Published March 18 2013
Many people with thyroid and autoimmune thyroid conditions have vitamin and mineral deficiencies. In this article I’m going to discuss five common nutrient deficiencies found in people with these conditions. So this includes people with hypothyroidism and Hashimoto’s Thyroiditis, as well as people with hyperthyroidism and Graves’ Disease.
1. Vitamin A. Vitamin A has many important roles in the body. It helps to maintain the health of the epithelial tissues, plays an important role in immune system function, vision, and other sources. While many people will supplement with beta-carotene, the problem is that some individuals might have problems converting beta-carotene into vitamin A. While it can be challenging to determine if someone has a deficiency in vitamin A, some of the common signs and symptoms of a moderate to severe vitamin A deficiency include night blindness, a decrease or loss of appetite, and being more susceptible to infection.
With regards to thyroid health, thyroid hormone is involved in the conversion of beta-carotene to vitamin A (1). As a result, if someone has hypothyroidism, then this can potentially lead to a vitamin A deficiency. And if you attempt to correct this by giving the person beta-carotene then this very well might not correct the deficiency since the body will have problems converting it into vitamin A. So in this situation one would want to take the entire vitamin A complex in the form of a whole food supplement.
2. Vitamin D. Vitamin D not only is important for strong bones, but is also important for the health of the immune system. Many of my patients who have Graves’ Disease and Hashimoto’s Thyroiditis are deficient in vitamin D, as this can easily be determined by a simple blood test. And this isn’t just my observation, as studies have shown that the prevalence of vitamin D deficiency is significantly higher in patients with autoimmune thyroid disease when compared to healthy individuals (2). One study also showed that a vitamin D deficiency was associated with the presence of antithyroid antibodies and abnormal thyroid function tests. However, while most labs have a reference range from 30 ng/ml to 100 ng/ml, for optimal immune system health one really wants these levels to be greater than 50 ng/ml. While the sun is usually the best source of vitamin D, if someone has a deficiency then usually supplementation with vitamin D3 will be necessary. Vitamin D also has a direct effect on thyroid health, as this vitamin has been shown to influence thyrocytes directly by attenuating thytrophin (TSH)-stimulated iodide uptake and cell growth (3).
3. Iron. Iron is required for the synthesis of thyroid hormone, and an Iron deficiency impairs thyroid hormone synthesis by reducing activity of heme-dependent thyroid peroxidase (4). This mineral has a lot of other important functions. While it is more common for cycling women to be deficient in iron due to menstruation, an iron deficiency can affect menopausal women as well, and sometimes men (especially vegetarians and vegans). As a result, I think that most people should have their serum iron and ferritin levels checked regularly, along with the % saturation. Besides being important for the synthesis of thyroid hormone, iron of course is important for the production of red blood cells. It is a component of hemoglobin, and as a result it plays a role in the delivery of oxygen to the tissues and cells of the body. Iron can interfere with the absorption of levothyroxine, and so people taking thyroid hormone should take their iron supplements two to four hours later.
4. Selenium. Selenium is a very important mineral when it comes to thyroid health. Not only does it play an important role in the conversion of T4 to T3, but it also is essential for optimal health of the immune system. In fact, some research studies have shown that taking selenium can lower thyroid antibodies (5). Of course other factors are important as well, and so while some people with Graves’ Disease and Hashimoto’s Thyroiditis notice a dramatic improvement in their health when taking selenium, many others don’t notice much of a difference. I’ve written about the importance of glutathione previously, and selenium is a cofactor for glutathione peroxidase synthesis.
With that being said, many people are deficient in selenium. And when this is the case, it is extremely important to correct this deficiency for anyone looking to restore their health when following a natural treatment protocol. Brazil nuts are a good food source of selenium. Sardines are also a good food source, although recently I learned that they are high in PCBs. However, just as is the case with other mineral deficiencies, when someone is deficient in selenium, then may need to take a selenium supplement. I usually recommend a whole food supplement, and the reason for this is because selenium is best taken with vitamin E and other nutrients and cofactors. In addition, I’ve had a few patients who had a negative reaction when taking synthetic selenium.
5. Iodine. Without question, iodine is the most controversial mineral when it comes to thyroid health. I’ve dedicated numerous blog posts and articles on this mineral, and so I’m not going to discuss this in great detail here. Iodine of course is important for the formation of thyroid hormone. As a result, a deficiency in iodine can potentially lead to a hypothyroid condition. These are facts, but from this point on the controversy begins. When it comes to an iodine deficiency, some sources claim that most people are iodine deficient, while other sources suggest that most people have sufficient levels of iodine. If I plan on giving iodine to anyone I will test them first to see if they have a deficiency. Of course there is some controversy over the different types of testing, which is yet another story.
As for whether people with thyroid and autoimmune thyroid conditions can benefit from taking iodine, there is even more controversy in this area. Although there is some evidence which shows that taking iodine can benefit people with hypothyroidism and hyperthyroidism, other studies show that taking iodine can actually cause a hypothyroid or hyperthyroid condition, and can perhaps even lead to autoimmune thyroiditis. As a result, some healthcare professionals will recommend for all of their patients with autoimmune thyroid conditions to completely avoid iodine. Other studies suggest that this is only true when someone has a selenium deficiency, and that iodine should always be taken with selenium.
So where do I stand when it comes to iodine supplementation? I’m definitely pro-iodine, and I feel that if someone has an iodine deficiency that it eventually needs to be corrected. With that being said, I’m still cautious about giving iodine to my patients, especially those with Hashimoto’s Thyroiditis. For anyone who supplements with iodine I first recommend getting tested, and then if it shows you’re iodine deficient I recommend starting with a small dosage, along with taking antioxidants such as selenium and vitamin C, along with magnesium.
Why Are People Commonly Deficient In These Vitamins And Minerals?
You might wonder why it’s common for people to be deficient in these nutrients. Well, there are numerous reasons. For example, with vitamin D it can be due to the person not getting enough sunlight, having darker skin, living at a high latitude, or perhaps living in an area where there is a lot of air pollution. With iron it can definitely be due to poor dietary intake, but other factors which can cause problems with iron absorption include a deficiency in vitamin C and/or hypochlorhydria.
If someone has a lot of vitamin and mineral deficiencies, then there are numerous reasons why this can happen. Of course eating a diet high in refined foods and sugars can cause this. And in most cases, just changing one’s diet won’t correct moderate to severe deficiencies. Certain medications can also interfere with the absorption of vitamins and minerals, such as oral contraceptives. Problems with intestinal permeability can also lead to numerous deficiencies. So while one will probably need to supplement with these vitamins and minerals to correct these deficiencies, it of course is important to address the cause of the deficiency so that one won’t need to take such supplements on a permanent basis.
In summary, many people with thyroid and autoimmune thyroid conditions are deficient in one or more of the nutrients I discussed in this article. And while a single vitamin or mineral deficiency can have a dramatic effect on one’s health, multiple deficiencies are very common. Although I focused on five nutrients in this article, other nutrients can also play a role in thyroid health, such as zinc and manganese. Even though supplementation is usually required to correct a moderate to severe deficiency, the overall goal should be to address the cause of the deficiency so that people will get maximum benefit from any vitamins or minerals they are taking.