Day 9 - Low Iodine Diet

Okay so, Dr. Blevins said I needed to start the low iodine diet so that when I do get to my radioactive iodine (I-131) treatment if there are any thyroid cells in my body they will be "starved" of iodine and will gobble up the radioactive stuff. That's basically the gist of it anyway. Now, this is a LOW iodine diet, not NO iodine so a little is okay. Iodine is naturally found in foods. Some have more than others but is not something that is labeled so it's not really a easy thing to measure. I have a feeling this will become a major pain in the buttocks!

So just what does this involve? Well, let's take a look shall we...this is taken from ThyCa.org (with commentary from me). This is not to be considered the complete list and is listed to give an idea of what is involved with this diet. For the complete list, with the removed iodine info counts please visit www.thyca.org and review the low iodine diet.

Things to AVOID

• Iodized salt and sea salt and any foods containing iodized salt or sea salt. Non-iodized salt may be used. For example, Kosher salt is okay unless the label says that it is iodized or sea salt.The reason to avoid sea salt is that all products from the ocean tend to be high in iodine. One teaspoon of iodized salt has 400 mcg of iodine.
• Seafood and sea products (fish, shellfish, seaweed, seaweed tablets, kelp). These are all very high in iodine and should be avoided.
• Foods or products that contain these sea-based additives: carrageenan, agar-agar, algin, alginate, nori (these food additives are seaweed by-products). Carregeenan I ran into in my non-dairy coffee creamer...meh
• Dairy products (milk, cheese, cream, yogurt, butter, ice cream, powdered dairy creamers, whey, casein, other dairy products). Note: Nondairy creamers often have iodine-containing ingredients, too. A study published in 2004 in the Journal of Clinical Endocrinology and Metabolism reported on tests of 18 brands of milk in the Boston, Massachusetts area. It reported that 250 ml of milk (about 8 ounces, or 1 cup, or 16 Tablespoons) contained from 88 to 168 micrograms of iodine and averaged 115 mcg. It noted that sources of iodine in milk include iodine in cattle feed, the products containing iodine used to clean teats and udders, and a small amount from equipment cleaning products. (Some low-iodine diets allow very small amounts of milk or other dairy, if not listed in the first three ingredients on a label. There is no dairy in any of the recipes in they thyca cookbook.) Growing up with a ranching and dairy family yeah I know exactly what's involved so...yeah...I may just kill someone without my Moo juice man!
• Egg yolks or whole eggs or foods containing whole eggs. Egg whites are acceptable, because they contain little or no iodine. (Some low- iodine diets allow foods with very small amounts of eggs, if not listed in the first three ingredients on a label.) Okay this one I draw the line at, I tend to have allergic reactions to JUST egg whites, this is going to be a long enough ordeal without having to deal with the nauseousness of JUST egg whites. Plus my eggs come from my hens so...if I want eggs, I'm eaten me MY eggs! I'll be good else where!
• Commercial bakery products. Avoid bread products that contain iodine/iodate dough conditioners (usually small bakery breads are safe; it’s best to bake it yourself or substitute with Matzos). If you read labels closely, you may also be able to find crackers made only with flour and water. Matzos...so I can have communion crackers? Awesome!
• Red Dye #3. However, Red Dye #40 is OK. We suggest that you avoid red, orange, or brown processed food, pills, and capsules. Many red, red-orange, and brown food dyes contain iodine and should be avoided. The problem with food colors is specific to Red Dye FD&C #3 (erythrosine) ONLY. However, the problem is that some food labels do not specify which red dyes are used. Better safe than sorry. Please always check with your physician.
• Most Chocolate (for its milk content). Cocoa powder and some dark chocolates are permitted. Check the label for other ingredients not allowed on the low-iodine diet. The ThyCa cookbook has recipes with permitted chocolate. NOOOOOO! Not my chocolate!!!!!!!!!!!!! Okay, I'm a really dark chocolate girl, but I will give it up to have an egg if I need/want it.
• Some Molasses. Avoid if sulfured or blackstrap, which is concentrated and has a bitter taste. It's okay to use the milder, fairly sweet unsulfured molasses usually used in cooking and that is the type most often available in grocery stores in the USA. Sulfur is not related to iodine.
• Soybeans and most soy products (soy sauce, soy milk, tofu). However, soy oil and soy lecithin are both okay. All this time "health experts" and the like have been pushing soy and for someone with a thyroid condition it's one food that should be avoided. Buggers
• Some beans besides soybeans.The National Institutes of Health diet says to avoid these beans: red kidney beans, lima beans, navy beans, pinto beans, and cowpeas. So that leaves me black beans and anasazis and lentils...okay I'll survive.
• Some diets diets say to avoid rhubarb and potato skins. The inside of the potato is fine. Wish I had some of Rich's mom's green rhubarb!
• Iodine-Containing Vitamins, and Food Supplements. Also products containing iodate or iodide. Check the label and ingredients and discontinue completely if iodine is included. Most vitamins with minerals contain iodine. I gave up trying to find one that didn't have it
• If you are taking a Medication that contains iodine, check with your physician.

