Goitrogen Clarity – By Dr. Alan Christianson:
Hey there. Dr. Alan Christianson here. I am really eager to talk to you all about Goiter and Goitrogen and help make some good sense out of this. Its so important because you know you sure want to do the right things to help your Thyroid and improve your health and you want to know which foods are going to be helpful and which food are going to make things better and which ones are problematic. So it is critical to get it all right and avoid foods that are harmful and get the ones that are helpful.
So lets back up a little bit. So what is a Goiter? What is a Goiter after all. So a Goiter is an enlargement of the Thyroid. It is a more diffused enlargement that is causing actual pressure upon the gland and the structures around it. This can effect the breathing and the swallowing. This can also effect circulation within the area and Goiter can be active meaning they make extra amounts of hormone or they can be inactive meaning they are a more dead type thyroid tissue that is not producing hormone tissue. They can be quit large or they can be barely noticeable and a goiter is not the same as a nodule. They are distinct in that they are a different density of tissue and we categorize those based upon size.
The first class of a Goiter is one that can be felt with palpation or via ultrasound but not noticeable. The second class is noticeable by palpation and also visible. Palpation just means feeling the neck. The third class is very large and its creating pressure behind the thyroid itself. There are often marks that are formed from that and then changes in swallowing and speaking.
Now the general idea behind a goiter is that it is formed by some combination of inflammation and a exaggerated growth signal. So inflammation just means that something is irritating the thyroid tissue. The growth signal in the cycle is that there is thyroid stimulating hormone that is made to help the thyroid produce hormone so when the gland has a low point of this activity the body makes more thyroid stimulating hormone, TSH, to stimulate the gland and what that does is causes the cells of the gland to divide. So the gland actually gets larger.
So a healthy gland with this slight increase in size will end up creating extra hormone and the body will be satisfied with that and the thyroid stimulating hormone will go back down again. So the size change is not very substantial. If the gland is inflamed especially from an auto immune attack like Hashimoto’s or if there is an iodine deficiency then that signal on the gland can keep on getting higher and higher and the gland can get larger and larger. So it can reach a point that even though it has grown substantially it is still not making enough hormone and it keeps on growing and growing.
Now this has been recognized as a condition for quit some time. The Chinese physicians from 2 Millinia ago had writings discussing Goiter. Pretty wild that they knew that you could effectively treat Goiter with the powder from burnt seaweed or by giving thyroid tissue from animals. They would dissect animals and remove there thyroid glands and then minced them up and fed them to people with Goiter. Pretty wild that they were able to cure them and that they had this knowledge. So it has been known about for quit some time.
So the most common causes for Goiter. The two most common by far would be iodine deficiency and then Hashimoto’s disease. Iodine deficiency is the most common global cause and that is because most of the world does not have iodized salt. Many areas that do not have high intakes of seafood can become low in iodine. You know iodine ultimately comes from the sea. So crops that are raised near the sea that have some sea water or iodine in the soil or food directly from the sea you know sea vegetables, fish, shell fish those are all things that have more iodine. We do also find iodine in dairy foods and bread products. Not because it is naturally occurring but in dairy foods sometimes iodine is used to sanitize the tits where they milk the cows from and that ends up causing some to be in the milk. For bread products sometimes iodine is used as a dough conditioner, not always but in some circles it is used that way and that causes bread to have a bit more iodine. So those are the big sources.
Areas that do not have coastal access or do not have iodine in the foods or dairy foods they can get low in that and in those cases there is more tendencies towards Goiter. It turns out that certain foods can make iodine a little bit harder to absorb. So if you do live in an area that has endemic iodine deficiency and your diet is high in certain foods you may have an impairment of iodine absorption.
Now this is a long list of foods and a lot of things can possibly do this. A lot of these foods that are on these lists you will see a lot of these foods have not been shown to do this in humans. They either have shown to do it in animals or it is theorized they could do it in humans. Some ones that have been documented would include cassava and cabbage. Also Pinenuts, peanuts, millet, cruciferous type vegetables which include broccoli, bok choy, Brussels sprouts, cabbage, cauliflower, collard greens, kale, mustard greens, radishes, rutabagas, turnips. Rutabagas are good foods. When we grew up on the farm we had those quit a bit. We will also see other foods possibly having this activity such as spinach, bamboo chutes, sweet potatoes, peaches and berries and strawberries and millet. Wow so what do you do. Those are all really good foods.
The way it works is that even in areas with endemic Goiter the effects are not very significant. If you have an area to where you have this with lets say per every 1000 people 100 would develop Goiter. Now if that same population had a high intake of cassava or millet rather then seeing a 100 who get Goiter they might see 150 Goiter. So it does not mean that everyone who eats those foods gets Goiter. It means that a few more do.
This is about iodine deficiency. So these foods cause Goiter because they change iodine absorption. So if the population is lower in iodine and they are lacking it or are on the border anything that impairs its absorption will cause a few more people to become deficient.
Now in the modern world the main cause for thyroid disease is Hashimoto’s disease. It is rather rare that Hashimoto’s develops Goiter but even when it does, Goiterogens do not promote that. Goiterogens only cause Goiter in small degrees in areas where Goiter are caused by iodine deficiency. So we are talking about Hashimoto’s which is the most common cause. All those Goiter are not triggers.
