Small But Mighty: A Thyroid Life

• Goitrogenic foods, such as cabbage, Brussels sprouts, broccoli, turnips, rutabagas, kohlrabi, radishes, cauliflower, African cassava, millet, and kale. (Taken from about.com thyroid disease). UPDATE 08/03/2012: Please note that avoiding foods may be detrimental to your health if you do not take in the vitamins/nutrients which they provide, or if you replace these useful meal-fillers with less healthy options. A useful book to understand what vitamins and nutrients are in which foods, is 'Super Juice', by Michael Van Straten.

• Soy is also a goitrogen and it is probably worth doing some of your own research on this as there appears to be a massive online debate about whether it is good, bad, or harmless and, as with most foods' affect on our health, scientistis appear to be changing their mind about as frequently as my blood test results. 
• The general assumption is that, when taken frequently, soy may cause you problems. It is worth checking the ingredients of your foods as many more purchased items contain soy than you might think. For example, there are many cereals which quote how wonderful they are for containing protein - what the protein is, is soy. In addition, watch out for the use of the sauce, and try not to eat excessive tofu. 
• About.com Thyroid Disease lists some important tips for those wanting to include soy in their diet and it includes tips relating to how much you should eat and how long after taking your pills - after 3 or 4 hours, apparently, so it may be worth throwing those soy cereals away! - the link is here:
• http://thyroid.about.com/cs/soyinfo/a/soy_4.htm
• I am not sure if it is only soy in a specific variety - i.e. soybeans but not soy sauce - so please let me know if you have any information about this, however I would advise generally watching your intake of this ingredient as it appears to be unfriendly to hypothyroids.

• Watch how much milk you are having in the morning after taking levothyroxine, and ensure you only take it a full half an hour or more (see below: Tip 5) after taking the pills. Calcium, but specifically, milk, can affect the absorption of levothyroxine. If your breakfast sizes have increased - perhaps due to increased appetite from a faster metabolism; or from seeking energy from food - and your thyroid levels have gone down, it may be worth reducing those breakfast sizes, eating it later, or switching the milk (or at least most of it) for yoghurt or something else. 

• Other foods to avoid, from personal experience, include the harder-to-digest sorts of foods and the high in sugar foods. I am going to start with pizza, which is supposed to be the hardest of all to digest. As of last year I have refused to eat it. It made me terribly dizzy and generally fill ill for some hours after eating eat. Then followed pasta - this is perhaps more of an issue with acid reflux or a slight wheat intolerance - but, as it is a thicker, heavier food, the body is going to struggle to deal with it. If you are finding you need to stop eating this, you can try switching to thinner pastas; using rye or other types instead of usual wheat (alternatives can be easier to digest and healthier); or smaller portions - perhaps pasta mixed with something else.
• The earliest foods I started having trouble with were sweets and chocolate, about 4 years ago, which then grew to all things unhealthy which you would eat on a day out at Thorpe Park - fast food, for instance, and anything that looks all shiny and disgusting with sugar (how did I ever think they looked nice?). The same symptoms would come - a general lightheadness or diziness and just feeling unwell but without too vigorous symptoms, which makes it difficult to explain. 
• Thinking about it, it makes sense - foods high in sugar, or generally very heavy, do of course require a fast metabolism (or at least a 'normal' one) to process and deal with. 
• Hence a hypothyroid patient, not yet taking medication, is going to be practically unable to deal with the foods correctly. I have not yet tried these foods since being on levothyroxine so I cannot say if it is purely related to being hypo and untreated - however I do notice the same symptoms when my thyroid levels drop, specifcally after meals (when the body is trying to deal with the food intake). My general suggestion would be that if you are experiencing these symptoms, try to work out if they are specifically after eating these foods - if they are, stop and switch. Choose the good options: cereal and seeds are always good! :)

TIP 2 - Drink and the thyroid

I have read on some sites that alcohol may aggrevate the thyroid. On Thyroid UK's symptom checker alcohol intolerance is actually listed, and I would tend to agree with the existance of this symptom. Whether or not alcohol should or should not be avoided, my general stance is that if it's bad for you, the chances are it's going to do your medical condition worse - so avoid it. Of course, if you already drink it occasionally and see no need to change, then this is fine - occassional should do you no harm. However, if you currently do not drink, or haven't drunk in a while and are planning to try some soon, remember to keep an eye on your thyroid levels and perhaps assume that if there is no other reason for any change which might appear, then it is due to the alcholol. 

