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Week 3

Welcome to week 3 of the BTF weight loss and wellbeing programme.

You can read our experts’ advice, tips and suggestions by following the links to this week’s articles below. You can also find the following to support you:

  • Expert advice - learn more about thyroid disease and weight management from our medical and other experts
  • Patient stories – find out how other thyroid patients have managed to successfully lose weight and improve their wellbeing
  • Webinars – if you would like to take part in our information webinars in week 3 and week 8 you can register free of charge now by clicking here
  • Community - share your weight loss journey with others taking part in our programme by joining our closed Facebook group

Diets and supplements for people with a thyroid disorder

There are many websites offering advice on what foods to eat or not eat in relation to hypothyroidism. However, these are often suggested as a way to alleviate symptoms and they are not necessarily in relation to weight loss.

And although there may not be specific foods or dietary supplements that you can use to manage your thyroid disorders, just as for people with a functioning thyroid, to help you remain as healthy as possible, it is important to eat the right variety of foods in the correct proportions.

The NHS Eatwell Guide recommends you should try to:

  • eat at least 5 portions of a variety of fruit and vegetables every day
  • base meals on higher fibre starchy foods like potatoes, bread, rice or pasta
  • have some dairy or dairy alternatives
  • eat some beans, pulses, fish, eggs, meat and other protein
  • choose unsaturated oils and spreads, and eat them in small amounts
  • drink plenty of fluids (at least 6 to 8 glasses a day)

Supplements and vitamins

It isn't always easy to maintain a varied and healthy diet, and for this reason some people may wish to take additional vitamins and supplements. If you decide to take vitamins and supplements you should avoid taking them in excessive amounts. This is because some can interfere with your thyroid function or your thyroid blood test results.

We recommend you take appropriate advice from your doctor or pharmacist before you start taking any supplements or vitamins.

Vitamin D

Vitamin D helps regulate calcium and phosphate production and is needed for healthy bones, teeth and muscles. Some studies have shown that the people with low levels of vitamin D may also have thyroid disorders but the link is not clearly defined and may be coincidental.

Since most people may be deficient in vitamin D (particularly in the autumn and winter months when the sunlight in the UK is not strong) the NHS advises that all adults and children over the age of five take a supplement of 10mcg each day. This applies during the autumn and winter for most people but throughout the year if you are concerned you may not get enough sunlight even at other times of the year, e.g. you aren’t often outdoors or you tend to cover yourself up with clothes when you are outside.

If you have dark skin you are also at risk of not getting enough vitamin D from sunlight and should consider taking 10mcg supplements throughout the year.

Calcium

Some calcium-rich foods and supplements interfere with levothyroxine absorption. A gap of four hours between the two would be adequate to ensure there is no significant impact on blood thyroxine levels. If you are trying to lose weight and use lower fat milk (i.e. semi-skimmed or skimmed), this remains high in calcium despite being lower in fat.

Iodine

If you have a properly functioning thyroid iodine is essential as it is required for the production of thyroxine. It is particularly important in women who are pregnant as it is needed to ensure the development of a baby's brain during pregnancy and early life.

If you are taking levothyroxine for hypothyroidism (underactive thyroid) or for a goitre (thyroid swelling) there is no need to take iodine supplements.

If you are being treated for hyperthyroidism (overactive thyroid) taking an iodine supplement is unnecessary and can worsen the condition. The extra iodine can counteract the benefits of the anti-thyroid drugs.

Soya

Soya interferes with levothyroxine absorption, therefore if you are taking thyroxine you should try to avoid soya. If you wish to take soya, you should leave as long as possible (at least four hours) between eating the soya and taking the levothyroxine.

Kelp

Avoid products such as kelp, as they may interfere with thyroid function and wellbeing. Kelp is derived from seaweed and is naturally high in iodine. Because of this, it is sometimes marketed as a ‘thyroid booster’ and can be purchased in dry preparations and tablets. As with iodine itself, it is of no health benefit to those with thyroid disease.

Iron Tablets

Some medications such as iron tablets (ferrous sulphate) can interfere with the absorption of thyroxine. Some doctors recommend a four-hour interval between taking thyroxine and the iron. Follow the advice of your doctor or pharmacist. Be aware that some multivitamin tablets contain iron.

Brassicas

Brassicas (e.g. cabbage, cauliflower, kale) may contribute to the formation of a goitre (swelling or enlargement of the thyroid gland) in some cases, but consumption would need to be very high before this is a real concern. In the UK, under normal dietary conditions, this is not normally a problem and the risk is very low.

