Thyroid Dietitian: Nicole Morgan, RDN, LD, CLT

Natural nutrition for the thyroid. Thyroid Registered Dietitian Nutritionist: Nicole Morgan, RDN, LD, CLT. Learn how to improve nutrition for hypothyroidism, Hashimoto's and more. Thyroid nutrition explained.

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Niacin for Thyroid Health

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Niacin aka vitamin B3 is found in many of the foods we eat today especially, meats and seafoods. Niacin is a controversial vitamin when it comes to supplementation. There is very limited research that indicates it may slightly lower thyroid hormone. But, I do not believe this to be conclusive research.

What I do know for sure is that when we get niacin in the whole food form it is crucial for promoting optimal energy and helping to fight free radicals and free radical damage. You often find niacin included in your multivitamin or B complex, and I do not consider this supplemental form to be a problem for thyroid levels.

Cholesterol, Niacin, and Thyroid

High cholesterol tends to be a problem for those with hypothyroidisim. Niacin is a popular treatment to try to reduce cholesterol. Not everyone responds to niacin supplementation and research is mixed. If your cholesterol is high and you have hypothyroidism, then the root cause is low thyroid hormones. I would not recommend using niacin to experiment in that case. Treat the root cause: the thyroid.

*This article is not a substitute for medical advice. Please see your doctor before implementing changes.

Niacin as an Antioxidant

There are a handful of experimental studies out there showing niacin as an antioxidant or at least an antioxidant “helper” for the glutathione cycle. More research is still needed to understand niacin as an antioxidant. I see it as even more reason to make sure we are eating a balanced diet and getting all the vitamins and minerals we need in balance.

Food Sources of Niacin

  • Tuna
  • Chicken
  • Turkey
  • Salmon
  • Beef
  • Sardines
  • Peanuts
  • Shrimp
  • Brown rice
  • Sweet potato
  • Sunflower seeds (I recommend sprouted seeds)
  • Green peas
  • Potato
  • Asparagus

A word of caution: Niacin should not be used for those with liver conditions, liver disease, or any other liver dysfunction.

Vitamin B2 for Thyroid Health

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Next up: Vitamin B2 aka riboflavin!

*This post is not a substitute for medical advice*

A little factoid for you all: riboflavin is what gives urine the yellow color when you take your B complex or multivitamin. In general, I do not think of ribofavin as critical for thyroid health, but it is much needed for helping out other key vitamins and minerals.

Critical Functions

Recycles glutathione. Glutathione is what I like to call the “master antioxidant” in our body. Anything we can do to make sure we have optimal levels of glutathione is key for reducing inflammation in autoimmune disease.

I generally think of riboflavin as a helper vitamin. It helps other vitamins, minerals, and antioxidants perform better in the body. Riboflavin especially helps with other vitamins and minerals that help the body produce energy like iron, folate, and B12. What are we all looking for with thyrid disease? Better energy!

Therefore, make sure you are topped off on the foods that contain vitamin B2 aka riboflavin:

  • spinach and leafy greens
  • soybeans (I do not recommend for thyroid health)
  • mushrooms
  • eggs
  • asparagus
  • milk, yogurt (if you are consuming dairy)
  • seaweed
  • turkey
  • almonds
  • sweet potato
  • sardines
  • tuna

Supplementation

There should not be a high demand for supplementation since riboflavin is present in many foods we eat every day. However, vitamin B2 or riboflavin is included in most all B complex supplements. Here is my favorite B complex of choice.

Vitamin B1: Thiamine and Thyroid Fatigue

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thiamine and thyroidNext up is B1 also known as thiamine. I am very excited to discuss thiamine and thyroid fatigue today because it can be an easy vitamin to supplement if needed! Many often think about taking B12 for energy, but those with Hashimoto’s need to look into B1 or thiamine for improving energy and reducing fatigue. Thiamine is critical for the production of energy and for the nervous system.

There are some studies out there that show great promise for the effectiveness of thiamine supplementation. However, it is not a heavily researched topic. But, I will give you all that I know!

This topic mostly relates to those with Hashimoto’s or autoimmune thyroid disease. We are not quite sure how or why, but we (healthcare professionals) think there is some sort of impairement in the process of transporting thiamine for use or an impairment using it in enzymatic processes. This mild deficiency of thiamine leads to lack of energy!

Additionally, low B1 can reduce stomach acid production. Sufficient stomach acid is needed for optimal nutrient absorption!

