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Nutrition for a Better Thyroid

October 27, 2022
Uncategorized
Dr. Sam

Nutrition for a Better Thyroid

A very common complaint you see, especially in functional medicine, is concerns about thyroid function. Interestingly, women are 5-8 times more likely to develop thyroid dysfunction than men with the lifetime risk of thyroid issues in women at about 12%.1  The most common cause of thyroid issues is an autoimmune disease called Hashimoto’s Thyroiditis. Like all autoimmune diseases, this is reversible. Another common thyroid issue is inadequate conversion of hormones in the periphery. We will focus on these two forms of thyroid disease.
Before getting started, I realized in the middle of writing this that thyroid issues are too complex to get through in one blog and therefore will become a three part series as well.
First, the thyroid is a powerful organ that is responsible for regulating the metabolism of every single cell in our body. If it doesn’t work, then you gain weight and experience things like brain fog, constipation, hair issues, and chronic fatigue. Because of its importance, we want to take good care of it and this starts with a deeply nourishing diet.
In order for your thyroid to function properly there are several nutrients that you need to ensure are in your diet at the proper levels. These include iron, selenium, iodine, selenium, zinc, tyrosine, vitamin A, Vitamin Bs (B2, B3, B6), and vitamin D. I will focus the major ones.
Selenium is involved in activating the enzymes that are naturally part of our body’s antioxidant systems. This helps protect a highly active thyroid from things like oxidative stress (too much work). Think of oxidative stress as long days at work and selenium as whatever you do to decompress from the long day. You want to shoot for 120 mcg/day. Plant food is an inconsistent source of selenium and would require you to eat 20 brazil nuts per day to meet your needs. In animal foods, we can get plenty from 1/2 oz of liver, 4 egg yolks, and 16 oz of lamb. This would give me 156 mcg and easily attainable for me.2,3
Zinc is involved in the production of essentially everything in the body, including thyroid hormones. It also aids in proper conversion of hormones. In order to get enough, we again need to go to animal foods as this form is 5 times more absorbable. The best sources are in oysters and red meat, so if you focus on getting at least one of these foods in your diet daily then you are likely to get enough zinc on a daily basis. I prefer people get red meat in at least twice a day to get enough protein as well. 2,3
Iron is well known for its role in blood formation, but also plays important roles in thyroid hormone production and deficiency can lead to hypothyroidism. This is a big reason that I often check iron levels on all patients, especially females. Heme iron is the form we want and again is only found in animal foods. This form is more absorbable and therefore usable by our bodies. Meat and organs are the two foods with large amounts of this vital nutrient.2,3
Iodine is the classic thyroid nutrient and is the major nutrient in thyroid hormone, hence its importance. However, it is also considered a “goldilocks” nutrient as too much can be as harmful as too little. Plant foods are again not a consistent source as foods grown in one area vs another can have 100 fold different levels of iodine because of variation in soil quality.  Focusing on milk, cheese, and fish/shellfish are the first places I have people focus on and then go from there. If you are very deficient, short term use of kelp can be beneficial, but work with someone that knows what they are doing if you are worried. Additionally, iodine deficiency is associated with fibrocystic breasts, so focusing on this nutrient can help with this as well.2,3
Vitamin A is another big player with thyroid health as it aids in both production and conversion at a nuclear level. This is again another food where focusing on animal foods is ideal. Retinol is the animal form and what is used by all the cells of our body. Beta-carotene is the plant version and requires an enzyme called BCMO1. If you have a dysfunctional variant (up to 65% of people have some level of dysfunction) then you will have a 60% reduction in retinol production from beta-carotene, making it a suboptimal nutrient form of vitamin A for most people. Again, this means focus on eggs and liver for your vitamin A.2,3
Lastly, vitamin D plays big roles in thyroid health through immune system function. Having optimal vitamin D means you are more likely to have optimal immune function, which means less likely to have autoimmune thyroid disease. During the summer, I recommend getting this from the sun (no, I don’t recommend sunscreen, but that sounds like another good blog post topic!), but during the winter I rely on high vitamin cod liver oil. Depending on the brand, you will need up to 3 tsp to get adequate vitamin D, but this is the best way I can come up with to get vitamin D from diet during less sunny months.2,3
I hope you noticed a trend when discussing nutrients for thyroid: focus on animal foods. This is where the bulk of everyone’s nutrition should come from if they want to function optimally. I always go back to ancestral wisdom when I have burning questions about nutrition and this tells me that meat and organs were the center of the diet. This means we evolved this way and because of that  we typically thrive with more animal foods in our diet.
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October 19, 2022
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Dr. Sam

