Full Transcript Intro to Thyroid Q&A 0:00 Doesn't it seem like when it comes to nutrition, there are more opinions than 0:04 facts to go around? Every day we hear new [music] theories 0:08 about diets and supplements and best foods to eat. Well, my role is to take 0:13 the mystery out of good nutrition and look at the science. Welcome to the 0:18 NutritionFacts podcast. I'm your host, Dr. [music] Michael Greger. 0:22 Today we finish the webinar on thyroid health with answers to questions from 0:26 our webinar audience. All right, it's time for me to take questions. First 0:30 question in the queue, which is, >> [music] 0:32 >> "Please comment on the effect of cruciferous vegetables, both raw and 0:39 cooked, have on the thyroid gland. I've heard a variety of opinions regarding 0:42 cruciferous vegetables, one being they need to be cooked for a minimum of 30 0:45 minutes and not to be eaten raw when dealing with thyroid disorder. What are 0:51 your thoughts?" Um a fantastic question. So, there are these uh so-called
Cruciferous Vegetables and Thyroid Health 0:56 goitrogenic compounds found in some really healthy foods. Soy we talked 1:01 about. There's also cruciferous vegetables, also flaxseeds. Now, these 1:05 goitrogenic compounds interfere with the uptake of iodine into the thyroid gland. 1:11 And so, really only cause a problem at normal 1:16 uh doses of these foods when you have inadequate iodine intake. So, if you 1:21 have marginal iodine status and then on top of that um you're eating uh lots of 1:27 soy, cruciferous, or flaxseeds, you can run into problems. Okay, so the answer 1:30 is to not avoid these super healthy foods. The answer is to just 1:36 um make sure you have enough iodine. Um uh now, that's No, I made a little 1:43 caveat saying normal amounts of food. If you go way back, and in fact, I looked 1:48 it up um during the break here, this was uh the video on uh November 3rd, 2010, 1:56 over 10 years ago on NutritionFacts. The video was called overdosing on greens, 2:01 raw cruciferous vegetables, how much is too much? And yes, you can indeed overdo 2:08 it. Um uh so, you don't have to worry about uh cooked cruciferous vegetables 2:12 because the the goitrogenic compounds are are totally destroyed and it doesn't 2:16 take 30 minutes. Um uh but uh you can overdose on raw 2:21 cruciferous vegetables whether or not you have thyroid issues cuz everybody 2:24 needs a functional thyroid gland. Um yes, New England Journal of Medicine, 2:28 coma induced by raw bok choy. She was eating 2:34 um about 3 lb a day, the the woman in this uh uh case study, 3 lb a day, every 2:40 day, of raw bok choy, 15 cups a day. Um uh of raw cruciferous is too much. In 2:48 the 2 months before she was admitted to the intensive care unit in respiratory 2:52 failure, um she'd consumed about a thousand cups of raw bok choy. 2:58 Too much. Um now, each cruciferous vegetable is 3:02 different in terms of the amount of these compounds. And so, if you actually 3:04 go to the video I show, um you can uh probably get away with 50, 3:09 5 0, cups of raw cauliflower a day um because cauliflower has less of these 3:14 compounds. Um the the uh the cruciferous vegetable with the most is mustard 3:19 greens. And so, just three cups of mustard greens, of raw mustard greens, 3:24 may be too much. I don't know who eats raw mustard 3:27 greens. I mean, cooked mustard greens is delicious, but I don't know. But yeah, 3:30 three cups of raw mustard greens, even if you have normal thyroid function, can 3:34 raise your levels so much, interfere with even normal iodine uh levels. 3:39 And so, yes, indeed. Okay. Next question is, "Could my thyroid be the cause of 3:45 periodic night sweats, inability to stay asleep, and general lack of energy?" 3:50 Um well, what you describe is a kind of a combination 3:54 of hyperthyroidism symptoms and hypothyroidism 3:58 uh symptoms. So, probably not, right? You can't simultaneously have an 4:02 overactive and an underactive thyroid gland. So, night sweats would more like 4:05 a hyperactive hyperthyroidism, um whereas lack of energy may be more
Night Sweats, Sleep, and Energy Symptoms 4:11 hypothyroidism. Um I I I don't know who the questioner is, but it sounds like 4:15 kind of symptoms of perimenopause. Um when you start going through menopause, 4:19 you have night sweats, um insomnia, a bunch of other issues. 4:23 But so, you go to your doctor, figure out what it is. Uh okay. 4:27 Um next question. >> [clears throat and cough] 4:30 >> Is there a connection between healthy thyroid and gut health, 4:35 uh specifically bowel health? Um I think from what I saw, it's mostly 4:43 yes, but it's the other way around. It's the impact of your gut on your thyroid, 4:47 rather than the impact of your thyroid. Now, like if you have hypothyroidism, 4:50 you get constipated, I mean, it can have implications for your gut, but what's I 4:54 what I find most fascinating is how the gut can impact your thyroid. Um and so, 5:01 uh what we want to do is eat a lot of prebiotics, which is fiber, resistant 5:04 starch, found throughout the plant kingdom and all whole plant foods, but 5:08 concentrated in the drier whole plant foods, which is whole grains 5:13 and legumes, beans, split peas, chickpeas, and lentils. Those are the 5:16 most concentrated sources. And so, that's where my broil bowl comes, right?
