbirth aside, iodine plays an integral role not only in ensuring adequate thyroid hormone production, but also in preserving the architectural integrity of the gland. Specifically, iodine deficiency may over time cause an enlargement of the thyroid gland in a condition known as goiter.[8] In fact, areas of the United States with iodine-deficient soil were once known as the “goiter belt” prior to the introduction of iodized salt to the U.S. market in the 1920’s.[9],[10]
As we become more aware of the negative health consequences of the sodium replete in table salt (such as its potential to elevate blood pressure),[11] more and more health-conscious consumers are opting for mineral-rich sea salt, Himalayan salt, and other alternative products. As salubrious as these salt preparations may be, they are seldom enriched with iodine, which may leave health food shoppers at increased risk of iodine deficiency. Consuming sea vegetables like kelp and kombu is one natural way to increase iodine levels.[12] Taking iodine supplements may also be of benefit – but beware: iodine excess can also cause harm to the thyroid.[13]
Selenium
The thyroid contains more selenium by weight than any other organ in the body.[14] Selenium protects the thyroid from oxidative damage by supporting the production of glutathione peroxidase, a potent antioxidant enzyme.[15],[16] Without this protective enzyme, the thyroid gland is much more susceptible to damage from iodine and other agents.[17],[18] It’s for this reason that those living in regions with poor selenium soil content are more likely to develop Hashimoto’s (autoimmune hypothyroidism)[19] and that selenium supplementation has been shown to decrease both thyroglobulin (TG)[20] and thyroid peroxidase (TPO) autoimmune antibodies.[21],[22]
The thyroid contains more selenium by weight than any other organ in the body.
Selenium is necessary not only for the health of the thyroid gland itself, but also for the proper activation of thyroid hormone: the enzymes that convert T4 (the less active form of thyroid hormone) to T3 (the bio-active version) rely on selenium.[23] In other words: there would be no activation of thyroid hormone without selenium.[24] It’s no surprise then that a lower ratio of T3 to T4 has been noted in those with low selenium status.[25]
There would be no activation of thyroid hormone without selenium.
Whereas a Brazil nut grown in selenium-rich soil contains roughly 100 mcg of selenium, one grown in selenium-poor soil may contain only one-tenth that amount.[26] Given the unreliability of the soil content of selenium from region to region, taking a selenium supplement may be a simple, reliable way to support the thyroid.
Zinc
Zinc not only contributes to the proper production of thyroid hormones, but, like selenium, increases the body’s conversion of T4 (the inactive form of thyroid hormone) to T3 (the bio-active form). Zinc also improves cellular sensitivity to that T3.[27] This means that zinc works not only at the level of the thyroid itself, but also in other areas of the body.[28]
Zinc supplementation has been shown to normalize thyroid-stimulating hormone (TSH) levels, support serum T3 and total T3 levels, and decrease levels of reverse T3 (or rT3, the inactive form of the hormone).[29] In a study done on rats consuming a zinc-deficient diet, zinc deficiency was correlated with reduced production of T3.[30]
As with iodine, excess zinc supplementation may suppress thyroid function.[31] Zinc also has an inverse relationship with copper, wherein zinc supplementation may interfere with copper absorption.[32] For this reason, it may be advisable to also take copper when supplementing with zinc in high doses or for long periods of time.
