Best Diet for Hypothyroidism: Foods to Eat, Foods to Avoid

What is hypothyroidism?

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 impact nearly every organ system in your body (3).

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 (2).

In hypothyroidism, the thyroid gland doesn’t release sufficient thyroid hormones, even when there is plenty of TSH (1).

Chronic autoimmune thyroiditis (Hashimoto’s thyroiditis), an autoimmune disease in which your immune system mistakenly attacks your thyroid gland, is the most common cause of hypothyroidism in iodine-sufficient areas of the world like the US (4).

Other causes of primary hypothyroidism are iodine deficiency, taking certain medications, thyroid surgeries, acute thyroid inflammation, and medical treatments that damage the thyroid (1).

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 causes a variety of symptoms, from extreme fatigue to constipation. Some people with hypothyroidism experience extreme symptoms while others don’t experience many symptoms at all.

Your healthcare provider 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 (1).

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

For example, people with Hashimoto’s disease 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 seek alternative treatment methods (5).

Research shows that, in addition to medication, dietary and lifestyle modification 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 like weight gain, cold intolerance, and constipation. Hypothyroidism is usually treated with thyroid hormone replacement medications, but some people with hypothyroidism still experience symptoms even when their thyroid function is considered normal.

Can certain diets help people with hypothyroidism?

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 disease is the most common cause of hypothyroidism in the US. It’s an autoimmune disease that leads to the gradual destruction of thyroid tissue by white blood cells called lymphocytes (4).

Hashimoto’s disease is more common in women and older adults, though men and younger people can develop Hashimoto’s disease, too (6).

Many studies have shown that dietary changes can benefit people with Hashimoto’s disease in a number of ways including 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 disease (7, 8).

For example, gluten free diets may help improve thyroid function while diets high in vegetables and fruits could protect against cellular damage and promote healthy body weight maintenance in people with Hashimoto’s disease (10, 11).

Additionally, some studies suggest that elimination diets, like a modified paleo diet that cuts out foods like grains and dairy, could help reduce symptoms like fatigue and improve quality of life in those with Hashimoto’s disease (5).

Following a nutritious, calorie-controlled diet can also help promote weight loss, which is something that people with hypothyroidism commonly struggle with (12).

What’s more, deficiencies in nutrients like vitamin D, zinc, thiamine, B6, iodine, magnesium, and selenium can exacerbate hypothyroid symptoms like fatigue, anxiety, and low mood, so it’s essential to make sure your diet is well-rounded and provides optimal amounts of both macronutrients and micronutrients (7).

In-general, a diet rich in nutritious foods and low in pro-inflammatory foods like added sugar and ultra-processed foods can be helpful for most everyone 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.

Which nutrients are important for those with hypothyroidism?

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 to the general population.

Iodine

Iodine is an essential mineral that is needed to make thyroid hormones and a deficiency in this nutrient can lead to hypothyroidism. In fact, insufficient iodine intake is the most common cause of hypothyroidism worldwide (1).

Even though iodine deficiency is common in many areas of the world, it’s less common in developed countries like the United States. However, people who don’t use iodized salt, pregnant women, and people following vegan diets are more at risk for developing low iodine levels (13).

If you have hypothyroidism, you should not supplement with iodine unless it’s recommended by your healthcare provider to treat low iodine levels. Taking in excessive amounts of iodine is harmful for the thyroid can even cause hyperthyroidism in people living in iodine abundant areas, like many parts of the USA (14).

If you’re concerned that you’re not taking in enough iodine, contact your healthcare professional 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. It’s needed for thyroid hormone production and also helps protect the thyroid from damage caused by oxidative stress (15).

Adding selenium-rich foods to your diet is a great way to boost your selenium levels. This includes Brazil nuts, tuna, sardines, eggs, and legumes.

Additionally, selenium supplements can be helpful for certain people with hypothyroidism. For example, supplementing with 200 mcg of selenium per day has been shown to decrease thyroid antibodies and improve certain symptoms like low mood in people with Hashimoto’s (16, 17).

