We’re in the midst of a podcast series all about thyroid health, featuring the expertise of Dr. Izabella Wentz and in this episode, we’re focusing on positive solutions including thyroid diet and lifestyle interventions.
Dr. Izabella Wentz and I cover a lot of ground, including medication, dietary triggers, adrenal health, treatment myths and supplements. We’ll also share the simplest first steps you can take toward improving your thyroid health on your own.
Diet and Lifestyle Interventions for Thyroid Disease
First and foremost, feeling better is possible. In fact, in some cases, thyroid conditions can go into remission. There are a variety of medications and interventions of diet and lifestyle that can help you along your journey towards thyroid wellness.
So when is medication needed for thyroid disease? The primary indicator is your Thyroid-Stimulating Hormone (TSH) levels. If you’ve been diagnosed with Hashimoto’s Thyroiditis and your TSH levels are elevated, that’s generally a good indication to start taking medication. Taking medications can potentially slow down the progression of the condition and prevent further damage of the thyroid gland. According to Dr. Wentz, thyroid medications—when taken appropriately—are generally considered “clean medications” and are unlikely to cause negative side effects. This is because they’re the exact same chemical structure as our naturally occurring thyroid hormones.
Nonetheless, in some cases it is possible to effectively treat thyroid disease without medication. For example, many people have found that eliminating gluten from their diet can significantly reduce thyroid disease symptoms. If the 100% natural-remedy route isn’t working for you, however, take this encouragement from Dr. Wentz: “keep an open mind and practice self-compassion. Be kind to yourself. If you are experiencing a lot of symptoms and if you could benefit from a medication, don’t martyr yourself for a cause of wanting to do things medication-free.”
In our conversation, Dr. Wentz and I also discuss other lifestyle and dietary factors that have contributed to the rise in autoimmune thyroid disease. Besides gluten, the two biggest dietary triggers are dairy and soy. According to Dr. Wentz, between 70-80% of people with Hashimoto’s will have a dairy sensitivity.
On a deeper, root-cause level, people experiencing an autoimmune disease like Hashimoto’s will likely also have intestinal permeability (also known as leaky gut). When seeking treatment for thyroid disease, it’s important to resolve any gut issues as well.
Furthermore, adrenal gland issues will also affect the thyroid. Adrenals are responsible for producing our stress hormones and they work in sync with our thyroid glands. When one is dysfunctional, be it adrenals or thyroid, the other is often experiencing dysfunction as well.
With so many potential triggers and factors to look at when it comes to thyroid health, seeking the help of a medical practitioner is recommended. But for those of you who are having trouble finding a medical practitioner, there are steps you can take now to reduce your symptoms:
Resources I Mention
- Dr. Izabella Wentz
- Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause
- Dr. Alessio Fasano
Get the Overcoming Thyroid Fatigue Guide!
If you struggle with thyroid disease or symptoms, get a free copy of Dr. Izabella Wentz’s “Overcoming Thyroid Fatigue Guide” by clicking here.
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Katie: We’ve talked about what thyroid disease is and the different forms it can
take and the symptoms and how to find the doctors to get diagnosed. At
this point, I’d love to switch gears and focus on the positive a little bit
more and look at things that can potentially help. One question I had from
a reader is, “When is medication needed for thyroid disease and how do
you know?” The follow-up to that would be what type is typically best to
take for the different forms of thyroid disease?
Izabella Wentz: Mm-hmm (affirmative). Those are great questions. Yeah, I love focusing
on solutions because there are so many different things that people can
do to get themselves better. Feeling better is possible and some people
can even get their condition into remission. Starting off with medications,
medications can make a really, really big difference in how a person feels.
Generally, I would say if somebody is having any thyroid symptoms with
Hashimoto’s … They’ve been diagnosed with Hashimoto’s and they have
any thyroid symptoms, and if their TSH is going to be elevated. That
would be a good indication to start on medications.
If their TSH is still within normal limits but they have Hashimoto’s, that’s a
controversial time for most doctors. Some doctors will say, “Well, let’s just
wait and watch.” Other doctors will say, “Hey, let’s try a medication now.”
