Foods to Eat or Avoid for Graves’ Disease (2024)

If you have Graves’ disease — an autoimmune condition that causes hyperthyroidism, which is an overactive thyroid gland — you may already be taking medication for it. Unlike some other conditions, Graves’ disease can’t be reversed with dietary changes alone. It has to be treated with conventional medicine.

“Medical intervention is always the first step with Graves’,” says Susan Spratt, MD, an endocrinologist at Duke University in Durham, North Carolina.

Once you’re being treated, though — and after your doctor has given you the green light — you can consider making changes to your diet. For people with Graves’ disease, some nutrients, such as calcium and vitamin D, are important, whereas others, including iodine, could be harmful, explains Kelly Kennedy, a registered dietitian with Everyday Health. This is also why Dr. Spratt always recommends medicine first and then dietary and lifestyle changes as complementary treatments.

Here’s what to eat and what to avoid if you have Graves’ disease. (Just remember to always talk to your doctor before making any changes to your diet.)

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Limit or Avoid: Iodized Salt

In the United States, salt manufacturers routinely add iodine, a trace mineral, to table salt to combat iodine deficiency. For people with Graves’ disease, though, too much iodine isn’t always a good thing.

Iodine is an essential component of thyroid-stimulating hormone (TSH), which tells the thyroid gland to make more thyroid hormones. Large doses of iodine produce elevated TSH levels, which can worsen hyperthyroidism in people with untreated Graves’ disease, explains Dr. Spratt. (Left untreated, an overactive thyroid can cause heart, bone, and muscle problems, according to the National Institute of Diabetes and Digestive and Kidney Diseases.)

Dr. Spratt says you don’t need to seek out iodine if you eat an American diet. But, if you are vegan and only eat fresh fruits, vegetables and rice, you should talk to your doctor about the best way to obtain the recommended iodine intake of 150 micrograms daily.

To find out if your salt contains iodine, look at the nutrition label, which would say “iodized” or “provides iodine.” Some specialty salts, such as sea salt and kosher salt, usually don’t contain iodine.

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Eat: Leafy Green Vegetables

An overactive thyroid can speed up bone turnover — the natural process of breaking down and rebuilding bones. This, in turn, can increase the body’s need for calcium. Not getting enough calcium, in the long run, can contribute to brittle bones and osteoporosis.

To avoid these complications, try to consume calcium-rich leafy green vegetables, such as spinach, broccoli, and kale — in moderation, says Dr. Spratt, as they contain iodine. Additionally, too much calcium can cause hypercalcemia, a condition found in 20 percent of people with hyperthyroidism, according to research. “I’m a big proponent of getting your vitamins and minerals from your plate and whole foods,” says Spratt. First, work with your doctor to get your thyroid hormone levels under control, and then you can introduce calcium-rich foods.

Dairy products, such as milk, are sources of calcium, but they also contain iodine, according to the Office of Dietary Supplements (ODS).

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Limit or Avoid: Seaweed

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Eat: Salmon

Because bone health is so important when you have hyperthyroidism, it’s recommended that you also consume vitamin D, which improves calcium absorption, explains Kennedy. One food that’s particularly high in vitamin D is salmon: One 3-ounce serving contains about 570 IU (international units).

Not sure if you’re getting enough vitamin D? Your doctor can check your levels with a blood test. “While there are many foods high in vitamin D, it’s rare you can get enough of it from foods alone,” says Kennedy, who notes that some people may want to take a water soluble supplement of 600–800 IU, depending on age. (Talk to your doctor before taking any supplements.)

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Eat: Brazil Nuts and Sunflower Seeds

Selenium plays a role in making thyroid hormones and regulating thyroid function. Though rare, thyroid eye disease (TED) — which causes progressive inflammation of the eye and can result in blindness — can develop in people with Graves’ disease. According to the American Thyroid Association, research has shown that a selenium deficiency may be linked to an increased risk of TED in people with Graves’ disease; supplementing your diet with selenium may help treat it. A study published in 2021 in Frontiers in Cellular and Infection Microbiology found that selenium can also have a positive effect on gut microbial diversity, which may play a role in reducing disease severity and eye involvement.

Foods that are rich in selenium include Brazil nuts and sunflower seeds.

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Limit or Avoid: Gluten

One study found that Graves’ disease can also be associated with celiac disease, another type of autoimmune disorder in which people can’t eat gluten, a protein commonly found in wheat, barley, and rye. (In people with celiac, eating gluten triggers a reaction that damages the lining of the small intestine.)

If you’ve been diagnosed with celiac disease, Kennedy recommends eliminating gluten from your diet so as not to exacerbate hyperthyroid symptoms or affect hormone levels. “But if you have not tested positive, and don’t have a negative reaction to it, there’s no reason to eliminate gluten from your diet,” she says.

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Eat: Berries

If you’re managing an autoimmune disease such as hyperthyroidism, consider eating a diet rich in antioxidants, which are substances found in fruits and vegetables that can help stave off cell damage.

“Antioxidants are great, because they reduce oxidative stress and inflammation in the body, which can help autoimmune diseases,” explains Kennedy. Plus, she adds, these foods “generally just make you feel better and make your body function better.”

One food group that’s particularly high in antioxidants? Berries, including raspberries, blackberries, and blueberries.

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Limit or Avoid: Caffeinated Beverages

Some of the symptoms associated with Graves’ disease include anxiety, nervousness, rapid heart rate, and weight loss, all of which can be made worse by too much caffeine.

Energy drinks are one of the biggest sources of caffeine. “I always recommend avoiding energy drinks no matter what, because they’re highly processed, high in sugar and artificial ingredients, and, obviously, high in caffeine,” says Kennedy.

Kennedy also suggests limiting coffee and tea. “Even though tea is lower in caffeine than coffee, it can add up,” she says.

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Eat: Legumes

Research shows that hyperthyroidism has been linked to low levels of iron in the body, says Kennedy, and one study, published in the American Journal of Blood Research, noted that Graves’ disease can decrease iron levels. If you suspect you’re deficient in iron, ask your physician to order routine blood work to check your levels, she says.

Celiac disease, the chronic digestive disorder that damages the small intestine and often occurs together with Graves’, has a higher likelihood of being the cause of iron deficiency, though, says Spratt. “Make sure you are tested for celiac disease if you are iron deficient,” she says.

If you’re running low, consider increasing your intake of iron-rich foods. But, before you go reaching for a steak, consider this: People who eat a vegan, lacto-ovo vegetarian, or pescetarian diet are less likely to have hyperthyroidism than people who eat meat, according to a study. One plant food that’s rich in iron? Legumes. A half-cup serving contains 3 milligrams of iron, or about 17 percent of your recommended daily intake, according to the ODS.

“The more iron you can get from vegetables and non-meat products, the better, as some research suggests decreasing your meat and poultry intake can improve hyperthyroid symptoms,” says Kennedy.

To maximize your body’s ability to absorb iron, pair iron-dense foods with foods high in vitamin C.