Three Weeks of Low-Iodine Menus

Good morning, everyone!

While I was in the midst of a "get healthier" plan, my thyroid had other food plans. So as not to drive myself nutty with so many different dietary goals, let's just put the thyroid one first, shall we?

A couple of weeks ago, I underwent a total thyroidectomy for papillary thyroid carcinoma -- the most common type of thyroid cancer. Because the cancer spread to a nearby lymph node, I will be undergoing high radiation treatment on an inpatient basis, later on in October.

To prepare my body for the radioactive iodine, I must starve any residual thyroid cells of iodine, so that, when they see the radioactive iodine, they suck it up quickly. In this way, any thyroid cells (good or bad) are dispatched, preventing any further shenanigans of the cancerous type.

So how do you starve yourself of iodine?

Iodine in Foods

A major source of iodine in our diets is iodized salt. The iodine is added because many of us would not get enough iodine, an important nutrient, unless we lived near the sea and ate products of the sea (salt-water fish, shellfish, kelp, etc.) on a regular basis. Other major sources of iodine are dairy products (because iodine in the cow's diet is naturally concentrated in the milk), and most processed baked goods (because dough conditioners contain iodine).

Seafood, cheese, iodized salt ... I'll see you in a few weeks...

Because even a little bit of salt or preservative in food contains enough iodine to throw off your low-iodine regimen, finding foods that are acceptable for a low-iodine diet can be a little challenging, at first. So I wanted to share with you what I have been eating.

Each post will have links to resources that I used to find low-iodine foods, as well as ways I adapted other recipes to make them low-iodine options.

The Menus, by Week

As I complete each day, I will post, and link to the menu, below. So come back often, and see what new things I've discovered that can be tasty and still keep your iodine low.

• Day 1 Menus
• Day 2 Menus
• Day 3 Menus
• Day 4 Menus
• Day 5 Menus
• Day 6 Menus
• Day 7
• Day 8
• Day 9
• Day 10
• Day 11
• Day 12
• Day 13
• Day 14
• Day 15
• Day 16
• Day 17
• Day 18
• Day 19
• Day 20
  

   

 

Low-Iodine Eating: Day 7 (Effects of a Low-Iodine Diet)

This is the seventh in a 21-day series showing how I kept a low-iodine diet in preparation for radioactive iodine treatment.

A Little (Innocent) Mistake...

This post is going to be a little different, and I'll tell you why...

I accidentally started the low-iodine diet a week early.

The amount of time you're on a low-iodine diet varies, but is usually 2-3 weeks. From what I've read, most people are on it about 2 weeks, but a lot depends on your lab work in between. You have enough thyroid hormone in your system to keep you going for about a month after your surgery, so your doctor will monitor your natural hormone levels, as she begins your replacement hormone therapy. Also, there are different replacement therapies, some fast-acting (like Cytomel), and some slow-acting (like Sythroid). If you are going to have tests that require weaning off your medication temporarily, your doctor is likely to prescribe Cytomel, so you later go off it to prepare for tests. All these reasons mean that a lot of your doctor's choices will depend on how your own body responds to various procedures and treatments.

Sooooo.... my bloodwork showed the doctor that ...

1. I had almost no TSH (thyroid stimulating hormone) = 0.0135
2. I had low Tg (thyroglobulin) = 3
3. I had no anti-Tg (thyroglobulin antibodies) = 0

The Tg tells us that there is no thyroid to produce Tg, and the TSH tells us that the brain is not detecting the need to stimulate the thyroid (because hormones are being provided artificially).

Because I officially was to begin my low-iodine diet the next week, I gave myself a day off, went to the Big E, and ate fairground food.

With some thought, you can eat a good, tasty diet, even when on a low-iodine regimen.

The Goal of the Treatment...

Over the next week, my doctor wants to prepare my body to make the most of the radiation treatment (scheduled for the end of the month). Here are the things that she is trying to do:

1. Decrease my body's iodine levels. We are doing this by cutting down on iodine in my diet. Iodine is required by the thyroid in order to produce thyroid hormone. By removing dietary iodine, it ensures that the only source of iodine available to any cancer cells is the radioactive iodine that I will ingest later this month.
2. Decrease any thyroid hormone in my body. We will do this by cutting my Cytomel (synthetic thyroid hormone) from two pills per day to one pill per day. This will cause my pituitary gland (in my brain) to detect low thyroid hormones, and cause it to produce thyroid stimulating hormone (TSH).
3. Increase thyroid stimulating hormone (TSH) in my body. We will do this by cutting out any artificial source of thyroid hormone. This will cause any scraps of thyroid cells to fire up, to try to make up the difference.
4. Any increase in Tg in the blood will be a sign that there are thyroid cells (and potential tumors) remaining in the body -- it is a good tumor marker.
5. Ablate (wipe out) any remaining thyroid cells (cancerous and normal). We will do this by providing the iodine that these cells are now craving (in their efforts to provide the body with thyroid hormone) -- but instead of dietary iodine, we will be tricking them into "eating" radioactive iodine -- a toxin to them.