Iron
The production of thyroid hormone relies upon the iron-dependent enzyme thyroid peroxidase (TPO).[33] Iron deficiency thus causes a reduction in the synthesis of thyroid hormones, in turn increasing TSH levels and enlarging the thyroid.[34] Iron repletion, on the other hand, has been shown to improve thyroid function in individuals with deficiency.[35] Eating iron-rich foods like red meat and liver are therefore also likely to support thyroid health.[36],[37]
Tyrosine
The thyroid gland makes hormone by combining the amino acid tyrosine and iodine. Supplementation with L-tyrosine may therefore provide the body with more of the building blocks it requires for thyroid health.[38]
Vitamin A
Vitamin A deficiency may disrupt signaling from the brain to the thyroid, and has also been shown to hinder the thyroid gland’s uptake of iodine, thereby limiting its ability to synthesize thyroid hormone.[39] Supplementation with vitamin A, however, has been shown in a study of premenopausal women to lower TSH levels and increase serum T3.[40] Vitamin A supplementation can also mitigate the effects of iodine deficiency on the thyroid gland, thus reducing the risk of goiter.[41] It’s also been said to improve the sensitivity of the cells of the body to thyroid hormone, like zinc.[42]
Vitamin A supplementation can mitigate the effects of iodine deficiency on the thyroid gland, thus reducing the risk of goiter.
B Vitamins
Hypothyroid patients tend to be deficient in B vitamins, but the exact reason for this is not yet clear.[43] One explanation, however, may be that the slowing of metabolism seen in hypothyroidism compromises the digestive system’s ability to absorb dietary nutrients like the B12 abundantly found in red meat.[44] The neurological problems that can result from B12 deficiency in particular make B vitamin supplementation warranted in those with thyroid problems. The B vitamins also support adrenal health,[45] in turn enhancing thyroid function.
Vitamin D
Vitamin D deficiency may increase the risk of Hashimoto’s, as those with lower vitamin D levels are more likely to have elevated thyroid autoantibodies.[46],[47] Vitamin D deficiency is also more common among those with thyroid nodules or thyroid cancer.[48] It’s worth noting that beyond its important immunomodulation action and effects on mental health, vitamin D also acts like a hormone in the body, making it relevant in the care of endocrine ailments.[49]
Those with lower vitamin D levels are more likely to have elevated thyroid autoantibodies.
Ashwagandha
Although it’s not a nutrient, the Ayurvedic herb ashwagandha – revered for its ability to help us better cope with stress – also deserves mention here.
In a 2018 randomized, double blind, placebo-controlled pilot study of 50 patients with hypothyroidism, 600 mg of ashwagandha root extract taken daily for 8 weeks was shown to improve serum TSH, T3, and T4 levels significantly as compared to placebo.[50] These findings echo those of a rodent study, in which ashwagandha root extract raised serum T3 and T4 levels by 18% and 111%, respectively.[51]
With all the hard work the thyroid does to support our health and wellbeing, it’s surely worth taking the care to feed it the nutrients it needs to continue doing its important job. Whether from food or from supplements, the thyroid is hungry for nutrition.
Click here to see References
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[2] Niwattisaiwong S, et al. Iodine deficiency: clinical implications. Cleve Clin J Med. 2017 Mar;84(3):236-44.
[3] Redman K, et al. Iodine deficiency and the brain: effects and mechanisms. Crit Rev Food Sci Nutr. 2016 Dec 9;56(16):2695-713.
[4] de Benoist B, et al. Iodine deficiency in 2007: global progress since 2003. Food Nutr Bull. 2008;29(3):195-202.
[5] Smallridge RC, Ladenson PW. Hypothyroidism in pregnancy: consequences to neonatal health. J Clin Endocrinol Metab. 2001 Jun;86(6):2349-53.
[6] Santiago-Fernandez P, et al. Intelligence quotient and iodine intake: a cross-sectional study in children. J Clin Endocrinol Metab. 2004 Aug;89(8):3851-7.
[7] Pearce EN, et al. Consequences of iodine deficiency and excess in pregnant women: an overview of current knowns and unknowns. Am J Clin Nutr. 2016 Sep;104 Suppl 3:918S-23S.
[8] Santiago Fernández P. [Iodine prophylaxis, voices from the past after 65 years]. Nutr Hosp. 2017 Jul 28;34(4):976-9.
[9] Markel H. A grain of salt. Milbank Quarterly. 2014 Sep; 92(3):407-12.
