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.

Guide

What’s In A Thyroid Dietitian’s Fridge?

By

I get some of my best ideas from other dietitians and nutritionists, so I thought it would be great to share some of what is in a thyroid dietitian’s fridge! However, my refrigerator is not perfect or ideal. My husband and daughter have many things that they like that take up space in my fridge. I also have various food sensitivities that are unique to me and may change my choices.

thyroid dietitian's fridge

Typical Foods in My Fridge

  • Carrots, celery, mini peppers for snacks and salads (or, other veggies I can get for snack and salads that look fresh or occaisonal farmer’s market haul)
  • Broccoli
  • Mixed greens or romaine lettuce for salads
  • Pre-made salad kits sometimes in a pinch for variety
  • Pears, apples, or other fruit in season (organic)
  • Unsweet coconut milk for smoothies
  • Cheese of some type for my daughter or I eat a small amount with a meal
  • Kerrygold butter (mostly grass fed and we can get in bulk at Costco)
  • Natural peanut butter (I can’t eat almonds, but we keep on hand for my family)
  • Avocado mayo like this
  • Eggs
  • Sometimes natural deli meat or natural sausage of some type (usually from Costco)
  • Ground flaxseed (I find adding a tablespoon to my smoothies helps my skin! I think it may have to do with helping to balance my hormones)
  • Some kind of pesto (we get the pesto from Costco) or tomato sauce to use with meats or lentil pasta (I get this from Trader Joe’s or the regular grocery store) for a quick meal
  • Cilantro: we keep extra greens and usually have extra cilantro for my 2 bunnies! They get fresh greens every morning (collard greens, red leaf lettuce, whatever lettuce we have, herbs, and they love cilantro)!
thyroid dietitian's bunnies

General Thyroid Shopping and Food Storage Tips

Try to use glass containers to store leftovers, and never keep leftovers longer than 4 days. Try not to use aluminum as we are not sure if this leaches into the food (in my food picture, my husband bought a quiche in an aluminum tray which doesn’t concern him hah). Also, try to ditch plastic in other areas in the fridge. This picture doesn’t show it, but I plan to use reusable produce bags when I go to the grocery store. Just remember to wash the produce bags periodically. You can snag some on Amazon (only $8 right now on Amazon) or even at your grocery store!

5 Quick Ways to Improve Your Thyroid Nutrition

By

I recently created this thyroid healthy checklist that highlights key areas to address to support thyroid health. However, it is a long list and may be overwhelming! One key to success is picking one thing to tackle, and do it well. Then, move on to the next habit or behavior to change. So, for this blog post, I figured I would highlight some of the most essential thyroid nutrition changes you can make to support thyroid health.

thyroid nutrition

1. Test out a gluten free lifestyle.

This blog post reviews reasoning behind going gluten free for thyroid concerns. So, if you want to learn more about why you may consider taking this on, check out that link!

Anyway, one thing we do know is that patient reports heavily state that they feel fewer symptoms and antibodies have been reduced going gluten free. Izabella Wentz surveyed 2,232 thyroid sufferers, and “88 percent of people with Hashimoto’s who became gluten free felt better“.

This is not conclusive research. However, this does give us a lot of insight on what to do nutritionally with thyroid concerns since research is lacking. One thing I do caution is to rule out Celiac disease before committing to a gluten free lifestyle, and as always, check with your Doctor or Registered Dietitian before beginning any new diet change. You can rule out Celiac disease with a negative genetic test. And, if your genetic test comes back showing you have the genes for potential for Celiac disease, then you can get a Celiac blood test panel to further investigate. Why? Going gluten free can show a false negative in a Celiac blood test panel and can prevent you from getting a correct diagnosis.

Not sure how to eat gluten free? This is what a Registered Dietitian can easily help you with for your thyroid nutrition. It can be very confusing, and if you feel overwhelmed, call in a professional. 🙂

2. Increase your nutrient dense foods.

Foods that rank extremely high in vitamins and minerals are foods like sweet potatoes, spinach (and leafy greens), carrots, berries, bananas (yes! I said banans), nuts/seeds (avoid raw nuts and seeds if you have food sensitivites or digestive concerns), fish, and the darker meats like the darker meat of chicken and turkey.

