An underactive thyroid can lead to a lot of symptoms.
What is an underactive thyroid?
Your thyroid is a gland in your neck. It makes energy-producing hormones.
Thyroid hormones are made out of iodine. ‘T4’ is the name of your active thyroid hormone which contains 4 molecules of iodine (hence the 4 in the name).
Your thyroid can become ‘underactive’ when you don’t have enough iodine to make thyroid hormones. (2)
An underactive thyroid is also called hypothyroidism. ‘Hypo’ means low and ‘hyper’ means high. So:
Your thyroid is a gland which produces energy hormones from iodine
What's the risk of underactive thyroid on a vegan diet?
You might be at higher risk of iodine deficiency and an underactive thyroid on a vegan diet.
Vegan women in the UK have been found to have significantly lower intakes of iodine and selenium (another important nutrient for your thyroid) compared to meat-eaters. (3)
But vegans have the lowest intake compared to other diet types because the best sources of iodine are milk and seafood. (4-7)
So, if you don’t eat much seaweed or fortified foods you could be low on iodine (8).
Did you know? Cow’s milk doesn’t naturally contain iodine. Iodine is actually added to the cow’s udders as an antibacterial to prevent infection. Some of the iodine simply ends up in the milk.
A vegan diet is naturally lower in iodine
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How much iodine for underactive thyroid
You may need more iodine on an underactive thyroid vegan diet.
On the other hand, too much iodine can lead to an overactive thyroid or hyperthyroidism i.e. too much energy. (9)
(Unsurprisingly, though, a vegan diet is found to be associated with a lower risk of hyperthyroidism.) (10)
A healthy thyroid getting the right amount of iodine is like a human having just the right amount of coffee each day.
If you skip your coffee you will probably feel drowsy and fatigued. If you have too much coffee you feel hyper and jittery. You need just the right amount - and it’s the same with iodine on an underactive thyroid vegan diet.
Ellie is a Registered Nutritionist (MSc, mBANT), expert in nutrigenetics and has been vegan for more than 10 years. Her mission is make sure you're getting everything you need from your plant-based diet to achieve your goals and inspire others to eat more plants.
In this article, we’re going to cover the difference between the total and active B12 test reference range and why you might be deficient even if your total B12 levels are in range.
What is vitamin B12?
B12 is a water-soluble vitamin essential for the maintenance of blood, nerve, and DNA cells. (1)
B12 isn’t naturally found in any plant-based foods so those following a plant-based or vegan diet are often deficient. (2)
Total B12 is the measure of BOTH active and inactive B12 in your body.
Active B12 is the measure of ONLY active B12.
💡 Active B12 is B12 that your body can use, inactive B12 is B12 that your body cannot use and total B12 is the measure of all B12 in your body.
What’s wrong with testing total B12?
The normal total B12 test reference range is between 200-1100 ng/L (nanograms per litre) and the normal active B12 test reference range is between 20-134 ng/L. (6)
So what’s the big problem?
Only testing for total B12 (as the NHS does) isn’t helpful as it doesn’t show how much active B12 you have.
You could be within a normal total B12 range but still be deficient if the majority of that B12 is inactive. (7)
To know how much B12 is actually being used you need to get your active B12 levels tested instead. (8,9)
💡 It’s important to test for active B12 instead of total.
Active B12 Test Reference Range: The Bottom Line
Are you dealing with symptoms of vitamin B12 deficiency even though your total B12 is within range? Get your active B12 levels tested!
We recommend a vegan blood test alongside our DNA test kit so you have all the information you need to meet your health goals.
The body’s main way of getting vitamin D is from sunlight exposure. (24)
So, of course, you’re at risk if you live in a colder climate (like the UK) where UV light is low during the winter.
But there are some more unexpected factors too…
For instance, vegans and athletes tend to have lower vitamin D levels than the rest of the population.
