Nutrition for Thyroid Conditions

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Thyroid problems can present in a variety of ways, and many of the symptoms can be attributed to other causes, however, I tend to be suspicious of the thyroid when someone experiences numerous of the following symptoms:

·      Tiredness and fatigue

·      Increased sensitivity to cold

·      Constipation, sluggish digestion, appetite changes

·      Dry/dull skin

·      Weight gain

·      Puffy/swollen face and/or neck

·      Hoarseness/voice changes

·      Muscle weakness, aches, and/or tenderness

·      Elevated blood cholesterol level

·      Joints pain or swelling

·      Menstrual changes

·      Thinning hair, increased hair loss on head and/or body

·      Decreased heart rate, feeling changes in heart beat

·      Changes in mood

·      Impaired memory/brain fog

 

The next step is to see a health professional! Tests I recommend are:

·      TSH

·      Total and Free T3

·      Total and Free T4

·      Reverse T3

 

If any of these are abnormal, check:

·      TPO (thyroid peroxidase) Antibody

·      TGAb (Thyroglubulin Antibody)

·      Thyroglobulin Antibody

·      Thyrotropin Receptor Ab

 

It is also important to check:

·      CBC, CMP, A1c

·      Vitamin D

·      Iron Studies

·      If female, pregnancy test

 

Other Auto-immune conditions to consider testing for:

·      Celiac

·      ANA panel

·      Rheumatoid Arthritis

 

From all my research, clinical experience and research work, I currently recommend a whole­foods plant­based diet for optimal health and happiness. This means your food intake is focused on fruits, vegetables, whole grains, legumes, nuts and seeds, with minimal refined foods or processed foods (within reason!). Instead of looking at foods as carbs/fats/proteins/calories, foods are viewed as a form of nutrients and energy, containing everything we need, with minimal planning, and the ability to eat when hungry and stop when full, leading to optimisation of energy, weight, mental function and long term minimisation of disease.

 

FOODS TO INCLUDE:

 

Gluten Free wholegrains:

·      Gluten free oats - rolled, steel cut, or oat bran

·      Millet

·      Buckwheat

·      Bulgar

·      Quinoa

·      Amaranth

·      Teff

·      Corn

·      Rice - white, brown, red, wild, black

·      Avoid gluten for now - wheat, rye and barley

·      Minimize refined foods, gluten free pasta, corn tortillas is ok

 

Legumes:

·      Chickpeas

·      Split peas

·      Beans - kidney, black, pinto, white, navy, etc

·      Lentils

·      Avoid soy for now

·      No protein powders

 

Vegetables:

·      Any and all including starchy vegetables such as sweet potatoes, white potatoes, pumpkin, beets, corn etc…

·      Organic where possible

·      Avoid kale juices

 

Fruits:

·      Any and all, including dried and juice

 

Nuts/seeds/high fat plant foods:

·      Any and all

·      Daily inclusion of flax and/or chia, walnuts, hemp

·      Avocado

·      No oils

·      Best brand for dairy substitutes in USA (in my opinion!) - Oatly low fat milk, Kite Hill yoghurts and cheeses, Pacific ‘milks’

·      Any plant-based ‘milk’ (almond, cashew, hemp, hazelnut, walnut etc) without oil

 

Seasonings:

·      Herbs, spices, balsamic and other vinegars, vegetable/fruit juice, broth

·      Sauces without oil

·      Hummus, nut butter sauces

 

Avoid:

·      All meats - red, white, fish

·      All eggs

·      All dairy - milk, cheese, yoghurt, cream, creamer, ice-cream

·      Coffee and caffeine, pre-workouts

·      Soda and sweetened drinks

·      Refined foods, processed foods, fast foods

·      Supplements

·      Oil of any kind, where possible

·      Kale/cruciferous greens juice

·      Soy

·      Gluten

 

Other:

·      20 mins sunlight daily without sunscreen

·      Relaxation/meditation, minimum 10 mins per day

·      Gentle yoga x 3 days per week

·      4 sheets nori per day

·      1 x Brazil nut every other day

·      Walk outside x 3 days per week

PUTTING IT ALL TOGETHER:

 

The simplest way I have found to think of meals and snack is­:

·      Starchy vegetable, whole grain or fruit (for energy)

·      +/­ Vegetables/salad +/­ Legumes +/­ Nuts, seeds, avocados +/­ Condiments +/­ Rare extras

·      Every meal/snack does not have to contain all of these! Choose one or more and aim for variety over days, weeks, months, learning how you feel best!