Why? Those of us with a thyroid condition often have more challenges absorbing nutrients in our digestive tract, so the increased level of nutrients from foods is very helpful. Second, the nutritious diet helps support lower stress and lower inflammation for the body which supports overall thyroid health. Last, but not least, the vitamins and minerals support the conversion of T4 to the active thyroid hormone, T3. Bingo!

A little added bonus is that nutrient dense but lower calorie foods like these can help support weight loss if that is your goal!

3. Filter your water and ditch the plastic water bottle.

I say this over and over again. Filter your water, do not use plastic water bottles, etc. The BPA or BPS in water bottles can act like an endocrine disruptor if it gets into our body. I even use a water filter that filters out BPA that is already in the water supply! How cool is that.

Now, a second reaction I often get is, “it’s too expensive”. Not true!!! My favorite water pitcher with filter is about $60, and you replace the filter every 3 to 6 months depending on usage. How much does bottle water cost? Multiply that.

These slightly more expensive filters can filter out chlorine and fluoride in addition to many other contaminants. However, if you can not afford a fluoride filter, something like a PUR filter is slightly less expensive and will at least filter out all contaminants except fluoride and chlorine.

There is more and more research coming out about how trace heavy metals, fluoride, and other contaminants can reduce thyroid hormone and affect thyroid nutrition. Chlorine also competes with iodine and can therefore affect thyroid hormone. And, my water tastes soooo much better! Filtering out chlorine almost makes the water taste sweet.

By the way, I still love using my Lifefactory glass water bottle. I have tried tons of non-plastic water bottles, and I still go back to this one. I have had this water bottle for about 6 years or longer and it is still going strong!

4. Ditch added sugar for thyroid nutrition.

I know, I know. We all know we should eat less sugar to improve health. Yes, it is inflammatory. Yes, it does not help with weight loss. Yes, it can cause issues with blood sugar, and those of us with a thyroid condition may be more sensitive with blood sugar swings.

So, how do we do this right? First, read all labels. Check for grams of added sugar on the nutrition facts label. Try to keep this as low as possible: 1 to 4 grams if possible per serving. Check everything you normally eat for about 3 days. Check salad dressing bottles, check gluten free bread labels, and anything you put in your mouth. You got this!

Now, what is the replacement or better swap? Stick to whole fresh fruits for your “sugar” fix. Also, try stevia or monk fruit in moderation in things like coffee, smoothies, gluten free oatmeal, and more.

Your future self will thank you for helping improve cravings and energy in the long run!

5. Consume alcohol and caffeine in true moderation and mindfulness.

Or, consume none at all… 😀

What does this mean? For women, consume no more than one alcoholic beverage (1 serving) per day. For men, no more than 2 servings. And, no, you can not save up! One serving equals one 12 ounce beer, one 5 ounce glass of wine, or 1.5 ounces of liquor. Got that? Now, stick to it!

This helps to support liver health and detoxification processes in the body which is crucial for thyroid health and autoimmune health. You may even need to measure the alcohol in a liquid measuring cup when you are just getting started with this.

For caffeine, I like to stick to a maximum of 16 ounces of coffee per day. This is two small 8 ounce coffees, or the equivalent of 3 ounces of espresso. For green tea, you would have to drink 4 or more 8 ounce cups of caffeinated tea to equal the caffeine in this amount of coffee.

The reason to reduce caffeine or drink in moderation is to support optimal adrenal health and improve the body’s stress response. This, then supports thyroid health!

I hope you have found these little thyroid nutrition tips and tricks helpful. Do you have anything nutrition techniques that have worked for you?

*This blog post is not a substitute for nutrition counseling.

Hashimoto’s Diet: Learn the Basics

By

The most common question I get asked is, “what should I eat?” for a Hashimoto’s Diet. First, if you are looking for clearer, more in-depth information, I would recommend listening and participating in my workshop here!