 Steps 1-4 will occur this week, leading up to Step 5 (the next week).

Effects of the Treatment on the Body

Effects of Low Iodine on the Body

In a person with a thyroid, low iodine effects are really the effects that having reduced iodine has on thyroid function: hypothyroid (low thyroid function), goiter, etc. We'll talk about those next. But there are some other effects of going on a low-iodine diet, as well.

• Weight loss.  Cutting out dairy, seafood (for the iodine), processed foods (for the salt), and processed baked goods (for the dough conditioners) cuts out a lot of calories and food choices for most of us. I have found that I have lost 6 lbs after one week of low-iodine diet (and I was very conscientious about my diet).
• Calcium deficiency. Since you are cutting out one of the primary sources of calcium in your diet, dairy, you will often be put on a calcium supplement while you are on a low-iodine diet. But you likely will be already on this, as your parathyroids sometimes shock after your surgery, and they control your body's calcium levels.

You will become an expert at reading food labels during your treatment.

Effects of Low Thyroid Hormone on the Body

While you are on the low-iodine diet, you will also likely be decreasing your thyroid medication, which will cause you to have low thyroid hormones, and symptoms of hypothyroid. Here are the ones listed at the Mayo Clinic website:

• Fatigue
• Sluggishness
• Increased sensitivity to cold
• Constipation
• Pale, dry skin
• A puffy face
• Hoarse voice
• An elevated blood cholesterol level
• Unexplained weight gain
• Muscle aches, tenderness and stiffness
• Pain, stiffness or swelling in your joints
• Muscle weakness
• Heavier than normal menstrual periods
• Brittle fingernails and hair
• Depression

Some of these will happen quickly, and others may develop over time, or not at all -- everyone is different. The one that most people comment about, and report as the most problematic, is the first one: fatigue. My doctor pointed out that the fatigue can often be enough to make driving hazardous.

My doctor also said that my bone health and heart health can be impacted by all the treatments, and will be closely monitored.

Getting others to help in household tasks will help you when you are fatigued.

Knowledge is Power

If you are fortunate, your endocrinologist will keep you very informed with your blood test results, treatment plan, any symptoms and side effects, and sources of information for help during your course of treatment. Here are some websites that I have found helpful:

ThyCA: The Thyroid Cancer Survivor's Association, Inc.  Takes you from your first symptoms, through your initial diagnosis, through various treatments, and aftercare. This is the site of the Low-Iodine Cookbook, a free .pdf file you can download and print out. The recipes were developed by other thyroid cancer survivors. 

LIVESTRONG, a website and organization developed by Lance Armstrong, world class cyclist and cancer survivor, has a separate section just about thyroid cancer. The site has lots of information about healthy living before, during and after cancer treatment.

The National Cancer Institute has a very thorough web page that is very useful for helping you understand the medical terms, types of cancers, tests and procedures. It also has a collection of links to other resources (such as the ones above) for all the questions you might have.

You will likely come across lots of chats and other online communities of thyroid cancer patients. These are helpful for showing you what most people go through. Remember to always consult with your doctor before trying anything, as the folks on the chat line are not medical professionals.

Do your research, and prepare yourself for your treatment.

Next Week:

1. Decrease Cytomel to one pill per day.
2. Continue low-iodine diet.
3. Continue taking Vitamin D and calcium supplements.
4. Prepare low-iodine meals for the second week of the diet (when I'll be hypothyroid, and too tired to prepare meals)
5. Purchase food items that other members of my family can prepare (see #3).
6. Think about where I have to drive the following week, and (perhaps) make alternative travel arrangements (see #3).

Low-Iodine Eating: Day 6 (Life Beyond Salt)

This is the sixth in a 21-day series showing how I kept a low-iodine diet in preparation for radioactive iodine treatment.

