Hi everyone. Thanks for joining me today on Help For Hashimoto’s. I’m so glad you are here. I’m on my spring break and have a week off. It is nice to be on my own schedule but I also seem to be much less productive. 

I had a guest on a few episodes ago who was an energy worker. Her name is Rachel Vineyard and she did an energy healing session with me that cleared up many many cords I had attached to me that were weighing me down. After she cleared and sealed them I felt so much better and lighter and happier. Now that my time is up with her and I’m on my own, I had a dream that a dark figure was trying to reattach itself to me and since that dream, I have had really low energy. I told Rachel I have a sneaking suspicion of where the dark energy was coming from and I am hopeful I can keep it from taking hold. It is so frustrating to feel good, almost normal, and then have my energy just stolen away from me again. I know some of you have this same issue. Just low energy all the time. Maybe some of it is I keep forgetting to take my afternoon dose of my medication. I had my labs done on Monday so I look forward to seeing what they are. Either way, I just keep swimming as Dori says in Finding Nemo. 

I received a question from a listener so let’s get right to it. 

Hi Stephanie,

 I hope you are well.

 Firstly I just want to let you know how much I love listening to your podcasts.  I listen to them after I drop my daughter off at school and before going to bed everyday.

 Thank you so much for the time that you put into these podcasts and for keeping it REAL!!

I first got diagnosed with Hashimoto's by my naturopath end of Jan this year after years and years of feeling crap! I have been back and forward to numerous Dr's only to tell me that everything was fine, only when i knew it wasn't.  I knew something was not right when none of my clothes fit me, I was feeling tired and exhausted all the time, I was feeling extremely anxious, getting rashes all over my body, constipated/diarrhoea and bloated all the time (to the point I look like I'm about to have triplets), body aches and pain and so the list went on.

I tried to treat it naturally with herbs and i gave it a month, but I just simply was not feeling right.  I was then told my naturopath to cut out gluten and goitrogenic vegetables and take supplements.  I was following all of this strictly, and cut out drinking on the weekends, but I was still feeling awful.  I was starting to feel so alone and lost in this journey that I felt suicidal.  I hated my puffy, chubby body, the pain I was in and this new person.

I have also suffered from candida since I was 11, to the point that I had a diatherme of the cervix, tried every anti candida diet, coconut oil-EVERYTHING YOU NAME IT!

 Now my Naturopath thinks I may have leaky gut or SIBO and wants to treat me for this.  I keep getting told by numerous health professionals that I cant be vegan with Hashimoto's but I have been eating this way for most of my adult life.  I have an extremely clean diet, don't eat the vegan junk processed foods (like people think), and prior to Hashimoto's was extremely active.  Now i just feel like this lost fish drowning in a deep sea taking Levrothyroxine which I had to force my endocronologist to give me a compounding script free without the CRAP!!

 I just feel like my head is spinning and so alone.  I don't want to give up my plant based lifestyle because I HATE MEAT.  I love vegetables, lentils and legumes. 

 Is there anyone that can help?

 (Sorry for the long email)

 Kind regards,

Lizz

I kept getting told by health coaches that I can

The short answer on whether you can be a vegan or vegetarian and have Hashimoto’s is yes but there is a few things we need to discuss. First, had anyone asked me this question even a year ago, I would have told you there is no way you can be healthy and be a vegan or a vegetarian. I have changed my mind on that by being open-minded and willing to listen to the other side. I will say, I don’t necessarily agree with any type of diet that requires supplementation because you can’t get all the nutrients you need in high enough amounts from food. This is not a philosophical episode. You believe what you want. I’m basing my opinion on science. I’m also prepared to say that for the majority of people who are vegetarian or vegan, you can have an autoimmune disease and be healthy. In fact, there is a lot of research on Rheumatoid Arthritis being helped significantly by a vegan diet.  So, there will be no dogma about this. I want to help each of you be the best you can be so here we go. 