Speaking from a personal experience, I stopped drinking alcohol shortly after trying and whilst undiagnosed, and haven't touched it since. I generally felt uncomfortable, with some dizziness, etc. I have yet to decide whether to try it again when my thyroid is back to normal. Interestingly, in this forum, some people talk about experiencing similar symptoms whilst taking levothyroxine:
http://www.sparkpeople.com/myspark/team_messageboard_thread.asp?board=261x732x26432592

I can't find much more information for drinks to avoid, but I will share some of the things which I avoid:

Similar to alcholol, I have found that fizzy drinks are a good one to avoid. Thinking about it, they contain nothing much more than sugar and stomach-irritating bubbles! Similar to the food issues, this is of course going to be a difficult one for a struggling and, to be honest, precocuupied, metabolism to manage. To add to this, if you find that acid reflux or heartburn is something you experience, it may be worth avoiding fruit juices except for when you really feel like having them, as they contain more acid. Again, I have not yet tried both of these with a 'normal' thyroid on levothyroxine.

TIP 3 - Empty Stomach

"Food may delay or reduce the absorption of many drugs, including thyroid hormone. Food can often slow the process of the stomach entering, but it may also affect absorption of the drug you're taking by binding with it, by decreasing access to absorption sites, by altering the rate at which it dissolves, or by changing the stomach's pH balance. This is why many doctors recommend that for best absorption of your thyroid hormone, you should take it first thing the morning, on an empty stomach"

 http://www.thyroid-info.com/articles/thyroid-drug-faq.htm



TIP 4 - How much time before breakfast?

If you search this one on the internet, you may find conflicting information: some say half an hour; some say an hour; some even say more. Personally, I think a whole hour, bear in mind you have to take the pills first thing in the morning and then continue with your day, is unrealistic. According to my doctor, half an hour is fine. Last year, when I started taking levothyroxine, I had exactly half an hour before eating breakfast and then leaving for school - and I gradually became 'normal'. As carefulness switched to routine - in some cases rushed, or late in the case of holidays and weekends - and I could no longer say how much time I had been leaving, I am now timing myself - half an hour or more before eating breakfast in the morning.


TIP 5 - What to take with? How much?

"It is very important to take levothyroxine with a full glass (8 ounces) of water. The levothyroxine tablet can dissolve very quickly and swell in the throat, possibly causing choking or gagging." http://health.yahoo.com/hormone-medications/levothyroxine/healthwise--d00278a1.html

As noted above, watch how much milk you are having in the morning after taking levothyroxine, and ensure you only take it a full half an hour or more after taking the pills. Calcium, but specifically, milk, can affect the absorption of levothyroxine. If your breakfast sizes have increased - perhaps due to increased appetite from a faster metabolism; or from seeking energy from food - and your thyroid levels have gone down, it may be worth reducing those breakfast sizes, eating it later, or switching the milk (or at least most of it) for yoghurt or something else.


TIP 6 - Exercise!

Exercise is always going to be good for you. With an underactive thyroid it is even more important, as exercise raises the metabolism and so, I find, kicks every vital process in the body into action. Be careful to take enough rest and not overdo it if you are still underactive or your dosage is going up and down. As you are going up to 'normal' try to 'work with' your thyroid - do more exercise, eat properly, go out a little more, push yourself that little bit harder and see how far you can go, how much you can do. This way, as your metabolism increases and everything else reacts, you will really start to see results and feel much better. Of course, it does depend on how quickly your body reacts to the levothyroxine - if you cannot find the right dose it may be more difficult to work with these changes or even to notice many of them. I have a theory which I have yet to put any evidence to, in which, once your TSH goes below a certain point (and so your T4 is higher and you are becoming 'normal') things will get much easier - you just have to get to that point. It's a waiting game, unfortunately.

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I will add to this article as and when I find any more information or can add from personal experience. Please, if you have any information relating to this or any of the other articles, or simply wish to question or comment, leave a comment in the box provided.