You just found out you need to follow the low iodine diet for radioactive iodine scans and/or treatment.  Before this, you never even knew iodine was in food.  

Then, you find out that iodine is NOT on the nutrition label for foods.  And many ready made foods are high in iodine, so you will need to be cooking more.

What in the world should you buy at the store?  What will you make with those ingredients?  

In this article, we go over the lists of allowed and restricted foods on the low iodine diet, go through some FAQs, provide a shopping list to get you started, and link to recipe ideas to use those ingredients.  

Low Iodine Diet Basics

Here is a simplified outline of foods to enjoy and foods to avoid on the low iodine diet.  For more details, see my post on Low Iodine Diet Basics. 

Foods Low in Iodine to Enjoy

• Fresh, frozen, canned, and dried fruits
• Fresh, frozen, and unsalted canned vegetables
• Unsalted nuts and nut butters
• Unsalted canned or dried black, white, and garbanzo beans
• Fresh meats and poultry
• Sugar, brown sugar, jelly, honey, maple syrup
• Egg whites
• Potatoes (white and sweet) without skins
• Popcorn
• Homemade bread/safe bread brands
• Pasta and rice
• Coffee and tea
• Vegetable oil, shortening, and margarine
• Pepper and other spices and herbs
• Soda, beer, wine, lemonade
• Nut and oat milk
• Homemade salad dressing
• Dairy free chocolate
• Hard lemon candies

Foods High in Iodine to Avoid

Many of these are the ingredients you should look for on a food label to avoid.  

• Iodized Salt
• Seasoning mixes with salt
• Seasonings with salt in the name – onion salt, garlic salt, etc.
• Fish or products from the sea, including seaweed, sea salt, carrageenan, kelp, dulse, agar-agar
• Dairy products
• Commercial breads with dough conditioners (iodate, iodide in the ingredients)
• Vitamin or supplements containing iodine or high iodine ingredients 
• Soy protein products, including soy beans, tofu, edamame, soy burgers, soy milk.
  • NOTE:  Soy lecithin and soy oil are ok as they do not contain soy protein
• Egg yolks
• Food dye red #3
• Commercial protein shakes or nutrition supplements such as Ensure, Boost, and Glucerna
• Most restaurant and processed foods
• Blackstrap molasses
• Chocolate with dairy
• Potato skins
• Rhubarb

Low Iodine Diet FAQs

Iodine in Food?

Iodine is found in food.  In some foods, it is naturally there from the soil,  including plant based foods as well as animal foods (meat) since that animal ate the plants. Iodine can also be added to food as a supplement or via residues from disinfectants on equipment. (1)

How Does My Body Use Iodine?

Iodine is used by the thyroid gland for making thyroid hormones.  Thyroid hormones have MANY functions in your body and can influence every cell in your body.  These include:

• Effects your metabolism, including how your body burns calories – this affects your weight as well as your energy levels
• Regulating your heartbeat
• Regulating body temperature
• Can affect digestion speed – meaning too much can cause diarrhea, too little constipation

Why do I Need a Low Iodine Diet?

A low iodine diet (LID) is used before radioactive iodine treatment to make the body “iodine hungry”. (1) The basic idea is if you deprive your body of iodine, any remaining thyroid cells (specifically thyroid cancer cells) will be very hungry and aggressively take up the radioactive iodine when you receive treatment.  This should make the treatment more effective.

How do I know if Iodine is in a Food?

There is not really a great way to know the iodine content of food.  Iodine is not required on nutrition labels and is not regularly measured in whole foods.

Most processed foods in the United States do NOT contain iodized salt.  However, manufacturers are NOT required to state on the label if they use iodized salt or not.  LIDLife has extensive lists of manufacturers they have contacted about what salt they use.

I have contacted some manufacturers, including for any items on this list.  However, please note that a manufacturer stating they use non iodized salt DOES NOT mean all of their products are safe.  They may contain other ingredients.

For example, Sara Lee Breads use non iodized salt.  But, many of their products use iodate based dough conditioner, so you still cannot have many of their products. 

Any other foods I should avoid? 

