Thyroid Category 3 dietary taboos

Patients with TI-RADS type 3 nodules (probability of malignancy <5%, most are benign) only really need to clearly avoid three types of dietary risks - long-term excessive intake of excessive amounts of high-iodine foods, long-term raw/excessive consumption of goitrogenic foods that can interfere with thyroid hormone synthesis, and frequent consumption of highly processed, pro-inflammatory foods that are high in oil and sugar. Other "cannot eat seafood at all" and "cannot touch cruciferous vegetables in one bite" spread on the Internet are all generalized rumors. There is no need to scare yourself.

Many people's first reaction when nodules are detected is to switch to non-iodized salt and ban all seafood. I just met a 32-year-old male patient a while ago. After he was found to have type 3 nodules of 4mm, he immediately threw away the iodized salt at home. Even when eating out, he repeatedly asked if iodized salt was added. He did not touch any seafood for three months. As a result, the thyroid stimulating hormone went up to 4.9 in the follow-up test, and the nodules actually grew 2mm. This is completely overcorrecting.

In fact, regarding iodine intake, different guidelines and clinical schools do have different recommendations: If your thyroid function and antibodies are all normal, there is no need to deliberately avoid iodine. Eat iodized salt normally, and occasionally eat low-iodine seafood such as shrimp and marine fish 1-2 times a week. It is no problem at all. As long as you don’t chew kelp or soak in seaweed soup every time, you can eat more than half a catty of high-iodine seafood at a time.； However, if hyperthyroidism is present at the same time, or Hashimoto's thyroiditis antibodies are several times higher, then iodine must be strictly limited. It is best to switch to iodized salt, and try not to touch seafood to avoid stimulating inflammation or aggravating the symptoms of hyperthyroidism.

After talking about the issue of iodine that everyone is most concerned about, let’s talk about the most bizarre saying that “all cruciferous vegetables are taboo”. I have seen many girls dare not touch cabbage, radish, and broccoli in order to eliminate knots, and only eat green vegetables and winter melon. In fact, it is really unnecessary.

Substances that cause goiter do exist in cruciferous foods such as broccoli, cabbage, and radishes, but for it to work, it must meet two conditions: either you eat more than 2 pounds of raw food at one time, or you are chronically deficient in iodine. Normally, we fry broccoli at home and eat half a plate at a meal. After heating, most of the goitrogenic substances have been destroyed and will not affect the thyroid gland at all. Of course, if you are a Hashimoto's patient with high levels of antibodies, some nutritionists will recommend eating as little raw cruciferous vegetables in salads as possible. This is also adjusted based on individual circumstances, and not everyone should avoid them all.

On the contrary, highly processed foods high in oil and sugar that many people do not take seriously are the "invisible killers" that quietly stimulate the growth of nodules. I had a 27-year-old female patient before. Last year, the Category 3 nodules were found to be only 5mm. She usually drinks milk tea, almost one cup a day, and always eats fried chicken and barbecue on weekends. During the six-month review, the nodules had grown to 10mm, and the boundaries were a little unclear. She almost needed a puncture to be upgraded to Category 4. Later, she gave up all milk tea and fried foods, and tried to eat less heavily processed foods such as pickled meats and candied fruits. She also adjusted her work and rest schedule. This year, the nodules shrunk back to 6mm during a review this year, and the borders became clearer.

Why is this happening? In fact, long-term consumption of such high-fat and high-sugar foods will increase the body's chronic inflammation level. The thyroid itself is a very sensitive endocrine organ. In an inflammatory environment for a long time, nodules will naturally be easily stimulated to grow. Regardless of whether there are thyroid problems, eating less of these foods will not harm the body.

As for the "cannot eat soy products" and "cannot drink coffee" posted online, there is currently no clear evidence-based evidence that it will affect thyroid nodules. As long as you don’t suffer from panic or insomnia after drinking coffee, it’s absolutely fine to drink 1-2 cups of Americano a day. ； You can eat soy products such as soy milk and tofu normally. As long as you don't drink three or four liters of soy milk at one time, it will not interfere with thyroid hormone levels at all.

In fact, to put it bluntly, Category 3 thyroid nodules are really not a big problem. More than 95% of them are benign. There is no need to control this and not eat or touch that. Calculating in front of the food list all day will only make you anxious. A bad mood will have a much greater impact on the nodules than eating seafood. Just remember not to go to extremes when it comes to diet. Don't eat kelp every day to supplement iodine, and don't completely avoid iodine deficiency. A balanced diet and less fussing are more effective than any folk prescription.