The first study I found is called Iodine Status and Thyroid Function of Boston-Area Vegetarians and Vegans.  We know iodine is important for thyroid hormone to be made. For women of childbearing age, getting enough iodine in your diet is important too. Iodine deficiency affects around 2 billion people worldwide and is the leading cause of preventable mental retardation (Leung et al., 2011). Here in the US, we get iodine from iodized salt, dairy products, eggs, seafood, and some bread. Iodine content isn’t usually on a food label and salt restriction is associated with iodine deficiency. Vegetarians consuming dairy and eggs may be getting enough iodine but vegans can end up deficient. This study recruited vegans and vegetarians who had been on their respective diets for at least 3 months and iodine was measured in their urine along with some other metabolites affecting thyroid function such as thiocynates in soy, a chemical found in cigarette smoke, and perchlorates which is an environmental toxin. The study had 78 vegetarians and 62 vegans of mixed races and sex. 

Vegans had lower iodine status compared to the general population and vegetarians. Women of childbearing age or those who are lactating should consume 150 ug (micrograms) of iodine per day as potassium iodide. The other compounds were measured to determine if they had an effect on thyroid function in competing with thyroid hormone. It wasn’t clear if that was the case but I think likely not since vegetarians had normal iodine status and vegans were low. 

Another study looked at lower intakes of iodine and selenium between vegans and vegetarians. While these diets tend to have better food quality and they also tend to be higher in vitamins C, E, B1, folate, magnesium they tend to be lower in vitamin A, D, B12, calcium, and zinc.  You may have read something different elsewhere. I am just telling you what the study says. Studies can be wrong but the internet can also be wrong. There were 62 women in this study- 26 omnivores, 16 vegetarians, and 20 vegans. A small study, so we need to take that into consideration. There were obvious differences between omnivores and vegans such as saturated fat intake and fiber intake- no excuse on the fiber intake for omnivores. All of us should be getting about 30 grams of fiber a day. I struggle with that myself which is so stupid because I feel exponentially better when I consume a lot of veggies. Anyway, this study reports all three eating groups had sufficient intakes of vitamins A, C, E, B’s and zinc and sodium. This information was taken via a food questionnaire that was analyzed by a computer. All three eating groups were not getting enough vitamin D, potassium, or iodine. The vegan group was especially low on selenium and iodine, B12, and calcium. (Fallon et al., 2020). 

Another study called Prevalence of Hyperthyroidism According to Type of Vegetarian Diet found that those consuming a vegan diet had a lower incidence of hyperthyroidism compared to meat-eaters and semi-vegetarian diets were not protective against hyperthyroidism. Hyperthyroidism is caused most commonly by Graves Disease which is also an autoimmune thyroid condition and equally not as fun to have. I’d even say less so than Hashimoto’s because while having a hyperfunctioning thyroid can cause weight loss, which many of us would not mind, it is not the right way to lose weight, and hyperthyroidism that isn’t controlled likely leads to thyroid storm and can result in you having to purposely destroy or remove your thyroid gland. This study used a food frequency questionnaire to determine nutrients taken in which is a common way to do that in scientific studies. It has some downsides, but it is a much less expensive way to determine this outside of monitoring or providing all food eaten by study participants. The information for this study was taken from the Adventist Health Study-2. Seventh Day Adventist’s are known for consuming a vegetarian diet, and 97,000 of them participated in this study. Predictors for hyperthyroidism were being overweight, obese, and female. Most vegans and vegetarians have a lower BMI which the researchers list as a possible reason for having autoimmune disease in general. That said, I know a lot of people who are not overweight who have an autoimmune disease so not sure how accurate that statement is. 

A study called Intake and Adequacy of The Vegan Diet. A Systematic Review of The Evidence (Bakaloudi et al., 2020) found that in general vegan diets are lower in protein than all other diets, and had lower intakes of B2, Niacin/B3, B12, Vitamin D, iodine, zinc, calcium, potassium, and selenium. 