Gut Health and the Thyroid 5:20 It's one of the myriad uses of a broil, which is this prebiotic mix to feed your 5:26 good gut bacteria and to foster the growth of the fiber-feeding bacteria 5:30 like Prevotella, which have an anti-inflammatory 5:33 effect. We feed them, they feed us right back with all sorts of wonderful things. 5:37 Um whereas if we eat um foods stripped of fiber, uh like junk foods or animal 5:42 foods, we can actually foster the growth of bad bacteria that make toxic things, 5:46 toxin metabolites like trimethylamine, etc., etc. Anyway, 5:51 so yes, there is a connection between healthy thyroid and gut health. And so, 5:56 and we're finding more and more diseases are linked to the gut, even psychiatric 6:01 uh diseases, anything having to do with inflammation because 6:05 uh the the gut microbiome can have such a uh impact on systemic inflammation. 6:10 So, keep your gut bugs happy. How do we do that? By feeding them prebiotics. 6:16 Um and not taking antibiotics unless we really need them. 6:20 Okay. Can I take black cumin alongside prescribed medications? Does it have to 6:27 be ground before eating? You can take black cumin with prescribed medications 6:31 as long as that prescribed medication isn't your thyroid replacement hormone, 6:36 right? We want to take uh uh all thyroid hormones on an empty stomach. Um but you 6:42 can otherwise take black cumin um with um with other meds. Does it have to be 6:47 ground before eating? Well, we don't know, but the study was done with 6:51 ground. So, I would do what the study says. 6:55 Uh so, so I would presume many of the benefits of a black cumin seeds are lost 7:01 if you don't grind them up. So, what do you do? You can buy pre-ground, 7:04 certainly. Um 7:06 uh and it uh or you can put it in a pepper grinder, which is what I do. I 7:10 put black cumin seeds in a pepper grinder and just grind it on your food 7:13 cuz it actually tastes tastes like pepper and it's tasty. 7:16 If you don't like the taste, uh some people don't like spicy food, some 7:19 people like bland food, you can get ground black cumin seed supplements. One
Black Cumin and Medication Use 7:24 ingredient, uh it's not an extract or anything, it's 7:28 not a black seed oil, there's a lot of supplements like that. Just pure ground 7:33 black cumin seeds. But uh try them out. I mean, it's 7:36 actually tasty. Um if you like it, then, you know, one 7:40 less pill to take. Okay. 7:44 This person had a complete bilateral thyroidectomy a dozen years ago. Any 7:48 specific advice for those who no longer have a thyroid? Um how much iodine 7:52 should those without a thyroid take? Okay. So, if you don't have a thyroid 7:56 gland, then, you know, uh suppressing the inflammation of your thyroid or 8:00 preventing the autoimmune antibodies, suppressing the autoimmune antibodies 8:05 that are attacking your thyroid glands, doesn't make any sense cuz you don't 8:08 have a thyroid to attack anymore. So, you need to be on thyroid replacement 8:11 hormone your whole whole life, like Synthroid, to just bring your levels up. 8:15 Uh many people are hesitant to take uh drugs, but don't think of it as a drug. 8:19 It's not really a drug. You're just bringing your levels up to normal. It's 8:21 not like adding some, you know, foreign substance. You're adding just normal, 8:26 regular substance that your body would normally make. It's the exact same 8:29 stuff. And you're just bringing your levels up 8:31 to up back up to normal. Um the question about iodine intake is fascinating. If 8:36 the only function of iodine in the body is to make thyroid hormones, then 8:43 um you don't need any iodine if you don't have a thyroid. Um but I actually 8:47 don't know if that's the case. That's the only thing that I know iodine does
Living Without a Thyroid 8:51 in the body is is as part of thyroid hormones. But does your body need iodine 8:55 for other things? I have no idea. Wow. Uh this so this 8:59 fascinates me when I don't know something I want to look it up. So, I 9:03 don't know the answer to that, if you need any iodine whatsoever, you don't 9:06 have a thyroid gland. Now, of course, if you got pregnant, then you do have a 9:10 thyroid gland in your uterus or developing one. So, then of course, you 9:14 need to get iodine. Okay. Um is intermittent fasting or 9:19 time-restricted eating safe for someone with Hashimoto's? Well, I don't see why 9:25 not. Um I mean, so if you have Hashimoto's and you have and you're 9:29 being treated with thyroid replacement hormone, you're just like everybody 9:32 else. Basically, you're just on this medication. I It's not really a 9:35 medication, right? You're just bringing your levels back to normal. So, you 9:38 should be able to intermittent fast or time-restricted