[10] Markel H. When it rains it pours: endemic goiter, iodized salt, and David Murray Cowie, MD. Am J Public Health. 1987 Feb; 77(2):219-29.
[11] Hypertension and nutrition [Internet]. Cleveland Clinic. Accessed Nov 8, 2018. Available from: https://my.clevelandclinic.org/health/articles/4249-hypertension-and-nutrition
[12] Combet E, Ma ZF. Low-level seaweed supplementation improves iodine status in iodine-insufficient women. Br J Nutr. 2014 Sep 14;112(5):753-61.
[13] Leung AM, Braverman LE. Iodine-induced thyroid dysfunction. Curr Opin Endocrinol Diabetes Obes. 2012 Oct;19(5):414-9.
[14] Kohrle J. The trace element selenium and the thyroid gland. Biochimie. 1999 May;81(5):527-33.
[15] Schomburg L. Selenium, selenoproteins and the thyroid gland: interactions in health and disease. Nat Rev Endocrinol. 2011 Oct 18;8(3):160-71.
[16] Ruz M, et al. Single and multiple selenium-zinc-iodine deficiencies affect rat thyroid metabolism and ultrastructure. J Nutr. 1999 Jan;129(1):174-80.
[17] Xue H, et al. Selenium upregulates CD4(+)CD25(+) regulatory T cells in iodine-induced autoimmune thyroiditis model of NOD.H-2(h4) mice. Endocr J. 2010;57(7):595-601.
[18] Zimmermann MB, Köhrle J. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid. 2002 Oct;12(10):867-78.
[19] Gladyshev VN. Selenoproteins and selenoproteomes. In: Hatfield DL, Berry MJ, Gladyshev VN, eds. Selenium: Its molecular biology and role in human health. 2nd ed. New York: Springer; 2006:99-114.
[20] Wang W, et al. Effects of selenium supplementation on spontaneous autoimmune thyroiditis in NOD.H-2h4 Mice. Thyroid. 2015 Oct;25(10):1137-44.
[21] Gärtner R, et al. Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. J Clin Endocrinol Metab. 2002 Apr;87(4):1687-91.
[22] Zhu L, et al. [Effects of selenium supplementation on antibodies of autoimmune thyroiditis]. Zhonghua Yi Xue Za Zhi. 2012 Aug 28;92(32):2256-60.
[23] Arthur JR, et al. Selenium deficiency, thyroid hormone metabolism, and thyroid hormone deiodinases. Am J Clin Nutr. 1993 Feb;57(2 Suppl):236S-9S.
[24] Rayman MP.The importance of selenium to human health. Lancet. 2000 Jul 15;356(9225):233-41.
[25] Olivieri O, et al. Selenium, zinc, and thyroid hormones in healthy subjects: low T3/T4 ratio in the elderly is related to impaired selenium status. Biol Trace Elem Res. 1996 Jan;51(1):31-41.
[26] Chang JC, et al. Selenium content of Brazil nuts from two geographic locations in Brazil. Chemosphere. 1995;30(4):801-2.
[27] Pedre V. The unexpected hormone triad: the gut-adrenals-thyroid [Internet]. Brooklyn (NY): Evolution of Medicine, Functional Forum; 2015 (cited 2018 Nov 5).
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[28] Kalinin M, Bibi H. [Interdependency between zinc and thyroid gland: the discussion is to be continued].Harefuah. 2016 Aug;155(8):495-7.
[29] Nishiyama S, et al. Zinc supplementation alters thyroid hormone metabolism in disabled patients with zinc deficiency. J Am Coll Nutr. 1994 Feb;13(1):62-7.
[30] Morley JE, et al. Zinc deficiency, chronic starvation, and hypothalamic-pituitary-thyroid function. Am J Clin Nutr 1980;33:1767-70.
[31] Maret W, Sandstead HH. Zinc requirements and the risks and benefits of zinc supplementation. J Trace Elem Med Biol. 2006;20(1):3-18.