Certain conditions increase your risk of vitamin D deficiency too:
Cystic Fibrosis
Inflammatory Bowel Disease
Short Bowel Syndrome
Celiac
Why? These conditions reduce the nutrients your gut can absorb from your food. (20-22)
Finally, genetics play a crucial role.
Genes like VDR (Vitamin D Receptor) can increase your risk of nutrient deficiencies because this receptor controls how your body absorbs certain nutrients. (23)
How to get more vitamin D
The recommended intake of vitamin D is between 400 and 800 IU per day depending on your age with a maximum intake of 4000 IU. (25)
Go outside
The best way to get more vitamin D is through sunlight exposure.
The form of folate in supplements is synthetic, called ‘folic acid’.
This is an important distinction because some people can’t use folic acid - so need to get more of the natural folate in food. (8,9)
Folate in Food: Top 7 Plant-Based Sources of Folate
High folate foods include beans, lentils, asparagus, spinach, broccoli, avocado, mangoes, lettuce, sweet corn, oranges, and whole wheat bread.
Let’s take a look at them one by one.
1. Edamame: 458 μg/serving
Edamame are soya beans harvested before they have ripened. They are high in protein, iron, calcium and contain no cholesterol.
A one-cup serving of cooked edamame will provide you with 458 μg of folate.
A good way to include edamame in your diet is by adding it to soups or boiling it as a side dish.
💡 One serving of edamame provides 450 μg folate.
2. Lentils: 358 μg/serving
Lentils are high in protein, fibre and complex carbohydrates. They are naturally low in gluten, fats and calories.
A one-cup serving of lentils will provide you with 358 μg of folate.
Like edamame, lentils are great in soups. Additionally, you could use them as a filling for a pie or casserole. Lentils make a great plant-based meat substitute.
A one-cup serving of black beans will provide you with 256 μg of folate.
Other types of beans such as kidney beans are also high in folate.
Beans are a highly versatile ingredient, meaning you can add them to just about anything! They’re great in salads, soups, casseroles, pastries and some even use them to make cakes!
💡 One serving of black beans provides 250 μg folate.
4. Asparagus: 268 μg/serving
Asparagus is a vegetable in the lily family. It’s low in calories, fat, sodium and high in vitamins C, K and B9 (folate). It has been known to have anti-inflammatory properties.
A one-cup serving of asparagus provides you with 268 μg of folate.
Asparagus is great boiled or roasted. Some people eat it raw but we recommend cooking it as this helps your body absorb more nutrients.
💡 One serving of asparagus provides 270 μg folate.
5. Spinach: 263 μg/serving
Spinach is a leafy vegetable belonging to the amaranth family. It’s packed full of nutrients and antioxidants such as folate.
A one-cup serving of cooked spinach will provide you with 263 μg of folate.
Broccoli is a vegetable belonging to the cabbage family. Additional to being high in folate it is also a good source of fibre, iron and potassium.
A one-cup serving of cooked broccoli provides you with 168 μg of folate.
Cooking your broccoli significantly increases the bioavailability of nutrients such as folate.
💡 One serving of broccoli provides 170 μg folate.
7. Avocado: 163 μg/serving
Avocado is a fruit belonging to the Lauraceae family. Surprisingly, they’re considered a berry despite being typically consumed as a vegetable. They’re a great source of healthy omega fats.
A one-cup serving of avocado provides 163 μg of folate.
A great way of including avocado in your diet is by mashing it with a squirt of lemon juice and using it as a dip.
💡 One serving of avocado provides 160 μg folate.
How much folate in food do I need?
The average daily requirement for folate (Vitamin B9) is 400 μg per day. (10)
I say ‘average’ because some people need more than others.
Folate in food and MTHFR
If you have a slow form of a gene called MTHFR it’s important you get more of your folate in food. (11,12)
This is because people with MTHFR can’t use synthetic folic acid properly.
An easy way to know if you have this gene is with our DNA test kits. We’ll send you a report personalised to your DNA so you know exactly how much you need to be consuming of all your essential nutrients.
Folate in Food: The Bottom Line
Vitamin B9 (folate) is crucial for brain function.