The advantage of trying the medication is going to be helpful in
addressing some of the symptoms. Even if your TSH is normal, you still
might have some of these symptoms like the fatigue and the trouble with
weight and so taking the medication can help.
It’s also been found that taking medication can actually reduce the
autoimmune attack on the thyroid gland. It acts as a protective layer for
the thyroid because what it does is it takes the pressure off the thyroid to
work so the thyroid doesn’t have to convert as much iodine and the
thyroid doesn’t have to produce as much thyroid hormone. That lowers
the TSH and that lowers all of these reactive oxygen species that are
produced in the thyroid gland and the immune system is not as attracted
to the thyroid gland then.
We’ll usually see when somebody starts on a thyroid medication, their
thyroid antibodies will go down. For those of you guys listening, thyroid
antibodies, the higher they are the more aggressive the autoimmune
attack is thought to be on the thyroid. Taking medications can potentially
slow down the progression of the condition and prevent further damage of
the thyroid gland.
Katie: That makes so much sense. I know there are a lot of people, and I would
even consider myself in this category, who don’t like to take medication
superfluously or without really a good cause. I actually am on a pretty low
dose of WP-Thyroid, which is a natural thyroid replacement. Can you talk
about how those particular type of medicines are a little bit different than
other types of medications, in that like they’re actually filling a role in the
body, they’re not … Because I think some people can be a little afraid of
taking any kind of medication, especially being stuck on a medication?
Can you talk about how thyroid medications work?
Izabella Wentz: Yeah, absolutely. This is a very, very important point because as a
pharmacist, I like to think of medications and as having different types of
mechanisms of action. Of course, one of my roles was to actually get
people off of medications because medications can have a lot of adverse
drug reactions and I’m very, very passionate about appropriate use of
medications.
With respect to thyroid hormones, I consider them to be very, very clean
medications. What I mean by that is there are clean medications that
work on the receptors. They’re supposed to do the job that they’re
supposed to do in the body. Then there are dirty drugs that basically will
bind all kinds of different receptors and then you end with a ton of
different side effects and unwanted types of things happening where
you’re trying to achieve one thing and another thing happens that you
don’t want to have like headaches or weird rashes or any kinds of weird
side effects.
The reason why thyroid medications are clean and why they are so not as
likely to produce side effects unless, of course, they’re overdosed or
under-dosed, is because they’re the exact same chemical structure as our
naturally occurring thyroid hormones. There are a few different ones out
there. There’s T4, which is levothyroxine. Synthroid is the brand name of
that and that was the number one prescribed drug in all of America in
2014, believe it or not. That is a synthetic version of one of the main
thyroid hormones. A lot of doctors will prescribe this medication for most
patients. Some people will do very, very well on this drug and they’ll say,
“Okay, it’s helped a lot of my symptoms and I feel great.”
Studies and doctors will say that majority of people will do well on this. In
my experience and just with the clients that I worked with, it seems to be
testosterone opposite. That most people don’t do well with this type of
medication. Of course, I am probably biased because people who are
doing just fine on their medications are probably not going to come and
ask me questions.
The other types of medications that can be helpful are going to be T4, T3-
containing medications, so like the one that you’re on. Nature-Throid as
well as Armour Thyroid are going to be options, and also compounded T4,
T3 medications. T3 is the other main active thyroid hormone and it’s
actually the more active thyroid hormone. It is four times more active than
the T4. Under normal circumstances when everything is going perfectly, a
person basically will convert as much of the T4 to T3 as they need.
Theoretically, T4 medications like the Synthroid should be just fine for
people because they should be able to convert them to T3 which is the
more active hormone which helps us to grow hair, lose weight, build up
our metabolism, make us warm. That doesn’t always happen. Sometimes,
it’s due to different toxins of nutrient deficiencies or even stress that the
conversion doesn’t happen properly. I always, whenever a person is not
feeling their best on thyroid medications, I would recommend doing a T4,
T3-containing medication like the Nature-Thyroid or WP Thyroid or
Armour Thyroid.
The other neat thing about these medications is they’re actually
bioidentical so they’re going to be derived from the thyroid glands of
usually pigs. Pigs have very similar, identical thyroid hormones to the
ones that we have. Basically, what we’re doing with thyroid medications is
giving ourselves the very same hormone our body can no longer make.