The Menus

Breakfast

Scrambled egg whites (see note)
Apple slices
Coffee, black, no sugar
Orange juice (no pulp, with extra calcium)
Morning meds (see Day 1)  

Lunch

Nordic Winter Vegetable Soup (see recipe) 
Matzo
Apple
Cranberry-Lime Seltzer
Afternoon meds (2:00) (see Day 1)

Dinner

Stir-fried Vegetables (see note)
White rice
Water
Evening meds (see Day 1)

Snacks

Pecan halves, dried cranberries 
Popcorn, no butter, non-iodized salt
Coffee, black, no sugar

The Recipes

Nordic Winter Vegetable

(Adapted from Food & Wine Annual Cookbook 2012)

This recipe, as written, is perfect for a low-iodine diet, with the substitution of non-iodized salt in the seasoning. I used my own homemade chicken broth, and substituted white rice for the barley, because that's what I had, and used 2 stalks of celery in place of the celery root. It made the soup very stew-like.

• 2 tablespoons extra-virgin olive oil
• 1 large onion, thinly sliced
• 2 leeks, white and tender green parts only, thinly sliced
• 2 garlic cloves, minced
• 1 cup uncooked white rice
• 8 cups low-sodium vegetable broth
• 4 cups water
• 10 thyme sprigs
• 2 bay leaves
• 2 stalks of celery, cut into 1/2-inch cubes
• 1 pound parsnips, peeled and cut into 1/2-inch pieces
• Non-iodized salt and freshly ground pepper
• 1 pound baby spinach
• 1 teaspoon freshly grated nutmeg

1. In a large pot, heat the oil. Add the onion, leeks and garlic and cook over moderate heat, stirring occasionally, until tender, about 5 minutes. Stir in the rice. Add the vegetable broth, water, thyme and bay leaves and bring to a boil. Add the celery and parsnips and season with salt and pepper. Simmer over moderately low heat until the rice and root vegetables are tender, about 40 minutes.
2. Stir in the spinach and nutmeg and simmer for 5 minutes. Season the soup with salt and pepper and serve in deep bowls.

My family substituted the matzo with buttermilk biscuits...

Notes on Other Menu Items

The Scrambled Egg Whites: Scrambled egg whites are not as bad as they sound. I scrambled two egg whites with about 1 T homemade chicken stock, and seasoned the mixture with a little curry powder, non-iodized salt and black pepper. I cooked them in a bit of olive oil. They were very tasty.

The Stir-fried Vegetables: Use whatever veggies you like for the stir-fry. I used my rainbow peppers from the farmer's market (see Day 3), plus onions, garlic, and a handful of frozen corn. I seasoned the vegetables with about 1 tsp of lemon-grass paste (I found it in the produce section), a splash of balsamic vinegar and a dusting of ground ginger.

 

Alternatives to Salt for Seasoning

Eating a low-iodine diet means avoiding anything that contains salt, as you can't be certain that the salt is non-iodized. But that doesn't mean your food should be tasteless. Here are some options that I found helpful for replacing salt and sauces that contain them:

• non-iodized salt (an easy switch you can make in your own kitchen)
• balsamic vinegar (substitutes well for Worcestershire, soy sauce and teriyaki sauce)
• hot sauce (check the label to make sure it doesn't contain salt)
• commercial salt-free seasoning mixtures, like Mrs. Dash
• garlic, lemon-grass or ginger pastes (find them in the produce section)
• lots of fresh vegetables
• all those herbs and spices in your cabinet -- now's the time to experiment (I like garam masala - a spicy herb and spice mix used in many Indian dishes)
• a splash of lemon or lime juice (or, for something really different, try grapefruit juice)
• beer and wine as part of the cooking liquid
• seasoned oils (I have sesame oil and a spicy cayenne olive oil that I use)

I think my new favorite seasoning has become balsamic vinegar. It's color and rich flavor are something I never took advantage of until I started preparing the recipes from the free Low-Iodine Cookbook, from ThyCA (Thyroid Cancer Survivors Association).

Low-Iodine Eating: Day 5 (How the Diet Works)

This is the fifth in a 21-day series showing how I kept a low-iodine diet in preparation for radioactive iodine treatment.

The Menus

Breakfast

Spicy Muffins (see Day 4)
Coffee, black, no sugar
Morning meds (see Day 1)

Lunch

Peanut butter (natural, no salt added) and strawberry preserves on matzo

Cranberry-Lime Seltzer
Apple
Kiwi
Afternoon meds (2:00) (see Day 1)

Dinner

Homemade Chicken Tenders (see recipe)
White rice
Lima beans
Water

Evening meds (see Day 1)

Snacks

Pecan halves, dried cranberries 
Coffee, black, no sugar

[NOTE: I freeze the muffins two at a time in sandwich size Ziploc baggies. That way, I can pop two out of the freezer the night before, and have them thawed and ready for breakfast the next day. This is helpful when you start decreasing your thyroid hormone  (you'll be hypothyroid)-- you'll be tired in the morning when you get up.]

