Six nutrients for hyperthyroidism

Hyperthyroidism occurs when the thyroid is unnecessarily producing and secreting thyroid hormones in excess despite the pituitary gland sending it signals telling it not to. In return we are left with a myriad if signs and symptoms such as weight loss, increased appetite, irregular periods, insomnia, diarrhoea, increased sweating, heat intolerance, heart palpitations and so many more! The main cause of hyperthyroidism is from an autoimmune condition called Graves’ disease. I’ve listed six beneficial nutrients and their food sources below that can help to alleviate symptoms of hyperthyroidism and may help to reverse Graves’ disease.

1. L-carnitine

Not only does hyperthyroidism deplete L-carnitine but it can also block circulating T3 from binding to the receptors. 2-4g per day of L-carnitine successfully reversed and prevented symptoms of hyperthyroidism in a small sample size over a 6-month period [1]. Interestingly, another study noted 500mg combined with 83mcg of selenium had similar results over a 1-month period [2]. L-carnitine is highest in red meat followed by pork, fish, chicken, cheese and avocado [3].

2. Resveratrol

Resveratrol is a powerful antioxidant that scavenges free radicals which occur in thyroid disease such as Graves' disease from an increased production of hydrogen peroxide and reactive oxygen species. It has also been shown to regulate TSH due to its iodine trapping effects [3]. A higher dose is often needed and therefore may be better off coming from a supplement rather than food. However, food sources are still going to be beneficial!! You can find resveratrol in red grapes (skin on, I know that there's grape peelers out there), cranberries, blueberries and dark chocolate [4].

3. Isoflavones

Isoflavones have been shown to slightly raise TSH levels which are either very low or undetectable in hyperthyroidism or Graves' disease. Research suggests that isoflavones may reduce thyroid peroxidase activity, an enzyme involved in the synthesis of thyroid hormones (meaning resveratrol can reduce overproduction of thyroid hormones) [5]. Isoflavones are found in soy products such as tofu and are generally higher in fermented soy products such as tempeh. Aim to consume 100g per day which equates to approximately 30mg of isoflavones!

4. Selenium

Selenium is a powerful antioxidant used in Graves’ disease to modulate the immune system, specifically Th and Treg cells. Wichman et al [6] concluded a reduction in thyroid antibodies in participants taking selenium! A correlation also exists between newly diagnosed Graves’ disease and low concentrations of selenium [7]. Interestingly, Wang et al. [8] concluded selenium can enhance the efficacy of antithyroid medications meaning that patients who are not reaching remission from antithyroid medications alone could combine it with selenium to achieve a greater effect. This should be discussed with your healthcare practitioner before taking selenium.

Think selenium could benefit you? Hold up! Selenium has a very narrow therapeutic index meaning you only need a small amount to make a big difference. It's best to seek advice from your healthcare practitioner before supplementing. You can find selenium in Brazil nuts, chicken liver, tuna, couscous, herring, salmon and turkey.

5. Brassica vegetables

Also known as cruciferous vegetables! These veges contain glucosinolates which compete with iodine uptake by the thyroid and the less iodine available, the less thyroid hormones we make [9]. This leads to a reduction in thyroid hormones within the body and therefore symptoms of hyperthyroidism and Graves’ disease. It's best to blanch these vegetables as cooking can degrade the glucosinolates. Brassica veges include brocolli, broccolini, brussel sprouts, cabbage, cauliflowers, kale and horseradish.

6. Quercetin

Quercetin not only inhibits thyroid peroxidase enzymes which are needed to convert thyroid hormones to their active form (T3), but it also inhibits iodine uptake by the thyroid due to downregulation of sodium/iodide symporters [10]. Again, this will reduce the production of thyroid hormones. Quercetin is also a powerful anti-inflammatory and antioxidant making it perfect for those suffering from Grave’s disease [11]. You can find quercetin in onions, asparagus, apples, blackcurrants, cranberries, buckwheat, garlic and rooibos tea.

