DR. KATIE LEAH, N.D.

Naturopathic Physician

Thyroid Balancing Lifestyle Program

The thyroid gland is a butterfly-shaped gland located at the base of the neck just below your Adam's apple. Despite its small size, the thyroid gland influences the function of many of the bodys most important organs, including the heart, brain, liver, kidneys and skin. Ensuring that the thyroid gland is healthy and functioning properly is important to your overall wellbeing. An underactive thyroid, or hypothyroidism, occurs when the thyroid gland produces less than the amount of thyroid hormone the body needs. This causes many bodily functions to slow down including metabolism, digestion and energy levels. Some of the most common symptoms of an underactive thyroid are: Persistent daily fatigue Intolerance to cold Weight gain and fluid retention Dry hair, nails and skin Puffy face Constipation Heavy and/or irregular periods Other symptoms that are commonly associated with an underactive thyroid are: Drowsiness, forgetfulness, poor memory High cholesterol Sore muscles Swelling around the throat Increased frequency of miscarriages

Common Causes of Hypothyroidism

Occasionally it is difficult to identify the root cause of an underactive thyroid. Some of the most common risk factors include: Family history of hypothyroidism Autoimmune disease Pregnancy Menopause Stress, surgery or trauma Previous treatment for an overactive thyroid condition (hyperthyroidism)
Dr. Katie Leah, N.D. 2011 Suite 730 1285 West Broadway, Vancouver, BC V6H 3X8 Phone: 604.738.1012 Fax: 604.732.9332 www.integrative.ca @drkatieleahND

Diagnosing Hypothyroidism
Hypothyroidism is diagnosed by lab testing of thyroid function. The management of thyroid conditions will vary dramatically based on the type of condition present; thus it is critical to have more comprehensive testing completed prior to treatment. The tests most useful in determining thyroid function are: Thyroid stimulating hormone (TSH) Free T4 (inactive thyroid hormone) Free T3 (active thyroid hormone) Reverse T3 Thyroid antibodies (to rule out autoimmune Hashimotos thyroiditis) Ask your Naturopathic Doctor about comprehensive thyroid testing to determine your current thyroid function.

General Recommendations for Supporting Thyroid Function

Diet, exercise, lifestyle and stress reduction are the foundation for thyroid balancing. There are many functional foods that can increase or decrease thyroid function. In underactive thyroid conditions, it is critical to avoid foods that can further block the production of thyroid hormone.

**Be sure to consult with your Naturopathic Physician or your primary healthcare provider before implementing any new healthcare regime, medication or supplementation.

Diet
Eat within 30 minutes of waking. This gets your metabolism moving for the rest of the day. Be sure to eat smaller, more frequent meals to maintain proper blood sugar levels and prevent any crashes in energy related to low blood sugar Drink 1-2 liters of filtered water per day. This helps your body use nutrients and eliminate waste products more efficiently Use the 80:20 rule to increase your success and make changes more sustainable.

Exercise

Enhances thyroid gland secretions and increases tissue sensitivity to thyroid hormone Make sure you get a combination of aerobic exercise that increases your heart rate (walking, running, cycling, elliptical training) and stretching/strengthening exercises (yoga, pilates, Dailey method or bar method) Daily exercise is a part of every optimal wellness plan. Consult with your Naturopathic Doctor about what types of exercise might be most beneficial for you.

Dr. Katie Leah, N.D. 2011 Suite 730 1285 West Broadway, Vancouver, BC V6H 3X8 Phone: 604.738.1012 Fax: 604.732.9332 www.integrative.ca @drkatieleahND

Lifestyle & Stress Reduction

The ill effects of poor lifestyle habits and high stress cannot be understated in all chronic health conditions. For emotional stress reduction, consider counselling or life coaching on a monthly basis Meditation helps to create a calm, still mind and body Create a balance in your life between work, play and rest Write a nourish/deplete list to identify the things in your life that both nourish and deplete you. Ideally, you should have 90% things that nourish you and only 10% that deplete you.

Nutritional Supplementation
There are several natural supplements (vitamin, mineral, amino acid and botanical) that can be helpful in a thyroid balancing program. Do not begin any new thyroid supplements without first consulting with your Naturopath

Thyroid Balancing Food Guidelines

It is important to avoid or limit goitrogenic foods, which may further suppress thyroid function and contribute to a goiter. If the symptoms of hypothyroidism are very severe, they should be omitted entirely. The following foods are the most important goitrogenic foods to be cautious of: Brassica family of vegetables: bok choy, broccoli, broccolini, brussel sprouts, cabbage, cauliflower, collard greens, horseradish, kale, kohlrabi, mizuna, mustard greens, rutabaga, radishes, rapini, sorrel, spinach, turnips, watercress Soybeans Millet Peanuts, pine nuts, walnuts Peaches, pears Canola oil *NOTE: Cooking with high heat may destroy the goitrogenic activity of brassica vegetables The trace mineral iodine, along with the amino acid tyrosine, help the thyroid gland to produce thyroid hormone. Chlorine and fluoride inhibit the activity of iodine so be cautious of these. Good sources of iodine include: Fish (sole, tilapia, salmon, cod) Sea vegetables: kelp, dulse, arame, hijiki, nori, kombu Iodized salt (table salt) Zinc, copper and selenium are important minerals for the conversion of inactive thyroid hormone (T4 ) to active thyroid hormone (T3 ). Good sources of zinc, copper and selenium include: Oysters Free range organic grass fed beef Free range organic chicken and eggs Liver (chicken, duck, beef) and other organ meats Raw, unroasted nuts and seeds (almonds, flax, brazil, sesame, pumpkin, sunflower) Beans and legumes
Dr. Katie Leah, N.D. 2011 Suite 730 1285 West Broadway, Vancouver, BC V6H 3X8 Phone: 604.738.1012 Fax: 604.732.9332 www.integrative.ca @drkatieleahND