Ginger

A study found that supplementing ginger in 2 x 500mg doses per day helped alleviate some symptoms of hypothyroidism. However, there were some limitations to the research suggesting that further human studies are needed with larger sample sizes, longer durations, different ginger doses, and a follow-up period after discontinuation of the supplement. There is no requirement for food supplements to be licensed or registered with the UK government. However, all foods must comply with the relevant food law. So, if you want to try ginger supplementation be mindful that the products will most likely vary in contents and cost between brands. If you see no improvement in symptoms, then discontinue.

Selenium

This is found in Brazil nuts, tuna, sardines, eggs and legumes (e.g. beans, chickpeas, lentils) it is thought that it helps with thyroid function. All of these are foods are recommended as part of a healthy balanced diet. Selenium supplements should not be taken until your natural levels have been measured, since too much selenium can damage health.

Selenium is also recommended as a treatment for people with mild thyroid eye disease.

Zinc

This is found in shellfish, beef, chicken and legumes (e.g. beans, chickpeas, lentils) and it is thought that it helps with thyroid function. All of these are foods are recommended as part of a healthy balanced diet.

Always take the recommended dose

Although it is tempting to think that large doses of certain supplements will do us good, exceeding the recommended intake (RI) can often do us more harm than good. We recommend you do not consume any vitamins or supplements in high doses and please remember to check your thyroid medication patient leaflet to find out whether the supplements are contraindicated. To avoid absorption issues, and unless otherwise indicated, you should always take them at least four hours apart from your thyroid medication.

If you have any concerns about whether you should take vitamins or other supplements please check with your doctor or pharmacist.

Is it safe to be physically active with thyroid disorders?

This is a question with a no ‘one size fits all’ answer as it always depends on us as individuals and our situation. That said, exercise is generally beneficial and safe for the majority of people. It is usually only dangerous if we live with a serious uncontrolled health condition such as uncontrolled hyperthyroidism, have very high blood pressure or a heart condition. So if we are living with one of these conditions, it is important to seek guidance from our own doctor before we begin a physical activity programme.

If your thyroid disorder is well controlled, there is no reason why you cannot exercise or be physically active just like anyone with a normally functioning thyroid gland. However, it can sometimes take a little while to become stable on a dose of thyroid medication to feel healthier. So, it is important that we listen to our bodies and know what we can and cannot do.

Generally, exercise has been shown to improve quality of life for people with controlled and uncontrolled thyroid disease so we should aim to do as much as we feel we can even if it sometimes feels hard just to go for a walk. The key is not to overwhelm ourselves with too much and to do small chunks over time. This helps us to understand what we can do and what may take more work to be able to do in the future. For example, you may want to start with a step count target of 5000 or 7500 steps per day or a 30 minute walk a few days each week and build on this gradually.

Can we exercise or be physically active at home?

Many people exercise at home now. Indeed, for many it has become the ‘norm’. This is a very good way of exercising particularly for those who of us who are busy or do not like gyms. It’s is all down to personal preference. For some, exercising well at home may mean following a good exercise instructor on YouTube or buying a DVD by a similarly qualified individual. There are plenty available to choose from which incorporate anything from cardiovascular exercise to get your heart rate up, core exercise programmes and resistance or strength training programmes to strengthen muscles.

There are also classes available online for those who enjoy yoga, Pilates or Zumba etc. It is always important to remember that being physically active does not strictly mean exercising. Many people find that they can keep up their cardiovascular health, strength, balance and other fitness components by doing home-based dance classes, gardening or housework. Some games consoles even incorporate some level of physical activity.

How can we be physically active outside a gym?

Gyms have their place, and many of us derive great enjoyment from being a member of a local gym. However, the gym isn’t for everyone. You may find it intimidating, inconvenient or just too costly. Or it may be that gyms don’t offer your preferred physical activity. You may find that you would rather participate in competitive sports and be a member of a sports club such as netball or squash, or that you prefer exercise such as ballet or tap.

There are so many places we can be active outdoors. Local parks often have gym equipment for example. Or simply walking in the countryside can be very beneficial to our health.

The important thing is to find something that gets you physically active, whether that is indoors or outdoors, and which gives you enjoyment which will motivate you to keep up your activity long-term. Whilst there are excellent short term benefits to exercising, we know that the real long-term benefits to our mental and physical health, whether they take place in a gym, in a sports club or at an outdoor green space, are what makes a lasting difference to our quality of life

Watch

Chartered psychologist, Dr Sue Jackson shares tips about the importance of self-kindness and self-compassion, including:

  • Being your own best friend
  • Managing good days and bad days
Week 2 info Week 4 info