While there aren’t any guaranteed ways to avoid thyroid disease, certain lifestyle changes may help reduce your risk.
This article describes 15 things you can do to lower your risk of thyroid disease.
2:195 Common Misconceptions About Thyroid Disease
2:19
5 Common Misconceptions About Thyroid Disease
Eat Less Sugar and Processed Foods
Diets high in sugar and processed foods are both linked to an increased risk of thyroid disease. They can also disrupt the production of thyroid hormones and make hypothyroidism and hyperthyroidism harder to control.
Refined sugar and highly processed foods are both known to alter the normal composition of bacteria and yeast in the intestines—known as the gut microbiome—leading to inflammation and tissue damage.
This increases the permeability of the intestines, allowing toxins and other substances into the body that the immune system overreacts to, triggering anautoimmune response. Research suggests that gut permeability plays a central role in the onset of Graves' disease and Hashimoto’s thyroiditis.
Another factor can be seen withdiabetesand thyroid disease. These conditions are closely linked becauseinsulin(the hormone that regulates blood sugar) can alter thyroid hormone levels, and vice versa.Studies suggest that up to 31% of people withtype 2 diabeteshave hypothyroidism and that poor blood sugar control makes thyroid disease harder to control.
The same effect is seen with the overconsumption of ultra-processed foods that are high in starches, added sugars, and hydrogenated fats.
What Are Processed Foods?
Exercise Regularly
Regular daily exercise has long been shown to improve thyroid function. On the other hand, a sedentary, inactive lifestyle reduces T4 levels and contributes to the risk of hypothyroidism.
The weekly program consists of 150 minutes of moderate-intensity physical activity (such as brisk walking) and two days of muscle-strengthening activity. The 150 minutes can be broken into shorter 30-minute sessions over five days.
If you go beyond 150 minutes per week or engage in 75 minutes of vigorous-intensity activity (such as jogging or running) per week, you’ll gain even more health benefits.
Reduce Stress
There are many things you can do to manage stress in your daily life, including getting plenty of sleep, exercising regularly, and practicing mind-body therapies like:
Discuss Selenium Supplements With Your Doctor
1:33What is Selenium and How Does It Work?
1:33
What is Selenium and How Does It Work?
However, keep in mind that soil in the United States is selenium replete and most people’s intake of selenium is at recommended level. Talk to your doctor before starting selenium supplements.
Talk to your doctor before you start taking selenium. Its role in thyroid health still isn’t completely understood. In fact, studies suggest that high selenium levels may be a risk factor for developing type 2 diabetes.
Selenium and Your Thyroid
Increase Probiotics
Probioticsare live bacteria and yeastsfound in certain foodsthat are thought to improve digestive health. There is increasing evidence they may also be beneficial to your thyroid health.
Thyroid and intestinal diseases are known to be closely linked. Graves' disease and Hashimoto’s disease, for instance, are commonly seen in people withceliac disease. All three conditions areautoimmune disorders, suggesting a common disease pathway that some experts refer to as the “thyroid-gut axis.”
Studies suggest that probiotics exert beneficial effects on thyroid hormones and thyroid function in general.In theory, this may lessen the risk of thyroid disease in people genetically predisposed to Graves' disease or Hashimoto’s disease.
In addition to commercial supplements, probiotics can also be found in fermented foods such:
Stop Smoking
Cigarette smoke contains toxins that can affect your thyroid. One of these isthiocyanate. This compound disrupts iodine uptake, which can block the production of thyroid hormones.
In general, smoking can cause elevated levels of T4. It can also cause a slight decrease in TSH levels. TSH tells your thyroid to make thyroid hormones.
Research has shown that smokers are more likely to developGraves' disease. This condition is a leading cause of hyperthyroidism, or overactive thyroid. Smoking can also lead to eye complications of Graves' disease, called Graves' orbitopathy.
It is not easy to quit smoking. Ask your doctor about treatment options that can help you successfully quit.
Smoking and Thyroid Disease
Get More Vitamin D
Vitamin Dis necessary for the normal function of many organs, including the thyroid gland. This is because vitamin D stimulates the production of an enzyme called type 2 deiodinase (Dio2) necessary for the conversion of T4 into T3.