DR. KATIE LEAH, N.D. Naturopathic Physician

General Thyroid Balancing Food List

Generally, the following foods should be avoided or consumed in moderation when following any thyroid balancing program: Alcohol, caffeine, sugar Dairy products Refined, processed foods Yeast containing foods

Food Group

Avoid
Cow milk: casein, whey, and lactose Cream American cheese Mozzarella cheese Brie cheese Blue cheese, stilton Parmesan cheese Cottage cheese Swiss cheese Camembert cheese Sour cream Cream cheese Butter Bread made from refined or whole wheat Breads and products leavened with yeast Cereals, refined Donuts Granola with sugar added Whole wheat Wheat, white flour Pastries Popcorn

Eat in Moderation < 2-3 x per week

Ask your practitioner if these are okay to eat:

Eat
Unsweetened, unflavoured:

Goat feta Goat cheddar Soft goat cheese Sheep cheese: manchego, pecorino Goat yogurt Sheep yogurt Organic Balkan style plain yogurt Organic plain kefir Soy milk Soy cheese (look out for hidden casein)

Almond milk Coconut milk Hemp milk Oat milk Rice milk

Dairy

Flours made from the following grains can be eaten in moderation: Barley

Rice (long grain brown, jasmine) Oat (steel, whole or scotch) Quinoa Kasha groats Buckwheat groats

Kamut Millet Spelt 100% rye Arrowroot Amaranth Brown rice (e.g. rice pastas and rice crackers) Chickpea/Garbanzo Nut, seed or legume flours Quejos Organic corn (tortilla chips, wraps) Cornmeal Organic corn pasta

Grains

Dr. Katie Leah, N.D. 2011 Suite 730 1285 West Broadway, Vancouver, BC V6H 3X8 Phone: 604.738.1012 Fax: 604.732.9332 www.integrative.ca @drkatieleahND

Cereal suggestions: oatmeal, granola with no sugar added, alternative wheat/yeast free bread with nut butter, quinoa or rice flakes in place of oatmeal Spelt, kamut, or rice cereals that dont contain wheat or sugar may be consumed in small quantities Amaranth, buckwheat or teff blueberry pancakes Wheat free waffles or pancakes can be made in batches ahead of time and frozen for a quick breakfast

Peaches Pears Tropical fruits (passion fruit, lychee, starfruit) Canned fruit in syrup Sweetened fruit juices Dried sulphured sweetened fruits (raisins, dates, cranberries, figs)

Apples Banana Cantaloupe Cherries Grapefruit (pink, white) Grapes, red and green Honeydew melon Mandarin Mango Orange Peach Pineapple Plums Raisin Papaya Unsweetened, unsulphured dry fruit Unsweetened fruit juice (apple, cranberry), no more than 4 ounces

Apricots Blueberries Cranberries Dates Kiwi Lemon Lime Prunes Raspberries Strawberries

Fruit

Note: fresh lemon and lime juice is allowed

Avoid fruit that tastes too sweet Eat ripe fruit, not over or under ripe; Avoid fruit with mold on it Eat raw fruit 15 minutes away from other foods Cooked fruit can be eaten with other foods (e.g. oatmeal with cooked apples) Dont eat fruit too late at night

Avoid
Broccoli Brussels sprouts Bok choy Cabbage Cassava root Cauliflower Collard greens Horseradish Kale Kohlrabi Mustard Mustard Greens Radishes Rutabaga Sorrel Spinach Turnip

Eat in Moderation
Beets Carrot Chestnuts Eggplant Mushrooms Potatoes (russet, white) Sweet corn

Eat
Artichokes Avocado Asparagus Arugula Beet greens Bean sprouts Chard Celery Cucumber Daikon Endive Fennel Garlic Ginger Green pepper Jicama Kelp and seaweed Leeks

Peas, green: fresh and frozen Peppers, red & yellow Peppers, chilli Scallions Shallots Snow peas Spirulina Squash (yellow, butternut, spaghetti) Taro Tomato Tomato paste Yams Yucca Vegetable broth Vegetable juice, unsweetened

Vegetables

Dr. Katie Leah, N.D. 2011 Suite 730 1285 West Broadway, Vancouver, BC V6H 3X8 Phone: 604.738.1012 Fax: 604.732.9332 www.integrative.ca @drkatieleahND

