What dietary recommendations are suitable for someone with hypothyroidism (underactive thyroid)?

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From the Guidelines

A person with hypothyroidism should follow a balanced diet rich in whole grains, fruits, vegetables, lean proteins, and healthy fats, while avoiding foods that may interfere with thyroid medication or hormone production, as recommended by the most recent and highest quality study 1. When it comes to managing hypothyroidism through diet, it's essential to focus on nutrient-dense foods that support thyroid function.

  • Iodine-rich foods like seafood, dairy products, and iodized salt are crucial for thyroid hormone production.
  • Selenium-rich foods such as Brazil nuts, tuna, and eggs help activate thyroid hormones.
  • Zinc, found in meat, legumes, and nuts, is also important for thyroid function.
  • Eating a variety of whole grains, like whole-wheat bread, whole-grain pasta, and brown rice, can help provide essential nutrients, as suggested by 1. Some key points to consider when creating a diet plan for someone with hypothyroidism include:
  • Limiting goitrogenic foods like raw cruciferous vegetables (broccoli, cauliflower, kale) as they can interfere with iodine uptake when consumed in large amounts, though cooking reduces this effect.
  • Avoiding consuming levothyroxine medication with calcium-rich foods, coffee, or high-fiber foods, as these can reduce absorption; taking medication on an empty stomach with water, typically 30-60 minutes before breakfast.
  • Maintaining consistent timing with both medication and meals to ensure stable hormone levels. While diet alone cannot cure hypothyroidism, these dietary choices can complement medical treatment and help manage symptoms effectively, as supported by 1.

From the FDA Drug Label

• Evaluate the need for dosage adjustments when regularly administering within one hour of certain foods that may affect levothyroxine sodium tablets absorption • Do not administer in foods that decrease absorption of levothyroxine sodium tablets, such as soybean-based infant formula

The patient with hypothyroidism should avoid consuming foods that may decrease the absorption of levothyroxine sodium tablets, such as soybean-based infant formula. It is also recommended to evaluate the need for dosage adjustments when administering levothyroxine sodium tablets with certain foods that may affect absorption. 2

From the Research

Dietary Recommendations for Hypothyroidism

  • A diet rich in essential micronutrients such as iodine, selenium, and zinc is crucial for managing hypothyroidism 3, 4, 5, 6.
  • Iodine supplementation is essential for preventing iodine deficiency disorders, including hypothyroidism, but excessive intake can cause thyroid disorders 3, 4.
  • Selenium and zinc supplementation has been found to be beneficial in specific populations, particularly in preventing new-onset hypothyroidism 5, 6.
  • Avoidance of gluten and dairy may have positive impacts on patients with concomitant sensitivities to these substances, improving absorption of levothyroxine 3, 7.
  • Cruciferous vegetables and soy have little proven benefit in patients with thyroid disorders, but may interfere with micronutrients and influence thyroid function 3, 4.

Key Nutrients for Thyroid Function

  • Iodine: essential for thyroid hormone synthesis and function 4.
  • Selenium: necessary for the activation and inactivation of thyroid hormones, and protects the thyroid from free radicals damage 4, 5, 6.
  • Zinc: involved in thyroid hormone metabolism and may have a beneficial effect on thyroid function when supplemented alone or in combination with selenium 5, 6.
  • Other essential nutrients: potassium, copper, magnesium, iron, vitamin A, C, D, and B, as well as proper protein intake, dietary fibre, and unsaturated fatty acids 7.

Dietary Management of Hypothyroidism

  • An anti-inflammatory diet may help regulate the immune system and manage symptoms of hypothyroidism 7.
  • Elimination of lactose and gluten may be necessary for some patients due to intolerance or interactions with levothyroxine 3, 7.
  • A well-balanced diet that includes a variety of whole foods, such as fruits, vegetables, whole grains, and lean proteins, can help support overall health and thyroid function 7.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Thyroid, Diet, and Alternative Approaches.

The Journal of clinical endocrinology and metabolism, 2022

Research

Role of iodine, selenium and other micronutrients in thyroid function and disorders.

Endocrine, metabolic & immune disorders drug targets, 2009

Research

The importance of nutritional factors and dietary management of Hashimoto's thyroiditis.

Annals of agricultural and environmental medicine : AAEM, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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