Foods to Eat, Foods to Avoid

The thyroid gland is a small, butterfly-shaped gland that sits near the base of the front of your neck.

It makes and stores thyroid hormones that affect nearly every organ system in your body.

When the thyroid gland receives a signal called thyroid-stimulating hormone (TSH), it releases thyroid hormones into the bloodstream. This signal is sent from the pituitary gland, a small gland found at the base of your brain, when thyroid hormone levels are low.

In hypothyroidism, the thyroid gland doesn’t release sufficient thyroid hormones, even when there is plenty of TSH.

Chronic autoimmune thyroiditis (Hashimoto’s thyroiditis) is an autoimmune disease in which your immune system mistakenly attacks your thyroid gland. It’s the most common cause of hypothyroidism in iodine-sufficient populations.

Causes of primary hypothyroidism include:

Other times, the thyroid gland doesn’t receive enough TSH. This happens when the pituitary gland is not working properly and is called secondary hypothyroidism.

When your thyroid isn’t working properly, it can cause a variety of symptoms, including extreme fatigue and constipation.

Some people with hypothyroidism may experience extreme symptoms, while others may not experience many symptoms at all.

A healthcare professional will choose an appropriate treatment plan based on your thyroid function, symptoms, and other health concerns.

Hypothyroidism is usually treated with thyroid hormone replacement medication, such as levothyroxine (Synthroid) or natural thyroid hormone medications like Armour Thyroid.

However, many people’s symptoms may persist even when they’re being treated with thyroid hormone replacement.

For example, people with Hashimoto’s thyroiditis may often experience symptoms like fatigue, cold intolerance, anxiety, and hair loss even after thyroid hormone medication has normalized their thyroid function. Because of this, many people with hypothyroidism may seek alternative treatment methods.

Research shows that, in addition to medication, dietary and lifestyle modifications can often help reduce certain symptoms and improve overall quality of life in people with hypothyroidism.

Learn more about the signs and symptoms of hypothyroidism.

Summary

Hypothyroidism is a condition in which the thyroid gland doesn’t make enough thyroid hormone. This can lead to a variety of symptoms, such as weight gain, cold intolerance, and constipation.

Hypothyroidism is usually treated with thyroid hormone replacement medications, but some people with hypothyroidism may still experience symptoms when their thyroid function is considered typical.

Following a nutritious diet is important for everyone, but studies show that certain dietary interventions can have specific benefits for people with hypothyroidism.

Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the United States. It’s an autoimmune disease that leads to the gradual destruction of thyroid tissue by white blood cells, or lymphocytes.

Hashimoto’s thyroiditis is more common in women and often develops between ages 30 and 50, though men and younger people can develop the disease too.

Many studies have shown that dietary changes can benefit people with Hashimoto’s thyroiditis in a number of ways. This includes improving thyroid function, promoting a healthy body weight, and reducing hypothyroid symptoms.

Gluten-free diets, autoimmune elimination diets, and anti-inflammatory diets are some of the dietary patterns shown to be helpful for those with Hashimoto’s thyroiditis.

For example, gluten-free diets may help improve thyroid function. Additionally, diets high in vegetables and fruits could protect against cellular damage and promote healthy body weight maintenance in people with Hashimoto’s thyroiditis.

Some studies also suggest that elimination diets, like a modified paleo diet, could help reduce symptoms such as fatigue and improve quality of life in people with Hashimoto’s thyroiditis.

Following a nutritious, calorie-controlled diet can also help promote weight loss, which is something that people with hypothyroidism may have difficulty with.

What’s more, nutrient deficiencies can worsen hypothyroid symptoms, like fatigue, anxiety, and low mood.

Some deficiencies that may be responsible for worsening these symptoms include:

Because of this, it’s essential to try to maintain a well-rounded diet that provides optimal amounts of both macronutrients and micronutrients.

In general, a diet rich in nutritious foods and low in pro-inflammatory foods with added sugar or ultra-processed foods can be helpful for many people with hypothyroidism.

Summary

Following a healthy, nutrient-rich diet could help people with hypothyroidism improve their thyroid function, prevent nutrient deficiencies, and improve hypothyroid symptoms.

There are a number of nutrients that are essential to the health of the thyroid.

Plus, people with hypothyroidism are more likely to develop certain nutrient deficiencies compared with the general population.

Iodine

Iodine is an essential mineral that is needed to make thyroid hormones, and a deficiency can lead to hypothyroidism. In fact, insufficient iodine intake is the most common cause of hypothyroidism worldwide.

Though iodine deficiency is common in many areas of the world, it’s less common in developed countries like the United States.

People who don’t use iodized salt, pregnant women, and people following vegan diets are more at risk of having low iodine levels.