I never have a clear, exact answer since each person is so unique and has a completely different medical and social history. It takes me a good hour long session with someone to understand their background and be able to give clear and specific recommendations. However, there are a few key foods or food groups that are more likely to help or hinder the thyroid condition.

Hashimoto's Diet
Hashimoto’s Diet

Next, what I am about to describe are generalities and should not be thought of as a diet therapy. The foods mentioned below are the foods that we currently have the most research on regarding autoimmune nutrition and thyroid nutrition. Always check with your own healthcare provider before beginning a new plan.

Foods I Avoid

Soy

Research explains that soy may interfere with thyroid hormone, and overall be likely to cause lower T3 levels in those who consume soy consistently. I generally avoid soy protein fortified foods, processed fake “meat” soy products, edamame, and tofu. In addition, soy is a food that may carry much higher levels of pesticide residues which may impact thyroid health.

Gluten

This a controversial topic. Some practitioners theorize that gluten appears similar to thyroid tissue, and the body may falsely recognize it as thyroid tissue and increase the autoimmune attack. For some, gluten may be a food that generally causes inflammation as it is a common food allergen. Other research and health experts argue that gluten deteriorates the health of the intestinal tract, and avoiding it may help improve the health of the intestinal tract, and therefore, improve an autoimmine condition. In addition, a small percentage of people who have Hashimoto’s may also have Celiac disease. So, I recommend Celiac testing before going 100% gluten free to rule this out. I highly recommend this article and video about Dr. Fasano’s point of view on gluten to learn more on the topic. Here is an article on gluten and Hashimoto’s.

I continue to avoid gluten, and it has taken my body a long time to heal after 25+ years of gluten ingestion.

What do I often tell my clients? At the least, trial a gluten free diet for 30 days. Journal and record symptoms and what you eat. Ideally, do this under the care of a Registered Dietitian who can help guide you with this. The majority of my clients report they feel significantly better and do not want to go back to eating gluten.

Added Sugar

I strive to avoid added sugar daily. I make conscious decisions. Why? Because excess sugar leads to excess inflammation. Limiting excess sugars can help promote better blood sugar balance and more optimal insulin levels which promotes longevity and lessens inflammation as well. This also helps to manage cravings and supports a healthier intestinal tract!

What counts as added sugar? Check food labels for one of these: cane sugar, anything with the word “syrup” like corn syrup and brown rice syrup, honey, maple syrup, brown sugar, agave. I continue to stevia to sweeten a few things here and there like a smoothie or a recipe.

Millet

Research has shown that millet, a type of gluten free grain, lowers thyroid hormone. Millet also does not contain much nutrition.

Foods to Use Caution With

Dairy

This is a common food allergen and/or intolerance for many people in the general population. Some have sensitivities, in particular, to the casein protein in dairy (dairy is made up of casein and whey protein). Others have lactose intolerance to some degree which can cause issues with digestions and nausea. Do you feel you are sensitive? You can get tested with MRT LEAP, or keep a food symptom journal as you eat to see if you notice a trend of increased symptoms with dairy consumption.

Many functional medicine practitioners recommend avoiding dairy for autoimmune thyroid conditions, however, I am on the fence. I do not believe that it is a must avoid. I believe it should be avoided on a case by case basis. Why? I know that I am able to tolerate dairy and still feel my best. However, I do not eat excessive amounts. And, I recommend the same for many of my clients: maximum of 2-3 servings of dairy per day, and choose high quality dairy from grass fed animals and organic varieties.

Less than 4 cups of raw cruciferous veggies daily

There is anectdotal research that more than 4 cups of raw cruciferous veggies may impact the thyroid enough to cause thyroid enlargement due to goitrogens. And, if we cook cruciferous veggies, the goitrogens are reduced. Cruciferous vegetables include brussels sprouts, kale, broccoli, cauliflower, and bok choy, for example. That being said, I highly recommend eating these veggies since they contain many amazing health benefits, but not overdoing it on the raw form.