However, this doesn’t mean that selenium supplements are necessary for all people with hypothyroidism. Only supplement with selenium if recommended by your healthcare provider.

The Institute of Medicine 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 (18).

Acute selenium toxicity can cause serious effects like kidney failure, heart attack, breathing problems and sometimes death (18).

Zinc

Like selenium, zinc is needed for thyroid hormone production and thyroid function (19).

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

Some studies show that zinc supplements could be helpful for those with hypothyroidism. When used alone or when combined with other nutrients like selenium and vitamin A, zinc supplements may help improve thyroid function in those with hypothyroidism (20, 21).

If you’re interested in taking a zinc supplement, talk to your healthcare provider. They can determine whether or not a zinc supplement may be appropriate.

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 impact thyroid function and worsen hypothyroid symptoms. Because vitamin D isn’t concentrated in many foods, supplementation is often necessary (22, 23).
• B12: B12 deficiency is common amongst people with hypothyroidism. Talk to your doctor about testing your B12 levels. If your levels are low or suboptimal, they can recommend a B12 or B-complex supplement (24, 25).
• Magnesium: Low or deficient magnesium levels are associate with thyroid dysfunction and can increase the risk of developing hypothyroidism. Supplementing with magnesium has been shown to improve hypothyroid symptoms (21, 26, 27, 28).
• Iron: Low iron levels or iron deficiency anemia can impair thyroid function. Unfortunately, iron deficiency is common in women with hypothyroidism. Iron supplementation is often necessary to reach and maintain healthy iron levels (29, 30).

These are just some of the many nutrients that are important for thyroid function and general health. Vitamin A, vitamin C, calcium, and proteins are examples of other nutrients important for those with hypothyroidism (31).

Summary

A number of vitamins and minerals are necessary for healthy thyroid function. People with hypothyroidism are more likely to be deficient in several nutrients and supplementing with certain vitamins and minerals could help improve thyroid function and hypothyroid symptoms. However, it’s recommended to talk to your healthcare provider before starting any new supplement.

Foods to limit and avoid

Fortunately, you don’t have to avoid many foods if you have hypothyroidism.

However, 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. Studies suggests that people with Hashimoto’s disease may benefit from following a gluten-free diet, though researchers still aren’t sure whether a gluten-free diet is necessary for everyone with Hashimoto’s (10, 11, 32).

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

For example, people with Hashimoto’s disease have been shown to have increased markers of inflammation and oxidative stress. Oxidative stress is a condition characterized by an excess of reactive compounds called free radicals in the body, which overwhelms the body’s antioxidant defenses and can lead to cellular damage (33, 34, 35, 36).

For this reason, it’s a good idea for people with hypothyroidism to avoid foods that may contribute to oxidative stress and inflammation such as ultra-processed foods, foods and beverages high in added sugar, and fried foods (37, 38, 39, 40).

In addition to contributing to oxidative stress, a diet high in these foods is linked to overweight and obesity, so cutting back on these products could also help you maintain a healthy body weight (41).

Goitrogens

You may have heard that people with thyroid conditions should avoid foods containing goitrogens – substances found in foods like cruciferous vegetables and soy products that may interfere with thyroid hormone production (42).

While goitrogens can impact thyroid function, most people, including people with hypothyroidism, can enjoy moderate amounts of goitrogen containing foods like cabbage, broccoli, and kale without negatively impacting their thyroid health.

Cruciferous vegetables like kale and broccoli are actually quite low in goitrogens. Plus, cooking goitrogen containing foods reduces goitrogenic activity, making them safer for people with hypothyroidism (43).

That being said, it’s a good idea to avoid eating large amounts of raw cruciferous vegetables like cabbage, Russian kale, bok choy, and Brussels sprouts as well as large amounts of juice made with raw cruciferous vegetables. Other goitrogenic foods include soy and pearl millet.