While you need to avoid foods high in iodine, you also need to avoid foods that could interfere with your body’s ability to take up the radioactive iodine. Soy products and cruciferous vegetables (spinach, broccoli) may decrease your body’s ability to absorb iodine. (2) (1) So avoid soy bean products (soy oil and lecithin are ok), and try to not over do the spinach and broccoli. 

Low Iodine Diet Shopping List

Here is a Low Iodine Diet shopping list, broken into categories.  If you are looking for a way to use these ingredients, check out my Simplified Low Iodine Diet Toolkit. 

Fruits 

• Lemons
• Limes
• Oranges
• Pineapple
• Strawberries
• Apples
• Bananas
• Frozen berries
• Grapes
• Applesauce
• Raisins
• Melons

Veggies

• Baby spinach
• Tomatoes
• Cilantro
• Garlic
• Onion
• Bell pepper
• Lettuce
• Potatoes
• Sweet potatoes
• Green Beans
• Ginger
• Radishes
• Zucchini
• Broccoli
• Brussels sprouts
• Mushrooms

Cold/Dairy Alternatives

• Liquid egg whites
• Elmhurst oat milk or almond milk
• Orange juice
• Forager Project Cashew Yogurt
• So Delicious Coconut Yogurt
• Kite Hill Dips
• Sabra Hummus
• Wholly Guacamole
• Earth Balance Buttery Soy Free Spread

Bread/Baking/Grains

• Plain oats
• Quaker Instant Oatmeal Packets
• Mission Flour Tortillas
• Thomas Bagels
• Nature’s Own 100% Whole Wheat Bread
• Matzo Crackers
• Pasta
• Basmati Rice
• Qunioa
• Jell-O
• Dairy free chocolate chips (Enjoy life or Nestle Toll House Allergen Free)
• Brown sugar
• Honey
• Nutritional Yeast (cheese substitute)

Meat

• Fresh chicken
• Fresh beef
• Fresh pork
• Fresh turkey

Boxed/Canned

• No salt added black beans
• No salt added garbanzo beans/chickpeas
• No salt added canned diced tomatoes
• No salt added canned tomato sauce
• Herbox Sodium Free Chicken/Vegetable/Beef broth or bouillon cubes
• Coconut milk
• Jam/jelly
• Tahini
• Unsalted nut butter 

Spices/Condiments

• Kosher or plain salt
• McCormick’s taco seasoning
• Black Pepper
• Balsamic vinegar
• French’s mustard
• Olive or canola oil

Snacks/Sweets

• Popcorn kernels
• Power Up Trail Mixes
• Oreos
• Gummy Bears
• Swedish Fish
• Junior Mints

• Enjoy Life chewy bars and protein bites 
• Sugar free lemon drops (for after RAI)

Low Iodine Recipe Ideas

Need some ideas for what to cook on your low iodine diet?  My Simplified Low Iodine Diet Toolkit has 3 weeks of meal plans complete with recipes and grocery lists.  

For recipes on the blog, try these:

• Tahini Toast with Apples and Honey
• Vegan Zucchini Muffins
• Healthy Apricot Almond Butter Energy Balls

Would you like a free printable of this shopping list as well as a blank list to fill in for yourself?  Enter your email below and it will be delivered to your inbox!

Receiving a thyroid cancer diagnosis comes with a lot of emotions and fears. A big concern for most people is weight gain after their thyroid removal. 

There are lots of stories of thyroid cancer survivors struggling to control their weight.  I even like to say that I’m not really in control of my weight, my endocrinologist is.

I’ve heard survivors say, “I gained 40 lbs with no change to my diet after thyroid removal,” and “Weight loss is an uphill battle.”

But is that true?  Does everyone gain weight after their thyroid is removed?

This post will outline some reasons behind possible weight gain, the data on how often it happens, and what steps you can take to avoid it.

How is weight gain related to the thyroid?

Thyroid hormones have MANY functions in your body and can influence every cell in your body (1).  These include:

• Affect your basal metabolism, which is the basic calories your body burns to live (breathe, be awake, heart pump) outside of physical activity
• Regulate your heart rate
• Regulate body temperature
• Regulate bone health and muscle movement

There are three different thyroid hormones you need to know about.