Watercress

Lettuce (leaf, butter, romaine, red) Onion (white, yellow, red) Olives Parsnip

Zucchini All fresh and dried herbs

Avoid all brassica vegetables: bok choy, broccoli, broccolini, brussel sprouts, cabbage, cauliflower, collard greens, horseradish, kale, kohlrabi, mizuna, mustard greens, rutabaga, radishes, rapini, sorrel, spinach, turnips, watercress

Food Group

Avoid
Bacon Deli meats Frankfurters Frozen burgers Ham Hot dogs Pork Sausages Scallops, mussels, clams Octopus

Eat in Moderation
Turkey, chicken or lamb sausages (whole foods) Beef Duck Organ meat, liver Organic, free-range, non-medicated: Chicken

Eat

Quail Cornish hens Lamb Game meats (buffalo, bison, venison)

Meat & Poultry

Egg: white and yolk Turkey

Shrimp and prawns Crab, lobster

Fish

Cod Haddock Halibut Mackerel Salmon Adzuki Black bean Black-eyed peas Chickpeas Fava Kidney

Sole Tuna Trout Tilapia Navy beans Pinto Lentils (red, yellow, green, brown, French) Mung Red beans Pecan Pumpkin Sesame Sunflower Tahini Nut butters Fennel Garlic Ginger Horseradish Paprika Pepper Salt (maldon, sea salt, kosher, mineral salts) Iodized salt (table salt)

Soy beans Textured vegetable protein (TVP) Miso paste Tofu

Beans & Legumes

Peanuts Pine nuts

Cashew Walnuts

Raw, unroasted Almond

Nuts & Seeds

Brazil nut Coconut Flax seeds Hazelnut Macadamia

Fresh or dried: Basil

Cayenne pepper Chilli Chives Cilantro Cinnamon Cumin

Spices

Dr. Katie Leah, N.D. 2011 Suite 730 1285 West Broadway, Vancouver, BC V6H 3X8 Phone: 604.738.1012 Fax: 604.732.9332 www.integrative.ca @drkatieleahND

Mustard Commercial salad dressing

White vinegar White wine vinegar Pickled foods Sauerkraut Soy sauce Wheat free tamari

Apple cider vinegar Homemade salsa Hot sauce Hummus Babaganoush Guacamole Black bean dip Rice vinegar Agar Amaranth Arrowroot Buckwheat (contains no wheat) Chickpea Millet Oat Quinoa Rice Sorghum Teff Bouillon cubes (organic) Coconut sap Honey Maple syrup Molasses Rice syrup Raw agave syrup Stevia

Condiments

Wheat, whole or white flour

YEAST, bakers and brewers Cocoa Cornstarch (use arrowroot powder or potato starch instead) Canned foods Guar gum Lecithin Soy flour Xanthan gum Spelt, kamut, rye, barley flour

Flours & Cooking Ingredients

Sugar & Sweetener

Artificial sweeteners, Aspartame, Splenda, Twin, Nutrisweet Brown sugar Cane sugar Corn sugar Fructose High fructose corn syrup

ALCOHOL Beer Hops

Green tea Unsweetened juice Sparkling water Mineral water

Water Warm water with lemon Herbal teas (peppermint, chamomile, ginger, goldenseal, licorice root) White tea Jasmine Peppermint

Rum Cognac Red & white wine Gin

Beverages

Rye CAFFEINE Coffee Decaf coffee Black tea Pop and soft drinks Canola Corn Peanut Natural, cold pressed, Almond

Oils & Fats

Flax Grapeseed

Dr. Katie Leah, N.D. 2011 Suite 730 1285 West Broadway, Vancouver, BC V6H 3X8 Phone: 604.738.1012 Fax: 604.732.9332 www.integrative.ca @drkatieleahND

Olive Pumpkin Sesame Sunflower Walnut

The following additives should be avoided as much as possible:

Alcohol sugars (maltol, sorbitol, mannitol) BHT, BHA Disodium EDTA Monosodium glutamate (MSG) Potassium bromide Preservatives Propyl gallate Sodium nitrate (smoked and cured meats, bacon, ham, hot dogs, luncheon meats, corned beef, smoked fish and other processed meats) Sulphur dioxide (boxed dry goods, dried fruits, wine with sulphites) Sodium bisulfate Tartrazine (yellow and green food dye banned in Europe) Red, yellow dye

Additives

Lactic acid and citric acid are natural preservatives and can be consumed in moderation

References and resources:

American Association of Clinical Endocrinologists. https://www.aace.com/public Women to Women. http://www.womentowomen.com/healthtopics_hypothyroidism.aspx Netter, F.J. (2003). Netters Internal Medicine. MediMedia. Carlstadt, NJ Groff, J. & Gropper, S. (2008). Advanced Nutrition and Human Metabolism. Wadsworth. Belmont, CA.

Dr. Katie Leah, N.D. 2011 Suite 730 1285 West Broadway, Vancouver, BC V6H 3X8 Phone: 604.738.1012 Fax: 604.732.9332 www.integrative.ca @drkatieleahND