Nuts and Seeds

The main issue here is that I find nuts and seeds can be a common allergen or food sensitivity. Or, they can be difficult to digest for those with more severe bowel disease. However, they provide excellent nutrients and excellent healthy fats and should not be avoided if there is no allergy issue. I did not discover I was extremely sensitive to almonds until I was tested! So, this is one area where you may want to test and not guess.

Foods to Eat More of

Sweet Potatoes

These days it seems everyone is on a form of a low carb diet. However, this is one starchy veggie not to skimp on as it contains loads of vitamins, minerals, great fiber, and phytochemicals that are all healthy for thyroid support. One neat fact about the sweet potato is that is is less likely to raise blood sugar as much as other refined carbohydrates like white rice!

Carrots are another excellent food to include as vitamin A in this food form may help improve thyroid levels!

Spinach

Especially organic varieties… Spinach is not a goitrogen, and contains loads of nutrients like iron which I find many women with thyroid conditions may run a little low on. This leafy green is easy to eat in salad form, cooked as a side with garlic and olive oil, and tossed into a smoothie for added nutrients.

Pineapple

Pineapple contains bromelain which is a nice enzyme that aids in digestion in our stomachs. Those of us with autoimmune thyroid conditions can get all the help we need for our digestion! Last but not least, pineapple adds a nice sweetness to meals when we are avoiding the added forms of sugars as well!

High Quality Proteins

Next, proteins like non-processed chicken (pasture raised is ideal), turkey, grass fed beef in moderation, eggs (if not sensitive), low mercury fish like salmon, and plant proteins (quinoa, sprouted legumes) provide excellent vitamins and amino acids to support thyroid funtion and to help maintain nice lean muscle mass to support optimal health. A Registered Dietitian can also help give you specific recommendations on how much protein you need in a day.

Thus, there are many more foods that I encourage eating, but it depends on the individual and their health history.

Avoid Extreme Low Carb Diets

You can read more about this here, on another blog post that I wrote about avoiding the extreme low carb.

Conclusion

In conclusion, this is not the end of the list or a complete guide for how to eat. However, I hope that is gives you are starting point for where to look next in your quest for optimal eating and optimal health!

References:

  • Gaitan E, Lindsay RH, Reichert RD, et al. Antithyroid and Goitrogenic Effects of Millet: Role of C-Glycosylflavones. J Clin Endocrinol Metab. 1989;68(4):707-714. doi:10.1210/jcem-68-4-707
  • Farhangi MA, Keshavarz SA, Eshraghian M, Ostadrahimi A, Saboor-Yaraghi AA. The effect of vitamin A supplementation on thyroid function in premenopausal women. J Am Coll Nutr. 2012;31(4):268-274.
  • Mori, K. Does the gut microbiota Trigger Hashimoto’s Disease? Discovery Magazine, November 2012
  • The Immunology of Immediate and Delayed Hypersensitivity to Gluten  – European Journal of Inflammation Vol 6 No. 1 1-10 (2008) Editorial – A. Vojdani Beverly Hills, CA (now Los Angeles, CA) T. O’Bryan, Warrenville, IL,( now Chicago, Il), G. H. Kellermann Neuroscience, WI, USA
  • The Immunology of Gluten Sensitivity Beyond the Intestinal Tract – European Journal of Inflammation Vol 6 No 2, 0-0 (2008) Aristo Vojdani, PH.D, M.T., Thomas O’Bryan, D.C., CCN, DACBN
  • Fasano A. Leaky Gut and autoimmune disease. Clin Rev Allergy Immunol. 2012 Feb;42(1):71-8.
  • Ulluwishewa, et.al. Regulation of Tight Junction Permeability by Intestinal Bacteria and Dietary Components. The Journal of Nutrition. March 23, 2011

The Non-Keto Diet

By

The keto diet is all the rage these days. It’s a low carb diet, but in a new, hip, cool way. I am not here to bash the keto diet, but rather explain a modified non-keto diet approach.

Non-Keto Diet

One thing to note is that ketosis may not be helpful for those at a lower body weight who do not have enugh body fat to mobilize to successfully follow a keto diet. It has been hypothesized that those with a BMI below 20.0 may not benefit as much.

