An Up-to-Date Look at Goitrogenic Substances in Food If you've wondered exactly what is meant by the terms "goitrogen" and "goitrogenic

food," you are definitely not alone. These widely used terms often raise red flags in relationship to our health. Yet, as it turns out, many people often use these terms in the wrong context. In the early 1950s, scientists wondered whether there might be identifiable chemical compounds in certain foods-such as cruciferous vegetables like broccoli and cauliflower and soy foods--that were not known to play a supportive role in nourishment but instead worked only to compromise health and in particular, health of the thyroid gland. They used the term "goitrogen" to describe the activity of these chemical compounds. Since then, scientists have learned more and more about food substances with goitrogenic effects and how they work. Over the past 50 years, however, researchers have determined that there are no such "negative" substances in food, but only health-supportive nutrients that are not a good match for certain individuals because of their unique health history and health status. Five decades of research have also determined that certain nutrients-like tyrosine, iodine, and selenium-play a unique role in thyroid health. (The exact nature of deiodinase enzymes, enzymes that are the key to production of thyroid hormones, was only discovered during this 50-year time period.) What has emerged from this scientific work on diet and health is a shift from a focus on "negative" foods that might be "bad" for the thyroid to a new focus on the need to create a "right fit" between each person's diet and the nutrients needed by his or her thyroid for optimal function.

Goitrogens From a science perspective, "goitrogen" is a term used to describe any substance that can cause enlargement of the thyroid gland. That's because "goiter" is an enlarged thyroid gland. (Sometimes a person with an enlarged thyroid gland is described as "having a goiter," and sometimes the condition itself is simply referred to as "goiter.") A "goitrogen" is simply any substance that causes or contributes to goiter. There are many different chemical substances that can contribute to goiter. From a chemical standpoint, they usually have nothing in common except for their ability to cause thyroid enlargement. Many drugs act as goitrogens. These drugs include lithium (a drug used to treat bipolar disorder) and phenylbutazone (a non-steroidal anti-inflammatory drug). Sometimes these drugs are described as having "goitrogenic effects" instead of being called goitrogens themselves. Most of the time, drugs with goitrogenic effects interfere with iodine metabolism. Since the thyroid needs iodine to produce thyroid hormones, drugs that interfere with iodine metabolism often prevent the thyroid from making its iodine-containing hormones properly. (Without the proper amount of iodine, the thyroid cannot make sufficient amounts of thyroid hormone. When the thyroid fails to make enough of its hormones, the pituitary gland in the brain sends a message to the thyroid to increase in size and make more thyroid hormone. That increase in thyroid size is

what scientists call goiter.) Nutritional deficiency of iodine is the most common dietary cause of goiter, and in this sense, iodine deficiency could be accurately described as goitrogenic. Goitrogenic Foods Contrary to popular belief, foods themselves are not "goitrogenic" in the sense of causing goiter whenever they are consumed, or even when they are consumed in excess. In fact, most foods that are commonly called "goitrogenic"-such as the cruciferous vegetables (including broccoli, cabbage, kale, and cauliflower) and soyfoods-do not interfere with thyroid function in healthy persons even when they are consumed on a daily basis. Nor is it scientifically correct to say that foods "contain goitrogens," at least not if you are thinking about goitrogens as a category of substances like proteins or carbohydrates or vitamins. With respect to the health of our thyroid gland, all that can be contained in a food are nutrients that provide us with a variety of health benefits but which, under certain circumstances, can also interfere with thyroid function. The term "goitrogenic food" makes it sound as if something is wrong with the food, but that is simply not the case. What causes problems for certain individuals is not the food itself but the mismatched nature of certain substances within the food to their unique health circumstances. Goiter, Thyroid Function, and Diet With respect to diet, the most common cause of goiter is iodine deficiency from lack of iodinecontaining foods. However, other food factors can come into play under certain unique circumstances.

For example, since the mineral selenium is required for certain activities within the thyroid gland, selenium deficiency can combine with borderline iodine deficiency to produce goiter. The selenium content of foods is highly variable and depends to a large extent upon soil conditions. For this reason, in parts of Asia, Africa, and Latin America where soils are particularly low in selenium, thyroid problems related to borderline iodine intake may be worsened by this added problem of soil selenium deficiency and inadequate intake of selenium-rich foods. Other dietary circumstances can contribute to problems with thyroid function, but the circumstances here are not common. One circumstance involves excessive intake of phytonutrients called thiocyanates. When an imbalanced diet overloads the body with excessive amounts of thiocyanates-as might happen, for example, in parts of Central Africa where cassava root and cassava flour may be relied on for too great a percentage of total carbohydrates-risk to thyroid function has been documented, especially when accompanied by deficiency of dietary selenium. Since isothiocyanates-one category of thiocyanates-are commonly made in the body from other phytonutrients (called glucosinolates) that are especially concentrated in cruciferous vegetables, some people have wondered whether daily intake of cruciferous vegetables can increase their risk of thyroid problems. The answer here is no; there is no research to show that daily intake of cruciferous vegetables in ordinary diet amounts poses any unwanted risk to the thyroid. In fact, there are many well-documented health benefits from daily consumption of cruciferous vegetables, including decreased risk of colorectal cancer. One study has even found a weak