If you have hypothyroidism, avoid supplementing with iodine unless a doctor recommends it to treat low iodine levels. Taking in excessive amounts of iodine is harmful for the thyroid and can cause hyperthyroidism in people living in iodine-abundant areas, like many parts of the United States.

If you’re concerned that you’re not taking in enough iodine, contact a healthcare professional or dietitian to assess your iodine levels and determine the best iodine intake plan for you.

Selenium

Selenium is another mineral that’s necessary for thyroid health and thyroid hormone production. It helps protect the thyroid from damage caused by oxidative stress.

Adding selenium-rich foods to your diet is a great way to boost your selenium levels. Examples include:

Additionally, selenium supplements can be helpful for certain people with hypothyroidism.

For example, research from 2023 suggests that supplementing with 200 micrograms (mcg) of selenium per day has been shown to decrease thyroid antibodies and improve certain symptoms like low mood in people with Hashimoto’s thyroiditis.

But this doesn’t mean that selenium supplements are necessary for all people with hypothyroidism. Only supplement with selenium if recommended by a healthcare professional.

The National Institutes of Health has identified 400 mcg of selenium as the daily upper limit for adults. Chronically high intake of selenium can cause symptoms like hair and nail loss, diarrhea, nausea, and skin rashes.

Acute selenium toxicity can have serious, and sometimes fatal, effects like kidney failure, heart attack, and breathing problems.

Zinc

Like selenium, zinc is needed for thyroid hormone production and thyroid function.

Not getting enough zinc can negatively affect your thyroid function and many other aspects of health, so it’s essential to get enough of this nutrient in your diet.

When used alone or combined with other nutrients like selenium and vitamin A, zinc supplements may help improve thyroid function in those with hypothyroidism.

If you’re interested in taking a zinc supplement, talk with a healthcare professional. They can determine whether or not a zinc supplement may be appropriate for you.

Other important nutrients

In addition to the nutrients listed above, there are other vitamins and minerals that people with hypothyroidism should be mindful of:

• Vitamin D: People with hypothyroidism are more likely to be deficient in vitamin D. Having low vitamin D levels can negatively affect thyroid function and worsen hypothyroid symptoms. Because vitamin D isn’t concentrated in many foods, supplementation is often necessary.
• Vitamin B12: B12 deficiency is common among people with hypothyroidism. Talk with a doctor about testing your B12 levels. If your levels are low or suboptimal, a doctor can recommend a B12 or B-complex supplement.
• Magnesium: Low or deficient magnesium levels are associated with thyroid dysfunction and can increase the risk of developing hypothyroidism. Supplementing with magnesium has been shown to improve hypothyroid symptoms.
• Iron: Iron deficiency is common in women with hypothyroidism. Low iron levels or iron deficiency anemia can impair thyroid function. Supplementation is often necessary to reach and maintain healthy iron levels.

These are just some of the many nutrients that are important for thyroid function and general health. Other examples of nutrients important for people with hypothyroidism include:

Summary

People with hypothyroidism are more likely to be deficient in several essential nutrients. Supplementing with certain vitamins and minerals could help improve thyroid function and hypothyroid symptoms. But it’s recommended to talk with a medical professional or dietitian before starting any new supplement.

You don’t have to avoid many foods if you have hypothyroidism, but there are certain foods that may cause issues in some people with hypothyroidism.

Gluten and ultra-processed foods

Gluten is a group of proteins found in wheat, barley, triticale, and rye.

Some studies suggest that people with Hashimoto’s thyroiditis may benefit from following a gluten-free diet. Other studies disagree on whether a gluten-free diet is necessary for everyone with the condition.

Additionally, people with hypothyroidism may want to limit certain foods in order to promote overall health.

For example, people with Hashimoto’s thyroiditis have been shown to have increased markers of inflammation and oxidative stress. Oxidative stress is characterized by an excess of reactive compounds called free radicals in the body, which overwhelm the body’s antioxidant defenses and can lead to cellular damage.

People with hypothyroidism may want to avoid foods that contribute to oxidative stress and inflammation, such as ultra-processed foods, foods and beverages high in added sugar, and fried foods.

In addition to contributing to oxidative stress, a diet high in these foods is linked to obesity, so cutting back on these products could also help people maintain a healthy body weight.

Goitrogens

Goitrogens are substances found in cruciferous vegetables, such as cabbage and Brussels sprouts, and soy products that may interfere with thyroid hormone production.

Most people, including those with hypothyroidism, can enjoy moderate amounts of goitrogenic foods without negatively affecting their thyroid health. Cruciferous vegetables like broccoli are actually quite low in goitrogens.

Plus, cooking goitrogenic foods reduces goitrogenic activity, making them safer for people with hypothyroidism.