1. Thyroid stimulating hormone (TSH) is made by the pituitary gland in the brain.  As its name suggests, this hormone stimulates the thyroid to make T3 and T4.
2. Triiodothyronine (T3) is the active form of thyroid hormone.  The thyroid makes less of this hormone than T4.  It stimulates receptors in cells to increase functions, such as increase heart rate, increase body temperature.
3. Thyroxine (T4) is the inactive form of thyroid hormone and lasts longer in your blood.  The thyroid makes more of this hormone than T3.  T4 converts to T3 inside the cells of the body. This conversion happens with or without a thyroid.

Measuring and Monitoring Thyroid Levels

The levels of your thyroid hormones – known as hypothyroidism or hyperthyroidism – indicate the effect on your metabolism. These levels are measured with your labs (blood tests).  

The blood tests will generally have the same name as the hormone they are measuring.  For T3 and T4, there are “total” tests and “free” tests, such as Total T4 and Free T4.  The “free” tests measure the levels of the hormone not bound to protein because these bound hormones aren’t usable by the body. (2) 

If you have thyroid cancer, your doctor may also monitor your thyroglobulin.  Thyroglobulin is a storage form of thyroid hormones only made by thyroid cells.  After total thyroidectomy and other treatment, it should stay the same or decrease.  An increase in thyroglobulin may mean there are still cancer cells in your body.  Always talk to your doctor about your labs.  (3)

Next, we will talk about what high or low levels of hormones mean.

Hypothyroidism

Hypothyroidism is when you have low levels of T3 and T4.  Because these hormones are low, you will have a high TSH, trying to get more T3 and T4 made.  

Hypothyroidism is generally associated with weight gain (4).  Other symptoms include:

• Fatigue
• Hair loss
• Feeling cold
• Constipation
• Loss of menstrual cycle in women
• Depression
• Brain fog or forgetfulness
• Muscle weakness or soreness.

Hyperthyroidism

Hyperthyroidism is when you have too much T3 and T4 in your body.  TSH levels will be low.

Hyperthyroidism is generally associated with weight loss (5).  Other symptoms include:

• Rapid heart beat
• Fatigue
• Difficulty sleeping
• Hair loss
• Increased appetite
• Tremor or shaking in your hands
• Sweating

When You May Experience Hypo- and Hyperthyroidism

Some people are diagnosed with thyroid cancer due to an abnormality in their thyroid labs. But many people diagnosed find a nodule in their neck but have normal labs.

After partial or total thyroid removal, you may experience some hypothyroidism while your dose is adjusted.  If you have a partial thyroidectomy, your thyroid may adjust and make enough hormones on it’s own without medication.  Your doctor may want to monitor you to see if that happens.  

If you have a total thyroidectomy, there is a science and art to getting your dosage right, so it may take awhile.  The science is there are loose guidelines of how much to give for your bodyweight.  However, each patient is unique, so it will take adjusting.

Prior to radioactive iodine treatment, doctors create a hypothyroid state in your body.  They do this by either stopping your oral thyroid medication or giving you thyrogen.  In both of these scenarios, your body makes more TSH, trying to stimulate any remaining thyroid (or cancer) cells.

For a few years after the removal of your thyroid, your doctor may keep you a bit hyperthyroid – give you more thyroid medication to keep your TSH level close to 0 (6).  This TSH suppression is to try and prevent the growth of any remaining cancer cells.  How low and how long your TSH is suppressed will depend on the stage of your cancer as well as your body’s response to other treatments – surgery, radiation, etc. 

Thyroid Hormone Replacement

There are different forms of thyroid hormone replacement.  I am not a pharmacist, so I will just give the basics of what different kinds are available.   For more information, see the American Thyroid Association.

T4 Replacement

The most common type of thyroid replacement patients receive is T4 replacement or levothyroxine.  The most common name brands are synthroid, Levo-T, levothyroxine sodium, levoxyl, novothrox, unithroid.

