Sometimes the smallest things have the biggest impact. Take, for example, the thyroid gland. It looks like an undersize bow tie; in fact, it sits just a bit higher in your neck than a real bow tie would. Despite its modest size, the thyroid plays a major role in your body, pumping out the thyroid hormones that circulate in your blood and communicate with all of your body’s cells. That’s right—all of your body’s cells.
So what sorts of messages are the thyroid hormones carrying? They help regulate your metabolism, appetite, and weight, for starters. They also collaborate with the neurotransmitters in your brain, affecting your mood, emotions, behavior, memory, and general mental function.
As you can imagine, a lot can go wrong if your thyroid for some reason goes off-kilter and produces too much or too little hormone. The list of possible symptoms of thyroid imbalance is mind-bogglingly long. But it makes sense, if you stop to consider the far-reaching effects of thyroid hormone in your body.
Symptoms of too little thyroid hormone—a condition known as hypothyroidism—include weight gain, hair loss, achy joints, menstrual irregularities, low libido, low energy, fatigue, mental fog, depression, irritability, loss of ambition, forgetfulness, and decreased interest in life. The most common cause of hypothyroidism is Hashimoto’s thyroiditis an autoimmune disorder in which an individual’s immune system attacks the thyroid gland. Hyperthyroidism, or too much thyroid hormone, produces an even wider range of symptoms, which taken together, are known as Graves’ disease. People with this condition may experience weight loss, tremors, shortness of breath, weakness, high blood pressure, heart palpitations, out-of-control appetite, decreased fertility, vision problems, depression, panic attacks, anxiety, uncontrollable anger, erratic behavior, wild emotional swings, even bipolar disorder.
Because the list of possible symptoms is all over the map, someone with a thyroid disorder may never suspect that a malfunctioning gland is the source of all the trouble, says Ridha Arem, MD, clinical professor of medicine at Baylor College of Medicine in Houston and author of The Thyroid Solution. Dr. Arem estimates that some 20 million Americans have a known thyroid disorder, while another 10 million—most of them women—remain undiagnosed. This is why he advocates routine blood tests for thyroid hormone levels, much like the blood tests for cholesterol that have become a standard part of physical exams.
If you’ve been experiencing seemingly random symptoms that don’t improve, it’s worth asking your doctor whether a thyroid disorder could be the cause. Treatment for an overactive or underactive thyroid gland usually includes medication to help bring thyroid hormones into balance.
Along with medication, a proper diet emphasizing specific nutrients can play a role in restoring and maintaining proper thyroid function. “I’ve always promoted a low-glycemic, high-fiber, low-saturated-fat, highprotein diet,” Dr. Arem says. “The immune system doesn’t like saturated fat, and most thyroid conditions are related to immune system attacks on the thyroid gland.” Protein supports healthy immunity, he adds.
If you’re not familiar with the phrase low-glycemic, it describes a diet that limits those foods known to cause spikes in blood sugar. This means avoiding white bread, potatoes, pasta, and sugary cereals, for example, and instead eating more whole grains, whole fruits (not juices), vegetables, beans, and nuts. According to Dr. Arem, a low-glycemic diet can help reduce the cardiovascular risks associated with thyroid disorders. It can also help improve mood, which is important, since many people with thyroid problems experience depression or anxiety.
By following a low-glycemic diet, you’ll naturally be getting plenty of fiber. This helps prevent constipation, another common complaint among people with thyroid imbalance.
Often doctors who treat patients with thyroid disorders do all the right things in terms of prescribing useful medication, but then don’t follow up with proper nutritional support, Dr. Arem says. “We ignore the micronutrients that are important to make the treatment work or to make the patient feel better and that help prevent further deterioration of the thyroid gland,” he explains.
A number of individual nutrients help support thyroid health; among the most noteworthy are these.
In 2006, Israeli researchers examined the relationship between B12 and autoimmune thyroid disease, in which the immune system attacks the thyroid gland. Of the 115 people in the study, 28 percent had low levels of B12.
Your body needs all of the B vitamins for brain function and cardiovascular health, both of which are of special concern to people with thyroid problems, Dr. Arem says. In particular, if you aren’t getting enough vitamin B12 and folic acid, your levels of homocysteine will rise. Homocysteine, an inflammatory substance, is a known risk factor for heart disease. Both B vitamins improve mood, too, Dr. Arem adds.
Taking a B-complex supplement will ensure that you’re getting all of your B vitamins and in adequate amounts, Dr. Arem says. Look for a product that supplies 1 to 2 micrograms of vitamin B12, plus 400 to 800 micrograms of folic acid.
Your body makes its own supply of coenzyme Q10, but as you get older, production of this potent antioxidant slows down. According to Dr. Arem, CoQ10 deficiency has been implicated in both Graves’ disease and thyroid cancer. The nutrient also helps protect against cardiovascular problems, which often go hand in hand with thyroid disorder, as mentioned earlier. Dr. Arem suggests taking 25 to 50 milligrams a day.
Years ago, people whose diets contained very little iodine sometimes developed a thyroid condition known as goiter. Its most obvious symptom is a grossly swollen neck, an enlargement of the thyroid, known as goiter. Then in 1924, salt manufacturers began adding iodine to table salt. Today, goiter is a relatively rare condition, especially in this country.
Although iodine is toxic in large amounts, your thyroid requires a little bit of the mineral in order to make the thyroid hormones. There are two kinds of thyroid hormone: T3 (short for triiodothyronine) and T4 (thyroxine). As Dr. Arem explains, the only difference between the two is that T3 contains three iodine molecules, while T4 has—you guessed it!—four molecules.