Now a couple exceptions. With Hashimoto’s you still want to consider soy, millet and some medications. Amiodarone, lithium, Dilantin also called Phenytoin and fluoride. Those are things that can be Goitergenic with Hashimoto’s. Soy you just want to avoid it across the board. Versions of soy that are fermented or are fresh so that is edameme and soy sauce, traditionally brewed soy sauce. Better to do the wheat free version called Tamari or also miso. Those are compounds that do not have significant amounts of the soy Goitrens. So small amounts are actually fine to have. Millet is a food that if you have ever cooked it is not the greatest. It is not the best type of a grain for a side dish anyways but it can possibly be a factor with Hashimoto’s. so it is worth avoiding.
The medications that I mentioned you know Amiodarone is not commonly used and it is a cardiac drug that regulates heart rate. It is full of a lot of side effects and that is because it is very high in iodine. Kind of a paradox. You know you can lack iodine and you can have a whopping dose of iodine and both can create the same types of problems. So Amiodarone is a culprit not commonly used. Lithium can be a culprit. There are pretty thorough guidelines encouraging prescribes of lithium to monitor and treat thyroid function. It is just too well known to off set the thyroid. Fluoride can be a culprit in higher dosages and it is good to avoid fluoride in general.
Now the other Goitrogens that cause such stress to people have no relevance to Hashimoto’s. The broccoli, the cabbage, the strawberries, the kale, the spinach, the cauliflower, collard greens, turnips, radishes those are such goods foods. The exact same parts of those foods that make them healthy make them Goitrogenic with iodine deficiency but they are actually healthy for those with Hashimoto’s. Those are same compounds that help detoxify.
If you take people with Hashimoto’s they have a gene defect which makes it harder for them to detoxify. They can not get waste out of there body the same as someone else would and they need the support of foods like broccoli and kale and spinach. I read the well intentioned writings of many bloggers and they say you know Goitorgens are okay in moderation or be sure and cook them. It is true that of course smaller amounts will do less then larger amounts. That cooking does neutralize many of these properties but honestly you do not have to worry about that even. If someone does have Hashimoto’s and they are on thyroid treatment there fine to have those foods. They do not need to be restricted from these healthy foods.
Here is a case study of how this stuff applies and it is quit rare. There was a young man I saw who was in his late teens or early twenties and he became an advocate for a rather extreme raw food diet and over the course of probably six months he shifted his diet to contain nothing but raw produce. You know not even vegetarian or vegan just raw produce only. Specifically he was making smoothies with a couple pounds of broccoli. Now that would not make the best smoothie. He would do that and do it with cabbage and carrots also and that was pretty much what he was living off of. So he had no iodized salt, no seafood, no dairy foods. Not a lot of other sources of produce but large amounts of Goitrogenic vegetables. He did develop a rather subtle stage one Goiter and he did develop early hyper thyroidism.
His father brought him into to see me because his father thought that he was getting lethargic and that he was seeming run down. Perhaps his hair was thinning. His father was just suspecting anemia and I was as well. Low and behold the boy was anemic and he also was developing hyper thyroidism without a clear auto immune component. So the radically complicated treatment I encouraged was for him to start eating again. To really get a bigger variety of foods. Sure be healthy and be off processed foods, I could not agree more with that but you need a little bit more variety. So he started doing that. Getting some sources of iodine and over the course of the next month or so his Thyroid function corrected and went back to normal. It stayed that way and I still watch every year or so and he has remained healthy. So that was one case I have seen where Goitrogen actually mattered.
People who have thyroid disease should eat there vegetables and enjoy them and do not even worry if they are cooked or raw and do not even worry about the dietary Goitrogens either. They are healthy foods. It is totally normal. Thyroid disease is really one of those diseases where there is really too little information the medical world gives and there is too much ambiguity and uncertainty. I think it is natural where people are left in a state of concern or worry and they want to do something for their health.
Those that do write about the disease you know they are well intentioned and they want to share information. They pass around these lists of Goitrogens but they often do not understand the relevance these things have or in which situations they apply. Thyroid disease is primarily Hashimoto’s. I should mention this in a tiny bit more in depth. If you have thyroid disease in glands that are active and you have been told that you do not have Hashimotos or you have not been told that you do have Hashimoto’s you probably have Hashimoto’s.
Some have an idea that if you do not test positive for thyroid anti bodies and if these do not test positive therefore you do not have Hashimoto’s. Well that is not true. If these anti body tests are positive that does show you have Hashimoto’s. If they are negative there are actually many more anti bodies that can attack your thyroid that we can not measure for. So 40% of people or more that have Hashimoto’s will never have positive anti bodies.
Hashimoto’s is a disease defined by the microscopic structure of the thyroid. So the only way that you can say that someone does not have Hashimoto’s would be to remove their gland and analyze every nook and cranny of it. You can not rule out Hashimotos by blood test and you can not even rule it out by imaging studies. So someone who has thyroid without another obvious cause like Thyroid surgery or medication to slow their thyroid it is assumed they have Hashimoto’s and in that case it is okay to have Goitergenic foods except for soy and millet and those meds.
So enjoy your veggies and take wonderful care of yourself. Thank you so much and we will talk soon. This is Dr. C signing out.