And there you have it; six nutrients with their food sources so that you can start incorporating them into your daily diet! As always, please consult your healthcare practitioner before supplementing with any of the nutrients listed above to determine whether they are suitable for you. Food forms are always the safest option and hey, they are packed full of synergistic nutrients!

Yours in health and happiness,

Ebony x

References:

[1] Benvenga, S., Ruggeri, R. M., Russo, A., Lapa, D., Campenni, A., & Trimarchi, F. (2001) Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: A randomized, double-blind, placebo-controlled clinical trial. The Journal of Clinical Endocrinology Metabolism, 86(8), 3579-3594. https://doi.org/10.1210/jcem.86.8.7747. PMID: 11502782.

[2] Nordio, M. (2017). A novel treatment for subclinical hyperthyroidism: A pilot study on the beneficial effects of l-carnitine and selenium. European Review for Medical and Pharmacological Sciences, 21, 2268-2273. Retrieved from https://www.europeanreview.org/wp/wp-content/uploads/2268-2273-A-novel-treatment-for-subclinical-hyperthyroidism.pdf

[3] Benvenga, S., Feldt-Rasmussen, U., Bonofiglio, D., & Asamoah, E. (2019). Nutraceutical supplements in the thyroid setting: Health benefits beyond basic nutrition. Nutrients, 11(9), 2214. https://doi.org/10.3390/nu11092214

[4] Chachay, V. S., Kirkpatrick, C. M., Hickman, I. J., Ferguson, M., Prins, J. B., & Martin, J. H. (2011). Resveratrol--pills to replace a healthy diet? British journal of clinical pharmacology, 72(1), 27–38. https://doi.org/10.1111/j.1365-2125.2011.03966.x

[5] Otun, J., Sahebkar, A., Östlundh, L., Atkin, S. L., & Sathyapalan, T. (2019). Systematic review and meta-analysis on the effect of soy on thyroid function. Scientific reports, 9(1), 3964. https://doi.org/10.1038/s41598-019-40647-x

[6] Wichman, J., Winther, K. H., Bonnema, S. J., & Hegedüs, L. (2016). Selenium supplementation significantly reduces thyroid autoantibody levels in patients with chronic autoimmune thyroiditis: A systematic review and meta-analysis. Thyroid: Official Journal of the American Thyroid Association, 26(12), 1681-1692. https://doi.org/10.1089/thy.2016.0256

[7] Zheng, H., Wei, J., Wang, L., Wang, Q., Zhao, J., Chen, S., & Wei, F. (2018). Effects of selenium supplementation on Graves' Disease: A systematic review and meta-analysis. Evidence-based Complementary and Alternative Medicine. https://doi.org/10.1155/2018/3763565

[8] Wang, L., Wang, B., Chen, S. R., Hou, X., Wang, X. F., Zhao, S. H., … Wang, Y. G. (2016). Effect of selenium supplementation on recurrent hyperthyroidism caused by Graves' Disease: A prospective pilot study. Hormone and Metabolic Research, 48(9), 559-64. https://doi.org/10.1055/s-0042-110491.

[9] Truong, T., Baron-Dubourdieu, D., Rougier, Y., & Guénel, P. (2010). Role of dietary iodine and cruciferous vegetables in thyroid cancer: A countrywide case-control study in New Caledonia. Cancer causes & control, 21(8), 1183–1192. https://doi.org/10.1007/s10552-010-9545-2

[10] Giuliani, C., Bucci, I., Di Santo, S., Rossi, C., Grassadonia, A., Piantelli, M., Monaco, F., & Napolitano, G. (2014). The flavonoid quercetin inhibits thyroid-restricted genes expression and thyroid function. Food and Chemical Toxicology, 66, 23-9. https://doi.org/10.1016/j.fct.2014.01.016

[11] Gonçalves, C., de Freitas, M. L., & Ferreira, A. (2017). Flavonoids, thyroid iodide uptake and thyroid cancer: A review. International Journal of Molecular Sciences, 18(6), 1247. https://doi.org/10.3390/ijms18061247