Freeze individual portions of special foods, to make meal preparation easier when you're hypothyroid.

 

The Recipes

Homemade Chicken Tenders

• Vegetable oil for frying
• 4 boneless, skinless chicken breasts, cut into strips
• Non-iodized salt
• Black pepper
• Garlic powder
• White flour for coating chicken (about 1 cup)

Heat oil in a heavy frying pan (I put about 1/4 in in the pan).

Season chicken strips to taste with salt, pepper and garlic powder.

Put flour in a gallon Ziploc bag. (NOTE: using a ratio of 3 parts of white flour to 1 part of corn flour (masa harina) [not corn meal] gives an extra crispiness to the chicken). Place chicken strips in the bag, and seal tightly. Shake the bag, turning to coat all the pieces evenly (when they don't stick to one another, they are floured well). Discard extra flour.

Place chicken strips in hot oil. Brown on all sides. Drain on paper towels.

The Seasonings: Experiment with one of the many great non-salt herb and spice mixes available. It just so happened that all my spice mixes contained salt, so I used garlic powder -- one of our old standbys.

What Is Happening in Your Body...

A little about the science behind this special diet I have been on...

Thyroids and Parathyroids

When you have your thyroid removed, it would seem that any chance of thyroid cancer returning is pretty, well, zero, since you no longer have a thyroid. 

I learned a bizarre and fascinating fact about the thyroid and parathyroids. It seems that the parathyroids sometimes hid inside the thyroid, and they get removed by accident when you have a thyroidectomy -- this is why your report will say that they counted and found all four of your parathyroids. If they didn't, that means they've removed one.

But fear not! If they accidentally remove one, they just make a little slit in the skin of your arm, slip that baby inside, close it in, and it's perfectly happy living there, not really attached to anything, doing its parathyroid job.

Weird, huh?

The thyroid is just as strange, it seems. Because, even if a few cells are left floating around in your neck, over time, your thyroid can try to grow back. Just like the parathyroid -- not really attached to anything, but pumping out thyroid hormone.

Soooo... if the normal cells can grow back, your endocrinologist worries about the abnormal ones (that don't follow rules) will also grow back. But how do you get rid of them, if you can't see them?

Iodine, Radiation, and Your Thyroid

Your thyroid gland loves iodine. In fact, most of the iodine in your diet ends up in your thyroid. Iodine keeps the thyroid running smoothly, and the thyroid is very important in keeping the rest of your body running smoothly.

If you've ever had or known someone who had cancer treatment, you know that radiation is often used to zap any cancer cells that are still lingering around. Radiation treatment has come a long way over the past 20 years, but external beam radiation still hits body parts that don't need to be irradiated. 

Did you know that there is an isotope of iodine that is radioactive? Because the thyroid loves iodine, and this particular form of iodine is radioactive, it's like sending a letter bomb to your thyroid. The letter isn't bad, in fact, it's good. But the attachment is a doosie. The thyroid takes up the iodine, but gets the radiation along with it. Much less collateral damage than external radiation. Any lonely thyroid cells floating around, waiting to re-grow, are sought out and destroyed.

So Why the Special Diet?

In order to get the most radioactive iodine to any remaining thyroid cells, you have to make them want it really, really bad. THEN you want to make it so the only way they get the iodine is to use the radioactive form. We do this in three steps...

Step 1: Starve the body of iodine. This is what we're in the middle of doing, right now, with this low-iodine diet.

Step 2: Fire up any lingering thyroid cells at the last minute. Right now, if there are any thyroid cells in your body, they're kind of sleeping on the job, because you are taking thyroid hormone pills. The thyroid hormone in your blood tells your pituitary gland (in your brain) - "We're good. You can turn off the thyroid gland right now." But we want the thyroid cells to wake up, so they will be hungry for the radioactive iodine. So, gradually, your doctor will lower your thyroid hormone until you aren't taking any more, at all. This will make your pituitary gland say, "Whoa! We better get some more thyroid hormone!" Which will, in turn, cause those rogue thyroid cells to wake up and try to work. They need iodine to work, so they'll be looking for it.

Step 3: Take radioactive iodine. This will be a liquid or a pill, and the doctor will decide whether you get a low dose or a high dose. By this time, any remaining thyroid cells (cancerous or normal) will be looking for iodine, and will take up the radioactive iodine, which destroys the cells.

