Have you been diagnosed with an underactive thyroid gland or hypothyroidism? Have you been experiencing fatigue, weight gain, constipation, depression, dry skin, hair loss, heavy and irregular menstrual period, or intolerance to cold?

The small butterfly-shaped gland located in the neck area, known as the thyroid gland, may be as small as the size of two thumbs put together, but it has the power to impact all the body's organs. The thyroid gland produces hormones that help in metabolism and weight management. It affects body temperature, regulates growth, development, mood, and other processes needed to keep the body in a state of equilibrium.

Many factors disrupt or damage the thyroid gland. Stress, smoking, poor sleep quality, and even malnutrition or nutrient deficiencies, especially iodine, iron, selenium, and zinc.

It is unsettling, to say the least, to be diagnosed with hypothyroidism. And getting false information from the internet and pseudo-health gurus makes a patient’s predicament worse, if not dangerous. Here are some common misconceptions that I have encountered in my private practice as a registered nutritionist dietitian concerning an underactive thyroid condition.

Fact: An underactive thyroid gland or having hypothyroidism will definitely cause a slower metabolism. It may be a bit harder to lose weight, as well as lose body fat, for a person with hyperthyroidism compared to an individual with normal thyroid function. It is not true, however, that one cannot lose weight simply because of hypothyroidism. Do not use your being in a hypothyroid state as an excuse for gaining weight or not losing weight. A holistic approach to weight management that includes a plant-predominant way of eating, an active lifestyle, stress management, and correct dosage or intake of doctor-prescribed thyroid hormone replacement medication will help you manage your weight. It is important to get a proper assessment by an endocrinologist. Seek the help of a registered nutritionist or dietitian to know your total caloric requirement per day and get guidance on how to increase the phytochemicals, antioxidants, anti-inflammatories, and fiber-rich food that can help repair the thyroid gland.

Fact: Individuals who have undergone thyroidectomy or removal of the thyroid gland and those who have undergone Radioactive Iodine Therapy for thyroid cancer and hyperthyroidism or an overactive thyroid gland will need to take a daily dose of thyroid hormone replacement. Consumption of soy and soy products may decrease the absorption of this medication. There is no need, however, to completely avoid soy. Just remember not to eat soy right after taking the medication. In fact, no food must be consumed within 30 to 60 minutes after ingestion of the thyroid medication for optimum absorption in the morning. For those who prefer to take the medication at night, allow three to four hours after your last bite before taking the medication.

In a systematic review and meta-analysis on the effect of soy on thyroid function by Jemiliat Otun and colleagues published on March 8, 2019, concluded that soy has no effect on thyroid hormones. The moderate rise in TSH or thyroid-stimulating hormone is clinically insignificant. Therefore, you can eat soy and soy products even if you are on thyroid hormone replacement therapy for life. It is important, however, to get wholesome sources of soy from fresh soybeans, edamame, fresh soymilk, and freeze-dried soy powder to get the full benefits of phytoestrogens or plant hormones known as isoflavones. Tofu, tempeh, taho without the syrup and sago, and boxed soymilk can also be a source of protein. Due to processing, however, they may no longer contain that much fiber and phytochemicals.

Fact: Cabbage and other cruciferous vegetables like broccoli, cauliflower, arugula, spinach, watercress, Bokchoy, kale, Brussels sprouts, radish, mustard greens, collard greens, and turnips all contain goitrogenic properties. Goitrogen prevents the absorption of iodine, a mineral that is needed to regulate thyroid function. These vegetables, however, contain high amounts of phytochemicals that are beneficial for the entire body. Where do we draw the line for individuals with hypothyroidism?

Cooking cruciferous vegetables, especially with moist heat such as steaming, poaching, simmering, boiling, braising, and stewing, will not only reduce the goitrogens but also help retain most of the nutrients compared to other cooking methods. Soaking, washing, and fermenting also remove goitrogens. Therefore, K-drama fans who like kimchi, there is no need to worry about the enzyme that forms goitrogens. It gets deactivated through fermentation.

Can you still eat raw cruciferous vegetables in salads? The answer is yes. Again, as long as you remember the proper timing of taking thyroid medication. Besides, for the goitrogens to truly wreak havoc with thyroid hormones, you have to consume so much of them. The question is, do you even meet the recommended minimum intake of three servings of vegetables in a day? That is approximately 1.5 cups of cooked vegetables or three cups of raw leafy greens. If you can’t even consume this much, then you should not worry about the goitrogenic effect of cruciferous vegetables.

If you eat a lot of cruciferous vegetables, pair them with selenium-rich sources like whole grains (brown, red, black rice, quinoa, oats), beans and lentils, Brazil nuts, and seafood. Selenium will decrease the absorption of goitrogens.

If you are struggling with your weight, don’t hesitate to seek the help of an endocrinologist for a proper diagnosis.