Hippocrates Was Dead On

Hippocrates, thousands of years ago, said that “all disease begins in the gut.” The more that I get into human optimization and functional medicine, the more I realize that this quote is true. The gut is our biggest interaction with the outside world and it is exposed to things regularly throughout the day. If we continually expose it to things that cause inflammation and dysfunction, then our gut will erode and with it will go nutrient absorption and proper immune function. If we can eliminate the things causing inflammation and give our gut what it needs to heal, then our body is capable of healing amazing things.
The microbiome in our intestine is a collection of trillions of bacteria, viruses, and fungi. When we are healthy, there is a symbiotic relationship with all of these bugs where we get immune system training and improved nutrition (i.e. B vitamin production by the bacteria) and they get a home. If we aren’t healthy, then they are capable of taking over, causing inflammation that eventually results in disease throughout the body.
The first step in healing your gut is eliminating the foods high in plant lectins, plant pesticides, oxalates, fiber, and other plant compounds that can be difficult for your gut to digest. This is mostly found in the roots, stems, nuts, seeds, and leaves of the plant. This is the part of the plant that doesn’t want to be eaten and thus has the highest quantity of compounds to deter you from eating it. Plants have no way of defending themselves other than producing chemicals that interfere with our hormones, gut function, and immune system and thus eliminating the parts of the plant high in these chemicals can be immensely beneficial, at least in the short term. Notice that I didn’t say fruit as this is the part of the plant that wants to be eaten and thus has the lowest levels of these compounds.
Another big aspect of gut health is glyphosate exposure. Glyphosate has been shown to have antibiotic properties, essentially wiping out much of our healthy flora as well as having a paralytic effect on the gut, linking it to constipation. If you look at the prevalence of inflammatory bowel disease and death from intestinal infections, it has increased in lockstep with glyphosate exposure. It has also been shown that glyphosate up regulates a protein called zonulin. This protein is involved in gut barrier and when production is increased your gut is more leaky. This allows your immune system to interact with everything you eat in ways that wouldn’t normally happen and can lead to the development of autoimmune disease. Finally, it raises the intestinal pH, which decreases the amount of butyrate and other short chain fatty acids, which supply our intestine with energy. In essence, eating organic food free from glyphosate and other pesticides is a big step in the right direction as far as our gut health is concerned.
Third, we need to add in beneficial bacteria. This is can be in the form of being outside in the dirt, eating food with dirt on it, eating yogurt or other fermented foods, and probiotic supplements. I am a big fan of the first 3 and only use supplements in certain circumstances. Yogurt is my personal favorite way of doing this and I use Lactobacillus reuteri, Lactobacillus gasseri, Bacillus coagulans, and Bifidobacteria infantis to make my yogurt. L. reuteri has been shown to make smoother skin, accelerate healing, and improve muscle. L. gasseri has been shown to improve IBS, reduce oxalates, and protect against SIBO. B. coagulans reduces symptoms of IBS and also accelerates recovery. B. inantis is essential for a healthy developing gut and should be included in a yogurt for anyone pregnant. This combination promotes overall gut health and is something I try to get in twice per day. If I use a probiotic, I will recommend Megaspore by Microbiome Labs and/or Seed probiotic. However, I always prefer to get these from food if possible.
How do you know if these interventions have worked? There really isn’t great testing for the gut so we rely on symptoms. Are you having well formed bowel movements without having to wipe much? Are you having minimal gas and bloating? Are your autoimmune, metabolic, neurologic, etc. symptoms improving? If yes to the above, then its likely your gut is getting better.
Now go out and try some of the above interventions and see how you do!
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October 13, 2022
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Dr. Sam

