Hyperthyroidism: Nutritional Considerations

Relationships between diet and hyperthyroidism relate to celiac disease and to excessive iodine intake. Patients with celiac disease have an increased prevalence of autoimmune disease, including Graves' disease.¹ It is unclear whether the association is due to a common genetic basis for the two conditions² or to an as-yet unidentified cause-and-effect relationship. Some have suggested that hyperthyroidism in celiac disease may relate to an autoantibody-induced stimulation of thyroid hormone output.³ Limited evidence indicates that antithyroid antibody production abates in celiac patients after 3 to 6 months on a gluten-free diet.⁴

Iodine-induced hyperthyroidism has been reported in patients in remission after treatment for previous thyroid diseases. For example, euthyroid patients previously treated with antithyroid drugs for Graves' disease are prone to develop iodine-induced hyperthyroidism.⁵ Remission rates for Graves' disease after treatment with antithyroid medication may be related to excess iodine intake.^6,7 However, this has not been established in controlled clinical trials.

Orders

See Basic Diet Orders.

A gluten-free diet may be tried prospectively.

What to Tell the Family

Hyperthyroidism is common and generally responds well to medical therapy. In some cases, the disease spontaneously remits. In others, radioactive iodine therapy is indicated to remove or destroy overactive thyroid cells, necessitating lifelong thyroid hormone replacement to maintain a normal hormone level. Patients should attempt a trial period of avoiding foods that contain high concentrations of iodine, including iodized salt, sea salt, seafood, dairy products, and eggs, and foods that contain iodides, iodate, algin, alginates, carrageen, agar, and red dye number 3.