Vitamin D deficiencymay increase the risk hypothyroidism (especially Hashimoto’s disease) in some populations (children, adolescents, and people with obesity).
Vitamin D deficiency is extremely common in the United States affecting roughly one in four adults, especially females.
To alleviate vitamin D deficiency—and possibly the risk of thyroid disease as well—you can take a daily supplement or eat vitamin D-rich foods like:
One of the best ways to overcome a deficiency is with regular sun exposure which stimulates skin cells to produce vitamin D naturally. To maintain healthy levels, get 10 to 30 minutes of midday sunlight several times a week. People with darker skin may need a little more.
Ask for a Thyroid Collar for X-Rays
Verywell / Cindy Chung
If you are going to have anX-ray, ask for a thyroid collar. This is especially important for:
A thyroid collar looks like the neck part of a turtleneck sweater. It’s heavy and lined with lead.
Your thyroid is the most vulnerable part of your head and neck area. The collar protects your thyroid gland from radiation exposure, which can lead to thyroid cancer.
Do a Thyroid Neck Check
Athyroid neck checkis one way to find a thyroid problem. This easy test can detect lumps and swelling if they’re close to the surface. Keep in mind, though, that many nodules can’t be seen or felt. If you have other symptoms, see your doctor.
This simple screening can be done at home in front of a mirror. Make sure to follow all the steps. If you feel or see anything unusual, see your doctor.
Ease Up on Soy and Cruciferous Vegetables
You may have heard that eating too much soy can be bad for thyroid health. Though recent research suggests eating soy is generally safe, it is probably best to do so in moderation.
Most people with thyroid disease take the thyroid hormone replacementlevothyroxine. It’s best to take this medication on an empty stomach. Wait 30 to 60 minutes before eating.
If you’re going to eat soy, wait until it’s been four hours since you took your medication.This is because evidence has consistently shown that soy can interfere with your body’s absorption of levothyroxine.
Similarly, a very high intake of cruciferous vegetables has been found to cause hypothyroidism in animal studies. The compound in cruciferous vegetables responsible for this, calledindole glucosinolate, indirectly blocks the production of T3 and T4.
While eating cruciferous vegetables is generally good for you and unlikely to cause any harm, eating a lot can potentially contribute to thyroid disease if you are at risk. These include foods like:
Thyroid Medication Mistakes
Get Celiac Disease Diagnosed and Treated
Celiac diseaseis an autoimmune condition that causes your intestines to react abnormally to gluten. Gluten is a protein found in wheat, rye, barley, oats, and other related grains.
Celiac disease is three times more common in people with an autoimmune thyroid disease like Hashimoto’s thyroiditis and Graves' disease.
It’s unclear why this association exists. It may be due in part to the genetic component of autoimmune diseases. Both conditions are also fairly common. Celiac disease also interferes with absorption of essential minerals like iodine and selenium, which can trigger thyroid dysfunction.
Symptoms of Celiac Disease
Some studies show that a low-gluten diet may help people with Hashimoto’s disease prevent potential complications, and possibly even the progression of the condition.
If you think you might have celiac disease or agluten sensitivity, talk to your doctor.
Limiting or avoiding gluten is a big dietary change. It’s important to only make these kinds of changes under the guidance of a healthcare provider.
The Celiac and Autoimmune Thyroid Disease Connection
Keep Potassium Iodide on Hand
Potassium iodide (KI) is an over-the-counter supplement. You may want to include it in your family emergency kit. It can be helpful in the unlikely event of a nuclear accident or an attack on a nuclear facility. If you’re not in the path of a radioactive plume, though, KI won’t be helpful.
Your thyroid needs iodine to function. It normally gets this from your bloodstream. It can’t, however, tell the difference between regular iodine and radioactive iodine. Radioactive iodine is the type that’s released from nuclear plants or from radioactive material during nuclear explosions.
Taking KI within the first few hours of exposure to radioactive iodine can help protect your thyroid from the risk of thyroid cancer.
Radioactive iodine can increase your chance of developing thyroid cancer. It’s especially risky for unborn babies, infants, and young children. When you take KI, you saturate your thyroid with iodine so it won’t take in radioactive iodine.