Some people have much higher folate needs than others. It’s important to know how much (and which type of folate) you need to be sure you’re getting enough.
Find out what your personal daily folate requirement is with our DNA test.
Some people have higher vitamin D requirements. (7)
The only way to know for sure is to test!
So have a vegan blood test for vitamin D. Especially if you don’t take a vitamin D supplement all year round.
3. Full blood count (FBC)
A full blood count is usually done with most blood tests.
It’s a blood test which counts how many of all the different types of blood cells you have in your blood.
It also looks at your haemoglobin levels, how large your blood cells are and more:
Haemoglobin (Hb)
Red Cell Count (RBC)
Packed Cell Volume (PCV)
Mean Cell Volume (MCV)
Platelets
White Blood Cells (WBC)
White Cell Differential
Your haemoglobin levels is one of the first markers to test for anaemia. The other full blood count (FBC) markers will confirm anaemia if your haemoglobin level (Hb) is below the laboratory reference range.
For example, the volume of your red blood cells might not seem important - but it can be crucial information.
If your blood cells are larger than normal, this can indicate anaemia.
It can also give us a clue about the causes of anaemia.
Anaemia can be due to different reasons. Iron deficiency, B12 deficiency, folate deficiency, etc.
So it’s crucial to have as much info as possible from various blood tests to discover the true cause.
You can have a DNA test to find out if you’re prone to either low or high iron.
But it’s crucial to have a blood test to track your levels - especially if you have iron issues running in your family.
The most important iron markers are:
Ferritin - A blood protein used to store iron in your body.
Total iron - The total amount of iron whether bound or free.
Other markers which your doctor may look at later if your other tests suggest anaemia are:
Total iron binding capacity (TIBC) - TIBC measures the total capacity of your blood to bind and transport iron.
Transferrin saturation (FESA) - Transferrin is a protein that attaches iron molecules and transports iron in the blood plasma.
Unsaturated iron binding capacity (UIBC) - The number of sites on transferrin that are not already carrying iron.
See below for the general protocol for diagnosing iron deficiency anaemia using blood testing.
Diagnosis of iron deficiency anaemia - from
Like B12, a total iron test will appear high if you’ve recently taken an iron supplement. But that doesn’t tell us anything about your long-term iron stores.
That’s why it’s actually most important to get a serum ferritin test…
5. Serum ferritin
Ferritin is so important it deserves it’s own heading.
Serum ferritin reflects your body’s iron stores. (12)
Vegans and vegetarians generally have lower iron stores (ferritin) than meat-eaters. This can be a good or a bad thing (if too low).
Serum ferritin is also a well known inflammatory marker. (13) Plus it can even give clues about your level of immunity. (14)
Some genetic variations make it hard to transfer iron into your cells to store as ferritin. That’s why it’s crucial to test for ferritin as well as iron.
A ferritin blood test is especially important if you’re experiencing:
So, it’s important to know the highest vegan sources of zinc and make sure you’re getting enough to avoid a deficiency.
Those following a vegan or plant-based diet should consume 50% more zinc than recommended as absorption of zinc from plant-based foods is lower than from animal foods.
7 highest vegan sources of zinc
Here are the highest vegan sources of zinc you should be including in your diet on a regular basis. Aim to eat these foods at least once a day…
1. Wheat germ
Wheat germ is part of a wheat kernel and is responsible for helping the plant reproduce and spawn new wheat. It’s highly nutritious, containing most of the zinc and other nutrients of the wheat plant. (5)
Luckily, the wheat germ is left in whole grain wheat. However, the best way to get the nutrients of wheat germ is to buy it separately as a ‘health food’ (highly available because it’s left over from making white wheat flour!)
You can sprinkle wheat germ on your breakfast, bake with it, etc.
Wheat germ is highly nutritious and a great source of zinc. It's readily available as a health food.
Having said that, firm tofu is usually a good source of zinc as well as many other nutrients. Tofu is also the only complete protein on a plant-based diet, providing all the essential amino acids.