If your thyroid levels are coming back pretty optimal, and you are still tired, I would recommend trying out thiamine (speak with your doctor or dietitian first). If that doesn’t do the job, I would highly recommend getting your ferritin tested and even a full iron panel would be a good idea to rule that out.

There are ways to test your thiamine levels, and you can do that with with micronutrient testing through Spectracell.

Supplementation

There are two options when it comes to thiamine supplementation.

  1. BenfoMax form of thiamine which is thiamine made fat soluble so it likely absorbs much better. Pure Encapsulations sells one option for this.
  2. Thiamine HCL which is your standard traditional water soluble form of thiamine supplementation. I would choose this one if you are on a strict budget since it is much cheaper.

Best Food Sources of Thiamine

Don’t forget about food sources! These are just as important to include. Get the antioxidants as well as the nutrients!

  • Sunflower seeds are an amazing source of thiamine, but can be tricky on our digestive system. We are not meant to be able to digest a lot of seeds. So, I always recommend sprouted sunflower seeds or at least sunflower seeds in the seed butter form to improve digestion. My husband likes to use sunflower butter in smoothies!
  • Navy beans, black beans, peas, pinto beans (recommend sprouting as well)
  • Lentils
  • Lima beans
  • Oats (gluten free)
  • Asparagus
  • Flaxseed: buying in the ground form is great for adding to smoothies and baked goods
  • Sweet potato
  • Tuna

Thyroid Nutrients: Vitamin A

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These series of posts are not a substitute for medical advice. For advice and recommendations on supplementation, ask your Doctor or local Registered Dietitian.

I am a big proponent of optimizing nutrients in order to improve thyroid health. There are many small things that affect the critical conversion of T4 to T3, and nutrients can be one of them. In this series of posts, we will dig deeper into each vitamin and mineral and how it may play a part in thyroid function!

Vitamin A

The vitamin known for keeping our vision and eyes healthy. I like to call vitamin A the “vegetable vitamin” since it is present in significant amounts in most all veggies and many fruits as well. I won’t dive deep into the nitty gritty of vitamin A types and functions since that could take all week.

As it relates to thyroid health…

  • The thyroid helps convert vitamin A to a more usable form in the body. If you are hypothyroid, this proecss will not function as well.
  • A 2012 study showed a link between supplemental vitamin A ro reducing TSH and improvement of other thyroid hormones.
  • Extremely low protein diets may also contribute to vitamin A deficiency (which could then possibly reduce thyroid function). This is why I see many who lack nutrients and protein/calories have issues with high TSH and low T3, T4.
  • Vitamin A very generally reduces inflammation in the body, but specifically, in the whole food plant form.
  • Other factors that reduce vitamin A absorption or coversion: digestive issues, toxins, alcohol, excess vitamin D supplementation

A Note on Supplementation

I never recommend a vitamin A supplement since it is fat soluble and can easily build up in the body and become toxic. It is extremely easy to get loads of vitamin A from food. For example, eating just one medium carrot (not one baby carrot, but a regular size) provides 204% daily value for your day! This is much safer and healthy as well!

Foods High in Vitamin A

  • carrots
  • sweet potato
  • kale (cook to reduce goitrogens)
  • spinach
  • broccoli (cook to reduce goitrogens)
  • other leafy greens (mustard, collards, turnip greens, beet greens, swiss chard)
  • winter squash
  • romaine lettuce (yes! there is nutritional value)
  • cantaloupe
  • bell peppers

Postnatal Thyroid Nutrition

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Ipostnatal thyroidf you are reading this post, you likely have a beautiful healthy baby or are about to! Congratulations!

My sweet girl.

*This post is not intended for medical advice.*

1 Month Postnatal

First, rest, relax, and enjoy the first few postnatal new baby months.

Focus on nutrient rich foods and supplements. You just had a baby that was depending on your body for nutrients and life. This means you may be a little depleted of your nutrients such as iron, vitamin D, B vitamins, or trace minerals and nutrients. You also need those nutrients and plenty of healthy fats if you are breastfeeding!

Keep up with your prenatal multivitamin, and double check to make sure you are getting a high quality absorbable B complex (this may be contained within the multivitamin). The B vitamins can help ward off postpartum depression and maintain energy during sleepless nights. The B vitamins are also crucial for acheiving optimal iron status. If your multi does not contain B vitamins that are of high quality (aka methylated B vitamins), this is one brand by Designs for Health I often recommend.