Taking KI does come with some risk. During a radiation emergency, the benefits are thought to outweigh the risk.
Taking KI can cause a number of health problems:
You should only take KI during a nuclear emergency when local health authorities instruct you to.
There are several reasons for this, including:
Potassium Iodide for Radiation Exposure
Consider Fluoride’s Role
Some research suggests that people living in areas with fluoridated drinking water are at a higher risk of developing hypothyroidism. Other research has not shown this. Until this link has been established, avoiding fluoride isnotgenerally recommended.
If you’re concerned about the health effects of fluoride, be sure to discuss this with your doctor.
Fluoride and the Thyroid: The Controversy
Look Out for Perchlorates
Perchloratesare odorless, colorless salts. They dissolve in water and are found naturally in certain parts of the United States. They’re also manufactured for explosives, fireworks, and rocket motors. In some parts of the nation, they can be found in the water supply.
A large percentage of U.S. produce is irrigated with perchlorate-contaminated water. This means perchlorate is present in the U.S. food supply and many Americans are exposed to low levels.
Your thyroid needs iodine to produce thyroid hormones. High levels of perchlorates can block your thyroid from taking up iodine. It’s a good idea to stay informed about perchlorate contamination in your area and maximum state levels for perchlorates in the water. If you use well water, consider having it tested for perchlorates contamination.
See Your Healthcare Provider Regularly
It is important to see your primary care doctor for regular checkups. This is especially true if you’re at risk for developing thyroid disease. If you have a family history of Hashimoto’s thyroiditis or Graves' disease, for example, your doctor may want to test your thyroid hormone levels annually.
Summary
There are things you can do that may reduce your risk of thyroid disease. These include common sense practices like eating a healthy diet, exercising regularly, quitting cigarettes, and getting plenty of vitamin D. Probiotic and selenium supplements may also help along with a reduction in your intake of sugar, soy, and processed foods.
Seeing your primary care provider every year is also a good idea, particularly if you have risk factors for hyperthyroidism or hypothyroidism.
While there are no guarantees that these interventions will prevent thyroid disease, it’s important to remember good health is beneficial to the health of your thyroid gland whether you are at risk or not.
28 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Thyroid Association.General information/press room.Ruggeri MD, Barbalace MC, Croce L, et al.Autoimmune thyroid disorders: the Mediterranean Diet as a protective choice.Nutrients.2023 Sep;15(18):3953. doi:10.3390/nu15183953Biondi B, Kahaly GJ, Robertson P.Thyroid dysfunction and diabetes mellitus: two closely associated disorders.Endocr Rev.2019 Jun;40(3):789–824. doi:10.1210/er.2018-00163Talwalkar P, Deshmukh V, Bhole M.Prevalence of hypothyroidism in patients with type 2 diabetes mellitus and hypertension in India: a cross-sectional observational study.Diabetes Metab Syndr Obes. 2019;12:369–376. doi:10.2147/DMSO.S181470Zhang Z, Zhu F, Cao Z, et al.Ultra-processed food consumption and the risk of subclinical thyroid dysfunction: a prospective cohort study.Food Funct. 