In general, people with hypothyroidism should avoid eating large amounts of any goitrogenic foods (44).

Diet and thyroid medication

You’ll want to make sure you’re taking your thyroid medication on an empty stomach to promote optimal absorption. Experts suggest taking thyroid medications like levothyroxine at least 30 to 60 minutes before breakfast or at least 3 to 4 hours after dinner (45).

Keep in mind that this includes avoiding beverages, foods, and supplements that could interfere with medication absorption.

Certain supplements and even coffee can significantly impact 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. You should also avoiding taking thyroid medication within 4 hours of taking iron or calcium supplements (45, 46).

Summary

People with hypothyroidism don’t have to avoid many foods. However, people with Hashimoto’s disease may benefit from a gluten-free diet. People with hypothyroidism should avoid consuming large amounts of goitrogenic foods and limit ultra-processed foods in order to promote overall health.

Foods to eat

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 like heart disease, obesity, and type 2 diabetes (47, 48, 49).

A diet high in fiber can also help lower the risk of constipation, which is a common symptom of hypothyroidism (1).

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

• Non-starchy vegetables: Greens, artichokes, zucchini, asparagus, carrots, peppers, spinach, mushrooms, etc.
• Fruits: Berries, apples, peaches, pears, grapes, citrus fruits, pineapple, bananas, etc.
• Starchy vegetables: Sweet potatoes, potatoes, peas, butternut squash, etc.
• Fish, eggs, meat, and poultry: Fish and shellfish, eggs, turkey, chicken, etc.
• Healthy fats: Olive oil, avocados, avocado oil, coconut oil, unsweetened coconut, full-fat yogurt, etc.
• Gluten-free grains: Brown rice, rolled oats, quinoa, brown rice pasta, etc.
• Seeds, nuts and nut butters: Almonds, cashews, macadamia nuts, pumpkin seeds, natural peanut butter, etc.
• Beans and lentils: Chickpeas, kidney beans, lentils, etc.
• Dairy and non-dairy substitutes: Coconut milk, cashew milk, coconut yogurt, almond milk, unsweetened yogurt, cheese, etc.
• Spices, herbs and condiments: Fresh and dried herbs like basil and rosemary, spices like paprika, saffron, and turmeric, and healthy condiments salsa and mustard.
• Beverages: Water, unsweetened tea, coffee, sparkling water, etc.

Keep in mind that some people with hypothyroidism may benefit from avoiding gluten and other ingredients like dairy, but others may not have to cut these foods from their diet and may be able to consume gluten and dairy without 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 may need to be eliminated and help develop a balanced eating plan that does not 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.

Sample meal plan

Remember, everyone with hypothyroidism has different health and dietary needs. Your calorie needs depend on a number of factors including your age, activity level, gender, height, and whether you’re trying to lose or gain weight.

That being said, 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 omelette served with a half 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

• Breakfast: chia pudding with almond butter and berries
• Lunch: grilled salmon salad
• Dinner: fish baked with lemon, thyme, and black pepper served with roasted vegetable and a baked potato

Wednesday

• Breakfast: egg and veggie muffins with a side of fruit
• Lunch: Mediterranean quinoa salad with chickpeas, vegetables, and feta
• Dinner: shrimp skewers and a salad

Thursday

• Breakfast: spinach, chickpea, and sweet potato breakfast hash
• Lunch: chicken salad with fresh veggies and fruit
• Dinner: butternut squash and lentil curry

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

• Breakfast: egg, mushroom, and zucchini frittata
• Lunch: Mediterranean tuna and quinoa salad
• Dinner: Brown rice pasta with chunky pasta sauce and chicken meatballs

Sunday

• Breakfast: Blueberry protein pancakes
• Lunch: fish taco bowls
• Dinner: sweet potato turkey chili

Summary

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

The bottom line

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.

Fortunately, eating the right nutrients and taking medications can help reduce your symptoms, improve your thyroid function, and promote overall wellbeing.

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