Long story short, I guess.
Katie: Yeah, exactly. Yeah, I feel like that’s been a struggle for a lot of my
readers and the question I’m not obviously qualified to answer, so I’m so
glad that you explained that in-depth. I know a lot of people personally
who are on Synthroid and who aren’t seeing the kind of the results they
were hoping for and they’re still struggling with some symptoms. That
makes so much sense that if they’re struggling with that conversion to T3,
they would still be potentially having a lot of those issues.
Izabella Wentz: Mm-hmm (affirmative), absolutely. The other thing that’s a bit concerning
to me, I know that AbbVie, the drug company is trying to work on
resolving this issue, but there were some reports of Synthroid being
cross-contaminated with gluten. We know that autoimmune conditions
often come in pairs or in three’s. People with Hashimoto’s are going to be
more likely to have Celiac disease and I’ve actually found that most
people with Hashimoto’s, even if they don’t have Celiac disease, 5% of
them might, the rest are very, very gluten sensitive.
When they take the Synthroid, they may actually be dosing themselves
with gluten and that can be contributing to additional symptoms for
people. Though Synthroid doesn’t have gluten ingredients, there have
been some cross-contamination issues.
Katie: That’s really good to know. I had a reader, January, ask me, “Is it possible
to overcome thyroid problems without taking medication?” If, say, a
person does have Hashimoto’s or even just hypothyroidism, is that
something they can handle without medication?
Izabella Wentz: In some cases, people can. I would give yourself … If you’re really gungho about doing a natural approach, so some people who had both celiac
disease and Hashimoto’s, about 20% of them on a gluten-free diet, within
3 to 6 months they were able to reverse subclinical hypothyroidism, which
means that they have the beginning stages of a sluggish thyroid and they
were able to normalize their thyroid function after the trigger which, in
their case, was gluten was removed and there was no longer that trigger
that was causing their immune system to attack their thyroid gland.
In some cases, that would be something that you can try. My
recommendation though for people is if you’re suffering with symptoms,
not to martyr yourself for a cause. A lot of times people will say like, “Oh, I
only want to do things naturally,” or “Natural medicine doesn’t work,” or “I
won’t do this or I won’t do that,” or “I won’t change my diet,” or “I’ll only do
things with diet.” I just encourage everybody to … You really keep an
open mind and practice self-compassion. Be kind to yourself. If you are
experiencing a lot of symptoms and if you could benefit from a
medication, don’t martyr yourself for a cause of wanting to do things
medication-free.
Katie: Yeah. That’s a great point. I’m curious if you have any insight into …
Because I’ve seen a lot of that research as well as far as the gluten
connection for those with thyroid disease, but I often hear people say and
I’ve wondered this as well, years ago, people liked gluten as much as
they do now or sometimes even more potentially since there’s more
awareness about it and we didn’t have these rates of thyroid disease or
perhaps we did and we didn’t know about them. Do you have any insight
as to why this seems to be a growing problem right now?
Izabella Wentz: A few reasons. One of the ways that breads were prepared back in the
day was through a fermentation sour dough process that actually burp
down a lot of gluten, so that could be potentially, back in the day, we were
not eating as much gluten as we are now. I know through, in just trying to
get more people fed, and then things are always down for good
intentions, right, so the gluten content in bread has increased and the use
of, unfortunately, genetically modified crops which seem to be, of course,
people or scientists were saying, “Oh yeah, let’s feed the masses and
let’s genetically modify these crops so that they are resistant to different
bugs and things.” Those are some potential reasons why gluten may be
more antigenic now.
It may not be recognized as the same protein that we used to have, and
definitely higher awareness is another thing. Whenever a person is in a
more toxic environment, they’re going to be more likely to react to
different things, too. Just our overall society being more toxic has been
implicated in higher Hashimoto’s rates. We do see trends with that
happening. They’ve looked at the blood samples of people who are not
froz- … People were not frozen. Their blood samples are frozen from 20
years ago and they just took recent blood samples and they looked at the
rates of Hashimoto’s and people from 20 years ago and people from now.