Low-Iodine Eating: Day 4 (Cooking with Juicer Pulp)

This is the fourth in a 21-day series showing how I kept a low-iodine diet in preparation for radioactive iodine treatment.
 

The Menus

Breakfast

Spicy Muffins (see recipe)
Coffee, black, no sugar
Morning meds (see Day 1)

Lunch

Sauteed Chicken and Peppers (see Day 3) 
White Rice
Cranberry-Lime Seltzer
Apple
Afternoon meds (2:00) (see Day 1)

Dinner

Pork Chops
Asparagus
French Fries 

Evening meds (see Day 1)

Snacks

Pecan halves, dried cranberries 
Coffee, black, no sugar

The Recipes

Spicy Muffins

(Adapted from Juicer Pulp Sweet Bread, The Hillbilly Housewife)

 Items marked * are adapted to suit a low-iodine diet.

• 1/2 c white sugar
• 1/4 c apple cider*
• 2 egg whites*
• 2 T vegetable oil
• 2 T honey
• 1 tsp vanilla extract
• 1 tsp ground cinnamon
• 1/2 tsp ground cloves
• 1 c whole wheat flour
• 1/3 cup all-purpose flour
• 3/4 tsp baking powder
• 1/2 tsp baking soda
• 1/8 tsp non-iodized salt
• 1 1/2 cups pulp from juicing (See Day 1)

Preheat oven to 350. Spray a muffin tin with cooking spray, or line with paper cupcake liners; set aside.

In a medium bowl, whisk together the sugar, cider, egg whites, oil, honey, vanilla extract, cinnamon, and cloves.

In a large bowl, stir together the flours, baking powder, baking soda, and salt. Add the sugar mixture, then the pulp from juicing. Stir with a wooden spoon until combined, but do not overmix.

Spoon the batter into the muffin tin. Bake for 25 minutes or until a knife inserted into the center comes out clean. Cool in the pan for 10 minutes. Remove the bread from the pan and cool on a wire rack. 

NOTES: 

The Apple Cider: The original recipe uses milk. Since most of the pulp was apple pulp, I figured cider would work well. You can use any juice, or even water. NOTE: Non-dairy "milks" usually have soy in them, and may have dairy-based components, so these are not part of a low-iodine diet.

The Egg Whites: You can't have yolks, but you can have whites. So if the recipe calls for an egg (like this one did), substitute another white for the yolk you removed, and save the yolks for someone else in the family. 

The Juicer Pulp: You can use whatever pulp you have. Mine usually has lots of apples, celery, and carrots, plus some other stuff. Depending on your juicer, you might have chunks that slipped by the grater, so I usually sift through the pulp with my (clean) fingers to pull out any large or hard pieces. Maybe you have a better way.  I bought my juicer in the summer, and couldn't bear to throw away the pulp -- it seemed a shame to discard something that I would have eaten (although my eldest child remarked, "Mom, if you're going to squeeze out the juice and then save the apple pulp, why don't you just eat the whole apple?"). There are lots of recipes using juicer pulp, but beware! I think a lot of them are recipes someone invented but never tried, as I have made some awful ones. This one is not only foolproof, but it's very tasty. Experiment with your zucchini bread and carrot cake recipes to start, remembering that your juicer squeezes out most of the water (so you'll have to adjust your liquid), and a lot of the sugar is in the juice, so you'll have to check the sweetness of your product).

 An Interesting Variation: Susanne at The Hillbilly Housewife suggests adding 1/2 c cocoa powder to the dry ingredients to create a moist, chocolate sweet bread or muffins. This sounds wonderful. You cannot have chocolate (because it contains milk products), but cocoa powder is allowable. I'll have to try that the next time. 

I freeze the pulp from my juicer in sandwich size Ziploc bags.

 

 

Low-Iodine Eating: Day 3 (Eat Those Fruits and Veggies!)

This is the third in a 21-day series showing how I kept a low-iodine diet in preparation for radioactive iodine treatment.


The Menus

Breakfast

Mixed Fruit Smoothie (see recipe)
Coffee, black, no sugar
Morning meds (see Day 1)

Lunch

Leftover potatoes and carrots from Beef Pot Roast (See Day 2)
Cranberry-lime seltzer
Apple
Afternoon meds (2:00) (see Day 1)

Dinner

Sauteed Chicken and Peppers (see recipe)
White rice
Water
Evening meds (see Day 1)

Snacks

Apple Brown Betty (see Day 1)
Coffee, black, no sugar

The Recipes

Mixed Fruit Smoothie  

• 1 banana, peeled and cut into chunks
• 5 strawberries, hulls removed, quartered
• 1 c orange juice with added calcium
• 1/2 c carrot juice

 Place all ingredients in blender jar. Process until smooth.