Infant Nutrition – How to Build a Whole Foods Diet for Your Little One

Transitioning your baby to food is an important step in raising a healthy child. Not only is it critical for ensuring that your baby undergoes proper physical and mental development, but is also important in establishing healthy eating habits for the rest of their life.
First, I think the key with adding in foods is to make sure that your baby enjoys whole foods. Limiting processed foods, including many baby foods, is essential in this process. My bias is obviously a nutrient dense, animal based diet, but regardless of diet preference, whole foods is key.
The transition of Hank to normal food was quite a bit easier than I thought it would be as he essentially eats the exact same as I do. This approach is called baby led weaning and there are many great resources out there on how to do this properly. It started out with mostly sucking on the foods and spitting them out, but this is just fine as this means his primary source of nutrients is breast milk, which is optimal for a growing baby.
The first foods that Hank was given were meat from beef or lamb, liver, heart, bone broth, eggs, yogurt, fruit, and white rice. As you can see, the predominant foods on this list are animal foods and that is intentional. They are by far the most nutrient dense options for babies, are very easy on their digestion, and are least likely to trigger an immune response. Babies have limited enzyme production and it takes up to 28 months for all of this to ramp up properly, which can make it difficult for them to break down lots of complex carbohydrates.1 They do have the ability to break down protein and fat as these are the predominant nutrients in the mother’s milk, hence animal foods being the perfect option. Hunter-gatherers often feed liver as one of the preferred first foods and I can attest that if you give it to babies at a young age, they love it.
Cereal and grain based foods are the worst thing that you can introduce at this point. First, they are processed and the last thing you want is your baby hooked on processed food from a young age. Second, they have been associated with low nutrient status in infants as they are nutrient devoid and have phytates and other plant defense chemicals that reduce absorption of key nutrients.2 They are full of lectins and can stimulate the immune system inappropriately, especially with their underdeveloped gut.
The three big foods that I think are essential are egg yolks, liver, and muscle meat. If they get these three things then you will be off and running in the right direction.
Egg yolks in particular are rich in choline, cholesterol, healthy fats, and B-vitamins. They really are “nature’s multivitamin.” They house all the nutrients to grow a healthy baby and in the exact forms that you want. There is some concern that the white of the egg is the more allergenic component and could cause issues, but its also a great source of protein and we decided to give Hank the whole egg.
Meat will provide a great source of many b-vitamins as well as heme iron. Multiple studies have shown that good iron status is important for the baby’s brain development and subsequent intelligence. Heme iron is the most bioavailable form for humans and thus meat is an essential component of a baby’s diet. Don’t fear the animal fat as well! It has many of the fat soluble vitamins needed for immune system, skeletal, and many other aspects of development.
Liver is the most nutrient dense food on the face of the planet. Liver is an amazing source of b-vitamins, choline, minerals (like selenium, zinc, iron, etc.), vitamin A, and many more nutrients. It really is a power house. Anyone who thinks kale is a super food should take a look at the nutritional profile of liver compared to kale! This will give your baby the nutrients it needs to form all the cells and chemical messengers his body needs to grow and thrive.
As for plant foods, we have mostly stuck with sweet fruit, as it is easy to digest . Remember, fruit is the part of the plant that wants to be eaten and thus is best tolerated by our digestive tracts. Avocados, melons, mangoes, and strawberries have been Hank’s favorites so far. As far as vegetables go, he hasn’t had many. I am sure that we will probably expose him to some eventually, likely starting with fermented ones, but as of now we are happy with his diet.
  1. https://www.westonaprice.org/health-topics/childrens-health/nourishing-a-growing-baby/#gsc.tab=0
  2. Are weaning foods causing impaired iron and zinc status in 1-year-old Swedish infants? A cohort study.
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October 4, 2022
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Dr. Sam