We definitely have seen an increased trend in those higher rates and
potentially toxins and potentially change how our food is processed and
created.
Katie: Gotcha. So that’s like perfect storm that you talked about. We’re almost
creating in environmentally as a society between adding the excess
iodine and probably not very much awareness about selenium and our
change in our processed food and food being less cultured and less
traditionally prepared than it used to be along with our high stress
lifestyle. That makes so much sense that we’re creating that perfect storm
that both you and I had.
Izabella Wentz: Mm-hmm (affirmative). Yeah, absolutely, and then other things come into
play too. Not eating fermented foods, not having enough vitamin D on
board. Fermented foods, we used to eat them and they would contribute
to getting us a very diverse microbiome. The microbiome has been
connected with autoimmune disease and then just a lot of vitamin D
deficiency has also been implicated in autoimmune thyroid disease. We’re
not spending as much time outdoors sunbathing as we used to or like
running around foraging for food.
Unfortunately, it’s really hard to isolate one thing. It just seems to be
collection of different things that can contribute. I spend a lot of time
looking at medical journals and reviewing different studies and there are
so many different things that can trigger Hashimoto’s. There’s
medications, there’s different toxins, there’s different foods, there’s
different infections and definitely stress is a contributor to that as well.
Katie: Yeah, that makes so much sense. You mentioned gluten, which I feel like
there is a lot more awareness lately especially in health circles and
people with thyroid disease. That’s something that comes up in the
research, but are there other dietary triggers that can contribute or that
are especially problematic for people who may have thyroid disease?
Izabella Wentz: Yeah, absolutely. I’m really, really glad that gluten is getting so much
awareness in them. Very, very happy to see that. I’ve had a lot of people
who submitted success stories through my website. After going glutenfree and getting into Hashimoto’s remission, feeling so much better, it just
makes me so happy that this kind of awareness is out there. Other foods
can be triggering as well. The two biggest ones are going to be dairy and
soy. The main proteins in dairy are going to be casein and whey, and
usually it’s the casein protein that seems to be sensitizing for people with
Hashimoto’s. Lactose is people often will say, “Oh, okay, so you have an
intolerance to dairy. Can you just have milk with lactate in it or lactosefree milk?”
Actually, the part of the dairy that people are sensitive to is going to be the
casein. That’s a dairy protein. I have seen a lot of people, I will say
probably 70 to 80 percent of people with Hashimoto’s are going to be
dairy sensitive and they’ll have improved outcomes once they get off of
dairy. I had one person who actually just went dairy-free, that was only for
intervention and she was able to get into remission from Hashimoto’s.
That’s almost as an important trigger as gluten. With my experience and
surveying my readers, about 88% felt that they were better off gluten-free
with dairy at somewhere between 70 and 80 percent.
Katie: Wow.
Izabella Wentz: Soy is another interesting kind of food that is often commonly reactive in
people with Hashimoto’s. I’ve seen people who get off of soy, they may
not have a lot of symptoms of soy intolerance, their thyroid antibodies do
start reducing indicating that the immune system attack is becoming less
aggressive.
Katie: That’s really fascinating. Another thing you mentioned in relation to, I
think, part of your own story was the role of gut health. This is another
topic that I feel like is awesome right now because we’re learning so
much about so quickly. There are a lot of studies right now that seemed to
be coming out about the role of gut health. How does this play into thyroid
disease? Because you hear terms like leaky gut and gut permeability and
different things related to digestive health, but how does that play a role in
how someone’s thyroid may work?
Izabella Wentz: It’s actually interesting because the thyroid gland is part of the same
tissues that were started off where the thyroid and the tongue, so they
come from similar tissue. You can say that the thyroid gland is actually
derived from our gut. That’s one interesting connection here. Really, the
main connection would be with respect to the three-legged theory of
autoimmunity. This was a theory that was recently explored and proved
by Dr. Alessio Fasano who’s a gastroenterologist that specializes in
autoimmunity and celiac disease.
He found that every person with a autoimmune condition, be it
Hashimoto’s, be it lupus or MS, had three things that needed to be
present in order for the autoimmune condition to develop. The person
had, obviously, the right genetic predisposition to develop the condition.