That being said, it’s a good idea to avoid consuming large amounts of juice made with raw cruciferous vegetables.

People with hypothyroidism may want to avoid eating large amounts of:

Other goitrogenic foods include soy and pearl millet.

In general, people with hypothyroidism may want to avoid eating large amounts of any goitrogenic foods.

Diet and thyroid medication

Make sure you’re taking your thyroid medication on an empty stomach to promote optimal absorption. This includes avoiding beverages, foods, and supplements that could interfere with medication absorption.

Experts suggest taking thyroid medications like levothyroxine at least 30–60 minutes before breakfast or at least 3–4 hours after dinner.

Even coffee can significantly affect thyroid medication absorption, so it’s important to always take your medication on an empty stomach and wait at least 30 minutes before consuming foods or beverages besides water.

It’s also important to avoid taking thyroid medication within 4 hours of taking iron or calcium supplements.

Summary

People with hypothyroidism don’t have to avoid many foods, but they may want to avoid consuming large amounts of goitrogenic foods and limit ultra-processed foods to promote overall health. Additionally, people with Hashimoto’s thyroiditis may benefit from a gluten-free diet.

Following a diet rich in nutritious foods can help improve overall health and promote healthy body weight maintenance.

Plus, a nutrient-dense diet can help reduce the risk of health conditions linked with hypothyroidism, such as heart disease, obesity, and type 2 diabetes.

A diet high in fiber can also help lower the risk of constipation, which is a common symptom of hypothyroidism.

If you have hypothyroidism, try incorporating the following nutritious foods into your diet:

• Non-starchy vegetables: greens, artichokes, zucchini, asparagus, carrots, peppers, spinach, or mushrooms
• Fruits: berries, apples, peaches, pears, grapes, citrus fruits, pineapple, or bananas
• Starchy vegetables: sweet potatoes, potatoes, peas, or butternut squash
• Fish, eggs, meat, and poultry: fish and shellfish, eggs, turkey, or chicken
• Healthy fats: olive oil, avocados, avocado oil, coconut oil, unsweetened coconut, or full fat yogurt
• Gluten-free grains: brown rice, rolled oats, quinoa, or brown rice pasta
• Seeds, nuts, and nut butters: almonds, cashews, macadamia nuts, pumpkin seeds, or natural peanut butter
• Beans and lentils: chickpeas, kidney beans, or lentils
• Dairy and nondairy substitutes: coconut milk, cashew milk, coconut yogurt, almond milk, unsweetened yogurt, or cheese
• Spices, herbs, and condiments: spices like paprika, saffron, or turmeric, fresh or dried herbs like basil or rosemary, and condiments salsa or mustard.
• Beverages: water, unsweetened tea, coffee, or sparkling water

Keep in mind that some people with hypothyroidism may benefit from avoiding gluten and other ingredients like dairy. Others may not need to cut these foods from their diet and may be able to consume gluten and dairy without an issue.

This is why it’s important to develop an eating plan that works for you and your specific health needs.

If you can, work with a registered dietitian who can help identify which foods you may need to eliminate. They can also help you develop a balanced eating plan that doesn’t unnecessarily cut out nutrient-rich ingredients.

Summary

There are plenty of healthy food options for people with hypothyroidism, including vegetables, fruits, healthy fats, and protein sources like fish and eggs.

Everyone with hypothyroidism has different health and dietary needs. Your calorie needs depend on a number of factors, including:

• age
• activity level
• gender
• height
• whether you’re trying to lose or gain weight

This general meal plan can help you get an idea of what healthy eating may look like when you’re living with hypothyroidism.

Monday

• Breakfast: egg and spinach omelet served with half of an avocado and a bowl of berries
• Lunch: a large green salad with chicken, beans, and pumpkin seeds
• Dinner: stir-fried shrimp and vegetables served with brown rice

Tuesday

Wednesday

Thursday

Friday

• Breakfast: protein berry smoothie made with vanilla pea protein, natural peanut butter, and frozen mixed berries
• Lunch: a large green salad with chicken, fresh vegetables, beans, and pumpkin seeds
• Dinner: stuffed peppers

Saturday

Sunday

Summary

This sample week-long meal plan is suitable for people with hypothyroidism. It provides plenty of options for a delicious and healthy menu.

Hypothyroidism, or an underactive thyroid, is a health condition that affects many people worldwide.

It can cause symptoms like tiredness, weight gain, constipation, low mood, and cold intolerance among many others.

There’s no “best” diet, but eating the right nutrients and taking medications can help manage hypothyroidism symptoms, improve thyroid function, and promote overall well-being.

Everyone has different diet needs, but people with hypothyroidism can benefit from a diet rich in whole, nutrient-dense foods like vegetables, fruits, nuts, and fish.