[32] Afrin LB. Fatal copper deficiency from excessive use of zinc-based denture adhesive. Am J Med Sci. 2010 Aug;340(2):164-8.
[33] Hess SY, et al. Iron deficiency anemia reduces thyroid peroxidase activity in rats. J Nutr. 2002 Jul;132(7):1951-5.
[34] Zimmermann MB, Kohrle J. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid.2002;12:867-78.
[35] Eftekhari MH, et al. Effect of iron repletion and correction of iron deficiency on thyroid function in iron-deficient Iranian adolescent girls. Pak J Biol
Sci. 2007;10:255-60.
[36] Marz R. Iron. In: Medical Nutrition from Marz. 2nd ed. Portland, Oregon: Omni-Press; 2002:114-9.
[37] Fallon S. Nourishing Traditions. Washington, DC: New Trends Publishing, Inc.; 2001.
[38] Penn State Hershey. Hypothyroidism [Internet]. Penn State Hershey; 2016 (cited 2018 Nov 5). Available from: http://pennstatehershey.adam.com/content.aspx?productId=107&pid=33&gid=000093.
[39] Kawicka A, et al. [Metabolic disorders and nutritional status in autoimmune thyroid diseases]. Postepy Hig Med Dosw (Online). 2015 Jan 2;69:80-90.
[40] Farhangi MA, et al. The effect of vitamin A supplementation on thyroid function in premenopausal women. J Am Coll Nutr. 2012 Aug;31(4):268-74.
[41] Zimmermann MB, et al. Vitamin A supplementation in iodine deficient
African children decreases thyrotropin stimulation of the thyroid and reduces the goiter rate. Am J ClinNutr. 2007;86:1040-4.
[42] Pedre V. The unexpected hormone triad: the gut-adrenals-thyroid [Internet]. Brooklyn (NY): Evolution of Medicine, Functional Forum; 2015 (cited 2018 Nov 5).
Available from:
https://functionalforum.com/wp-content/uploads/2015/04/The-Unexpected-Hormone-Triad-Handout.pdf
[43] Life Extension. Thyroid regulation: nutrients to support thyroid function [Internet]. Available from: https://www.lifeextension.com/Protocols/Metabolic-Health/Thyroid-Regulation/Page-08. Accessed Nov 5, 2018.
[44] Marz R. Vitamin B-12 (Cobalamin). In: Medical Nutrition from Marz, 2nd ed. Portland, Oregon: Omni-Press; 2002:220-5.
[45] Deane HW, Shaw JH. Changes in the adrenal cortex and thymus induced by different B-vitamin deficiencies. Anat Rec. 1947 Mar;97(3):329.
[46] Kim D. Low vitamin D status is associated with hypothyroid Hashimoto’s thyroiditis. Hormones (Athens). 2016 Jul;15(3):385-93.
[47] Goswami R, et al. Prevalence of vitamin D deficiency and its relationship with thyroid autoimmunity in Asian Indians: a community-based survey. Br J Nutr. 2009 Aug;102(3):382-6.
[48] Laney N, Meza J, et al. The prevalence of vitamin D deficiency is similar between thyroid nodule and thyroid cancer patients. Int J Endocrinol. 2010;2010:805716.
[49] Merrill SJ, Minucci SB. Thyroid autoimmunity: an interplay of factors. Vitam Horm. 2018;106:129-45.
[50] Sharma AK, et al. Efficacy and safety of ashwagandha root extract in subclinical hypothyroid patients: a double-blind, randomized placebo-controlled trial. J Altern Complement Med. 2018 Mar;24(3):243-8.
[51] Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol. Sep 1998;50(9):1065-8.
The information provided is for educational purposes only. Consult your physician or healthcare provider if you have specific questions before instituting any changes in your daily lifestyle including changes in diet, exercise, and supplement use.
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Dr. Erica Zelfand
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