These items should be "LIMITED"

• Fresh meats. Up to 5 ounces per day of fresh meats such as chicken, beef, pork, lamb, and veal are fine. Whole cuts tend to contain less iodine than do ground meats. Also, check the package label on meats, including whole turkeys, turkey breasts, turkey cutlets, chicken, and all pork products. Many food makers inject broths into turkey or chicken or pork. The label may not indicate whether the broth contains iodized salt. If you are not sure, go to your local butcher for fresh turkey, pork, or chicken. Well I have fresh beef from our ranch so I KNOW where that meat came from. The pork is from wild hogs at the ranch so I'm pretty sure I know what they've been eating too, so other than poultry I'm good to go!
• Grains, cereals. Up to 4 servings per day of grains, cereals, pasta, and breads without iodine-containing ingredients are fine on this diet. The iodine content depends on the iodine content of the region where the grain was grown. Homemade baked goods and cereals are best on this diet. If you use processed foods, read the labels carefully to avoid iodine-containing ingredients. Also, remember that labels are not always accurate or up to date. GREAT
• Rices. Like grains, rices vary in the amount of iodine depending on the region where grown, so rice should be eaten only in limited amounts. Some low-iodine diets recommend avoiding rice. Basmati rice has been mentioned as the best for the diet. So...no sushi

Also...Although restaurants generally use non-iodized salt, it is not possible to know whether a particular restaurant is using iodized salt or sea salt. The manager or serving staff may not know what product is being used, or whether butter or other dairy products are present in foods. The ingredients that chain and fast-food restaurants use may change.
Therefore, we suggest that you avoid restaurant foods other than plain juices or soft drinks, or the inside of a plain baked potato. For most restaurant foods, there is no reasonable way to determine which restaurants use iodized salt. Avoid if in doubt. So...I can have an undressed baked potato and tea. What about a salad menu? Oh wait...let's not jump ahead.

So, what can I have?

Mostly fresh, low-fat, low-calorie foods. Because of this, following this diet greatly reduces the tendency to gain weight while hypothyroid. That is a plus.

The following foods and ingredients are fine to eat. You do not need to limit the quantity, except as noted.

• Fresh fruits and fruit juices, except rhubarb, maraschino cherries (if they contain Red Dye #3), and fruit cocktail with maraschino cherries.
• Vegetables, preferably raw and fresh-cooked or frozen without salt. (But not skins of potatoes, soybeans, and, according to the NIH diet, some other beans like pinto, lima, navy, red kidney, cowpeas).
• Unsalted nuts and unsalted nut butters.
• Grain/cereal products in moderate amounts (see above).
• Fresh chicken, beef, and other meats in moderate amounts (see above).
• Sugar, jelly, honey, maple syrup, and unsulfured molasses.
• Black pepper and fresh or dried herbs.
• All vegetable oils. Salad dressings provided they contain only allowed ingredients.
• Homemade foods (see the free Low-Iodine Cookbook from the ThyCa web site.) The Chicken and portabella mushroom dish I fixed was nummmy!
• Cola, diet cola, lemonade, sodas (except those with Red Dye #3), non-instant coffee and tea, beer, wine, other alcohol.

Food prepared from fresh meats, fresh poultry, fresh or frozen vegetables, and fresh fruits should be fine for this diet, provided that you do not add any of the iodine-containing ingredients listed above. The cookbook also has a handy snack list.

A Final Note
The key to coping well with this diet is being prepared ahead of time, especially if you are preparing for RAI by stopping your levothyroxine pills and becoming hypothyroid. Before you start becoming hypothyroid, prepare the basics and freeze. You do not want to be making chicken stock while you are hypothyroid.
Remember also the handy snack list. We suggest that you stock up on snack items from the list for times when you do not feel like cooking.
Let me tell you they ain't kidding. You may think you are doing great and get into something and then..BOOM!...you turn into a sloth and EVERYTHING takes a million times longer to do.

So I guess it's time to make a shopping list and get going!