Cancer Update: Day 6 of Low Iodine Diet
Good Morning! I just wanted to take a moment to give everyone a quick update on where I am at for my treatment. As you know from my last cancer update post I have one more stage of treatment ahead, Radioactive iodine therapy.
A Little About RAI Therapy
Radioiodine, I-131 or RAI is used after surgery to eliminate (ablate) any remaining cancer cells or normal thyroid tissue that the surgeon could not remove. Ablation also aims to eliminate any thyroid cancer cells that may have spread to other parts of the body.
Eliminating the remnant of normal thyroid tissue will make it easier to do the ongoing monitoring for any possible recurrence. RAI ablation has also been shown to improve survival rates if the cancer has spread to the neck or other parts of the body.
Preparation for RAI
There are 2 main parts to preparing for this phase of treatment. The first is to increase the TSH level (thyroid-stimulating hormone, or thyrotropin) levels to well above the normal range to encourage them to absorb any iodine, including radioiodine.
In my case, this is done by completely withdrawing from all thyroid hormone replacement for 2 weeks prior to treatment (a process that I am going through now). Getting the TSH level as high as possible before RAI treatment will help all thyroid cells both cancerous and non cancerous better absorb the RAI.
The seconds part of course is a low iodine diet to “starve” any remaining thyroid tissue for iodine. This way when the radioiodine is administered the cells will absorb as much as possible. The unfortunate thing is that iodine is found in many foods, which leaves you to do a lot of cooking.
Allowed Foods and Ingredients on a Low Iodine Diet
• Fruits except rhubarb and maraschino cherries (with Red Dye #3 or E127 in the United Kingdom).
• Vegetables: preferably raw or frozen without salt, except soybeans and (according to NIH diet) a few other beans.
• Unsalted nuts and unsalted nut butters.
• Whites of eggs.
• Fresh meats up to 6 ounces a day.
• Grain and cereal products up to 4 servings per day, provided they have no high-iodine ingredients.
• Pasta, provided it has no high-iodine ingredients.
• Sugar, jelly, jam, honey, maple syrup.
• Black pepper, fresh or dried herbs and spices.
• Oils. All vegetable oils, including soy oil.
• Sodas (except with Red Dye #3 or E127 in the UK), cola, diet cola, non-instant coffee, non-instant tea, beer, wine, other alcoholic beverages, lemonade, fruit juices.
Foods Not Allowed on a Low Iodine Diet
• Iodized salt, sea salt, and any foods containing iodized salt and sea salt.
• Seafood and sea products (fish, shellfish, seaweed,
seaweed tablets, carrageenan, agar-agar, alginate, nori and other sea-based foods or ingredients).
• Dairy products of any kind (milk, cheese, yogurt, butter, ice cream).
• Egg yolks or whole eggs or foods containing whole eggs.
• Bakery products containing iodine/iodate dough conditioners or high-iodine ingredients. Low- iodine homemade and commercial baked goods are fine.
• Red Dye #3. (E127 in the United Kingdom)
• Most Chocolate (due to milk content). Cocoa powder and some dark chocolates are allowed.
• Some molasses (if sulfured, such as blackstrap molasses). Unsulfured molasses, which is more common, is okay. Sulfur is a term used on labels and does not relate to iodine.
• Soybeans and soybean products such as tofu, TVP, soy milk, soy sauce. The NIH diet says to avoid some other beans: red kidney beans, lima beans, navy beans, pinto beans, and cowpeas.
• On some diets, rhubarb and potato skins (inside of the potato is fine).
• Iodine-containing vitamins and food supplements.
Hiring a Personal Chef
The hard part about a low iodine diet is that when your body is withdrawn from thyroid hormone your energy is very unpredictable which makes it hard to keep up with your day to day life, let alone grocery shop cook from scratch for every single meal you need.
While withdrawn from thyroid hormone you can expect to experience tiredness, weight gain, sleepiness, muscle aches, inability to concentrate, depression. These symptoms can range from mild to serve on any given day so I found it best to ask for help.
A quick google search lead me to this excellent private chef service, Big City Chefs. I almost wrote this option off thinking that it would be way to expensive to consider, but I was pleasantly surprised.
On Sunday, Big City Chef Josh did all of my grocery shopping, came to my house and prepared 5 meals for me from of the low iodine cookbook…and it cost less than $200.00 (including my groceries.
Having all of my food prepared for the week has been a huge help and has made sticking to this low iodine diet pretty easy. I had him prepare the components of each meal separately and label them in the containers. When it’s time for a meal, I simply assemble the pieces. Example: Fajita Chicken with Sautéed Bell Peppers & Onions and them I add some low iodine rice.
This Week’s Low Iodine Meals
My low iodine fridge prepared by Big City Chefs.
Low iodine diet friendly rice that cooks in 90 seconds.
Oatmeal is my go to breakfast. Unfortunately I can’t have whey protein like I normally do. My solution: add 5oz liquid egg whites, an apple, a spoon full of coconut oil to help with the texture cinnamon and stevia to taste. I microwave this combo for about 1 minute, stir and then microwave for 90 seconds more. It’s delicious!
This is the Danish Carrot Salad from the Low Iodine Cookbook by Thyca.org. I mixed it with Spinach & Sprouts I had from the farmers market and tossed it with lemon and tangerine balsamic vinegar. Super yummy.
This is one of my favorite recipes from the Low Iodine Cookbook so far. I had the chef prepare the boiled egg whites and chop the onions, celery, etc and make the low iodine “mayonnaise” from the Thyca cookbook. I add the avocado, spinach and mix it all up. It’s so good!
Here is the fajita chicken recipe prepared with the basmati (low iodine friendly rice). It takes about 3 minutes to assemble and heat up which is fantastic!
Recovery
Lastly, I wanted to share this amazing product I found on amazon.com called Scarguard MD
The incision initially after surgery.
2 weeks after surgery.
4 weeks after surgery.
Progress
Overall I am doing well and am having as many good days as not-so-good days. Thank you for all of the thoughts, prayers, phone calls and messages. They help to keep my spirits lifted on the days when I am bummed about not being able to do everything I use to. On a positive note, did have the energy to make it to 2 of my aerial classes this week, so I am on my way. 🙂
My friend Chiara and I at Cirque Du Soleil’s Amaluna earlier this week. This totally motivated me to get back to my classes ASAP.
More Information on Thyroid Cancer, Low Iodine Diets & RAI Therapy:
http://thyca.org/download/document/229/Cookbook1pgEng.pdf
http://thyca.org/download/document/231/Cookbook.pdf
http://www.thyroidcancercanada.org/userfiles/files/LID_FAQ_Feb_2012.pdf
http://www.thyroidcancercanada.org/userfiles/files/LID_English_Aug_2014_sm.pdf
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