eat like anybody else. 9:41 Of course, I would encourage people to check out my videos or read the chapter 9:46 in How Not to Diet on intermittent fasting. I talk about the pros and cons 9:49 of all the different types. There's actually downsides to many of 9:52 them. So, there benefits to the um fast fasting mimicking diet and early time 9:58 restricted feeding. Okay, that's the that's the kind of 10:03 spoiler alert there. All right. Um do I think it's possible to reverse 10:09 hypothyroidism or Hashimoto's with dietary change? Okay, well, it depends 10:13 what's causing the hypothyroidism. Now, all hypothyroidism means is underactive 10:17 thyroid gland. If it's caused by iodine deficiency, 10:23 well, then absolutely can be reversed with diet. In fact, that's the only way 10:27 to reverse I mean that's that's where you do you're not getting enough iodine 10:30 getting enough iodine poof it reverses because that was a it was a it was a 10:33 consequence of your iodine deficiency. Probably the most common cause 10:38 um hypothyroidism on the planet uh presumably that's iodine deficiency not 10:43 in the not in the industrialized world, but in the total world. 10:48 Um and so yeah, diet is the preferred treatment. Um but in terms of
Intermittent Fasting with Hashimoto's 10:53 Hashimoto's, can you reverse Hashimoto's with um dietary change alone? 10:59 And we have no data. I mean well, the paleo diet was put to the test and found 11:03 to be useless. Um there's never been a study where they 11:07 put people on plant-based diet to see if you can actually change. 11:11 Um and then there's this black human study which showed an improvement. So, I 11:17 guess you could say that's a reversal of the progression, right? It's actually 11:19 improvement in thyroid function actually start pumping out more thyroid hormone 11:23 in your body which is responding and it decreased these anti-thyroid antibodies 11:28 that were attacking your thyroid. So, in that way I guess it's reversing, but 11:31 like when you talk about reversal like so that you don't have the disease at 11:35 all anymore and your thyroid function is fine, um that we don't know. But, it's
Can Diet Reverse Hypothyroidism or Hashimoto's? 11:41 certainly um particularly because those because 11:45 Hashimoto's patients are at higher risk for heart disease, well, then you have 11:49 to be on a plant-based diet. I mean, we should be on a plant-based diet anyway 11:53 uh hopeful plant-based diet um uh to protect yourself from heart 11:56 disease. So, and try adding the black human and and report back to me and tell 12:02 me how well it works. Okay. Uh next is uh question can a 12:08 gluten-free diet help with Hashimoto's? Should gluten be um avoided uh for 12:13 people with high thyroid antibodies? Before I say 12:17 no, let me look up. Uh I'm doing quick PubMed search just to make sure. 12:22 But, the connection one here between gluten-free diets and Hashimoto's is 12:26 just a connection between different autoimmune diseases. If you have one 12:29 autoimmune disease, you are at increased likelihood of having another autoimmune 12:32 disease. So, if you have type 1 diabetes or if you have Hashimoto's or if you 12:37 have rheumatoid arthritis or lupus or um then you're 12:42 you may be at higher likelihood of having other ones including an 12:46 autoimmune disease called celiac disease. For celiac disease patients, 12:51 you absolutely have to avoid gluten. Um it's rare. It's only about 1 in 140 12:57 uh um uh people here in the states. Um but, if 13:00 you're at the less than 1% that actually has celiac disease, then you have to 13:04 avoid gluten. And so, if you have anti-thyroid antibodies, you're um 13:09 you're at higher risk um uh of having celiac disease, but it 13:13 doesn't mean um you have celiac disease. And in terms of could it help? 13:19 There was just an article published um in uh summer of uh 2019 13:24 and it found that serum titers 13:31 gluten So, a gluten-free diet for 6 months uh small group of 34 women Oh, 13:37 yeah, did not affect thyroid hormone levels. So, going on a gluten-free diet 13:40 for those without celiac disease um did not affect their um thyroid function. 13:46 So, I there's the answer to your question. 13:49 And are there any other studies that looked at it? Just I don't want to You 13:52 always got to look at all the studies done on the There's only 19 19 papers 13:57 and no it's only been put to the test once and it failed in the one time it 14:00 was put to the test. Of course, you have celiac disease, it's another question. 14:03 Um I mean and you just have to avoid gluten, but it's not because your