2022 Mar 21;13(6):3431-3440. doi:10.1039/d1fo03279hKlasson CL, Sahdir S, Pontzer H.Daily physical activity is negatively associated with thyroid hormone levels, inflammation, and immune system markers among men and women in the NHANES dataset.PLoS One.2022;17(7):e0270221. doi:10.1371/journal.pone.0270221Centers for Disease Control and Prevention.Physical activity for adults: An overview.Sinha SR, Prakash P, Keshari JR, Kumari R, Prakash V.Assessment of serum cortisol levels in hypothyroidism patients: a cross-sectional study.Cureus.2023 Dec 8;15(12):e50199. doi 10.7759/cureus.50199Ventura M, Melo M, Carrilho F.Selenium and thyroid disease: from pathophysiology to treatment.Int J Endocrinol. 2017. doi:10.1155/2017/1297658Wei J, Zeng C, Gong QY, et al.The association between dietary selenium intake and diabetes: a cross-sectional study among middle-aged and older adults.Nutr J. 2015;14(1):1-6. doi:10.1186/s12937-015-0007-2Knezevic J, Starchl C, Berisha AT, Amrein K.Thyroid-gut-axis: how does the microbiota influence thyroid function?Nutrients.2020 Jun;12(6):1769. doi:10.3390/nu12061769Sniffen JC, McFarland LV, Evans CT, Goldstein EJC.Choosing an appropriate probiotic product for your patient: an evidence-based practical guide.PLoS One.2018;13:e0209205. doi:10.1371/journal.pone.0209205Sawicka-Gutaj N, Gutaj P, Sowiński J, et al.Influence of cigarette smoking on thyroid gland—an update.Endokrynol Pol. 2014;65(1):54-62. doi:10.5603/EP.2014.0008Leko MB, Juresko I, Rozic I, Pleic N, Gunjaca I, Zemunik T.Vitamin D and the thyroid: a critical review of the current evidence.Int J Mol Sci.2023 Feb;24(4):3586. doi:10.3390/ijms24043586Lebiedziński F, Lisowska KA.Impact of vitamin D on immunopathology of Hashimoto’s thyroiditis: from theory to practice.Nutrients. 2023;15(14):3174. doi:10.3390/nu15143174Cui A, Xiao P, Ma Y, et al.Prevalence, trend, and predictor analyses of vitamin D deficiency in the US population, 2001–2018.Front Nutr.2022;9:965376. doi:10.3389/fnut.2022.965376National Institutes of Health.Vitamin D: consumer fact sheet.Pilz S, Zittermann A, Trummer C, et al.Vitamin D testing and treatment: a narrative review of current evidence.Endocr Connect. 2019;8(2):R27-R43. doi:10.1530/EC-18-0432Qu XM, Li G, Sanderink GC, Zhang ZY, Ma XC.Dose reduction of cone beam CT scanning for the entire oral and maxillofacial regions with thyroid collars.Dentomaxillofac Rad. 2012;41(5):373-8. doi:10.1259/dmfr/30200901Messina M.Soy and health update: evaluation of the clinical and epidemiologic literature.Nutrients. 2016;8(12):754. doi:10.3390/nu8120754.UCLA Health.How should I take thyroid hormone (L-thyroxine)?Felker P, Bunch R, Leung AM.Concentrations of thiocyanate and goitrin in human plasma, their precursor concentrations in brassica vegetables, and associated potential risk for hypothyroidism.Nutr Rev.2016;74(4):248–58 doi:=10.1093/nutrit/nuv110Azizi F, Mehran L, Hosseinpanah F, Delshad H, Amouzegar A.Primordial and primary preventions of thyroid disease, Int J Endocrinol Metab. 2017;15(4):e57871. doi:10.5812/ijem.57871Liontiris MI, Mazokopakis EE.A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients. Points that need more investigation.Hell J Nucl Med. 2017;20(1):51-6.Tang J, Kong D, Cui Q, et al.The role of radioactive iodine therapy in papillary thyroid cancer: an observational study based on SEER.Onco Targets Ther. 2018;11:3551. doi:10.2147/OTT.S160752American Thyroid Association.Questions and answers about potassium Iodide (KI).American Thyroid Association.Is fluoridated drinking water associated with a higher prevalence of hypothyroidism?Centers for Disease Control and Prevention (CDC).ToxFAQs for perchlorates.Additional ReadingCenters for Disease Control and Prevention (CDC).Emergency preparedness and response: potassium iodide (KI).
