Okay, RJ Douglas says, what would be your nutritional recommendations for a 35 year old woman with hypothyroidism and low zinc levels? Well, if you have low zinc levels, then you should increase those zinc levels up to normal with either changing your diet or supplementing. So oysters, beef, and cheese are the best sources of zinc. Oysters are by far and away, better than beef and cheese. So honestly, I think a vegan with poor zinc levels should supplement with zinc. You know, it’s one thing if you have a vegan whose diet just happens to provide good zinc status, despite the fact that their diet is dramatically lower in total zinc than an omnivore who eats a lot of red meat or seafood, particularly oysters, and that the bioavailability of zinc from those foods is dramatically less. So a vegan probably needs twice as much zinc as an omnivore needs because of the inhibitory effect of phytate and the beneficial effect on zinc absorption by the amino acid composition of most animal proteins. And so vegan foods are arguably intrinsically inferior to animal proteins as sources of zinc. And I’m not saying that someone whose vegan can’t get enough zinc period, full stop. I’m just saying that if you sort of draw a box around those foods and say, these are the foods that you really want to disproportionately increase in your diet, if you’re low intake, none of them are vegan. And so I think a vegan who has low zinc levels you can look at the diet and if it’s an obviously bad quality diet, then eat a better diet and see if it increases the zinc levels. But if it’s a pretty good vegan diet, as you would try to construct one, and the zinc levels are still low, that person just needs supplement. And so I would start with something like seven to 15 milligrams of zinc. You’re probably not going to find seven, unless you’re taking something like oyster supplements or some other whole food supplement, but I would take a low dose zinc supplement and I would take it on an empty stomach if the person tolerates it, if not try to take it with food that does not contain any whole grains, nuts, seeds or legumes including soy protein. And so if that’s difficult based on the diet, take the zinc with a little bit of juice or just something. If it causes nausea, just put something in the stomach that isn’t a full meal and doesn’t have those foods that I just mentioned. And that would be the main thing. Now there’s other things with hypothyroidism that you can think about, but aren’t automatic, right? Just because there are a bunch of nutrients that play an important role in hypothyroidism, it doesn’t mean that that person needs all of them. And so some of the ones to think about are iodine because iodine is a component of thyroid hormone, protein because protein provides the tyrosine that is needed to combine with iodine to make thyroid hormone. Vegans have lower protein intakes than almost everyone else. Selenium, but I would be very careful with selenium. I don’t like the idea of someone supplementing with more than a hundred micrograms of selenium for more than a few weeks without testing plasma selenium levels because some people have too much selenium. Protein can be a very big one. So vegans often have low protein intakes. I mean, they basically universally have lower protein intakes than omnivores. And there is one study and I’ll make a note to put this in the show notes.
There’s one study showing that the intake of glycine is deficient in, and this wasn’t even vegans, this is vegetarians, it was showing that the intake of glycine is deficient with respect to maximizing glutathione synthesis. And there’s a way that you can measure that. So when someone excretes, pyroglutamate also known as five L Oxo proline into the urine, that means that they didn’t have enough glycine to make glutathione, according to their body’s own perception of how much glutathione was needed. And when they fed them more protein, that marker went down to normal or down to the omnivore level in the vegetarians. And so that’s sort of proof of principle that many vegans and vegetarians aren’t consuming enough total protein to provide the amount of glycine. Either they didn’t have enough glycine per se, or they didn’t have enough nitrogen. And they were breaking down glycine in order to use nitrogen for other purposes. Either way, the studies showed that it was reversed by eating more total protein. So if you don’t… It’s not just tyrosine that you need to make thyroid hormone, but it is glutathione that you need to protect the thyroid gland. And when the Q&A broke down, I was saying that selenium gets a lot of attention in Hashimoto’s, but what doesn’t get much attention is that the role of selenium in the thyroid gland is to protect the thyrocyte from the large amount of hydrogen peroxide that has to be produced to go into the thyroid follicle lumen for the purpose of preparing iodine to be added to tyrosine to make thyroid hormone. That hydrogen peroxide is a major liability. And so therefore you need strong antioxidant support. And among that antioxidant support is selenium. Selenium is there because it is a co factor glutathione peroxidase. Glutathione peroxidase needs glutathione, glutathione is made from protein.
And so anything that boosts glutathione status, or even glutathione can be considered in a case of hypothyroidism, but more to the point, if someone’s a vegan, then they probably have a very good chance of not getting enough protein to maximize their glutathione status. And then more broadly all of the antioxidant nutrients come into play. And so among those are zinc copper, manganese, iron, we already talked about selenium, vitamin E, vitamin C, and you can go on down the list and you can kind of check off certain boxes as probably the vegan’s getting that, probably the vegan’s not getting that, right? So in terms of a well constructed vegan diet, especially with respect to how a vegan nutritionist would think of a well constructed diet, that person’s probably getting enough vitamin C, they’re probably doing pretty good on vitamin E. We already know this person’s deficient in zinc. Probably they’re getting enough copper, probably not getting enough iron. In fact, generally if someone’s not getting enough zinc they’re not getting enough iron and vice versa. It’s complicated a little bit by the fact that a female who’s menstruating will be more likely to be deficient in iron than zinc, but the dietary patterns that lead to good or bad zinc and iron status are very much overlapping. And a vegan diet is very high in iron absorption inhibitors, very high in zinc absorption inhibitors, very low in zinc, not necessarily low in iron, in total iron, but probably low in absorbable iron. And if you add on to that, I believe this woman was a young female, So I believe that was a 38 year old female, and so that person would, probably, if they’re deficient in zinc probably has a pretty decent chance of also being deficient iron through combination of menstruation increasing iron loss and having a diet that, just as it is not that great at provided highly absorbent zinc, is similarly not that great at providing highly absorbable iron.
And then there’s other considerations, but I would list this at the top for thinking about hypothyroidism in that case.
Source: Chris Masterjohn, PhD
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