 

EXAMPLE MEALS:

 

Breakfast:

·      Oats with chia/flax, fruits, and plant-based milk/yoghurt if desired (make sure no oil ingredients)

·      Baked potato with spinach, tomatoes and tomato beans

·      Corn tortilla with nut butter and fruit

·      Buckwheat oatmeal/Rice farina porridge with fruit and plant-based milk alternative

·      Fruit salad with nuts/seeds

·      Smoothie made with fruits and non-dairy milk

·      Gluten free cereal with minimal sugars/salt/oils + fruit with non­dairy milk or juice to moisten

·      Homemade muesli (rolled grains, dried fruit, nuts, coconut) over stewed/tinned fruit with a spoonful of non­dairy yoghurt

·      Fruit salads topped with nuts/granola/cereal/non dairy yoghurt etc...

·      Vegan ‘omelets’ made with chickpea/Besan flour and shredded vegetables

·      Grilled, poached or baked fruit

·      Vegan, gluten free wholegrain, homemade healthy fruit crumbles and similar recipes

·      Any leftovers!

 

Lunch/dinner:

·      Rice, beans, salsa, avocado

·      Gluten free pasta with lentil Bolognese

·      Millet with vegetable stirfry

·      Baked potato with bean and vegetable mix

·      Roast vegetable salad with chickpeas

·      Corn tortilla wraps with hummus and salad

·      Vegetable sushi

·      Rice and steamed vegetables

·      Baked potato and salad with lentils

·      Quinoa with bean and vegetable chili

·      Grilled corn cob with salad

·      Pumpkin/potato/bean soups

·      Potatoes mashed with non-dairy milk and vegetables

·      Corn tortilla with refried beans, guacamole and salad

·      Salad with bean mix and salsa dressing

·      Lentil and vegetable soup with corn and potatoes inside

·      Cold potatoes mixed with savory vegan yoghurt with salad

·      Brown rice sushi with avocado and vegetables

·      Pumpkin soup with gluten free vegan cornbread

·      Wholegrain rice cakes as an alternative to bread for your favourite sandwich

·      fillings

·      Lentil dahl with brown/red/black rice and steamed vegetables

·      Balsamic roast vegetables with quinoa and chickpeas

·      Buckwheat risotto made with tomato puree and frozen vegetables

·      Baked sweet potato filled with bean and vegetable chili

·      Satay vegetables with rice (homemade satay sauce­ 1 TBLSP peanut butter, lime juice, curry powder)

·      Short­grain rice cooked with onion, tomato paste and Mexican spices served with refried beans and salad

·      Rice paper rolls filled with fresh herbs and shredded vegetables with peanut dip (peanut/almond butter, curry powder and vinegar)

·      Rice paper rolls filled with vegetables and oven baked with spicy sauce (almond

·      butter, lime and curry powder)

·      Stir Fry rice noodles with vegetables

·      Brown rice vegetable vegan lasagna

·      Vegetable patties/burgers using shredded or mashed vegetables mixed with cooked legumes and oven baked, served with vegetables or salad

·      Falafel made with chickpeas, parsley and cumin and oven baked, on a roasted

·      vegetable salad

·      Hummus as a salad dressing over oil­-free roast vegetables

·      Mexican style beans with rice, avocado, salsa, corn and salad (or baked corn tortillas)

·      Red kidney beans cooked with tomato and chili served with wholegrain rice

·      Cottage pie with lentil and vegetables topped with potato

·      Potato and leek soup

·      Home Baked oil-free potato fries with guacamole and hummus for dipping

·      Roast vegetable salads with potato, sweet potato, beetroot, carrot, onion, rocket,

·      balsamic vinegar and chickpeas

·      Potato hash made from shredded potatoes and baked in the oven

·      Bubble and squeak made from mashed potatoes, peas, corn, carrot and any other leftover vegetables

·      Vegan Corn with vegetable soup

·      Corn chips made from baked corn tortillas with salsa

·      Grilled corn cobs with salad

·      Mashed potato, mashed pumpkin, lentil patty and salad

 

Snacks:

·      Fresh fruit

·      Dried fruit

·      Nuts

·      Lara bars

·      Carrot/celery sticks and hummus or nut butter

·      Fresh juice

·      Smoothies made with fruit and non-dairy milk

·      Air-popped popcorn

·      Frozen blended fruit (such as banana ‘nicecream’ or mango sorbet)

·      Banana ‘nice­cream’ made with frozen then blended bananas, either plain or with the addition of vanilla, cinnamon, cacao, carob powder, spinach, berries, mango or other fruits makes an amazingly creamy healthy treat.

