"suppose i'm using synthroid"...

I know -- most of what I write about enhancing thyroid performance is from the point of view of maximizing the production and efficiency of a weak but functioning gland.  A lot of people however have been victims of bad science, having their thyroid removed or killed because an incompetent MD didn't know how to "cure" it.  Others, sadly, have had a thyroidectomy through accidental causes.  These people probably feel my posts on the subject don't apply to them.

But they do.  Skip over the bits about tyrosine, and lessen the strictures on iodine, but yes -- they do.

The very first point I make is that THE MORE CARBOHYDRATE YOU EAT, THE MORE THYROID HORMONE IS REQUIRED TO PROCESS IT.  This applies to everyone, hypothyroid or normal.  I'll leave it to people with hyper problems to present their point of view about carbs, but the blanket statement STILL applies.

If you're obliged to take the pharmaceutical form of thyroid that contains thyroxine (T4) but not triiodothyronine (T3), maximizing active conversion and reception is crucial.  THIS is the place where your actions and choices make a difference.  And again -- even if you're taking a T4+T3 formulation, this area can still apply to you!  Who says that the exact ratio you're getting in your supplement is what YOUR BODY wants?  Why is T4 in there at all, if your body's conversion isn't important?

And many people aren't doing all that's possible to optimize T4 conversion!  They've been told by broscience that they're getting all the nutrients they need on a paleo/primal diet, so supplementation is for SAD-eaters -- but unfortunately, broscience doesn't know shit about bodies that don't work as designed, i.e., hypothyroid bodies.  They don't take into account the fact that diminished thyroid function EQUALS diminished nutrient absorption from whole-food sources, and that intelligent supplementation hot-wires this limitation significantly.

Selenium and zinc are the sine-qua-non of supplementation for the T3-challenged.  If you're female, then you probably need iron as well.  The "man behind the curtain" keeps telling you that iron-overload is a PRAWWWWBLEM -- and it is for some.  FEW.  RARE.  Most women are iron-deficient, not overloaded.  Even if you eat red meat.  If you're hypothyroid and losing hair, i'll BET you're iron-deficient.

B12, especially, but all of the B vitamins probably should be added to your regimen.  Repeat this mantra:  IF YOU'RE HYPOTHYROID, YOU DON'T ABSORB NUTRIENTS APPROPRIATELY. 

Choose a sublingual in the form "HYDROXOcobalamin" because the cyanocobalamin isn't doing you a damn bit of good.  Know why a lot of goitrogens ARE goitrogens?  Cuz they often contain cyanides -- you know, that stuff murder mysteries use to poison people in a very short time, using massive doses.  Just because the dose in your food doesn't kill you immediately doesn't mean it's innocuous, like sugar (<- irony alert).  Your thyroid hates cyanide.  ;-)

(If you know that you're a poor methylator via a genetic test, go straight for the methylcobalamin, but some people have the opposite problem, and the hydroxo form is apparently effective for everyone.)

As a matter of fact, choosing a sublingual or transdermal form of many vitamins and minerals is superior -- this is why Epsom salts are so good.  If your intestinal absorption is inhibited, or if you experience irritation with it, taking the shortcut to your bloodstream can be an excellent idea.

You can have plenty of T3 in your bloodstream, too, but if it can't get into your cells because of a lack of receptors, you're shit-outa-luck.  Saturated fats in the diet maximize receptors, PUFAs minimize them, and MUFA is somewhere in the middle.  DON'T eat fried foods away from home, because you know they'll use the cheapest vegetable oil on the market.  DON'T eat commercial salad dressings and mayo. 

JUST DON'T.

Tweaking diet and supplementation isn't out of place, even if you DO have to depend on pharmaceuticals.  I suspect that the more pharmaceuticals one is forced to take rather makes our personal choices MORE important in the end.