I looked at one last study called Vegan Diets and Hypothyroidism. They discuss the higher incidence of hypothyroidism as autoimmune thyroiditis aka Hashimoto’s where almost all of us have anti-thyroid antibodies, are women, and are of increased age. Again, this study discusses the lower BMI found in most vegans/vegetarians as being protective against autoimmunity. This study also combed through the data from the Adventist Health Study-2. It is interesting to me that the folks with hypothyroidism in this study were found to be more likely to use salt, had higher BMI, lower-income, and education compared to people without hypothyroidism. Their main findings were that those following a vegan diet tended to not have hypothyroidism but this finding was not statistically significant which means that there wasn’t enough of a difference between groups for it to be a big deal. 

Outside of looking at diets, it appears that many hypothyroid patients are low in Zinc compared to normal healthy people. One reason for this can be that if you have hypothyroidism, you are not absorbing zinc as well in your gut or that other areas of the body are stealing it for their use. There is also a possibility that levels are just lower in hypothyroid patients as one study found that hyperthyroid patients had higher levels of zinc. We need zinc for thyroid hormone to be made, we need it to make proteins and it helps T3 get where it needs to go. 

Selenium is needed for thyroid gland function and a bunch of other stuff in the body. Rat studies show that production of T3 is inhibited in selenium deficiency without changing how much is stored in the liver and in rats, a deficiency will present as higher T4, lower T3, and lower enzyme activity involved in thyroid hormone conversion from T4 to T3.  Low selenium also means less glutathione which is a big antioxidant in the body that can play a role in more damage to the thyroid gland. 

The bottom line is you will want to be pretty diligent in making sure you get adequate amounts of foods with these nutrients. You can look up food sources of any nutrient at world’s healthiest foods dot com or whfoods.com. Just put selenium in the search bar or whatever vitamin or mineral you are looking for and it will show you which foods are highest in those nutrients. If you don’t think you can get enough from food then you should probably supplement. 

I’m awaiting a book that can help me further understand how to help my vegetarian and vegan clients but I can share some information on how to get enough of some nutrients through food. 

Calcium recommendations for adults is 1000mg/day but if you are a woman over 50 you need 1200mg/day. Plant-based sources are navy and pinto beans, dark leafy greens, tofu, blackstrap molasses, corn tortillas, figs, almonds, fortified juice or soy milk. Soy is okay to eat- please be sure it is organic. Vitamin D will help your body absorb calcium and if you supplement, you can take calcium citrate or malate any time of day, not just with meals. If you take it between meals, it is less likely to interfere with the absorption of other minerals. 

Vegans can get enough iron but it is not as well absorbed in plants so you need to consume more iron than the RDA to make sure you get enough, around 32g/day. Legumes, dark chocolate, spinach, blackstrap molasses, seeds, or fortified cereals are good sources. Foods with vitamin C increase iron absorption and you can cook more acidic foods in cast iron. 

Zinc- RDA is 11mg/day for men and 8 mg/day for women. If deficient it can manifest as poor wound healing, hair loss, immune system dysfunction, or dermatitis. You can get zinc from legumes, whole grains, nuts and seeds, and fortified foods. It is not as bio-available in plant foods compared to animal sources. I see a lot about “well planned” diets which to me means you must be really aware of what you plan to eat say over a weeks time to ensure you get all the adequate nutrients your body needs. 

Iodine- RDA is 150 micrograms with the upper tolerable limit at 1100 micrograms which is equal to 1/2 teaspoon of iodized salt, sea vegetables, and 1/16th teaspoon of kelp. If you are deficient in iodine, then brassicas and soy can cause thyroid issues. This one is kind of Goldilocks like- you can get too little and you can get too much and it will cause thyroid problems. 

B12- this is made in the gut of animals by bacteria. Vegans should supplement with this nutrient as it is not in many plant foods. You can get some in tempeh, sea veggies, and chlorella but the amounts are inconsistent. Supplement first, then fortified foods. RDA for B12 is 2.4 mcg per day and can be checked in serum on a lab test. The normal range depending on the lab can be from around 225 to 950. You can supplement with 1000-2500mcg 2x/week to get enough. If you are deficient, the type of B12 you should consume is methylmalonic acid. Deficiency presents as weakness, fatigue, mood changes (ha- maybe I am B12 deficient) with more severe symptoms of deficiency as megaloblastic anemia and nerve damage. 