Between 300 and 400 micrograms of iodine a day can help ensure proper thyroid function. Interestingly, because so many Americans are watching their salt intake, roughly 1 in 5 are iodine deficient, according to Dr. Arem. On the other hand, too much iodine can backfire, triggering Graves’ and other autoimmune diseases, he says.
Iodine is plentiful in our food supply, with seafood and, of course, iodized table salt among the best sources. So for most people, getting an adequate amount of the mineral is not an issue. But for anyone with a suspected or diagnosed thyroid disorder, a urine test for iodine levels may be called for, Dr. Arem says. If iodine supplementation is necessary, he generally prescribes a daily dosage of around 300 micrograms. “I don’t believe in the high-dose iodine supplements that some people recommend,” he says.
If you eat a lot of soy foods, you may need to pay special attention to your iodine intake. With all of the ballyhoo about the health benefits of soy, some critics charged that the isoflavones in soy may adversely affect thyroid function. So, in 2006, researchers at Loma Linda University in California launched a review of 14 studies that examined how isoflavones impact thyroid function. They concluded that people with healthy thyroids have no cause for concern. Those with compromised thyroid function, however, should be sure to balance their soy consumption with adequate iodine intake. Isoflavones may slightly reduce the absorption of the synthetic thyroid hormones that these patients are often on.
Omega-3 fatty acids—especially the EPA and DHA found in abundance in fish oil—can help reduce inflammation of the thyroid, Dr. Arem says. These good fats are also beneficial for brain function, cognition, mood, and metabolism, all of which can suffer in the presence of a thyroid disorder. Dr. Arem suggests taking 1,000 to 2,000 milligrams a day as fish oil.
Like iodine, selenium is essential to the manufacture of thyroid hormone. Simply put, without an adequate supply of the mineral, your thyroid can’t make enough of the hormone.
In addition, your body requires an assist from selenium in order to use thyroid hormone once it’s circulating in the blood. And your immune system can’t do its job without the mineral, Dr. Arem says.
So how much selenium do you need? Dr. Arem recommends 50 to 100 micrograms a day in supplement form. More than that is not helpful, and too much could damage your thyroid gland, he says. If you’re pregnant, make sure you discuss any supplements you wish to take, including this one, with your doctor.
If you have a thyroid disorder, don’t shortchange yourself on vitamin C, Dr. Arem advises. Besides being a potent antioxidant, this vitamin supports the proper function of neurotransmitters in the brain, in this way helping to improve cognition and mood. Dr. Arem’s Rx: 750 to 1,000 milligrams a day.
People with Graves’ disease tend to run low on vitamin D; it may be that a D deficiency is a triggering factor for the condition, Dr. Arem says. “Vitamin D is very important for the functioning of the immune system,” he explains. “A deficiency of the vitamin can promote an autoimmune attack.” Anyone with an autoimmune condition like Graves’ should have their blood levels of vitamin D evaluated.
Dr. Arem recommends taking 1,000 IU daily, in the form of vitamin D3. If a blood test shows that you’re deficient in D, your doctor may prescribe a much larger dosage for a short period.
The Thyroid Solution: The Doctor-Developed, Clinically Proven Plan to Diagnose Thyroid Imbalance and Reverse Thyroid Symptoms by Ridha Arem, MD
Vitamin E can help counter the increased cardiovascular risk in people with thyroid problems, Dr. Arem says. It also supports memory and cognitive function. Dr. Arem suggests taking 150 to 200 IU daily.
Like vitamin E, zinc is a potent antioxidant. Getting adequate amounts of antioxidants is important for those with thyroid disorders, Dr. Arem says, because they tend to form more free radicals than usual. Free radicals are naturally occurring molecules that cause tissue damage. Antioxidants like zinc are able to mop up the renegade molecules before they do harm.
Another reason to make sure you’re getting enough zinc: A shortfall of the mineral can slow metabolism, which already is a concern for people with hypothyroidism. If this group includes you, you need to be especially careful to get an adequate supply of zinc. An optimal intake in supplement form is 10 to 15 milligrams, Dr. Arem says. You should also be eating foods rich in zinc, including fish, lean beef, turkey, green vegetables, and nuts.
If you have a thyroid condition, you should be under the care of a physician. Be sure to check with him or her before adding any nutritional supplements to your treatment plan. The following recommendations from Dr. Arem are specifically for supplements. If you eat a diet rich in fruits and vegetables, whole grains, fish, and lean meats that he recommends, you’ll be getting additional servings of these important nutrients.
B vitamins |
B-complex supplement; follow package directions for proper dosage |
Coenzyme Q10 |
25 to 50 milligrams |
Fish oil |
1,000 to 2,000 milligrams* |
Folic acid† |
400 to 800 micrograms |
Iodine‡ |
300 to 400 micrograms from food sources |
Selenium |
50 to 100 micrograms |
Vitamin B12† |
1 to 2 micrograms |
Vitamin C |
750 to 1,000 milligrams |
Vitamin D§ |
1,000 IU as vitamin D3 |
Vitamin E* |
150 to 200 IU |
Zinc |
10 to 15 milligrams |
*Fish oil has a blood-thinning effect. So does vitamin E. If you’re taking any kind of blood-thinning drug, talk to your doctor before taking these supplements.
†Folic acid and vitamin B12 can be part of your B-complex supplement.
‡Getting too much or too little iodine is harmful to your thyroid. Do not take an iodine supplement unless your doctor recommends it.
§If you have a thyroid condition that involves autoimmunity, ask your doctor for a blood test to check your vitamin D level. He or she may advise you to take a larger dosage than what’s recommended here for a brief period.