They also had some sort of a trigger that brought on the condition. We
talked a little bit about the different triggers out there. Then the third piece
of the puzzle is that they also had intestinal permeability or leaky gut. All
three of those things need to present in order for the autoimmune
condition to manifest or to develop.
If you had a genetically predisposed person who only had the trigger but
not the gut permeability, they would not develop autoimmune condition. If
they only had the gut permeability but not the trigger, they would also not
develop a gut condition. That was really, really exciting for prevention
when you first came across this. Later on, he also came across
something else. It’s that if you are able to either remove the trigger or
remove the intestinal permeability, the autoimmune condition would go
into remission. Obviously, we can’t change our genes. We’re always going
to have these genetic predisposition that we have but we can definitely
change how the genes are expressed and that’s through manipulating our
triggers, be they nutrient deficiencies or foods or infections.
Then we can also look at healing our gut which is where the intestinal
permeability comes into play. There’s a few different reasons for intestinal
permeability. Whenever I work with people and what I like to write about is
really looking at all of the potential root causes of intestinal permeability
and trying to figure them out and address them so that we can get a
person feeling better and potentially into remission.
Katie: That’s what I love so much about your approach and especially your book
which delves into the root causes so much, is that even though your
background is more in the conventional medicine as a pharmacist, you’ve
really learned so much as delving into the root causes and not just
treating with medicine. I love the two-prong approach that you have
seemed so effective for so many people. What about the adrenal health?
Because you also mentioned that sometimes symptoms can look like
thyroid disease but they’re actually adrenal related. I’ve also seen that
you’ve written about how adrenal health can impact thyroid health. Can
you talk about that connection too?
Izabella Wentz: Yeah, absolutely. There’s like basically five main things that are going to
be happening in Hashimoto’s that are going to be contributing. They’re
going to be nutrient depletion, food sensitivities, poor stress response
which is where the adrenals come in, impaired ability to get rid of toxins,
infections which are oftentimes going to be in the gut. Adrenals are two
little glands that sit on top of our kidneys. They’re responsible for
producing our stress hormones. They’re very closely in synergy and work
in sync with our thyroid glands.
A lot of times when you have one adrenal dysfunction, you will have
thyroid dysfunction and vice versa. Adrenal depletions and dysfunctions in
adrenals oftentimes are going to precede autoimmune disease. What will
happen a lot of times is people will experience a very, very stressful time
and release a lot of stress hormones, and then the body can’t keep up
with the stress hormone production and starts becoming low in these
stress hormones like the cortisol. Once we are low in cortisol, that makes
us susceptible to different types of infections and then a person will often,
at that point, develop some sort of a gut infection. That’s the triggering
and starting point of the intestinal permeability which can then lead to
autoimmune conditions.
With the other ways that the adrenals and thyroid work in feedback with
one another is whenever there’s excess thyroid hormones, the body will
try to slow things down and they’ll produce reverse T3 instead of the
active T3 so that to basically not to activate the thyroid receptors but just
to take up the thyroid receptors and prevent a person from becoming
hyperthyroid. The adrenals play a very, very important role in making sure
that we are keeping with homeostasis.
Under normal conditions, the two work very, very well together, but in
terms of autoimmunity and thyroid dysfunction, you’ll often see that both
adrenals and thyroid gland are going to be impacted. Majority of my
clients who didn’t get better with just maybe some nutrition or medications
will find that they have some degree of adrenal fatigue or adrenal
dysfunction where they’re not producing enough of the stress hormones
and that’s dragging their thyroid hormone production down as well.
Katie: Wow. It’s really such a vicious cycle that any of those factors whether it’s
intestinal permeability or adrenal issues or even like stress or diet, they
can all trigger that cascade that affects everything. I feel like hopefully
that’s going to become the future of medicine is looking at all of those
factors in a holistic way. I feel like there are people like you who are
leading that charge and looking at root causes and looking at all the
factors. I think that’s so hopeful what you said that even just if you can fix
one of those legs, whether it be the intestinal permeability or the trigger,
that that can help put a condition in remission even if you still have, like
you said, that genetic predisposition or maybe you still have a trigger but
you don’t have the intestinal issue or vice versa.