28 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Thyroid Association.General information/press room.Ruggeri MD, Barbalace MC, Croce L, et al.Autoimmune thyroid disorders: the Mediterranean Diet as a protective choice.Nutrients.2023 Sep;15(18):3953. doi:10.3390/nu15183953Biondi B, Kahaly GJ, Robertson P.Thyroid dysfunction and diabetes mellitus: two closely associated disorders.Endocr Rev.2019 Jun;40(3):789–824. doi:10.1210/er.2018-00163Talwalkar P, Deshmukh V, Bhole M.Prevalence of hypothyroidism in patients with type 2 diabetes mellitus and hypertension in India: a cross-sectional observational study.Diabetes Metab Syndr Obes. 2019;12:369–376. doi:10.2147/DMSO.S181470Zhang Z, Zhu F, Cao Z, et al.Ultra-processed food consumption and the risk of subclinical thyroid dysfunction: a prospective cohort study.Food Funct. 2022 Mar 21;13(6):3431-3440. doi:10.1039/d1fo03279hKlasson CL, Sahdir S, Pontzer H.Daily physical activity is negatively associated with thyroid hormone levels, inflammation, and immune system markers among men and women in the NHANES dataset.PLoS One.2022;17(7):e0270221. doi:10.1371/journal.pone.0270221Centers for Disease Control and Prevention.Physical activity for adults: An overview.Sinha SR, Prakash P, Keshari JR, Kumari R, Prakash V.Assessment of serum cortisol levels in hypothyroidism patients: a cross-sectional study.Cureus.2023 Dec 8;15(12):e50199. doi 10.7759/cureus.50199Ventura M, Melo M, Carrilho F.Selenium and thyroid disease: from pathophysiology to treatment.Int J Endocrinol. 2017. doi:10.1155/2017/1297658Wei J, Zeng C, Gong QY, et al.The association between dietary selenium intake and diabetes: a cross-sectional study among middle-aged and older adults.Nutr J. 2015;14(1):1-6. doi:10.1186/s12937-015-0007-2Knezevic J, Starchl C, Berisha AT, Amrein K.Thyroid-gut-axis: how does the microbiota influence thyroid function?Nutrients.2020 Jun;12(6):1769. doi:10.3390/nu12061769Sniffen JC, McFarland LV, Evans CT, Goldstein EJC.Choosing an appropriate probiotic product for your patient: an evidence-based practical guide.PLoS One.2018;13:e0209205. doi:10.1371/journal.pone.0209205Sawicka-Gutaj N, Gutaj P, Sowiński J, et al.Influence of cigarette smoking on thyroid gland—an update.Endokrynol Pol. 2014;65(1):54-62. doi:10.5603/EP.2014.0008Leko MB, Juresko I, Rozic I, Pleic N, Gunjaca I, Zemunik T.Vitamin D and the thyroid: a critical review of the current evidence.Int J Mol Sci.2023 Feb;24(4):3586. doi:10.3390/ijms24043586Lebiedziński F, Lisowska KA.Impact of vitamin D on immunopathology of Hashimoto’s thyroiditis: from theory to practice.Nutrients. 2023;15(14):3174. doi:10.3390/nu15143174Cui A, Xiao P, Ma Y, et al.Prevalence, trend, and predictor analyses of vitamin D deficiency in the US population, 2001–2018.Front Nutr.2022;9:965376. doi:10.3389/fnut.2022.965376National Institutes of Health.Vitamin D: consumer fact sheet.Pilz S, Zittermann A, Trummer C, et al.Vitamin D testing and treatment: a narrative review of current evidence.Endocr Connect. 2019;8(2):R27-R43. doi:10.1530/EC-18-0432Qu XM, Li G, Sanderink GC, Zhang ZY, Ma XC.Dose reduction of cone beam CT scanning for the entire oral and maxillofacial regions with thyroid collars.Dentomaxillofac Rad. 2012;41(5):373-8. doi:10.1259/dmfr/30200901Messina M.Soy and health update: evaluation of the clinical and epidemiologic literature.Nutrients. 2016;8(12):754. doi:10.3390/nu8120754.UCLA Health.How should I take thyroid hormone (L-thyroxine)?Felker P, Bunch R, Leung AM.Concentrations of thiocyanate and goitrin in human plasma, their precursor concentrations in brassica vegetables, and associated potential risk for hypothyroidism.Nutr Rev.2016;74(4):248–58 doi:=10.1093/nutrit/nuv110Azizi F, Mehran L, Hosseinpanah F, Delshad H, Amouzegar A.Primordial and primary preventions of thyroid disease, Int J Endocrinol Metab. 