Keto Diet and Hypothyroidism

A second group of people who may not benefit from a keto diet are those with hypothyroidism. Why?! Research hints that a diet that overly restricts carbohydrates (in a starvation type of diet or very low carbohydrate diet for an extended period of time) will reduce thyroid hormones.

However, it depends on the individual. Nutrition should be and can be 100% customized to the individual.

So, how do we make a compromise and work towards a diet that is healthier for hypothyroidism? Bump up the carbodyrates a little bit, and lower the fat a little bit. Trust me, your liver will thank you! The liver plays a role in processing fats, and we are finding that those with a higher fat intake from a keto diet, are testing high for liver enzyme tests. There has already been some research on this topic. Extreme high fat intake even when including some healthy fats, it not 100% the healthiest plan.

Thus, I am a big proponent of eating fatty fish, good quality olive oil, nuts and seeds, and avocados many days of the week. However, at some point, it could be too much.

The keto diet heavily focuses on fats as a main source for fuel in the diet. A healthier keto diet relies on vegetables as the base, then the healthy fats like an salad with olive oil and avocado. To improve upon this diet for hypothyroidism, I would add a little healthy carbohydrate like fresh fruits, sweet potato, and butternut squash, for example. This helps to add more fiber to the diet, more variety, more vitamins and minerals which support the thyroid, and more carbohydrate to fuel the thyroid as well!

Macronutrients

So, what macronutrient breakdown do I recommend for hypothyroidism? First, check with your doctor or dietitian before implementing a new nutrition or eating plan for yourself. This is only meant to create a talking point with your own healthcare professional.

30-40% Carbohydrate

20-25% Protein

30-40% Fat

Again, everyone is different. Your genetic makeup is different. Your medical history and preferences are different. This is why nutrition is 100% different and customizable, and not everyone should be on a keto diet. In conclusion, I highly recommend speaking with a Registered Dietitian to determine what will make the most sense for your life.

Optimal Thyroid Lab Values

By

This blog post is not intended to treat or diagnose any condition. Please see your doctor for all recommendations on lab test results.

Did you know that the lab test “normal” ranges vary from state to state and across all countries? Did you also know that the “normal” ranges are not optimal thyroid lab ranges? A normal range means a “not sick” range or a range that may not require immediate medical intervention (please refer to your doctor on this, however).

Do you want to live in optimal health, or just ok, average, not-so-sick health?

In my own personal experience and professional practice, I have seen many patients still suffering from symptoms even when their lab tests are within the normal ranges. But, if you look at a person’s lab test values and check to see if they fall into optimal ranges, you may discover they complain of more symptoms when they are outside the “optimal” ranges, yet still within “normal”.

So, what do I look for? …you may be asking.

optimal thyroid lab
My Thyroid Labs
  • TSH: 0.45-2.0 uIU/mL
  • Free T4: 1.0-1.5 ng/dL
  • Free T3: 3.3-4.2 pg/mL
  • Reverse T3: < 10:1 ratio Reverse T3:Free T3. For help calculating this, visit this website or ask your doctor.
  • TPO Antibodies (also check TgAb if possible): < 15 IU/ml (This is controversial as some believe the levels should be even less than this, yet there are some who may still have Hashimoto’s but have very low antibodies. If your levels are <15, please review with a functional medicine doctor or consider a second opinion. You may also then want to test TgAb and TSI).

These numbers are averaged levels recommended by various functional medicine practitioners and research below. There is not enough research to conclude specific guidelines for free T3 and free T4 labs, so much of what we understand and based on the clinical practice of functional medicine doctors. 

If you fall outside of optimal ranges, this does not necessarily mean you require treatment–check with your doctor. Improving diet and lifestyle habits may be key!

Again, please make sure to review your lab results with your doctor, or consider a second opinion from another healthcare provider that you trust. Visit my resources page for more information on finding a healthcare provider. It is important to be your own advocate for your health. Always make sure to get a copy of your labwork, and if a provider tells you everything is “normal”, ask questions and look into optimal ranges. If you are feeling symptoms, seek out help for reducing those symptoms! Be your own health detective.