association between high intake of cruciferous vegetables and slightly decreased risk of thyroid cancer. From a practical standpoint, a food like broccoli (with its thiocyanates) is not "bad" for your thyroid. The only time you should be concerned about broccoli and your thyroid is if you are an individual with a history of thyroid problems who regularly eats large amounts of raw broccoli (or other cruciferous vegetables). In that case, it would be worthwhile for you to talk with your healthcare provider about the best dietary steps to take. Another circumstance that may contribute to risk of thyroid problems involves excessive intake of phytonutrients called isoflavones. In this case, however, research findings show a limited impact of excess isoflavone intake, even at levels higher than expected from food. For example, one small-scale study looked at the impact of 141 milligrams of dietary isoflavones from soy protein isolate each day over the course of one week and found no impact on thyroid measurements. Since commonly eaten foods almost always contain less than 100 mg of isoflavones per 4 ounces, and since isoflavone-containing foods like tofu or broccoli typically provide about 40 mg of isoflavones at most (per 4 ounces), the overall evidence here suggests that a number of unusual dietary factors need to overlap (involving some combination of iodine deficiency, selenium deficiency, thiocyanate excess, or isoflavone excess) in order for thyroid risk from a diet containing isoflavone-rich foods to be likely. Goitrogens, Diet, and Health

Given the research evidence described above, we believe there is no good basis for the vast majority of individuals to avoid any of the World's Healthiest Foods-including cruciferous vegetables like broccoli or soy foods like tofu-in a healthy everyday diet. A healthy mix of the World's Healthiest Foods will help protect all of your organ systems, including your thyroid gland. There are just far too many health benefits from these foods (in addition to their flavors and textures) to consider omitting them from a health-supportive diet. However, in the context of known dietary deficiency for either iodine or selenium or both, and especially when coupled with a previously diagnosed thyroid problem, it would be worth discussing the role of these foods in your diet with your healthcare provider. Impact of Cooking on Isoflavones and Isothiocyanates Although research studies are limited in this area, cooking does appear to help inactivate both isoflavones (commonly found in soy foods) and isothiocyanates (commonly found in cruciferous vegetables). These compounds appear to be heat-sensitive, and cooking appears to lower their availability. In the case of isothiocyanates in cruciferous vegetables like broccoli, as much as one third of this goitrogenic substance may be deactivated when broccoli is boiled in water. WHFoods Recommendations For the vast majority of individuals, foods containing potentially goitrogenic substances like thiocyanates and isoflavones pose no documented health risk to the thyroid and can be included on a daily basis in a balanced diet. Most of us can simply enjoy the delicious taste of these foods

and the amazing variety of nutrients they provide. For individuals with known dietary deficiency of iodine or selenium or both, especially when combined with previously diagnosed thyroid problems, intake of soy foods (high in isoflavones) and cruciferous vegetables (high in glucosinolates that can be converted into thiocyanates) may need to be discussed with a healthcare practitioner. (If you are a person who belongs to this latter group, you can still work together with your healthcare provider to determine what food combinations are the right fit for you and your thyroid, and these food combinations may end up containing both soy foods and cruciferous vegetables.) Since cooking may help to inactivate some of the potentially goitrogenic substances found in food, any individual wishing to lower his or her intake of these substances can consume soy foods and cruciferous vegetable in cooked versus raw form. References Dal Maso L, Bosetti C, La Vecchia C et al. Risk factors for thyroid cancer: an epidemiological review focused on nutritional factors. Cancer Causes Control. 2009 Feb;20(1):75-86. Hampl R, Ostatnikova D, Celec P et al. Short-term effect of soy consumption on thyroid hormone levels and correlation with phytoestrogen level in healthy subjects. Endocr Regul. 2008 Jun;42(2-3):53-61. Messina M and Redmond G. Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature. Thyroid. 2006 Mar;16(3):249-58.

Milerov J, Cerovsk J, Zamrazil V et al. Actual levels of soy phytoestrogens in children correlate with thyroid laboratory parameters. Clin Chem Lab Med. 2006;44(2):171-4. Teas J, Braverman LE, Kurzer MS, et al. Seaweed and soy: companion foods in Asian cuisine and their effects on thyroid function in American women. J Med Food. 2007 Mar;10(1):90-100. Vanderpas J. Nutritional epidemiology and thyroid hormone metabolism. Annu Rev Nutr. 2006;26:293-322.