Vegetarian has Hypothyroidism, B12 Deficiency

I’m having a multi-level nutritional dilemma. I’ve been a vegetarian for 6 years. I was recently diagnosed with hypothyroidism and severe B12 deficiency

Dr. Dilemna

I’m having a multi-level nutritional dilemma.

I’ve been a vegetarian for 6 years. I was recently diagnosed with hypothyroidism and severe B12 deficiency.

Having watched many of my holistic friends spend thousands of dollars trying to find “natural” treatments for their thyroid problems, I went mainstream and started taking 25mcg of Synthroid a day as well as 2,000 mcg of sublingual Vitamin B12 a day.

My doctor told me to steer clear of soy, which was at least 50% of my daily diet – everything seems to have soy! Now, I have been on B12 and meds and soy free for two weeks.

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I am dreaming about steak. And I mean all night long. It’s the first thing I think about when I wake up. Why am I craving steak when I’m on a supplement which also has folic acid, B6, and Vit. C? I finally ate steak last night and it was so good I wanted to eat more. It’s such an unfamiliar feeling. Does iron help B12 is some way?

I thought I had a well rounded diet, but this whole no-soy thing is new to me. What do you suggest? Thank you! B. S.

Savvy Vegetarian Advice:

Your question is a bit beyond my expertise. You should consult a veg-oriented dietitian. But I have a few thoughts:

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1. If soy was 50% of your diet, cutting that could leave you protein deficient. Eat a lot more beans and lentils, whole grains, nuts and seeds. Here are a few links to help you get a better nutritional balance:
How To Get Enough Protein In Your Veg Diet
Plant Based Diet Protein Chart
Savvy Vegetarian Nutrition Report

2. The medication plus the high daily dose of B12 could be upsetting your nutrient balance, esp. the B vitamins. That might account for your steak craving. I think that B12 and iron are related, though I don’t know how exactly. Here’s an article on iron and vegetarian diet.

You might want to take a daily food based multivitamin (Rainbow Light makes a good one for women) to try to balance things out.

3. Cravings could be your body telling you that you aren’t giving it what it needs. Could be B-vitamins, could be iron, I don’t know. One way to find out is to get tested for iron deficiency, folic acid deficiency and other vitamin deficiencies, such as zinc & magnesium. This book excerpt has some interesting info.

3. Nutrition is holistic. For the long term, you shouldn’t just rely on a pill to fix things. You need to fix your diet too. Start with the vegetarian nutrition report, and read the book ‘Becoming Vegetarian’ by Vesanto Melina and Brenda Davis. I recommend it for ALL vegetarians.

I’m forwarding your letter to a vegan dietitian I know, to see if she has better, more specific info. I’ll let you know.


I had a reply from Virginia Messina, MPH, RD. Always good to consult a real expert! She has a different view of food cravings, which makes a lot of sense. This is what she said:

“With a few exceptions, food cravings are usually more psychological in nature than nutrition-related. I think the fact that you have eliminated a whole category of foods–soy–from your diet, has you feeling somewhat deprived and looking for ways to replace those foods. The steak might look especially good if you were eating some fake meats made from soy, like veggie burgers. But even if you were eating lots of tofu, tempeh and other more traditional soy foods, you might be feeling like you want something very protein dense to replace those foods.”

“Variety is always key to good nutrition, so getting 50% of your calories from soy foods wouldn’t be a good idea no matter what. But, many people who are taking synthetic thyroid hormone medication do continue to eat soy. Soy foods have compounds that can very slightly raise your need for thyroid medication. But the key is to be consistent, by eating about the same amount of soy every day and then working with your doctor to adjust your thyroid medication accordingly.” Read The Truth About Soy – an excellent article by Virginia and her husband Mark Messina.

“It’s probably going to take a little while before you really start to feel better since you need to get your Vitamin B12 levels raised. So maybe that should be the first thing you work on. Once that is normalized, you could move back to a vegetarian diet and add one serving of soy foods to your diet per day. Make sure your doctor knows you are doing that, and have your thyroid levels tested.”

“It will take a little bit of experimenting, but you should be able to find a level of soy intake that is satisfying to you and compatible with your dosage of medication.”

Virginia Messina, MPH, RD, the Seattle Vegan Examiner

SV Note: Virginia is right about food cravings, I think. If you didn’t know about steak, you couldn’t crave it. It has been a long time since I ate meat, I never liked it, and I don’t think of it as food, so I don’t crave it. On the other hand, I do crave sugar and chocolate, which I ate for quick energy as a malnourished child. If I’m run down and not eating right, I think of them as “the fix”. But of course, they aren’t – just the opposite!

You will get protein and B vitamins from steak. You’ll also get them from enriched non-dairy milk, whole grains, beans, lentils, nuts and seeds. But what you eat is your decision, your business, and you should do what feels right to you.

Judith Kingsbury, Savvy Vegetarian

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2 Responses to “Vegetarian has Hypothyroidism, B12 Deficiency”

  1. J Kingsbury says:

    Thanks, Anon. Yes, GM foods are dangerous and should be avoided like the plague that they are.

  2. Anonymous says:

    Did anyone stop to consider that her problems may have arisen from the fact that soy constituted 50% of her diet? 85% of the soy beans grown in North America are genetically modified… only organic soy is natural. If she was eating organic soy then perhaps not… but if she has been eating a large amount of GM soy, that could be the whole problem right there. GM foods are dangerous.

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