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Author Topic: Hypothyroidism and zero calcium & iron breakfasts  (Read 1174 times)

PerditaPickle

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Hypothyroidism and zero calcium & iron breakfasts
« on: February 21, 2020, 06:06:49 pm »
Hi all,

So, as the thread title says, this post is aimed at those with hypothyroidism (or who know someone with this), seeking any resources you may have for zero calcium and zero iron breakfast foods.

I was diagnosed many years ago and although I was advised not to consume calcium and iron at the same time of day as taking my medication, it was not made clear that I need to avoid these nutrients for four hours, and I've only just come across this info (for a variety of reasons).  I'd been aiming for a half hour as a minimum or an hour ideally, and thought I was doing okay (as one General Practitioner who clearly had no idea had erroneously told me some years ago that ten minutes would suffice!)  However, this could well be the reason why I've never felt any better even though taking the medication daily!  (For anyone reading who doesn't know a lot about hypothyroidism and is wondering, these nutrients inhibit the absorption of the medication by the body.)

Is it relatively safe to assume that if the packaging of a foodstuff doesn't list calcium among the nutritional content then it doesn't contain any (I'm in the UK)?  As I've found that some foods list it, with an amount, and some make no mention of it.  Iron, on the other hand, I'm not sure I've ever actually seen listed on any packaging (so even this would only solve half my issue.)

I'll also need to find an additive for my morning teas to replace milk, as I can't survive on black coffee & tea all morning and fruit juice is out, too (as can contain both nutrients).

I tried the usual Google search* but (as always seems to be the case) most of what I've found has been written by other sufferers, such as patient message boards, and varies hugely in what it advises & it's impossible to tell quickly what's sound info and what isn't (there's a lotof back and forth between different individuals out there just directly contradicting one another (arguing!), and almost no-one cites any sources!)

Thanks, if anyone's any advice!

*Though not Google Scholar yet, as not sure how to frame my search and haven't had the brain for it yet.

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Re: Hypothyroidism and zero calcium & iron breakfasts
« Reply #1 on: February 21, 2020, 06:57:19 pm »
So, as the thread title says, this post is aimed at those with hypothyroidism (or who know someone with this), seeking any resources you may have for zero calcium and zero iron breakfast foods.

So, I think radical changes to your diet and schedule are not the place I'd personally start with this. (Usual disclaimers here: not a doctor, not your doctor, am someone with hypothyroidism)

The advice I've seen (and gotten from my doctor and dietician) is that levothyroxine should be taken on an empty stomach and that you should refrain from eating or drinking for 45-60 minutes after.

However! If you consistently eat the same thing every morning, you can also eat when you wake up (as some people really need to) and adjust the dosage to get suitable results as needed. I.e. having coffee with milk right when you wake up sometimes and not other times is not great and can lead to irregular dosing, but doing it basically every day may be fine. Depends on your body.

What I do is:
1) Wake up (6 or 6:30am, depending on plans for exercise)

2) Sit up, rearrange the cat, take my levothyroxine pill

3) Do other morning things, leave for work (I leave at 7) I get to work at 7:30 so this is 60-90 minutes later.

4) Get to work at 7:30, by 8, have breakfast at work, which is almost always either cottage cheese or yogurt. I take an iron pill at the same time, and my other morning med. (So usually a 2 hour gap, sometimes a bit less.) I'm not very hungry in the mornings, I do need to eat for blood sugar reasons, so this is the combo that works for me. (But I do really need protein, which basically means dairy, for eating at work purposes.)

5) My food on weekends varies a lot more, but I still wait at least an hour.

I have run this by doctor and dietician, and both of them have gone "Yeah, that's well over the margin of concern" - other research (for example, this) has focused mostly on an hour or so interval (i.e. enough time for food to pass out of your stomach, which is where the levothyroxine mostly gets absorbed.) But even that study is sort of awful, because they were doing it in people without thyroid disease.

This one says waiting 30-60 minutes is best, but less can be worked with.

My blood work has been up and down in the couple of years I've had that particular routine, but I've only had one dosage increase in that time (and actually dropped back twice when my TSH got too low). I prefer my TSH to hover between 1 and 1.5, and I feel completely awful and non-functional at 3. Bodies vary, but in the US, 3 is finally now the diagnosable level by most recently trained doctors.

(My understanding is that because most people in the US/UK have autoimmune issues at the root of their hypothyroidism, it is considered fairly normal for you to need increased doses as your thyroid gets attacked and eventually mostly stops working over time - any increases will plateau when you hit the level your body would have produced and needs and you can't produce that much. You can get fairly rapid changes in your needs if you have a particularly strong autoimmune flare.)

So, other solutions possible:
Rather than cutting all calcium and iron out of your entire morning (which as you note, is likely to be pretty tricky)

1) Be consistent about what you eat in the morning, push your doctor for updated blood work, and see how that goes if you do any needed dosage adjustment.