The dosing is not always completely interchangeable between brands, so doctors and pharmacists recommend you try to stick to 1 brand.  If you take “synthroid”, you will always get the same brand.  If you take “generic”, different pharmacies may carry different ones of the other 5 brands.  However, if you stick with 1 pharmacy, they generally try to stay with the same brand.

Tirosint is a name brand of levothyroxine with less dyes and fillers for people with allergies to those ingredients. 

T3 Replacement

T3 is a short acting hormone and made in smaller amounts in the body naturally by the thyroid.  Most patients do not receive long term T3 medication because of the possible side effects.

When taking T3, you have too high a level of T3 in your blood initially and then it rapidly decreases.  You can have rapid heart rate, insomnia, and anxiety.  It decreases so quickly that you often have to take it several times a day.  Because you cannot have steady levels of thyroid hormone in your bloodstream, it can be hard to manage and monitor this treatment. 

Cytomel is the brand name of synthetic T3.

Combination T3 and T4 Replacement

There are two types of combination replacement: synthetic and natural.

Synthetic combination replacement is not very common.  The pill is taken once a day and has much more T3 than would naturally be in the body, so it has the same side effects mentioned above. 

There is a growing interest in combination therapy by taking T3 and T4 pills at the same time.  There are trials ongoing in the effectiveness in patients who don’t achieve good results on T4 alone.

“Natural” thyroid replacement is made from dried and powdered animal thyroid glands.  NP Thyroid, Armour, and Nature Thyroid are the common names.  These contain both T3 and T4.  However, the ratio of T3 to T4 varies from animal to animal and differs from the ratio found in humans.  It will also contain fillers or binders, so it is not 100% natural.

Weight Changes Prior to Thyroid Removal

Going into cancer treatment, you may have had some weight changes.

Maybe you had Hashimoto’s or Grave’s disease.  Maybe you had symptoms of your thyroid not functioning properly and that is how you were diagnosed.

Weight gain or loss is possible prior to thyroid cancer diagnosis and treatment.  However, it is possible you had no issues.

Weight Changes During Treatment

There are several aspects to thyroid cancer treatment that can have an effect on your weight.

Mental Health

It is important to acknowledge that mental health plays a big role in how we eat, which can affect weight.  Also, life post cancer diagnosis is full of mental health pitfalls.

You may experience depression or anxiety from the time of your diagnosis on.  These symptoms alone can lead to weight loss and gain respectively.  If your mental health problems are severe enough for medication, those carry side effects of weight gain as well.  

Never discount the effect your mental health may have on your weight and overall well being.

Surgery

Surgery in and of itself is a major event for your body.  Often, people have sore throats after being intubated for surgery.  Their body also feels tired and weak.  They may lose weight as they are not able to prepare and eat much. 

On the flip side, if you are less active than normal as you recover, you could gain weight.  Also, your thyroid hormone replacement medication may not be adequate during this time, making you prone to weight gain.

Preparing for Radioactive Iodine Treatment

If you have to undergo radioactive iodine treatment (RAI), there are definite chances for weight changes. The most common effect I have seen for myself and in hearing from others is weight loss.  I’ll talk about all the reasons for either.

Raising TSH

Before RAI, your doctor will want to raise your TSH to well above normal levels to help the cancer cells absorb the RAI (7).  If this is done by stopping your thyroid medication, you will become severely hypothyroid. 

This may seem like it would make you gain weight.  However, you become so extremely hypothyroid that you feel unwell and often don’t want to eat much.  While you could gain weight, it is likely you could lose as well.  

Another option is to receive injections of Thyrogen prior to RAI and not withdraw from medication.  Thyrogen quickly raises your TSH, allowing the RAI to be absorbed without you being hypothyroid for several weeks. 

If you receive Thyrogen, the likelihood of weight changes related to your TSH levels is minimal.

Low Iodine Diet

The low iodine diet is also generally a cause of weight loss for people.  You follow the low iodine diet whether you are withdrawn from medication or receive Thyrogen.

Weight loss is common because the diet eliminates most processed foods and is very restrictive.  Patients eat healthier and/or less just because of the limited options, generally leading to weight loss.

Radioactive Iodine Treatment

During active radioactive iodine treatment, weight loss is still likely.

