Thyroid precautions and dietary taboos

90% of people with benign thyroid nodules and completely normal thyroid function do not need to eat anything special at all. They only need to have a thyroid color ultrasound + thyroid function follow-up once a year.； Only people with abnormal thyroid function (hyperthyroidism/hypothyroidism/active Hashimoto's thyroiditis) need to make targeted adjustments to their living habits and diet. There is no "taboo list" that is common to all patients with thyroid problems.

Let’s first discuss the most frequently asked dietary questions.

First of all, let’s talk about the most controversial iodine. Don’t quit it blindly. I used to go to the outpatient clinic with the director of the endocrinology department and met a 32-year-old girl. The physical examination showed that she had high Hashimoto's antibodies. She changed the iodized salt to iodine-free one when she returned home. She didn't even touch the kelp or seaweed or even the shrimp. Half a year later, her hair fell out and she was almost bald. The reexamination of her thyroid function directly turned into clinical hypothyroidism. The urine iodine test was only 37 μg/L, which is less than 1/3 of the lowest value for normal adults. Now regarding the intake of iodine, there are indeed differences in the recommendations of different guidelines: the Dietary Guidelines for Chinese Residents recommend that ordinary adults consume 120 μg of iodine per day, and people with thyroid problems who have normal thyroid function do not need to adjust at all. ； The American Thyroid Association's recommendation for Hashimoto's patients is to avoid long-term intake of large amounts of iodine-rich foods, but there is no need to completely ban iodine. As long as urinary iodine is maintained within the normal range of 100-199 μg/L, there will be no problem. Only patients in the active stage of hyperthyroidism need to strictly avoid foods with high iodine content, including kelp, seaweed, and wakame, as well as iodine-containing additives in plums, processed spicy strips, and some functional drinks that many people ignore. They must be avoided at this time.

Speaking of this, someone must ask about the cruciferous family - what broccoli, cabbage, and cabbage cannot be eaten, will it cause goiter? There's really no need to be sensational. Swelling-causing substances such as glucosinolates must be eaten raw at least two or three pounds a day to affect iodine absorption. If you usually fry a plate of broccoli or make a bowl of cabbage soup, most of the substances have been deactivated during the cooking process, so there will be no problem at all if you eat them. I have a friend from Hashimoto who didn’t eat cruciferous vegetables for half a year due to food taboos. He was so vitamin deficient that the corners of his mouth were sore every day. Later he ate normally and his thyroid function did not fluctuate after a follow-up check. Oh, by the way, there is another popular saying in recent years that Hashimoto should avoid gluten. There is currently no clear guideline recommendation in China. A few foreign studies believe that abstaining from gluten can reduce antibody levels. My suggestion is that if you eat wheat and barley products, you are prone to flatulence and diarrhea. You can try abstaining for 3 months to see the changes in antibodies. If you don’t feel any discomfort after eating them, there is really no need to abstain from all steamed buns and noodles, which will affect your happiness in life.

Oh, by the way, there is another pitfall that is rarely mentioned: don’t blindly take health care products containing “thyroid extract”, especially some Internet celebrity products that claim to “lose weight and improve metabolism.” There have been patients who have taken such health care products before, and their thyroid function indicators were in a mess, and it took a long time to adjust them back.

Let’s talk about the pitfalls that are easy to step into in life.

Don't blame eating the wrong thing as soon as you see the nodules swell. Most of the time, it's the late nights and anger that are causing the problem. Last month, a young man who works in Internet operations came for a review. Half a year ago, the nodule was 2mm, but this time it increased to 4mm. As soon as he walked in, he asked if he had eaten Japanese food twice last time. After further questioning, he found out that he had been working on projects until 2 a.m. for the past three months. He was scolded by his boss for not being able to write a weekly report, and he hid at home crying every day. The thyroid is a well-known "emotional organ". The endocrine fluctuations caused by long-term stress and staying up late will have a much greater impact on it than if you eat kelp ten times.

Some people also ask whether the radiation from X-rays and CT will damage the thyroid gland? The radiation dose of routine physical examinations such as chest X-rays and head CTs is far below the safety threshold. You don’t need to wear a lead scarf every time you do it. If you do frequent neck CT scans, you can just ask for protection. As for whether mobile phone radiation or airport security radiation can damage the thyroid gland, that is completely an IQ tax. That kind of non-ionizing radiation will not damage thyroid cells at all. Don't spend hundreds of dollars to buy a thyroid radiation prevention necklace. It is a waste of money.

By the way, never do a neck massage! No matter whether you have nodules or not, don’t perform random massages. I met a 29-year-old girl in the emergency department before. She went to a beauty salon for neck dredging. The next day after the massage, she felt flustered, had trembling hands, and had a fever. She was sent to the hospital for hyperthyroidism crisis. Later, it was found that she had an undiscovered high-functioning adenoma. The massage broke it, and a large amount of thyroid hormone was released into the blood. Really, there are many blood vessels and nerves around the thyroid gland, so don’t touch them if you have nothing to do.

Finally, to put it bluntly, most thyroid problems are "lazy problems". Many people live with nodules for a lifetime without any problems. Don't mess around with the list of taboos on the Internet every day, and don't be so scared that you can't sleep as soon as a nodule is found. Check the color ultrasound and thyroid function once every six months. Eat and drink when you should, be less angry and sleep more, it is more effective than any taboo.