Diet taboos for thyroid nodules

More than 90% of benign thyroid nodules have no absolute dietary taboos at all. Ninety-percent of the statements posted on the Internet about "no iodized salt, no seafood, and no touching of hairy food" are misinformation. Whether and what food to avoid depends entirely on the nature of your nodule, your thyroid function status, and your own iodine metabolism level. There has never been a unified standard that applies to everyone.

I really didn’t say this casually. Last week I saw a 1998-year-old girl. The physical examination revealed a 3mm benign nodule. Her thyroid function was normal. She went home and replaced the iodized salt she had been eating for more than 20 years with iodine-free one. She didn’t even touch a bite of her favorite seaweed and pork ribs soup. After half a month, she felt so tired that she couldn’t even bring herself to work. When she came to the clinic, she looked sad and asked me, “Am I not going to have anything to do with seafood in my life?” ”

There are really too many similar questions, and the first one is the issue of iodine, which is currently the most controversial point in the academic community. Many people's first reaction when nodules are detected is to avoid iodine. In fact, it is really not necessary. If your nodules are benign, all three thyroid functions and antibodies are within the normal range, and the urinary iodine test is also within a reasonable range, then you can eat iodized salt when you should, and meet up with friends to eat Japanese food or steam scallops on the weekend, which is totally fine. On the contrary, long-term deliberate avoidance of iodine will lead to insufficient iodine intake, resulting in hypothyroidism and goiter, which will more easily stimulate the nodules to grow. But if your nodules are combined with hyperthyroidism, there is no need to discuss it. Strict avoidance of iodine is a must. When it comes to non-iodized salt, don’t touch a bite of high-iodine foods such as kelp, seaweed, and jellyfish, otherwise it will only aggravate the symptoms of hyperthyroidism. If you have nodules associated with Hashimoto's thyroiditis, there is currently no unified conclusion: some guidelines recommend moderate iodine restriction, that is, don't show off high-iodine foods every day. For example, if you originally eat kimbap every day, just change it to once every two weeks. ； Many clinicians have also followed up and found that as long as the thyroid function is stable within the normal range, even an occasional seafood meal will have no effect on the nodules, and there is no need to tighten it excessively.

As for the myth that "beef, mutton, seafood, and spicy food are harmful substances, and eating them will make the nodules bigger" that is so popular on the Internet, it is even more true. There is no clear concept of "hair growth" in medicine. Many people think that the growth of nodules after eating something is mostly a coincidence of time - the nodules themselves have the probability of growing naturally, and it really has nothing to do with the plate of spicy chicken you ate that day. I have an old patient who has been followed up for 4 years. He is a native of Chongqing. He likes all kinds of spicy food. He eats hot pot twice a week. The nodules are stable at 3mm when reviewed every year, and they have not changed at all. ； On the contrary, there was another patient who did not dare to eat or touch anything after the nodules were detected. He lost 8 pounds in three months. Malnutrition caused fluctuations in thyroid function, and the nodules grew by 2mm.

Of course, this does not mean that there is nothing to be tabooed about. There are two pitfalls that you really need to avoid. One is not to eat large amounts of raw cruciferous vegetables for a long time. For example, if you eat two pounds of broccoli, cabbage, and purple cabbage every day to lose weight, the thiocyanate in them will indeed competitively inhibit the iodine uptake of the thyroid gland. Eating large amounts for a long time may affect thyroid function, but if you eat them normally and cooked, and eat a small half plate each time, it will have no effect at all. Don't stop eating because of choking. The other is not to eat random health products, especially those that boast of "beauty and nourishing", "ovary care" and "detoxification and dissipation". Many illegally add estrogen, and long-term consumption will really stimulate the growth of nodules. I met a patient last year who spent 50,000 to 60,000 yuan a year on health care products. Originally, a small nodule of 2mm grew to 1.2cm in a year. When punctured, it was borderline, so the gain outweighed the gain.

The most common thing I say to patients in the outpatient clinic is: don’t treat thyroid nodules as a scourge, and don’t put so many shackles on your diet. If you are really unsure, just check your urine iodine to see if you have iodine deficiency or excess. It is more useful than searching ten "diet taboos" on the Internet. Eat normally, stay up less late at night, and think less about sulking. This is more effective than any of the prescriptions for dispersing joints spread online.