Some people do need more than levothyroxine - some people need T3 or T4 (related hormones that help process thyroid). Some people react very differently to different makers, so if you've been taking it a while and the pills have changed (i.e. different maker) you may need to see if you can get stable on a specific maker and dosage, and make sure your prescriptions are written for that specific one. Your bloodwork should help sort this out.

(Also, you may already know this, but it takes 2-3 months to be sure about dosage adjustments and whether they're working. Pharmacologically/biologically speaking, levothyroxine is a weird drug. Tiny tiny dosage compared to many things, takes a long time for your body to decide about the effects for ongoing use.)

2) Some people instead take their pill last thing at night, at least 2 hours after eating anything. I fairly reliably have a snack an hour or so before bed, so I don't do it, but it can work really well if you're someone who desperately needs to eat first things when you wake up.

It's a fairly common variant, so check with your doctor, but the chance they'll have issues with it is probably small.

3) As you know, but is worth saying again, there are a bunch of reasons you can feel lousy that produce similar symptoms to hypothyroidism, even when that bit is well managed. In particular, vitamin deficiencies (particularly D and B, and most people in the northern US and UK are deficient a lot of the year in D). I also had a really substantial improvement in some related symptoms with a CPAP machine, even though my sleep apnea is quite mild.

There are a bunch of other options, so if you feel lousy, keep track of how you feel lousy, what it's keeping you from doing, anything measureable (i.e. if you can demonstrate you're getting what should be plenty of sleep, are exhausted on mild exertion, etc. that helps doctors take you seriously) and push for more ideas.

(On the downside, I suspect I'm starting to hit perimenopause symptoms, and another med change has me dealing with some other side effects, so this is the never ending circle of "which of the things it might be is causing this fatigue and brain fog, I really don't know.")
« Last Edit: February 21, 2020, 07:01:32 pm by Jenett »
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Re: Hypothyroidism and zero calcium & iron breakfasts
« Reply #2 on: February 21, 2020, 07:26:45 pm »
However, this could well be the reason why I've never felt any better even though taking the medication daily!

Sooooo I don't have any thoughts about dietary stuff but I absolutely have things to say about this.

Not all thyroid medications are equal.

I take brand-name Levoxyl. (The doc who actually diagnosed me said outright and in so many words that it has less crap in it than other meds.)  When it was on recall (for a brutal year or so) the first thing we did was swap me to a generic version thereof, and after about a week all of my symptoms came back. Basically simultaneously.

I spent the rest of the recall time on Tirosint, which did the same thing for my bloodwork numbers, was about 2/3 as effective at symptom alleviation, and cost five times as much.

I was on Synthroid in my teen years and noticed zero practical effect. (I have seen other people say that Synthroid in particular is useless.)

If you're not getting any symptom alleviation despite having a sound TSH/T3/T4 number to support it, it might well be worth talking to your doc/endocrinologist about whether a different brand of levothyroxine Is Right For You.  Ideally one with, as the man said, less crap in it.
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Anon100

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Re: Hypothyroidism and zero calcium & iron breakfasts
« Reply #3 on: February 21, 2020, 07:40:31 pm »
Hi all,

So, as the thread title says, this post is aimed at those with hypothyroidism (or who know someone with this), seeking any resources you may have for zero calcium and zero iron breakfast foods.


I'm also not of any medical skill and don't even have a similar condition so please bear that in mind and that this is just a suggestion to narrow your search; should you still want/need to find low iron foods ( and it sounds from both Jenetts and Darkhawks advice that you may not ), it may be worth searching for Hemochromatosis diets.
I did a quick google for low iron foods and discovered that Hemochromatosis is a condition where the body has too much iron and people with it need low iron foods.

That said ( you probably realise this but I want to make sure I don't hurt you with bad suggestions ), there are obviously some foods recommended for other effects of this illness and also, you probably don't want to end up with iron deficiency.

Noctua

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Re: Hypothyroidism and zero calcium & iron breakfasts
« Reply #4 on: February 22, 2020, 10:36:08 am »
Hi all,

So, as the thread title says, this post is aimed at those with hypothyroidism (or who know someone with this), seeking any resources you may have for zero calcium and zero iron breakfast foods.

I was diagnosed many years ago and although I was advised not to consume calcium and iron at the same time of day as taking my medication, it was not made clear that I need to avoid these nutrients for four hours, and I've only just come across this info (for a variety of reasons).  I'd been aiming for a half hour as a minimum or an hour ideally, and thought I was doing okay (as one General Practitioner who clearly had no idea had erroneously told me some years ago that ten minutes would suffice!)  However, this could well be the reason why I've never felt any better even though taking the medication daily!  (For anyone reading who doesn't know a lot about hypothyroidism and is wondering, these nutrients inhibit the absorption of the medication by the body.)