Prenatal Nutrition – First Step Towards a Healthy Baby

The second I found out Suz was pregnant I became a little obsessed with how to grow the strongest and healthiest baby possible. Through my functional medicine training I knew that much of a person’s future health was determined by the quality of nutrition while in the womb and in the first two years of life. This forms the base of your life’s pyramid and if you want a pyramid that lasts, you can’t have cracks in the foundation. I wanted to pour as good of a foundation for my baby as possible so that when setbacks come he can lean on the excellent foundation we poured for him.
This started with Suz’s nutrition through pregnancy. The sources of information I leaned heavily on included an amazing book called Real Food for Pregnancy  by Lily Nichols, the Weston A. Price Foundation (WAPF), and the primary research cited by these two sources. The WAPF puts out amazing information that every parent should read to raise a healthy child.
The nutrients that we paid special attention to were the fat soluble vitamins (vitamins A, E, D, K), EPA/DHA, biotin, folate, B12, and choline.
The fat soluble vitamins play essential roles in skeletal formation, immune system development, and brain development. Vitamin E is needed for proper placenta formation and is a potent antioxidant. This is the least studied fat soluble vitamin with pregnancy, but nonetheless important to mention.
Vitamin A is a crucial vitamin for proper development of every organ in our bodies and was written about extensively by Weston A. Price in his book Nutrition and Physical Degeneration. Vitamin A deficiency in laboratory animals has shown to cause spontaneous abortion, prolonged labor with death of the mother, eye defects, defects of the snout and dental arch, displacement of internal organs (kidneys, ovaries, testes), and deafness. There is controversy about how much as there was one study that used synthetic vitamin A and found above 10,000 units caused birth defects. Every other study on vitamin A has essentially shown that higher doses, up to 40,000 units, cut the risk of birth defects. I believe it comes down to whole foods vs synthetic vitamins. The WAPF recommends 10,000-20,000 units per day from whole foods and I think this is a reasonable goal, but if people are getting it from whole foods I suspect they will be around 10,000 units per day. I believe this will get you all the benefits and none of the risks. Note: beta carotene isn’t a replacement or equivalent to retinol. You need to get vitamin A in its active form as this is the only form used by our bodies and most people don’t have the cellular machinery to convert beta-carotene at a high enough rate to make it useful. Retinol only comes from animal foods, so focus on these as your source of vitamin A.
Vitamin D is more well known to most people and plays big roles in skeletal development. It also plays roles in lung maturation and immune system development. This is especially true when derived from a food source. The WAPF recommends cod liver oil as the source of vitamin D and I tend to agree with them. There was a study out of Finland that looked prospectively at 12,058 children and found that children supplemented with vitamin D at 2000 units essentially had no risk of type 1 diabetes compared to those that didn’t supplement.2 To me, this shows the immense role that it plays in proper immune system development. Having a properly formed skeleton is no small matter so everyone should focus on getting enough of this vital nutrient from food sources (i.e. cod liver oil).
Vitamin K2 is the vitamin made famous by Weston A. Price (initially called activator X) and then more recently by Chris Masterjohn Phd. Vitamin K tells your body where to put calcium (i.e. your bones) and where to keep it out of (i.e. your organs). It is essential in forming every solid structure in your body. It also plays roles in hormone production and signaling as well as protects our genes. MK-4 is form of vitamin K2 that you get from food and is essential for healthy baby development. Weston A. Price believed this was the missing nutrient from our modern diet and with it we could eliminate much of western disease. He found that it was in high concentrations in the butterfat of milk of mammals, eggs, and organs/fats of animals. Traditional cultures have cherished these foods for pregnant women because they know the vital importance of this nutrient in developing healthy children, even if they don’t have the “science” to prove it.3
In order to get these fat soluble vitamins in Suz’s diet during pregnancy, we did an ounce of liver per day (in the form of 6 capsules), 4-5 egg yolks, 1.5 tsp of a fermented cod liver oil, and lots of whole milk, hard cheese, and other dairy products. As of now, if I could do it over again, I would have added a fermented butter oil to increase the vitamin K2 content of her diet.
EPA and DHA are major fats in the brain and are thus tied to cognitive development. A fetus uses massive amounts of DHA during development, at a rate ten times that which it can synthesized by the growing baby. This means we must get much of it from our diet in order to feed our growing baby’s brain. The best sources of this are cod liver oil, egg yolks, fatty fish, and to a lesser extent, grass fed meat. Eggs from chickens that are not fed corn and soy are a great source with as much as 350 mg per egg. This was a big source for us as well as the 1-2 Tbsp of cod liver oil that she consumed daily.
Biotin is another B vitamin that is essential for pregnancy. In animals, it has been shown that even a marginal deficiency can cause problems in the offspring, especially in limb and palate development. This hasn’t been studied in humans, but I still took this nutrient very seriously during Suz’s pregnancy. It is mostly found in liver and egg yolks and she was consuming these foods everyday. Please note that egg white, and especially raw egg white, has something called avidin that will bind biotin and make it unavailable to our bodies, so just consuming the yoke or cooking your whole eggs is needed to absorb a good portion of the biotin.
Folate is the nutrient that everyone relates to pregnancy. This is because it is very important for proper neurologic development. You need 600 mcg of folate during pregnancy in order to prevent birth defects. Most will take a prenatal vitamin, which should always be methylated folate as that is the active form your body needs. However, if you are ambitious and make intentional food choices you can do it without a prenatal vitamin. Using an app like cronometer can be great as you can log your food and they tell you the exact amount that you are getting. With Suz, we did a combination of prenatals and food. If she hit the targets for the day then we skipped it, but if she didn’t she took enough prenatal to cover her needs.
Choline is the last of our specific nutrients that I will address. This nutrient is essential for proper brain development. Rats fed large amounts during pregnancy give birth to offspring with increased visuospatial memory, better cognitive function with aging, better ability to concentrate, and are more resilient to  neurotoxic insults in our environment. Obviously this is something we want lots of. I may sound like a broken record, but this is mostly found in egg yolks, high quality dairy, and liver. Thus, these foods should be staples in every pregnant woman’s diet.
Pregnancy is a very exciting time and when you take the time to learn and implement the changes above it can be very empowering. However, obsessing over this is not beneficial and it takes time and effort in order to incorporate all this properly. Its often best to work with someone that knows this information and can help you implement it, but you can also learn it on your own if you read and are intentional about what you put in your body. Good luck!
  4. Vitamins and Minerals 101 by Chris Masterjohn
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