NOTE: Because a total thyroidectomy (and many other thyroid problems and treatments) can cause a calcium deficiency, I take calcium supplements and choose juices with added calcium, when available.

Sauteed Chicken and Peppers

• 4 boneless, skinless chicken breasts, cut into thin strips
• 1-2 T olive oil
• 1 onion, sliced thinly
• 1 Italian frying pepper, cut into thin strips
• 1 orange bell pepper, cut into thin strips 
• 1 black bell pepper, cut into thin strips
• 2 tsp minced garlic
• Non-iodized salt
• Black pepper  

Heat oil over med-high heat.  Add chicken; season with salt and pepper, to taste. Sautee over med-high heat until beginning to brown; remove from pan.

Add additional oil, if needed. Add vegetables to pan (onion, peppers, garlic), and sautee until tender. Return chicken to pan, and heat through. Adjust seasoning, if needed. 

[NOTE: Meats, except for seafoods, are allowed, but the recommendation is to keep your daily meat intake to 1/4 lb or less, per day. Adding tasty vegetables stretches this portion and adds variety.]

 

.

Colorful peppers, onion and garlic help to stretch the meat and add flavor.

Low-Iodine Eating: Day 2 (Juicing for Your Health)

This is the second in a 21-day series showing how I kept a low-iodine diet in preparation for radioactive iodine treatment.

The Menu

Breakfast

• Instant oatmeal with chopped pecans and dried cranberries
• Apple-Strawberry-Kiwi Juice (see recipe)
• Coffee, black, no sugar
• Morning meds (see Day 1)

Lunch

• Matzo, apple slice and pecan halves
• Natural peanut butter for dipping (get one with no salt added -- peanuts only!)
• Cranberry-lime seltzer
• Remaining Apple-Strawberry-Kiwi Juice
• Noon meds (see Day 1)

Snacks (2:00)

• Home-popped popcorn, no butter/margarine, non-iodized salt
• Herb tea
• Small apple
• Afternoon meds (see Day 1)

Dinner

• Beef Pot Roast with Potatoes and Carrots (see recipe)
• Water
• Red wine (1 glass)
• Coffee, black, no sugar

Notes: 

1. You can eat unsalted nuts -- go to the baking section to find these most easily. 
2. Butter contains milk, which naturally concentrates iodine from the cow's diet. Margarine and other spreads often contain milk products (my soft spread has whey, which is the solids from milk). Oils of any kind are ok. I substituted vegetable oil for butter and margarine in recipes. 
3. Buy a carton of non-iodized salt and hide your other carton.
4. Wine, beer, coffee and tea are all allowable.

 

The Recipes

Apple-Strawberry-Kiwi Juice

(I invented this recipe, using fruits that I had in the house)

 

• 4 apples, cut into eighths (or size to fit in the chute of your juicer)
• 5 large strawberries, halved
• 1 kiwi fruit, halved 
• 1/2 c. Green Machine juice, by Naked 

Put the fruits through your juicer (I alternate harder and softer fruits, so that I get the most juice out of the softer ones. I don't peel or core them). Save the pulp (see note).

Pour the juice into a quart jar, and add Green Machine to top it off.

Notes: 

The Juicer Pulp: I save the pulp from my juicer in sandwich-sized zip-style baggies, and keep it in the freezer. I use it to make the Spicy Muffins (in Day 3 post). Alternatively, you can put the pulp in your compost pile. I just can't bear to throw it away!

The Green Machine Juice: I like to keep a bottle of one of the "amped up" juices in my refrigerator, to round out my juicer projects. Old standbys have been carrot juice or pomegranate juice, which can be added to almost anything to boost antioxidants. NOTE: If you are undergoing ionizing radiation treatment, check with your doctor. Mine had me stop taking antioxidant supplements during external beam radiation treatment -- kind of makes no sense to take antioxidants during a treatment that is oxidizing, right? Not sure about superfood juices, so best to check with your doctor. ALSO check the labels carefully for banned substances during your low-iodine diet: soy, multivitamins containing iodine, Red Dye #3, and dairy-derived products. I looked up spirulina, chlorella and blue-green algae in Natural News: all are freshwater (so no iodine traces). All have healing qualities for your body after you have had radiation treatment. Good stuff. Follow the links for more interesting information.

Look at how smart you're getting, taking such good care of yourself!

I use my juicer almost daily, here, for fresh grapefruit juice.