You will continue on the low iodine diet for several days after receiving the radioactive iodine.

The side effects of radiation may make you feel physically unwell.

You may have salivary gland inflammation, leading to extreme mouth dryness and taste changes, again, leading you to eat less.

While in isolation, your food options are limited to what you purchased ahead of time.

However, if you feel fine and eat to pass the time during your isolation, you may gain weight if you are severely hypothyroid.  

Weight Changes Beyond Active Treatment

Theoretically, you never “stop” being treated for your thyroid cancer, as you will likely be monitored for a long time and require hormone replacement.

However, as you go into your new normal life, it is important to be aware of how your thyroid levels can affect your weight.

Issues with hyperthyroidism

As I mentioned above, your TSH may be suppressed for a few years after treatment, leading to hyperthyroidism.  This could lead to weight loss.

However, it is important to not allow yourself to “abuse” your hyperthyroid state and use it as an excuse to eat anything you want.  That will lead to weight gain.  

During this time, it is extremely important to learn how to balance your intakes, as your levels will be more normal later and you don’t want to have to adjust then.

Issues with hypothyroidism

As I mentioned above, your thyroid blood levels will take time to adjust after surgery.  Especially if you went off thyroid medication for RAI, it will take awhile for your blood work to normalize after restarting medication.

It is also important to note that changes in blood levels cannot be fully seen for 6-8 weeks after a medication change.  So even dose changes can take awhile to take effect.

This time may be prone to weight gain.  So again, it is important to learn to eat healthy, balanced meals and snacks in proportion to your needs.

Aging

The peak age for papillary thyroid cancer diagnosis is 30-50 years old. (8) This age span is also when our metabolisms tend to slow and we tend to be less physically active.  Combined with thyroid issues, you could be prone to gain weight if you are not careful.  Many people without thyroid issues gain weight during this time frame.

So, is Weight Gain Inevitable?

This is a tricky question.  The research out there is not conclusive.  Anecdotal evidence from talking with thyroid cancer survivors will lead you to think it is inevitable.  

The tricky part of looking at the research is not that thyroid cancer patients do not gain weight.  It is whether or not they gain significantly more weight than normal thyroid patients.  Studies often do not find that difference.

What does that mean?

It possibly means thyroid cancer patients tend to gain weight as they age, as do most adults unfortunately.

Patients with total thyroid removal did gain more weight than others in one study, even though they had normal thyroid labs with medication. Postmenopausal women had the most weight gain. (9) 

How to Avoid Weight Gain After Thyroid Removal

There are several steps I would recommend to avoiding weight gain after thyroid removal.

• Take your medication as prescribed.  Take your medication every day, on an empty stomach, 30-60 minutes before eating.  Don’t take supplements within 4 hours.  By taking your medication regularly, you have the best chance of your labs being accurate.

• Find a doctor you like and who listens to you.  You will be seeing your endocrinologist on a regular basis.  Make sure you feel comfortable with him or her and can discuss any problems.

• Talk to your doctor about other options.  If you still don’t feel normal, talk to your doctor about measuring your T3 or other hormones.  Maybe you would benefit from supplemental T3.  Maybe another hormone or vitamin level is off in your body.

• Stay on top of your lab work.  If you start noticing a change in how you feel, talk to your doctor about checking labs.

• Recognize when other things are changing in your body.  Are you getting older?  More sedentary?  Are you going through menopause?  Other health issues?  Mental health changes?  Realize that your thyroid medication is not the only reason you may be gaining weight.

• Talk to your doctor at the first sign of weight gain.  Weight gain is always easiest to take care of when it is small.  Wouldn’t you rather lose 10 pounds than 50 pounds?  .

• Live a healthy lifestyle.  See my post on Diet After Thyroid Removal for more on this.

• See a registered dietitian.  Dietitians are THE nutrition experts and will have the best tools to help you with your diet. Many endocrinologists have dietitians as part of their practice.  Or find your own dietitian.  I have some listed on my resources page or look for one in your area at Academy of Nutrition and Dietetics. 