I feel like that’s really hopeful because sometimes the conversation about
thyroid problems can get gloomy. It’s good to hear that there are people
who are getting in remission and that’s a definite possibility, that it’s
backed by the research.
Izabella Wentz: Mm-hmm (affirmative). Yeah, absolutely. Sometimes it’s an infection that
triggers the condition. There’s research supporting H. pylori infection
being a common thing in Hashimoto’s. Treating that infection, I’ve seen
some people get into remission from that. A new infection that’s just been
recently described in the literature that I’ve seen for a few years not is
blastocystis hominis. It’s a protozoan parasite and that can actually
contribute to leaky gut in the person. I’ve seen whenever we treat that
infection in people, that their gut permeability will reduce, their food
sensitivities will reduce and their thyroid antibodies will start declining.
Katie: That’s fascinating. I’d love to get your take on a couple of myths that
seem to be related to thyroid disease as well, or at least maybe they have
truth to them but they’re very often repeated. In fact, I’ll even have people
come leave comments on my blog to tell me about them quite often. The
first one is that if you have any kind of thyroid problem, you should
absolutely not eat cruciferous vegetables because they have compounds
that attack the thyroid. I know that you’ve written about these and there
seems to be a lot of back and forth, but can you clarify that?
Izabella Wentz: Mm-hmm (affirmative). Yeah, absolutely. That’s a really good one, Katie.
Those poor cruciferous vegetables, they’re so good, they’re so tasty but
they get this bad rap, don’t they?
Katie: They do, yeah.
Izabella Wentz: Basically, there’s a word that people should be familiar with. It’s goitrogen.
This is an old word and it’s not the best descriptive word in the world
because what it basically means is something that interferes with thyroid
function. There’s a few different mechanisms for interfering with thyroid
function. We talked about soy and how people with Hashimoto’s and
thyroid conditions should avoid it. Soy is a goitrogen because it interferes
with the thyroid peroxidase enzyme, which if you guys remember, that’s
the enzyme that’s usually a target for the autoimmune attack.
Soy can lead to increased amounts of thyroid antibodies. That’s a
goitrogen that we definitely don’t recommend. The cruciferous vegetables,
they are listed as goitrogens because they can block iodine absorption
into the thyroid gland. Now, back in the day when primary cause of
hypothyroidism was due to iodine deficiency, that can potentially
exacerbate iodine deficiency if you are eating all these vegetables, all
these big heads of cabbage and lots of kale. That could potentially
prevent any tiny traces of iodine to get into your thyroid gland. That’s how
that myth got started.
For people with Hashimoto’s, generally that’s not going to be an iodine
deficiency condition. Studies time and time again have shown that the
rates of Hashimoto’s increase with iodine, so the higher rates of iodine
you have, the more likely you are to develop Hashimoto’s if you are
genetically predisposed to get that. Looking at goitrogens from the
respect of the broccoli and the cruciferous, those are not going to play a
role in Hashimoto’s. If anything, they’re going to be helpful for
detoxifications because they have a lot of great sulfur-based compounds
that help us detoxify and we talked about how detoxification is a system
that’s often impaired in Hashimoto’s.
Definitely, you can eat your broccoli, you can eat your cabbage. A small
percentage of people with Hashimoto’s, I would say less than 10, maybe
iodine deficient or may not be able to tolerate the cruciferous vegetables
in their raw state. That can be due to … Because of the iodine blocking
reasons or because they cannot just tolerate raw vegetables. In that
instance, I would recommend steaming them or fermenting them.
Fermentation process and steaming will actually reduce the iodine
clocking components of these vegetables. Yeah, that’s one of those myths
that has a little bit of truth in it, but we’ve clarified that and more people
will buy more broccoli.
Katie: Exactly. Basically, unless you have a very specifically diagnosed iodine
deficiency that you’re working on correcting, there’s no reason to avoid
them at all. You’ve mentioned the iodine thing quite a bit. One reader,
Savannah, asked, is iodine okay if you combine it with selenium properly?
Because a lot of the research, at least, that I’ve read and I’m not a doctor
obviously, but it seems to say that it’s most dangerous when it’s out of
balance with selenium. She wanted to know if you combine it with
selenium in proper ratios, is it okay? If so, how much to take of each one?