 

Beef Pot Roast with Potatoes and Carrots

(My own adaptation...)

Note: Items marked (*) are changes to accommodate a low-iodine diet. See notes at end of recipe for explanation

• 1 1/2 c salt-free beef broth*
• 2 T balsamic vinegar*
• 1/4 c red wine*
• 1 1/2 T garlic powder
• 2 tsp non-iodized salt*
• 2 T onion powder
• 1 5-lb beef pot roast
• 3 T minced garlic
• 1 T balsamic vinegar*
• 1 T red wine*
• 1/2 tsp crushed red pepper flakes*
• 1 12-oz can of beer*
• 1 onion, sliced thinly in rings
• 1 Italian frying pepper, sliced thinly in rings*
• 5 white potatoes, peeled and cut into quarters*
• 1/2 lb. baby carrots

In a bowl, combine the beef broth, vinegar, wine, garlic powder, salt, and onion powder. Pour all into a gallon-sized zip-style bag. Stab roast all over with a fork, then place in bag, and zip closed. Set bag in a baking pan and marinate in the refrigerator for 24 hours, turning occasionally to make sure all sides are exposed to the marinade.

The next day, preheat oven to 275 degrees. 

In small bowl, combine minced garlic, vinegar, wine and pepper flakes. Pour onto the bottom of a 9" x 13" baking dish. Remove roast from bag, and place in baking dish. Pour beer over the roast in the pan. Cover roast with the onion and pepper slices.

Cover tightly with aluminum foil, and place in center of oven. Bake at 275 degrees for 4 1/2 hrs. Uncover; add potatoes and carrots to pan juices around roast, cover and continue baking for an additional 1/2 hr, or until vegetables are tender.

Notes:

The Beef Broth: You can buy no-salt-added beef broth in a carton in the soup aisle at most grocery stores. Remember, it's not the sodium that's the problem -- it's the iodine that probably was in the salt during production. Since you can't tell from the label, you have to assume they used iodized salt.

The Balsamic Vinegar: Balsamic vinegar will be your go-to condiment when you want to add rich flavor to anything. It doesn't substitute for the other sauce, but has the depth of flavor to take its place. For example, the original recipe called for liquid smoke. I didn't want that flavor, but needed something equally bold for the marinade. This was delicious.

The Red Wine: The original recipe called for Worcestershire sauce -- full of tons of salt, and, potentially, iodine. Red wine worked like a gem to add bite.

The Salt: Remember, you hid your old salt carton, right?

The Red Pepper Flakes: Alternatively, you can keep a bottle of no-salt herb seasoning (like Mrs. Dash) -- even my salt-loving husband will accept this instead of salt, in some things.

The Beer: You can increase this to 2 cans, if you want to drink one while you cook! Beer is allowed on a low-iodine diet.

The Peppers: Just adding tasty vegetables to a dish helps boost the flavor. I bought these peppers at the orchard last week, and they were delicious.

The Potatoes: I almost left the skins on (I like roasted potatoes that way). But potato skins are a no-no on a low-iodine diet (they accumulate iodine). Peel them, and you're good to go.

Salt-free broth (dry and liquid) can be found in the soup aisle, or you can make and freeze your own.

Other Notes...

It took us extra time to shop for this first week, because we read so many labels. Not all grocery stores had natural peanut butter, and many had added salt. Check the natural or organic section of the store, or go to your local natural food store, and grind your own (great fun for kids).

Low-iodine Eating: Day 1 (Adjusting Your Cooking)

This is the second in a 21-day series showing how I kept a low-iodine diet in preparation for radioactive iodine treatment.

The Menu

Breakfast

• Coffee, black, no sugar
• Apple Brown Betty (see recipe)
• Morning meds: 2000 units Vit D, Arimidex (aromatase inhibitor), Cytomel (thyroid hormone replacement)
• Water

Lunch

• Chicken and Mixed Greens Salad with Strawberry Balsamic Vinaigrette Dressing (see recipe)
• Cranberry-lime seltzer
• Kiwi
• Noon meds: 500 mg calcium supplement

Snack (2:00)

• Unsalted pecan halves (from the baking section, not the snack section) and dried cranberries
• Herb tea
• Small apple
• Afternoon meds: Cytomel

Dinner

• Pan-fried tilapia (breaded in cornmeal, no egg)
• White rice 
• Lima beans
• Water, coffee 

Note: Fish and shellfish are my favorite protein sources, so "no seafood" was sad for me. Fortunately, freshwater fish does not have the iodine content of seafood, so I ate my tilapia with gusto.