Is it relatively safe to assume that if the packaging of a foodstuff doesn't list calcium among the nutritional content then it doesn't contain any (I'm in the UK)?  As I've found that some foods list it, with an amount, and some make no mention of it.  Iron, on the other hand, I'm not sure I've ever actually seen listed on any packaging (so even this would only solve half my issue.)

I'll also need to find an additive for my morning teas to replace milk, as I can't survive on black coffee & tea all morning and fruit juice is out, too (as can contain both nutrients).

I tried the usual Google search* but (as always seems to be the case) most of what I've found has been written by other sufferers, such as patient message boards, and varies hugely in what it advises & it's impossible to tell quickly what's sound info and what isn't (there's a lotof back and forth between different individuals out there just directly contradicting one another (arguing!), and almost no-one cites any sources!)

Thanks, if anyone's any advice!

*Though not Google Scholar yet, as not sure how to frame my search and haven't had the brain for it yet.

OK so let me start by saying that I have experience on this in 2 areas- I'm in the healthcare field, and I've been taking levothyroxine for autoimmune hypothyroid for nearly 30 years now.

When they recommend avoiding calcium and iron because they interfere with absorption, they usually mean supplements, not what's naturally present in food. It is true that you should avoid taking those supplements for some time (studies show varying amounts, probably depends on individual digestive processes) after taking thyroxine replacements, but that's because they're usually a big huge amount of unbound minerals. What you have in food is more complex compounds that through the process of digestion will eventually break down and release those elements, but won't interfere with the thyroxine before they're digested (meaning they don't impact absorption in the same way as the supplements).

Also, what Jennett said is absolutely correct- as long as your morning routine is consistent, your dosage can be adjusted to reflect this. My routine is less than ideal due to necessity- I have maybe 15-20 minutes of empty stomach time to process my levothyroxine before I have to eat, because I have other meds I absolutely HAVE to take to function that also HAVE to be taken with food. So my routine is wake up, take levo which is right by my bed, shower and get dressed, then go downstairs and take other morning meds with coffee and breakfast. But because I do that every single day, and have done that every day for years, my dose is appropriate for that routine. It might be higher than what I would take if I were able to do things "perfectly" but we have to be realists, there is no perfect.

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Re: Hypothyroidism and zero calcium & iron breakfasts
« Reply #5 on: March 05, 2020, 02:06:49 am »
If you're not getting any symptom alleviation despite having a sound TSH/T3/T4 number to support it, it might well be worth talking to your doc/endocrinologist about whether a different brand of levothyroxine Is Right For You.  Ideally one with, as the man said, less crap in it.

This whole thread makes me wistful for a GP who took my concerns about my hypothyroid symptoms seriously.
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Re: Hypothyroidism and zero calcium & iron breakfasts
« Reply #6 on: March 05, 2020, 12:15:19 pm »
This whole thread makes me wistful for a GP who took my concerns about my hypothyroid symptoms seriously.

Oh, if it makes you feel any better (tho it probably won't) ... me too!

Jainarayan

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Re: Hypothyroidism and zero calcium & iron breakfasts
« Reply #7 on: March 10, 2020, 01:39:46 pm »
So, I think radical changes to your diet and schedule are not the place I'd personally start with this. (Usual disclaimers here: not a doctor, not your doctor, am someone with hypothyroidism)

Same here. Was diagnosed >30 years ago in my early 30s. I've been on levothyroxine for most of that time, with one detour to Armour Thyroid, and several years of adding Cytomel (T3, liothyronine) to my T4. I've read that men don't convert T4 to T3 very well. T3, as some may know is the hormone that actually does the metabolic work. T4 is the "storage" form.

Anyway, I'm about ready to do violence (figuratively of course  :P) on my doctor. He has been chasing the numbers like Alice and the White Rabbit. My TSH dropped to <.1 for one blood test. What does he do? He lowers my dose. Next blood test my TSH is in the penthouse. He raises my T4 and takes me off T3. Tl;dr, my TSH last month was 76. I'm waiting for his call. I've had several blood tests, with all kinds of variations and dosage adjustments.

I had an excellent endocrinologist who had me balanced and stable, and refused to change dosage on just one or two tests. Unfortunately she didn't take insurance, and I couldn't afford to keep going, and wait for my insurance to reimburse me. Now that she takes insurance, she's moved to a location that is way out of the way for me. But you know, it just might be worth taking a day off here and there to see her.  Hmmm!!!!

So yeah... #metoosuckothyroid. I get up 05:00 - 05:30, do my 3 sh's, take my morning meds which include my T4 (225 mcg), but no supplements at that time. If I take them it's at night. I have coffee with some creamer. I do this consistently, so it's factored into my dosage. No food until about 09:30 - 10:00 at work.

So yeah, I feel everyone's pain.
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