2017;15(4):e57871. doi:10.5812/ijem.57871Liontiris MI, Mazokopakis EE.A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients. Points that need more investigation.Hell J Nucl Med. 2017;20(1):51-6.Tang J, Kong D, Cui Q, et al.The role of radioactive iodine therapy in papillary thyroid cancer: an observational study based on SEER.Onco Targets Ther. 2018;11:3551. doi:10.2147/OTT.S160752American Thyroid Association.Questions and answers about potassium Iodide (KI).American Thyroid Association.Is fluoridated drinking water associated with a higher prevalence of hypothyroidism?Centers for Disease Control and Prevention (CDC).ToxFAQs for perchlorates.Additional ReadingCenters for Disease Control and Prevention (CDC).Emergency preparedness and response: potassium iodide (KI).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Thyroid Association.General information/press room.Ruggeri MD, Barbalace MC, Croce L, et al.Autoimmune thyroid disorders: the Mediterranean Diet as a protective choice.Nutrients.2023 Sep;15(18):3953. doi:10.3390/nu15183953Biondi B, Kahaly GJ, Robertson P.Thyroid dysfunction and diabetes mellitus: two closely associated disorders.Endocr Rev.2019 Jun;40(3):789–824. doi:10.1210/er.2018-00163Talwalkar P, Deshmukh V, Bhole M.Prevalence of hypothyroidism in patients with type 2 diabetes mellitus and hypertension in India: a cross-sectional observational study.Diabetes Metab Syndr Obes. 2019;12:369–376. doi:10.2147/DMSO.S181470Zhang Z, Zhu F, Cao Z, et al.Ultra-processed food consumption and the risk of subclinical thyroid dysfunction: a prospective cohort study.Food Funct. 2022 Mar 21;13(6):3431-3440. doi:10.1039/d1fo03279hKlasson CL, Sahdir S, Pontzer H.Daily physical activity is negatively associated with thyroid hormone levels, inflammation, and immune system markers among men and women in the NHANES dataset.PLoS One.2022;17(7):e0270221. doi:10.1371/journal.pone.0270221Centers for Disease Control and Prevention.Physical activity for adults: An overview.Sinha SR, Prakash P, Keshari JR, Kumari R, Prakash V.Assessment of serum cortisol levels in hypothyroidism patients: a cross-sectional study.Cureus.2023 Dec 8;15(12):e50199. doi 10.7759/cureus.50199Ventura M, Melo M, Carrilho F.Selenium and thyroid disease: from pathophysiology to treatment.Int J Endocrinol. 2017. doi:10.1155/2017/1297658Wei J, Zeng C, Gong QY, et al.The association between dietary selenium intake and diabetes: a cross-sectional study among middle-aged and older adults.Nutr J. 2015;14(1):1-6. doi:10.1186/s12937-015-0007-2Knezevic J, Starchl C, Berisha AT, Amrein K.Thyroid-gut-axis: how does the microbiota influence thyroid function?Nutrients.2020 Jun;12(6):1769. doi:10.3390/nu12061769Sniffen JC, McFarland LV, Evans CT, Goldstein EJC.Choosing an appropriate probiotic product for your patient: an evidence-based practical guide.PLoS One.2018;13:e0209205. doi:10.1371/journal.pone.0209205Sawicka-Gutaj N, Gutaj P, Sowiński J, et al.Influence of cigarette smoking on thyroid gland—an update.Endokrynol Pol. 2014;65(1):54-62. doi:10.5603/EP.2014.0008Leko MB, Juresko I, Rozic I, Pleic N, Gunjaca I, Zemunik T.Vitamin D and the thyroid: a critical review of the current evidence.Int J Mol Sci.2023 Feb;24(4):3586. doi:10.3390/ijms24043586Lebiedziński F, Lisowska KA.Impact of vitamin D on immunopathology of Hashimoto’s thyroiditis: from theory to practice.Nutrients. 2023;15(14):3174. doi:10.3390/nu15143174Cui A, Xiao P, Ma Y, et al.Prevalence, trend, and predictor analyses of vitamin D deficiency in the US population, 2001–2018.Front Nutr.2022;9:965376. doi:10.3389/fnut.2022.965376National Institutes of Health.Vitamin D: consumer fact sheet.Pilz S, Zittermann A, Trummer C, et al.Vitamin D testing and treatment: a narrative review of current evidence.Endocr Connect. 