Vitamin D- get it from sunshine, fortified foods,  and supplements. RDA is 600 IU/day with the government saying the upper limit is 4000IU per day. Some studies show up to 1800 per day will improve health while over that will worsen some health outcomes. Hashimoto’s patients need to be sure this is at a level above 30 since it plays a role in immune health and helps the cells grow and mature. 

As I learn more about this, I will share it with you all. I think we just need to be mindful of what works for our situation, beliefs, and body paying special attention to what works for our body. My body feels better when I eat a lot of plants but I also enjoy eating meat so I have no plans to give that up. If you prefer only plants for whatever reason, then do that. I do believe that vegan diets do have to be well planned. It can’t be all impossible burgers and fries with pop/soda and vegan cheesecake for dessert. There are plenty of ways to eat junk food no matter what kind of diet you eat. The most important piece is to make sure you are eating real whole foods as often as possible with the majority of them being plants no matter what kind of diet you choose. 

I made a few plant-based recipes over the last couple of days from the app Deliciously Ella. I discovered her from watching the Netflix show with Zac Efron where he traveled the world talking about sustainability or something. Anyway, Ella made him a vegan curry dish that looked so delicious I wanted the recipe. It was on her app so I bought it. I think it is around $15 for the year and let me tell you it is worth every penny. She has amazing recipes and there is a wellness component so you can exercise and track food, water, and sleep. I do struggle to get enough veggies in and this app helps. I will say it is a lot of chopping of veggies but the end products are worth it and I do feel so much better when I eat a ton of vegetables so there is a trade-off. 

We sometimes are looking for shortcuts to health because they seem like they are easier and the internet makes them look really alluring. Things like fix your gut with these five steps or 3 herbs that heal your thyroid, the 3 step plan to fix your thyroid. These are all internet marketing terms and if you have been listening awhile you know you can’t fix anything in just three steps. Our bodies are machines dependent on the proper fuel to keep them running well. You didn’t end up with hashimoto’s in three short steps and you are not going to fix it in three short steps. Diet and lifestyle changes are key for long-term health. 

Thanks for listening. Please sign up for my newsletter over at outofthewoodsnutrition.com and if you would be so kind to leave a rating and review on apple podcasts I would so appreciate it. Send me your questions too. I love hearing from you guys.

Also, there is a theory about women who have lost their voice in life and the relationship it has to thyroid problems. If you have a story of losing your voice in your life- due to emotional abuse or whatever if you want to share your story with me email me at stephanie@outofthewoodsnutrition.com .  Until next time. 

References:

1. Leung, A. M., Lamar, A., He, X., Braverman, L. E., & Pearce, E. N. (2011). Iodine status and thyroid function of Boston-area vegetarians and vegans. The Journal of Clinical Endocrinology and Metabolism, 96(8), E1303–E1307.

2. Fallon, N., & Dillon, S. A. (2020). Low Intakes of Iodine and Selenium Amongst Vegan and Vegetarian Women Highlight a Potential Nutritional Vulnerability. Frontiers in Nutrition. 

3. Bakaloudi, D. R., Halloran, A., Rippin, H. L., Oikonomidou, A. C., Dardavesis, T. I., Williams, J., Wickramasinghe, K., Breda, J., & Chourdakis, M. (2020). Intake and adequacy of the vegan diet. A systematic review of the evidence. Clinical Nutrition.

4. Tonstad, S., Nathan, E., Oda, K., & Fraser, G. E. (2015). Prevalence of hyperthyroidism according to type of vegetarian diet. Public Health Nutrition, 18(8), 1482–1487.

5. Tonstad, S., Nathan, E., Oda, K., & Fraser, G. (2013). Vegan Diets and Hypothyroidism. Nutrients, 5(11), 4642–4652.