·      Rice cakes/corn thins with tomato/avocado, white bean spread, bruschetta mix, hummus, fruit preserves, nut butter etc.

·      Carrot, celery, capsicum sticks, cherry tomatoes with hummus, refried beans, guacamole, savoury herb plant-based yoghurt or nut-based cheese

·      Homemade trail mix using nuts, seeds, dried fruit, air-popped popcorn

·      Oat cookies­ mix mashed banana, rolled oats, sultanas (or similar combinations) and oven bake

·      Chia puddings­ soak chia seeds overnight in non­dairy milk or juice

·      Fruit and nut balls or Larabars­ blend dried fruit and nuts to form balls, such as apricot/cashew/coconut, date/walnut, sultana/almond, pecan/date, pistachio/figs, get creative!

 

FAQS: BUT WHERE DO I GET MY…?

 

Vegan omega three sources:

No…. you don’t need fish.

*Recommended daily intake is about 1,000­-1,500mg (that’s about 1g or 1⁄4 of a tsp!), and averaged over time, rather than day by day.

·      Flaxseeds, preferably freshly ground­ 1 oz/28g = 6,000mg

·      Chia seeds, preferably soaked­ 1 oz/28g = 5,000 mg

·      Walnuts­ 1⁄4 cup = 2,500mg

·      Lettuce, especially romaine­ one head =2,000mg

·      Hemp seeds­ 1 oz/28g = 1,000mg

·      Brussels sprouts­ 1 cup cooked = 430 mg

·      Winter squash­ 1 cup cooked = 350mg

·      Spinach­ 1 cup cooked = 350mg

·      Cauliflower­ 1 cup cooked = 200mg

·      Blueberries­ 1 cup = 175 mg

·      Mangoes­ 1 mango = 100mg

·      Honeydew melon­ 1 cup = 60mg

·      Other sources­

o   Sesame seeds/tahini, black and kidney beans and other leafy green vegetables.

Example uses­:

·      Oatmeal with a TBLSP ground flax, cooked in plant-based milk, topped with a cup of blueberries

·      Corn tortilla spread with tahini with a bowl of honeydew melon

·      Smoothie made with mango and non-dairy yoghurt

·      Bean burger with spinach salad topped with hemp seeds

·      Roasted winter squash and Brussels sprouts sprinkled with walnuts

·      Cauliflower soup served with kidney beans corn tortilla wraps

·      Blueberry chia pudding

·      Frozen mango blended into sorbet

 

Vegan Calcium Sources:

But what about calcium? It’s in plants. Unless you are starving, dietary deficiency is very rare. If a giraffe can grow and maintain a 20ft skeleton on leaves alone, the average 5’5 female will be just fine. Whilst dairy foods are high in calcium, humans can only absorb about 1/3 of it, making it no better a source than plant foods. Bone health is related to regular weight bearing physical activity, consumption of green ­leafy vegetables, daily sunlight for at least 6 months of the year, avoiding animal protein, caffeine, soft­ drinks, excess sodium, and tobacco, and having balanced hormone levels

*To meet the daily recommended intake of 1,000­-1,200mg/day consume about 5­-6 of the following­:

·      1 cup kale

·      1 TBLSP blackstrap molasses

·      2 TBSP hemp seeds

·      2 TBLSP tahini

·      2 cups beans

·      2 cups broccoli

·      4 oranges

·      3⁄4 cup figs

·      3⁄4 cup amaranth

·      3⁄4 cup cooked Asian greens such a bokchoy

·      3⁄4 cup bean sprouts

·      1⁄2 cup almonds

Other sources­:

·      Green leafy vegetables (kale, collard greens, rocket), almonds

Example uses­:

·      Kale and orange salad with tahini dressing

·      Steamed broccoli topped with hemp seeds

·      Stir-­fried Asian greens served over boiled amaranth

·      Baked beans with tomato/­molasses sauce

·      Thai-­style sour soup with green beans, beansprouts and Asian greens

·      Kale, fig and almond milk smoothie

 

Vegan Protein Sources:

I do not recommend protein powders, even vegan ones. They are essentially the white sugar of the protein world, super refined and processed foods that are not natural. Most people eat far too much protein to the detriment of their health. Provided sufficient calories are eaten with a wide variety of whole foods, it’s almost impossible to create a dietary deficiency. There is not even a medical term for isolated protein deficiency! Why you don’t have to worry about protein intake­

http://www.jeffnovick.com/RD/Articles/Entries/2012/2/11_Protein_Requirements.html

*The recommended daily intake at the highest level for a strength training female athlete is 0.8g/kg, based on ideal weight.

·      Oats­ 17g per 1⁄2 cup (dry weight)

·      Oat bran­ 22g per 1⁄2 cup (dry weight)

·      Quinoa­ 9g per cup

·      Buckwheat­ 24g per cup

·      Chickpeas­ 20g per cup (cooked)

·      Split peas­ 25g per cup (cooked)

·      Lentils­ 27g per cup (cooked)

·      Kidney beans­ 24g per cup (cooked)

·      Black bean pasta­ 46g per 100g (dry weight)

·      Spinach­ 14g per 500g

·      Silverbeet­ 8g per 500g

·      Broccoli­ 14g per 500g

·      Cauliflower­ 10g per 500g

·      Mushrooms­ 15g per 500g

·      Potato­ 10g per 500g

·      Corn­ 16g per 500g OR 8g per large ear

·      Asparagus­ 16g per 500g

·      Kale­ 16g per 500g

·      Lentil sprouts­ 22g per cup

·      Green peas­ 8g per cup

·      Broad beans­ 20g per cup

·      Peas (fresh or frozen)­ 9g per cup

·      Pepitas­ 18.5g per 50g or 8g per TBLSP

·      Sunflower seeds­ 8g per TBLSP

·      Almonds­ 10.5g per 50g

·      Pistachios­ 10g per 50g

·      Hemp seed­ 18g per 50g

Example uses­:

·      Oat Bran cooked in plant-based milk with almonds, cinnamon and sliced banana.

·      Beans cooked in tomato puree with baked grated potatoes (hash browns), grilled tomatoes with basil, steamed kale and asparagus with balsamic vinegar.

·      Lentil Bolognese

·      Vegetable stir fry served with boiled quinoa

·      Black bean pasta with mixed vegetables

·      Buckwheat sushi filled with hummus and salad

·      Corn cobs spread with sunflower seed butter served with chili green vegetables

 

Iron:

Despite popular belief, red meat is not the best source of iron. Whilst it is correct that heme ­iron (the kind found in animal products) is more absorbable than the non­-heme iron in plant sources, this doesn’t automatically make meat the best source of iron. In animal products only 40% of the total iron is in the form of heme iron, so the majority is actually present in the non­-heme form like in plant foods. Analyses of most mixed (non­ vegan diets) suggest heme ­iron provides only 10­-20% of total dietary intake of iron, so even those die­hard ‘you’ll become anaemic if you don’t eat meat’ advocates are actually getting the majority of their iron from plant foods as well! Somewhat surprisingly to many, most of the body’s iron requirement is met via the recycling of iron from red blood cells rather than dietary intake. The body can also adapt to a relatively wide range of iron intakes, increasing absorption if iron intake or iron stores are low, or if iron requirements are increased, via gastrointestinal absorption and excretion. However, this can only be done via plant­-based, non-­heme iron. The body cannot regulate absorption of iron from meat sources (heme iron)­ the body takes it up regardless of how much is stored in the body or taken in by the diet. In contrast, non­-heme iron absorption is tightly regulated by iron status and food intake, giving it a protective measure against iron overload, which is essential as the body has only limited mechanisms for excreting excess iron. Iron overload is actually far more common than most people realise, and is usually due to excess red meat consumption, excess iron supplementation or disease states such as haemochromatosis. There are a number of alternative ways to increase your iron levels however if they are low (as confirmed by a blood test (FULL iron panel, not just serum Fe) and presence of symptoms)­:

·      Eat small servings of iron rich foods regularly as opposed to one big meal.