For my first month, here is a sample of what I ate to focus on nutrients: Breakfast was either a lot of fresh fruit with natural nut butter OR gluten free oatmeal with nut butter or peanut butter powder (for protein) mixed in and topped with dried cherries. Lunch: smoothie made from frozen fruit (usually frozen cherries), organic whey protein, nut butter OR a veggie omelet. Dinner: varied, but was a lot of

my typical stuff: sweet potatoes, wild Alaskan salmon burgers, broccoli/veggies (that is just one of my easy go-to meals). For snacks, I either had a smaller smoothie, a “mug cake”, veggies/seed crackers and hummus. But, I didn’t have as many snacks the first month. And, my favorite… coffee!

Small amounts of caffeine are fine. However, baby can not truly process caffeine until around 3 months old.

2-3 Months Postnatal

At the end of month 2, headed into month 3 is when you should schedule to have a full thyroid panel done as well as a panel to test your vitamin D and ferritin (iron). 8-10 weeks postpartum is the time when the immune system should shift back to where is was before pregnancy if you have Hashimoto’s or Grave’s disease. This is also around the time when Moms may develop postnatal hypothyroidism if they previously had healthy thyroid levels prior to pregnancy. Therfore, all new Mamas should be screened for hypothyroidism and make sure to get a full thyroid panel that includes a test for free T3 and thyroid antibodies.

It is important to test vitamin D to make sure levels are optimal to promote healthy breastmilk (if you are breastfeeding). Breastmilk does not contain tons of vitamin D, but the thought is that moms who have optimal D promote better levels in baby.

As most of us know, many new moms can become anemic at the end of pregnancy or early postnatal. This is why I recommend ferritin lab testing to check iron status. Optimal iron levels are crucial for acheiving optimal thyroid levels and helping you to rely on less medication if that is your goal.

Once again, I was lucky that my postnatal thyroid labs came back healthy (I still continue to take Nature-Throid). I did not start to notice any thyroid or autoimmune related issues until about 10-12 weeks postpartum I would say. The only thing I began to notice was that the little bumps on my skin returned (autoimmune related I think) and my skin was not so pregnancy “glowy” anymore. I also noticed I became the most tired and exhausted around 5 or 6 months postpartum. I am still working to figure this out. I am almost positive it is sleep related. My hair, fortunately, has remained very thick and healthy after pregnancy. I did not experience any thinning or falling out and I am currently 7 months postpartum as I write this post.

Thinning Hair?

That brings me to my next topic that I get a lot of questions about–thinning hair. Like I mentioned, I did not stuggle with thinning hair pre or postnatal. But, I did have extremely thin hair at the onset of Hashimoto’s and when I also lost weight unintentionally about 12-13 years ago. This was likely when my immune system was likely going crazy, and I was lacking nutrients. Prior to pregnancy, during pregnancy, and postnatally is when I have enjoyed the thickest, best hair. I attribute this to my attention to increasing my nutrients and taking my high quality B complex and vitamin. I have also been working on calming my immune system, and healing for the last few years. In general, this has helped to improve my hair.

I do not recommend generic biotin or “hair supplements”. If anything, you should test your nutrient status and not just guess that is the problem. Or, maybe you need to work on healing your entire body: stress less, address nutrients, ditch gluten, eat well, relaxing exercise, sleep, optimize thyroid hormone, and more.

Breastfeeding Supply and Thyroid

If thyroid levels are not optimal, this can reduce milk supply. If you are suffering from low milk supply, first, I recommend reaching out to a lactation consultant in your area. An IBCLC will best be able to advise you. Then, if you are doing everything they have recommended, test those thyroid labs (FULL panel as always), and check for low thyroid levels.

This concludes the 3-part thyroid and all things pregnancy! I will write further posts explaining the topics that need more explanation like hair/skin/nails, supplements, lab testing, and more.

Thyroid Prenatal Nutrition

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thyroid prenatal

Part 2: Thyroid Prenatal Nutrition and Health

My previous post addressed the pre-conception time period, and this post is dedicated to all things pregnancy! Here are thoughts on thyroid health during pregnancy, and if there is anything special to be done for nutrition during pregnancy.
*This post is not a substitute for medical advice.*

Basic Nutrition

Anyone with a thyroid condition should follow all of the standard guidelines for pregnancy nutrition:

  • Limit seafood that is high in mercury like white tuna, mackerel, etc (I completely avoided because I am a little paranoid about mercury… I know). Max serving is 6 oz per week, but I prefer less.
  • 2 servings of the lowest mercury seafood per week is recommended (or, can consider DHA/EPA supplement which is what I took along with eating some wild salmon)
  • Limit caffeine (approx max of 200 mg per day)
  • Avoid unpasteurized foods as they are risks for foodborne illness
  • Avoid deli meats unless heated above 150 degrees F.
  • Monitor foods that contain Listeria by checking this website so you know what to look for and avoid. Frozen vegetables and packaged lettuce made the list last year!
  • Eat no raw fish or meat
  • Take a 400 mg folate supplement that is well absorbed aka methylfolate (NatureFolate is brand name, 5-MTHF, or methyltetrahydrofolate). I took Prenatal Pro multi that includes the right type of folate.
Little bump growing at 20 weeks.

Special Prenatal Nutrition Considerations for Hashimoto’s

  • Ditch gluten if you have Hashimoto’s or Grave’s and have not done so already. Read all about gluten and Hashimoto’s here.
  • Iron: Monitor iron (ferritin levels not just hemoglobin/hematocrit) throughout pregnancy. I recommend testing each trimester. Those with Hashimoto’s and hypothyroidism tend to run lower on iron. You may need an additional absorbable iron supplement. I used an iron bisglycinate supplement occaisonally. In addition, make sure to consume plenty of iron-rich foods such as organic red meats (if you eat meat), cooked leafy greens (especially organic spinach), some dried fruit (but, do not go overboard due to sugar), peas/pea products, sardines, poultry, sprouted seeds, sprouted beans, potato, and nuts.
  • Vitamin D: Needs are higher during pregnancy. Have your vitamin D tested during the first trimester, and supplement accordingly. If you take a higher amount of vitamin D, I recommend magnesium and vitamin K2 to balance out that vitamin D. Why vitamin D? It tends to run low in those with autoimmune conditions like Hashimoto’s. Optimal levels (50 -70) support the immune system. Lastly, the growing baby can deplete mama of vitamin D. Optimal vitamin D is also needed down the road for healthy breastmilk. Overall, this is mostly to make sure your body does not get depleted of an essential vitamin.
  • Calcium: Needs are also higher during pregnancy to help build healthy bones in baby. Calcium is often forgotten for those avoiding dairy and those with Hashimoto’s. Basically, I am saying, “don’t forget your calcium!” even if you do not consume dairy. I got a small supplement in my prenatal multi, but also consumed salmon, cooked leafy greens, white beans, and dried figs. Other non-dairy sources of calcium: almonds, oranges, cooked kale, molasses, and sardines.
  • Iodine is controversial for those with Hashimoto’s. Some experts say iodine restriction can improve the autoimmune condition, while others recommend supplementation. This is a tricky guideline for pregnancy since the growing baby needs iodine for proper development. I would never recommend iodine restriction during pregnancy. Here is what I did:

I went ahead took iodine (200 mcg) that was included in my prenatal multi, and this seems like it was a good option. 200 mcg seemed to be a good amount for me (not excessive and not too low). I never experienced any symptoms from taking the iodine.

Lab Testing is Key!

In addition to nutrition guidelines, you will also want to get a full thyroid panel each trimester. This means to make sure you get your free T4 and free T3 tested at each visit. Make sure to get a full thyroid panel done as soon as you find out you are pregnant. This can help to avoid miscarriage (by making sure you levels are in range). Get your progesterone checked at this time as well as your vitamin D and ferritin.

My Experience

My thyroid levels were really wacky the first trimester, and then looked pretty darn perfect (the best I had ever seen) during the second and third trimester. Antibody levels also dropped to the lowest I had ever seen during my pregnancy. My immune system must have shifted for the better. I was concerned about not having enough T4 in the first trimester since I was taking Nature-Throid (a T4 and T3 combination medicine), but my provider reassured me my labs were ok. Most practitioners DO NOT recommend natural dessicated thyroid medicines (the ones containing T3) during pregnancy since the baby needs much more T4. Baby does not produce their own thyroid hormone until approximately 10 weeks gestation, and relies on Mom’s thyroid hormone before then. So, I was nervous continuing to take my Nature-Throid. But, I knew if that is how my body got pregnant, I should continue to take the medicine that made it happen.

Another key is to find a provider that thoroughly understands T4 and T3 hormones.

Feel free to posts questions below! I will leave you with this fun and healthy pregnancy drink:

My healthier, lower sugar virgin pina colada during pregnancy. Frozen pineapple and frozen coconut chunks blended up!