 Snack (evening)

• Apple

The Recipes

Apple Brown Betty

(Adapted from Food & Wine Annual Cookbook, 2012)

Apple Betty you CAN eat on the left... pecan pie you CAN'T eat on the right!

 

Note: Items marked (*) are changes to accommodate a low-iodine diet. See notes at end of recipe for explanation.

• 1 1/2 c quick oats* 
• Cooking spray
• 1 1/2 c white sugar
• 1/4 tsp ground nutmeg
• 1/2 tsp ground cinnamon
• 2 tsp grated lemon zest
• Pinch of non-iodized salt*
• 4 lbs apples, peeled, cored and thinly sliced (I had Gala, Empire, Cortland and McIntosh)
• 1/2 c apple cider
• Juice from one lemon (about 2 T)
• 2 T orange juice (mine had calcium added)
• 3 T vegetable oil*

Preheat oven to 350 degrees. Spray a 9" x 13" baking pan with cooking spray. Spread 1/3 of the oats over the bottom of the pan. Spread 1/2 of the apple slices over the oats.

In a small bowl, combine sugar, nutmeg, cinnamon, lemon zest and salt. Spread 1/2 of the sugar mixture over the apples in the pan.

In another bowl, combine cider with lemon and orange juices; drizzle over the apples. Add another layer of oats, the remaining apple slices, and the remaining sugar mixture. Cover all with remaining oats. Drizzle oil over all.

Bake in the center of the oven for 1 hr. Cover with foil the last 15 min to prevent the top from getting too browned. Let cool for 30 min.

Adaptations: 

The oats: The original recipe called for homemade bread crumbs that you make from bread slices. If you make your own bread, you could still use bread crumbs - the recipe calls for 6 slices of bread, toasted at 350 degrees, then processed to crumbs in the food processor.

The salt: You are not on a low-salt diet, but a low-iodine diet. I put away my iodized salt carton, and replaced it with a non-iodized salt carton. Salt as you usually would. With processed foods, unfortunately, you can have no confidence that the salt was non-iodized, so if there's salt on the label, don't eat it.

The oil: The original recipe called for 3 T of butter, shaved over the top of the whole dish. Iodine from the cow's diet accumulates and concentrates in milk, naturally, so any dairy product contains lots of iodine. I didn't miss it in this recipe.

I made this recipe previous to my special diet, as originally written, and the oats adds a cakier, more breakfast-y texture to the dish -- not as pie-like, but I liked it for breakfast or dessert.

Chicken and Mixed Greens Salad with Strawberry Vinaigrette Dressing

(Adapted from the Low-Iodine Cookbook, ThyCA -- click for a free, downloadable .pdf version)

The Salad:

• 1 1/2 c sliced strawberries (set aside enough to make 1/8 c., mashed)
• 4 c mixed greens
• 1/4 c chopped pecans
• 1 boneless chicken breast, cooked and cut into bite-sized pieces

The Dressing:

• 1/8 c mashed strawberries 
• 1/4 c olive oil
• 1 1/2 T balsamic vinegar
• 1/2 T sugar
• Non-iodized salt & pepper to taste

Mash enough berries to measure 1/8 cup. Reserve remaining berries. Whisk together oil, vinegar and sugar to blend. Stir in mashed berries. Season with salt and pepper. (Note: I put everything in a jar with a lid, and shook it to mix). Use as dressing for the remaining salad ingredients.

Either plate individually and pour sauce on top or mix it all in a bowl and serve. Salad dressing does not keep well. Must be used right away. (Note: This is delicious. I normally don't like sweet dressings, but this is fabulous. Adding the chicken made it a satisfying meal. I think you could add grape halves, as well.)

About the Meds

I added the meds to the meal menus, because of a mistake I made (actually, two mistakes).

Mistake Number 1: There is a reason you take the second Cytomel at 2:00. It's because if you take it later, you will be up all night. Trust me. I wondered why I didn't sleep past midnight for three days -- I was forgetting to take the Cytomel until dinner (2:00 is not a normal pill-taking time for me).

Mistake Number 2: I didn't realize (didn't remember, wasn't told, not sure...) that you should not take the calcium supplement within four hours of taking the cytomel. I'm not sure why. I'm wondering if this is why I was so tired at the end of the day, when I was taking the cytomel and the calcium together at breakfast.

Arimidex has nothing to do with the low-iodine diet or thyroid, except that the breast cancer and thyroid cancer (for me) are related issues. You'll need to make your own meds list. Incidentally, I cut back on other vitamins and supplements, so I don't confuse myself further. Plus multi-vitamins often contain iodide as a nutrient.