References:
Carter JN, Corcoran JM, Eastman CJ, Lazarus L. EFFECT OF SEVERE, CHRONIC ILLNESS ON THYROID FUNCTION. The Lancet. 1974;304(7887):971-974. doi:10.1016/S0140-6736(74)92070-4

Garber JR, Cobin RH, Gharib H, et al. CLINICAL PRACTICE GUIDELINES FOR HYPOTHYROIDISM IN ADULTS: COSPONSORED BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND THE AMERICAN THYROID ASSOCIATION. :41.

Iervasi G, Pingitore A, Landi P, et al. Low-T3 Syndrome: A Strong Prognostic Predictor of Death in Patients With Heart Disease. Circulation. 2003;107(5):708-713. doi:10.1161/01.CIR.0000048124.64204.3F

Wartofsky L, Dickey RA. The Evidence for a Narrower Thyrotropin Reference Range Is Compelling. J Clin Endocrinol Metab. 2005;90(9):5483-5488. doi:10.1210/jc.2005-0455

Top 5 Healthiest Sugars

By

Healthiest and sugar should not be two words used in the same sentence! But, I like a little something sweet from time to time, and want to choose something that is going to be a healthier option for me. I have made a little list of my top 5 healthiest sugars. I get questions about these all the time, and am excited to help you feel better about a little sweet indulgence. 😉

Top 5 Healthiest Sugars

  1. Date Sugar: This is my favorite choice. Date sugar is just dates that have been pulverized into a dry powdery sugar. Date sugar still contains fiber and vitamins and minerals. It is also less sweet than other sugar sources: about 2.7 g sugar for date sugar instead of 5 g sugar for table sugar. Date sugar can be expensive for a sugar source, but I suppose the point is not to use too much! Can be found on Amazon here or at health food stores.
  2. Organic, Pesticide-free Honey. Not all honey is created equally. About 75% or more of the honey we consume is loaded with pesticides!! Yikes. Pesticides can disrupt hormone function. My go-to honey is an organic one from Heavenly Organics. I also like the Wholesome Sweetener’s honey. Both are pesticide free and you can find at many local grocery stores. You have to double check and do a little research to make sure it is pesticide free. Honey contains antibacterial properties, antioxidants, and perhaps some immune boosting properties which is why I rank it number two!
  3. healthiest sugarsMaple Syrup: this is one of my favorite tasting sweeteners. It makes my list for its higher vitamin and mineral content like zinc and manganese. I prefer to choose organic maple syrup as well to help reduce pesticide exposure once again.
  4. Stevia: OK, so this is not really sugar. But, stevia is a natural sweetener and often used to take the place of sugar. Stevia is not an artificial sweetener, and does not promote the growth of bad bacteria in the intestinal tract like artificial sweeteners do. The main thing you want to watch for here is additives in the brand of stevia you buy. Check first to make sure it is labeled gluten free (most are). Next, check the ingredient list to see what else may be blended with the stevia (often done to reduce bitterness). Avoid anything you don’t know the name of as a good general rule of thumb. You will often see dextrose added. Dextrose is most commonly corn which is fine, but I prefer it organic. I tend to buy store brand stevia and organic when I can. The best thing about stevia is that there are no grams of sugar involved!! I love adding it to smoothies when needed, “mug cakes”, recipes to reduce sugar, and sweet potatoes when I want them sweet.
  5. Coconut Sugar: First, don’t believe all the hype you may read about coconut sugar. It is STILL sugar. However, coconut sugar has a slightly lower glycemic index, and slightly less fructose than table sugar. And, it is natural! All this means is that coconut sugar will absorb a little bit more slowly and be a tad bit healthier. I would not go around loading up on this sweetener. But, it can be a nice, more natural option for dessert recipes.

If you would like to know even more about any of these sweeteners, let me know and I can do a whole blog post about one individual one. This post is just to give a quick run-through to help you select something healthier!

Amazon affiliate links may be used, but all opinions are my honest words. I earn a very small percentage when you use the link and it supports the blog!