2019;8(2):R27-R43. doi:10.1530/EC-18-0432Qu XM, Li G, Sanderink GC, Zhang ZY, Ma XC.Dose reduction of cone beam CT scanning for the entire oral and maxillofacial regions with thyroid collars.Dentomaxillofac Rad. 2012;41(5):373-8. doi:10.1259/dmfr/30200901Messina M.Soy and health update: evaluation of the clinical and epidemiologic literature.Nutrients. 2016;8(12):754. doi:10.3390/nu8120754.UCLA Health.How should I take thyroid hormone (L-thyroxine)?Felker P, Bunch R, Leung AM.Concentrations of thiocyanate and goitrin in human plasma, their precursor concentrations in brassica vegetables, and associated potential risk for hypothyroidism.Nutr Rev.2016;74(4):248–58 doi:=10.1093/nutrit/nuv110Azizi F, Mehran L, Hosseinpanah F, Delshad H, Amouzegar A.Primordial and primary preventions of thyroid disease, Int J Endocrinol Metab. 2017;15(4):e57871. doi:10.5812/ijem.57871Liontiris MI, Mazokopakis EE.A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients. Points that need more investigation.Hell J Nucl Med. 2017;20(1):51-6.Tang J, Kong D, Cui Q, et al.The role of radioactive iodine therapy in papillary thyroid cancer: an observational study based on SEER.Onco Targets Ther. 2018;11:3551. doi:10.2147/OTT.S160752American Thyroid Association.Questions and answers about potassium Iodide (KI).American Thyroid Association.Is fluoridated drinking water associated with a higher prevalence of hypothyroidism?Centers for Disease Control and Prevention (CDC).ToxFAQs for perchlorates.
American Thyroid Association.General information/press room.
Ruggeri MD, Barbalace MC, Croce L, et al.Autoimmune thyroid disorders: the Mediterranean Diet as a protective choice.Nutrients.2023 Sep;15(18):3953. doi:10.3390/nu15183953
Biondi B, Kahaly GJ, Robertson P.Thyroid dysfunction and diabetes mellitus: two closely associated disorders.Endocr Rev.2019 Jun;40(3):789–824. doi:10.1210/er.2018-00163
Talwalkar P, Deshmukh V, Bhole M.Prevalence of hypothyroidism in patients with type 2 diabetes mellitus and hypertension in India: a cross-sectional observational study.Diabetes Metab Syndr Obes. 2019;12:369–376. doi:10.2147/DMSO.S181470
Zhang Z, Zhu F, Cao Z, et al.Ultra-processed food consumption and the risk of subclinical thyroid dysfunction: a prospective cohort study.Food Funct. 2022 Mar 21;13(6):3431-3440. doi:10.1039/d1fo03279h
Klasson CL, Sahdir S, Pontzer H.Daily physical activity is negatively associated with thyroid hormone levels, inflammation, and immune system markers among men and women in the NHANES dataset.PLoS One.2022;17(7):e0270221. doi:10.1371/journal.pone.0270221
Centers for Disease Control and Prevention.Physical activity for adults: An overview.
Sinha SR, Prakash P, Keshari JR, Kumari R, Prakash V.Assessment of serum cortisol levels in hypothyroidism patients: a cross-sectional study.Cureus.2023 Dec 8;15(12):e50199. doi 10.7759/cureus.50199
Ventura M, Melo M, Carrilho F.Selenium and thyroid disease: from pathophysiology to treatment.Int J Endocrinol. 2017. doi:10.1155/2017/1297658
Wei J, Zeng C, Gong QY, et al.The association between dietary selenium intake and diabetes: a cross-sectional study among middle-aged and older adults.Nutr J. 2015;14(1):1-6. doi:10.1186/s12937-015-0007-2
Knezevic J, Starchl C, Berisha AT, Amrein K.Thyroid-gut-axis: how does the microbiota influence thyroid function?Nutrients.2020 Jun;12(6):1769. doi:10.3390/nu12061769
Sniffen JC, McFarland LV, Evans CT, Goldstein EJC.Choosing an appropriate probiotic product for your patient: an evidence-based practical guide.PLoS One.2018;13:e0209205. doi:10.1371/journal.pone.0209205
Sawicka-Gutaj N, Gutaj P, Sowiński J, et al.Influence of cigarette smoking on thyroid gland—an update.Endokrynol Pol. 2014;65(1):54-62. doi:10.5603/EP.2014.0008
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