Izabella Wentz: That’s a really great question. That is a big thing in the research is
basically iodine and selenium play very well together. When you don’t
have enough of one, you can have problems with the other. Definitely, we
talked about that pathway whenever thyroid hormones are produced from
iodine and get converted and hydrogen peroxide is a byproduct of that.
That can be damaging; where selenium actually makes specific proteins
that help detoxify this hydrogen peroxide. Having enough selenium
onboard can be protective of higher doses of iodine. This can be very,
very helpful but at the same time, unfortunately, clinically, I haven’t seen
that in everybody. Some advocates of iodine will say you can take iodine
as long as you take selenium. In some cases, this can help, but not in
every case.
Katie: That makes sense. Maybe if someone suspects that they have, over the
course of their life, gotten too much iodine, they can work with their
practitioner to take selenium to see if that helps or to maybe get it from
food. I know things like Brazil nuts are supposed to be pretty high in
selenium and just see if maybe raisin g their levels hopefully does help,
but that wouldn’t necessarily mean that as long as you’re taking selenium,
it’s fine to just consume as much iodine as you want.
Izabella Wentz: Yeah, absolutely. As we talked about iodine seems to be a narrow
therapeutic index are goldilocks nutrient, when you have dosages of it too
high, that can be potentially irritating to the thyroid in Hashimoto’s.
Studies have looked at what dosages were tolerated by people with
Hashimoto’s. Up to 250 micrograms is generally going to be welltolerated. Some people may even be sensitive to that. Generally, I’ll tell women, especially of child-bearing age, that usually the amounts that are found in multivitamins or prenatal vitamins of iodine are going to be fine,
like the 150 micrograms and the multis will usually have a selenium in there as well. I get concerned when people start doing those really high dosages or iodine in the milligrams which is like a thousand times more than a microgram.
Because I’ve seen unfortunately some people who would have their TSH
go to like a hundred, their T4 go to 0, and their thyroid antibodies go in the
thousand range with the high dosages of iodine which can actually
accelerate the thyroid tissue damage. With selenium, that seems to be
something that is very, very well-tolerated by most people with
Hashimoto’s and Grave’s disease as well as women who want to prevent
post partum thyroiditis if they’re at-risk for Hashimoto’s. The dosage of
that seems to be 200 micrograms per day of selenium methionine. That’s
been the most well-studied dose. It’s been found to reduce thyroid
antibodies, reduce anxiety, and then reduce the incidence of post partum
thyroiditis and post partum thyroid abnormalities.
That’s something that I definitely recommend for people to keep in
balance and talk to their practitioners if they have any questions.
Generally, the dosages in multivitamins of iodine should be okay for many
people even with Hashimoto’s, and then with the selenium supplement, I
generally recommend doing 200 micrograms a day up to 400 micrograms
a day. You don’t want to go above 800 of the selenium because it’s also
one of those goldilocks nutrients. Anything above 800 may be toxic.
Whenever you’re working with nutrients, you want to be mindful of what
effect they’re going to have on your body and having the right balance of
them.
Katie: Yeah, absolutely. To recap everything we just talked about as far as the
positive things that can start helping, even if someone is having trouble
maybe finding a practitioner they can work with, from what you said, there
are things they can absolutely do that are in their control. Like they could
try an elimination diet with some of those triggers and see if that makes a
difference or they could look at gut health and start doing some of the
things that can help improve gut health and see if that makes a difference.
I feel like that’s such a positive step. Even someone who maybe can’t find
the medical help that they’re looking for, those are things they can start
trying in the meantime.
Izabella Wentz: Mm-hmm (affirmative). Yeah, absolutely. Making sure that they’re eating
nutrient-dense diet free of any reactive foods is one of the first steps that
people can take and start feeling much better. I also surveyed my clients
and patients and readers on what things help the most. We talked about
removing inflammatory foods works wonders so does of removing
inflammatory people. Making sure that you’re not stressed out and you’re
not spending time with people that stress you out, doing things you love,
all those things are going to be very, very helpful. As we know, stress
contributes to just about every condition, especially thyroid conditions.
Katie: Exactly.
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