Gluten, Elimination Diets, and Hashimoto's 14:07 thyroid is because of your celiac. Okay. Um uh next question, what are the 14:12 chances of introducing eliminated foods back to your diet intermittently at a 14:16 later time after healing? So, this question is um 14:22 implying that an elimination diet will help with 14:26 Hashimoto's and that's not the case. Uh elimination diets are useful for if 14:31 somebody has some strange allergy or food intolerance to figure out what is 14:35 causing uh the an issue. I would not expect that to be the case 14:39 with um uh thyroid function. Okay. Uh next question, is there a 14:45 relationship between thyroid um issues and uh PCOS, polycystic ovarian 14:52 syndrome? Hmm, I don't know. Let's find out. 14:56 It says Hashimoto's may increase um polycystic ovary syndrome in Asia. This 15:02 is a 2020 study. It does look like there's an increased 15:05 risk of PCOS in those with autoimmune thyroid 15:08 disease. All right. Oh, even suggesting that PCOS 15:13 may actually be an autoimmune disease or have some autoimmune component. I'm just 15:17 trying to see um the hazard ratios here. Not huge 15:22 amount, but increased risk like uh 40%. That's significant. Um so, whatever risk 15:28 you have for polycystic ovaries, um if you have autoimmune thyroiditis, your 15:33 risk is about 40% more based on the single study published April 2020. It's 15:38 just the most recent study that's been done on it at least that's cataloged by 15:42 the largest medical library uh database um which is PubMed. Um can a person 15:48 following a plant-based diet ever completely come off thyroid medications 15:51 like levothyroxine? Um and the answer is probably no because most people with 15:57 Hashimoto's, they so fibrosed their thyroid so scarred it up cuz your body 16:02 was attacking it um that it basically loses its function. 16:06 Just like, you know, if you have type 2 diabetes, uh plant-based diet can often 16:10 reverse completely type 2 diabetes, but the good odds are only within like the
PCOS and Thyroid Autoimmunity 16:14 first 8 years you can get some really good success rates with reversing type 2 16:18 diabetes completely, but after 8 years it's still possible, but the reversal 16:23 rates go down and that's because your ability of your pancreas to secrete 16:26 insulin uh just gets so hammered after so many 16:30 years that even if you go on a good diet, um it may be kind of too late. 16:33 Your pancreas may have petered out. Well, another gland, your thyroid, can 16:37 also get so adversely affected there's just kind of 16:40 uh no going back even if you were able to decrease the inflammation, decrease 16:45 the autoimmune antibodies, it may be too late. Um but again, it's not really 16:49 thought I don't think about the thyroid medication 16:52 cuz it's not medication. It's just the actual hormone that your body makes or
Coming Off Thyroid Medication on a Plant-Based Diet 16:58 used to make, but just doesn't make enough. So, you're just bringing your 17:01 levels up. So, you're not introducing some kind of 17:04 um you know, fancy pharma drug. You're 17:07 literally just taking the same hormones, very simple hormone, simple 17:11 molecule back to the levels where it should be for optimal health which 17:15 [music] is important. Visit nutritionfacts.org/audio 17:21 to see all the podcast episodes with descriptions that include links to the 17:24 associated videos. Sources cited and other details are available on each 17:29 video's page. Information about my books, How Not to Die, How Not to Diet, 17:33 and How Not to Age is at nutritionfacts.org/books. 17:37 All proceeds of which I get are donated directly to charity. And I've got a new 17:43 book in the publication pipeline, the manuscript for How Not to Hurt 17:47 on diet and lifestyle approaches to pain management. It's been handed in and will 17:52 be published December 15th. Going to be doing a series of webinars to feature 17:57 some of the new research I discovered. Sign up for our free newsletter at 18:01 nutritionfacts.org/subscribe to stay updated on when those will be. 18:07 Nutritionfacts.org is a science-based nonprofit and everything on the website 18:11 is free. There are no ads, no corporate sponsorships, no kickbacks. We're 18:15 strictly noncommercial, not selling anything, just put up as a public 18:18 service as a labor of love, as a tribute to my grandmother 18:23 whose own life was saved with evidence-based nutrition. We just have 18:26 like a a [music] Wikipedia type nonprofit model where everything's free 18:30 and we just hope maybe, you [music] know, one in a thousand people will find 18:33 it so valuable that they'll kick in a few bucks so we can continue to churn 18:37 out new content >> [music] 18:38 >> to help you and your family be healthier. Thanks for listening.
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