I would like to better help some of my vegetarian clients who are dealing with high cholesterol levels and hyperthyroidism. In the cases of hyperthyroidism, they eat super-healthy fats from coconut oil, avocados, olive oil, and ghee and overeat crucifers such as kale, broccoli, and cauliflower.

Dr. Amy Nett: I think I might need a little bit of clarification on this question, Elianie, because with hyperthyroidism I actually don’t worry as much about cruciferous vegetables. When you’re talking about brassica family vegetables like kale, broccoli, cauliflower, Brussels sprouts, I’m more concerned about hypothyroidism. I think unless you’re saying, like, in hyperthyroid, maybe the goitrogenic foods, maybe the hyperthyroid patients already have a goiter. I’m not sure if it’s hyperthyroid or hypothyroid patients.

Then you’re saying they also have high cholesterol, so there are a couple of pieces here. I’m kind of trying to figure out how to put them all together. In high cholesterol, you still need to check for dysbiosis. Do they have a chronic infection that’s leading to the high cholesterol? Are there metals? Let’s say you’ve ruled all of that out. You’re saying they eat healthy fats like coconut, avocado, olive oil, and ghee. OK, remember that depending on the degree of high cholesterol and what the markers like LDL-P and Lp(a) look like, you might need to think about a Mediterranean Paleo diet.

Anjolie, I’m going to save a few minutes for your question because you also had a question, I believe, about LDL and when to go to a Mediterranean Paleo diet.

If you’ve ruled out other causes of hyperlipidemia or dyslipidemia, then probably take out the coconut oil and ghee. Take out the saturated fats. The emphasis, then, is really going to be on olive oil, nuts, seeds, that sort of thing. So for the cholesterol piece, if there are no other causes of high cholesterol, think about a Mediterranean Paleo diet where you’re removing the saturated fats.

Then you’re saying that they overeat cruciferous vegetables. I think there, in terms of helping your vegetarian clients, it’s just a matter of education. Again, in hyperthyroid, I don’t normally have the same concern about brassicas as I do with hypothyroidism, but explain your concern to them, why you’re concerned about hyperthyroidism and brassicas, and then just give people a list of vegetables that don’t have the goitrogenic properties. Give them a list of vegetables that you do want them to eat. I would just say giving them other options and letting them know why you might want them to avoid some of these goitrogens might be the best way to help them from that perspective.