Radioactive iodine treatment isolation is hard. You don’t feel well, are tired, and are lonely. The low iodine diet makes eating challenging. The world is still reeling from your surgery and cancer diagnosis in the first place. The treatment itself can have unpleasant side effects.

However, it’s all in how you look at it. Radioactive iodine treatment isolation does not have to be the worst 5-8 days of your life.

Today, I’m sharing 7 tips that helped me get through my radioactive iodine treatment isolation periods.

Focus on the Positive

Mindset is at least half the battle with isolation. There are plenty of negatives in your life going into isolation. I’ve listed just a few above.

But if you focus on all the negatives, it could be the most depressing time. Try to find things to be positive about. Like what? Here are some examples:

• Are you an introvert? Hello alone time.
• You have an excuse to work on time consuming projects.
• Catch up on sleep.
• You only have to do one radiation treatment, not multiple treatments like other cancers.
• Thyroid cancer has a high survival rate.

Each individual person can find something positive for their situation. When I had my radioactive iodine treatment, I was in grad school. My thesis committee had decided I needed to re-do the entire data set for my project. That was hours of just sitting at my computer re-coding a giant excel spreadsheet. Wouldn’t you know, during my isolation, I had all those hours to sit and do it, with nothing else pressing on my time and attention. That doesn’t mean it was “fun”, but definitely not as stressful if my regular life was also happening right then.

Be a Little Selfish

Other than being careful not to expose others to radiation, you do not need to put others first during this time. What to do I mean?

Choose a room with a comfy bed or couch. Choose a room with a TV. Take over the passwords for the video streaming services. Found a low iodine treat you love? Don’t share it with others. You are the most important thing right now. Focus on you.

Indulge

It can be hard to indulge on the low iodine diet, but you can do it. I got a giant bag of gummy bears and ate the whole thing. I binge watched Jane Austen movies.

Craving a fountain diet Coke? Order a DoorDash.

Bored? Sign up for a new video streaming service for a few days.

Do some online shopping.

Watch cat videos on youtube.

Do whatever makes you feel good. Even if it seems frivolous.

Set a Fun Goal

Focus on something you want to do but never have time to do. Be creative!

• Watch all of a TV series or movie series.
• Read all the Harry Potter books, War and Peace, you get the idea.
• Do 10 push ups everyday. (Or increase your push ups every day).
• Try new kinds of gummy candies.
• Learn a language. (or a bit at least)
• Complete a house project or craft project.
• Learn a new skill, like knitting, painting, etc. YouTube is full of how-to videos.

Reach Out

Radioactive iodine treatment isolation is…well…isolating. Even introverts get lonely after awhile. Your friends and family are likely looking for ways they can help but don’t know what to do. Reach out. Connection will help the time go by and help you feel less alone.

Set up phone or zoom calls to catch up with people. Ask someone to bring lunch to your door. Eat on your porch and chat while they sit in the front yard. Ask a friend to pick up some supplies you may need. Don’t think you have to do this on your own.

Hygiene

You are strongly encouraged to have good hygiene post radioactive iodine. The iodine comes out in your bodily secretions – saliva, sweat, urine. Showering daily and frequent tooth brushing are included in thyca.org’s list of recommendations.

However, I mean a step beyond this. Put on some comfortable but decent clothes. Do your hair. Maybe put on make-up. The more “normal” you feel, the better you will feel. If you are sitting around in pjs, you will feel tired and down all the time. Perk yourself up a bit.

Get Out

Just because you have to be in isolation, does not mean you have to stay inside 4 walls. Go for a walk. Get some sunshine. Breathe fresh air. Be cautious in staying away from people, obviously. But going outdoors can be a real boost.

Get creative in where you go. Walk in a park or different area than you normally do. Once I was clear to leave my apartment but still needed to be cautious, I went to a movie in the middle of the day. I got there right as the movie started to ensure I could pick a seat a distance from others. It was fun.

There are plenty of ways that radioactive iodine treatment isolation is hard. Focus on being creative, helping yourself, and having fun as best you can. The time will go much quicker!

When you are on a restricted diet for an allergy, diagnosis, or medical procedure, eating out can be tricky. But life doesn’t stop around you. There will be times you will need or want to eat out.

