Approximately 17 percent of women in the United States live with hypothyroidism, a condition where the thyroid gland becomes underactive. While medication remains the primary treatment, certain dietary adjustments may help manage symptoms such as fatigue, hair loss, and joint and muscle pain.
“The biggest cause of hypothyroidism is an autoimmune disorder called Hashimoto’s thyroiditis,” explains Sarah Fishman, MD, PhD, an endocrinologist specializing in diabetes, thyroid disorders and weight loss at Premiere Endocrine in New York City.
In Hashimoto’s thyroiditis, the immune system attacks the thyroid, preventing it from producing hormones that regulate metabolism, cardiovascular function, body temperature, mental function, brain development, and reproductive health. Other causes include certain medications, thyroid surgery, and iodine deficiencies.
Standard treatment involves synthetic thyroid hormone taken daily to replace what the body cannot produce naturally. While finding the optimal dosage may take time and requires ongoing monitoring, most patients can lead normal lives once properly treated.
Beyond medication, nutrition plays a supporting role in managing hypothyroidism, particularly for those with Hashimoto’s. Experts recommend several dietary strategies that may help alleviate symptoms.
Foods rich in zinc—such as beans, nuts, whole grains, seafood, poultry, and red meat—assist in converting thyroid hormone T4 into its more active form, T3, according to Bojana Jankovic Weatherly, MD, who is double board-certified in internal and integrative medicine.
Women should aim for 8 mg of zinc daily. Good sources include pumpkin seeds (2.2 mg per ounce), cashews (1.6 mg per ounce), quinoa (1 mg per half cup), chickpeas (1.2 mg per half cup), and cheddar cheese (1.2 mg per ounce).
Selenium is another important nutrient that supports thyroid hormone production and reduces inflammation. Just one Brazil nut provides up to 91 mcg of selenium, exceeding the daily requirement of 55 mcg for women. Other selenium sources include yellowfin tuna, cottage cheese, eggs, baked beans, oatmeal, and portabella mushrooms.
Iron deficiency may also affect thyroid function. Women over 50 need 8 mg of iron daily, while those between 19 and 50 require 18 mg. Fortified cereals, white beans, lentils, spinach, and tofu are all good dietary sources.
Iodine requires careful balance—too little causes thyroid dysfunction, but excess can worsen hypothyroidism or trigger autoimmune thyroiditis. The recommended daily intake is 150 mcg, easily met with half a teaspoon of iodized salt. Those on salt-restricted diets should consult their physician about alternative sources.
Calorie restriction can reduce thyroid hormone by 11 percent, according to research published in Rejuvenation Research, potentially compounding problems for those with hypothyroidism. Since weight gain affects about half of hypothyroid patients, many attempt calorie-cutting diets. However, the same study found that exercise-based weight loss didn’t cause similar hormone decreases.
For patients with autoimmune hypothyroidism specifically, eliminating gluten, dairy, and processed foods sometimes improves thyroid function enough to reduce medication needs.
“In susceptible individuals, gluten [and sometimes dairy] can trigger the immune system,” Dr. Fishman explains. “Adopting an anti-inflammatory diet in general can help reduce the autoimmunity and reduce the attack on the thyroid, so the thyroid is then able to keep up with thyroid hormone production.”
However, these dietary restrictions don’t benefit everyone and can be difficult to maintain long-term. Patients should weigh potential benefits against practicality before making significant dietary changes.