·      Add vitamin C source, such as fresh fruit and vegetables to increase absorption of non-­heme iron.

·      Decrease or eliminate tea, coffee, red wine, and cocoa, as the tannins/polyphenols decrease iron absorption.

·      Avoid calcium supplements.

·      Be careful to not over consume oxalates, such as in bran and raw spinach, as they can decrease iron absorption.

·      Adding vitamin A and beta­carotene rich foods (such as carrots) can increase iron

·      absorption.

·      Decreasing animal proteins, egg protein and milk protein can increase iron absorption from non­-heme sources and increase intake of plant­-based high iron foods.

 

As a final point, if you compare the following popular meats, you can see that the total content of iron in animal foods is not significantly higher, and in many cases actually lower than plant-­based sources!

·      100g steak = 2­3 mg

·      100g lamb= 3 mg

·      One egg= 1.6mg

·      100g chicken breast= 0.5mg

·      1 cup cow’s milk= 0.1mg

 

More on iron here­:

http://www.wholefoodsplantbasedhealth.com.au/vitamin­minerals/iron/

Vegan iron sources­:

*Recommended intake­ Males and postmenopausal females­ 8.7mg Menstruating females­ 15-­18mg Pregnancy­ 27mg + Fruit/veg­ for co­factors for absorption

·      1⁄2 cup Brussels sprouts = 0.9 mg

·      2 cups arugula/rocket = 0.6mg

·      2 cups collard greens= 4.4mg

·      1 large potato with skin = 5mg

·      1⁄2 cup sun-dried tomatoes= 2.5mg

·      1 TBLSP tomato paste= 4 mg

·      1 cup broccoli= 0.6mg

·      2 cups kale= 2.2mg

·      1 cup peas= 2.4mg

·      1 cup cooked spinach= 6.4mg

·      1⁄2 cup raisins = 1.6 mg

·      1⁄2 cup dried peaches= 3.2 mg

·      1⁄2 cup dried apricots= 2 mg

·      50g dried dates= 1.3mg

·      1 cup prune juice= 3mg

·      1 cup cooked pinto beans= 3.6mg

·      1 cup cooked lentils= 6.6 mg

·      1 cup black beans= 3.6mg

·      1 cup cooked lima beans = 4.5mg

·      1 cup cooked chickpeas= 4.7mg

·      1 oz (28g) pumpkin seeds = 0.9mg

·      2 TBLSP tahini= 0.8mg

·      1⁄2 cup sunflower seeds= 3.7mg

·      50g cashew nuts= 2.5mg

·      1 TBLSP chia seeds= 2 mg

·      1 cup cooked brown rice= 0.8mg

·      1 cup oatmeal= 3.4mg

·      1 cup quinoa= 2.8mg

·      2 TBLSP molasses = 8mg

·      2 tsp dried thyme= 2.4mg

Example uses­:

·      Oatmeal topped with molasses and dried fruit.

·      Bean and rocket salad with sun-dried tomatoes, and pumpkin seeds.

·      Prune juice mixed with chia seeds

·      Brown rice mixed with tahini and vegetables

·      Brown rice spaghetti with lentils cooked in tomato paste with kale salad

·      Roast potato, and Brussels sprouts with thyme, served with pureed pinto beans

·      Poached dried fruit topped with cashew crème

·      Creamed rice made with non-dairy milk and raisins

·      Dried fruit, nuts and seed mixes

·      Bean dips and vegetable sticks

·      Homemade granola made with oats, dried fruit, nuts, seeds, and molasses

 

Zinc:

*Dietary requirement is about 8 mg per day for females, increasing to 11-­12 mg/day during pregnancy and lactation. Fermented soy foods, such as miso and tempeh can increase zinc absorption.