If you’re vegan or plant-based, you should really be eating tofu at least a few times a week - and every day if possible! (6)
Firm tofu is a good source of zinc and many other nutrients.
3. Hemp seeds
Hemp seeds are little powerhouses of nutrients. They are especially high in minerals such as zinc.
You don’t even have to consume whole hemp seeds (they can be a little crunchy…) Actually it’s the hemp seed hearts (not the husk) which contain most of the nutrients. (7)
Adding a spoonful of hemp flour or hemp protein is a really easy way to add more zinc (and protein) to your porridge, smoothies, cakes, breads, etc.
A spoonful of hemp flour or protein is a great way to add more zinc to your diet.
All types of lentils provide zinc and are highly nutritious. Split lentils are faster to cook and the nutrients may be more easily absorbed too.
You can add lentils to dahl, curries, vegan burgers, and you can even make lentil flour at home by roasting red lentils for 5-10 mins in the oven, leaving to cook then grinding into a powder in a blender.
As with all the whole grains high in zinc, there is the issue of oats being high in phytic acid, though. To reduce the phytic acid and increase the absorption of the nutrients like zinc make sure to soak your oats in water or plant milk overnight. (10)
Additional to zinc oats also provide magnesium, iron, protein and fibres.
6. Pumpkin seeds
Pumpkin seeds are a great source of zinc. Just one 30 g serving (2 tablespoons) can give you 2 mg zinc - a good proportion of your daily needs. (11)
Here’s a really easy hack to make your pumpkin seeds much more nutritious in just 10 minutes…
Studies show that you can absorb much more of the nutrients from roasted pumpkin seeds compared to raw pumpkin seeds! So not only do roasted pumpkin seeds taste better, they’re also better for you!
Spread your pumpkin seeds out in a single layer on a baking tray and roast them on 180 degrees Celsius for 10 minutes or until slightly browned. Keep checking - they burn quickly!
Pumpkin seeds are high in zinc. Roasted pumpkin seeds are even higher!
7. Quinoa
Last but definitely not least - quinoa! If you don’t eat quinoa at least once per week, you need to start…
Not only is quinoa one of the highest vegan sources of zinc - it’s also one of the highest vegan sources of iron, protein and other minerals. (12)
Zinc requirements range from 6.2 to 12.7 mg/day. If you are unsure of your personal requirement aim to consume more.
How to increase zinc absorption
Here are the best ways to increase zinc absorption:
Pressure cooking is one the easiest (and best!) ways to break down the antinutrients like phytic acid and increase zinc absorption. (14)
Soaking your pulses, beans and grains for 6-12 hours before cooking to break down the phytic acid. For example, if you eat porridge, soak the oats before you go to bed overnight in preparation for the morning. (15)
Sprouting decreases the lectin levels and protease inhibitors of your foods therefore increasing your absorption of nutrients such as zinc. (15)
Fermenting improves the zinc absorption from your foods by breaking down antinutrients such as phytate acid. (16)
Pressure cooking, soaking, sprouting and fermenting these foods can increase zinc absorption.
The 7 Highest Vegan Sources of Zinc: The Bottom Line
Zinc is much harder to get on a vegan or plant-based diet.
Zinc is very important for you hair health, skin health, immune function and gut health. If you’re not getting enough zinc you may start to feel run down, brain foggy, have bad skin and hair, and get ill more often than normal.
Make sure you’re eating enough zinc every day. We recommend topping up with a zinc supplement to be on the safe side - especially if you calculate that you’re not getting enough on a day-to-day basis!
Zinc is one of the main nutrient reports we provide in your Personal Nutrition Guide from Vojo’s DNA test kit. Make sure you’re getting everything you need to avoid deficiency and feel great with Vojo.
Ellie is a Registered Nutritionist (MSc, mBANT), expert in nutrigenetics and has been vegan for more than 10 years. Her mission is make sure you're getting everything you need from your plant-based diet to achieve your goals and inspire others to eat more plants.
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