No problem. Today I’m sharing 5 tips for dining out on any restricted diet, including the low iodine diet for radioactive iodine treatment.

Look at Menus Before You Go

Most restaurants have a website with their menu listed. If it is a large chain restaurant, the nutrition information will be available online. Any restaurant with more than 20 locations is required to provide nutrition information, such as calories, etc. Since food allergies are quite common, most of those restaurants also provide the ingredient information as well. (Look for ingredients or allergen information).

By looking at the menu, you can see what you can eat a specific restaurant. Generally, this will still require some planning, which I’ll discuss more later. But maybe you don’t find anything. Then you can look for a different place to eat before you get there and everyone is hungry.

This isn’t fool proof but is a step. You can check if there are menu items you could customize – such as a salad with no cheese. Or maybe leave condiments off of a sandwich.

For the low iodine diet, it is tricky. Often the menu will just list “salt” as an ingredient, and you have no idea what kind of salt they use. Maybe you will get lucky and the site is like Chipotle, which states they only use kosher salt. But most do not. This leads us to our next tip.

Call Ahead

If the menu online isn’t clear, you can try calling the restaurant. Most sit-down restaurants will be able to tell you what ingredients they use. Fast food restaurants, may or may not provide you more information. Here are two conflicting examples.

Example 1: Chik-Fil-A lists “salt” as an ingredient for the chicken on their market salad. However, this chicken is not seasoned and prepared at the individual restaurant – it comes ready for them to heat. So your local Chik-Fil-A will not have more information than what is online.

Example 2: Five Guys lists “salt” as an ingredient for their french fries. That is something they add on location – they fresh cut the potatoes and season them in house. When I was on the low iodine diet in 2011, I called my local Five Guys. . When I asked at that time, they said, “We use regular iodized salt.” (Don’t take this as definitive for right now or your location.)

It never hurts to call ahead. Some restaurants may be able to make changes for a medically necessary diet and do no list it on their website. Especially if you need to go somewhere for an event, they will likely be able to work with you if you call ahead but may not be able to make something special on the fly.

Ask the Restaurant for a Special Order

This is a bit trickier with fast food. Many things come prepackaged or preseasoned for them. But you can always ask. Here are some examples:

• salad with no cheese or meat
• fries with no salt added
• burger with only veggies, no bun

They may or may not be able to accommodate you. But it never hurts to ask.

This tip works even better at a sit down restaurant. They will be much more able and willing to accommodate your needs. But you should probably follow the previous two tips first.

My example for this happened in 2010. I was in graduate school, and my thesis advisor took all of her students out for a nice dinner at Christmas time. I had brought my own bread and salad dressing and planned to order a plain salad. However, our server was very nice and talked with the chef. They were able to cook me some pasta (they used kosher salt in the cooking water) and toss it with olive oil, fresh tomatoes, and some basil. It may not sound super delicious, but at the time, it was heavenly to me.

BYO…lots of things

It may seem weird to bring your own food to a restaurant, but it will likely be necessary when on the low iodine diet or other restrictive diets. I never had a problem with any restaurants since I was a paying customer and explained my dietary restrictions. If you are nervous, you can call ahead.

What should you bring? For the low iodine diet, homemade bread, salad dressing, and plastic silverware were the most common items for me.

Again, I was a paying customer. I would buy a salad from the menu (with high iodine ingredients removed), then use my own dressing and eat my own bread if I brought it to supplement the salad.

Eat Before, Drink and Snack There

If you need to dine out for work or social reasons but can’t control the location, you may not find much on the menu. Maybe the restaurant won’t work with you. Never fear.

I suggest you eat a more sustaining meal before hand. Then order a drink and a small item on the menu that you can eat – most places have fresh fruit or a side salad. You can still be present and participating in the “activity” of dining out, with less stress on actually finding food to eat to fill you up.

I hope these tips and tricks help you feel more confident about eating fast food on the low iodine diet or any restricted diet. Eating out is part of our everyday lives, so you have to find the best way to make it work for you.

Check out my review of fast food menus for specific items at 11 different fast food restaurants.