·      1/2 cup chickpeas­ 1.3mg

·      1/2 cup lentils­ 1.3mg

·      1/4 cup almonds­ 1.1mg

·      1/4 cup cashews­ 1.9mg

·      1/4 cup sunflower seeds­ 1.7mg

·      1 cup corn­ 0.9mg

·      1 cup peas­ 1.0mg

·      1 TBLSP chia seeds­ 1.0mg

·      1/2 cup oats­ 4mg

Example meals­

·      Vegetable oil­-free stir-fry topped with sunflower seeds

·      Lentil salad with peas and corn

·      Oatmeal topped with almonds

·      Chia pudding made with almond milk

·      Hummus on corn thins

More information­:

·      https://www.mja.com.au/open/2012/1/2/zinc­and­vegetarian­diets

 

Iodine:

This can sometimes be an issue on vegan diets, mostly because of the depletion of the soil and chlorination of drinking water, as well as modern day human sanitisation (similarly to B12 and not necessarily bad!) If concerned, test blood levels and if necessary, add a pinch of iodised salt or a few TBLSPs of sea vegetables/seaweed a few days a week. Note that sea salt does not have iodine (it evaporates in the process of making it).

 

For more information see here­:

http://www.wholefoodsplantbasedhealth.com.au/vitamin­minerals/iodine/

 

More information on potential deficiencies in vegan diets (real or imagined) see here­:

 

Nutrient summary­:

http://nutritionfacts.org/2011/09/12/dr­gregers­2011­optimum­nutrition­recommendations/

 

If you only read one book on health­:

https://www.brendadavisrd.com/books/becoming-vegan/

Getting rid of the eggs and dairy:

Why I recommend no eggs­:

·      http://www.forksoverknives.com/whats­wrong­with­eggs/

·      http://nutritionfacts.org/?fwp_search=egg

·      http://www.ncbi.nlm.nih.gov/pubmed/21076725

 

Why I recommend no dairy­:

·      http://doctorklaper.com/answers/answers11/

·      https://www.drmcdougall.com/misc/2007nl/mar/dairy.htm

·      http://nutritionfacts.org/?fwp_search=dairy

·      http://www.notmilk.com/a­z.txt

 

Milk substitutes­:

·      There are a lot commercially available, but most have either added oil or refined sugars, or unnecessary stabilisers, preservatives, additives etc... Look for ones where they contain a nut or bean or grain + water and not much else!

·      The very basic home recipe is soak nuts, seeds, oats, cooked rice, cooked beans or any other base desired then blend in a high speed blender, strain if desired, then flavour as desired (vanilla, cinnamon, blended fruit, herbs for savoury etc...)

·      http://healthyblenderrecipes.com/recipes/type/home_made_milk_recipes

 

Egg substitutes­:

·      Chickpea/besan flour for omelets/quiches - http://plantbasedonabudget.com/recipe/frittata­esque­potato­bake/

·      http://minimalistbaker.com/simple­vegan­omelet/

·      Baking­ chia or flax egg, mashed bananas, applesauce

·      Pretty much anything imaginable (not all healthy!) - http://freefromharm.org/food­products/delicious­vegan­eggs­recipes/

·      Other substitutions­ http://www.peta.org/living/food/egg­replacements/

 

Cooking without oil-

·      https://happyherbivore.com/2012/03/how­replace­oil­fat/

·      https://happyherbivore.com/2013/03/how­to­cook­without­oil­plus­video/

·      http://fatfreevegan.com/substitutes­and­techniques­for­fat­free­cooking/

·      http://www.straightupfood.com/blog/2012/05/23/cooking­without­oil/

 

Recipes:

·      http://www.straightupfood.com/blog/

·      http://blog.fatfreevegan.com/

·      https://www.drmcdougall.com/health/education/recipes/

·      https://happyherbivore.com/

·      http://www.klunkerskitchen.com/

·      http://www.forksoverknives.com/recipes/

·      https://cookingwithplants.com/

·      http://lanimuelrath.com/500­recipes­for­mcdougall­maximum­weight­loss­diet/

·      http://www.plantbasedkatie.com/

·      http://www.nutritionmd.org/recipes/all.html

·      http://www.plantplate.com/Recipe/List  

·      https://plantzst.com/indexes/recipe­library/  

·      http://pcrm.org/health/diets/recipes

 

Quick start guides­:

·      https://share.kaiserpermanente.org/wp­content/uploads/2015/10/The­Plant­Based­Diet­booklet.pdf

·      http://plantricianproject.org/quickstartguide

 

Further readings (recommended!):

·      https://www.drmcdougall.com/misc/2014nl/may/tencases.htm - Autoimmune and elimination diets

·      https://www.doctorklaper.com/diet-arthritis-autoimmune

·      https://www.drmcdougall.com/misc/2005nl/dec/thyroid.htm