Edith's Medical Diet Guide - Post-Thyroid Surgery & Diabetes

🚫 ABSOLUTELY NEVER EAT - RED FLAGS

TIER 1: MEDICAL EMERGENCY - Will Make You Sick

1. ALL CASSAVA PRODUCTS (Most Dangerous)

FUFU (cassava-based)

BANKU (cassava + corn)

GARI (fermented cassava)

KONKONTE (dried cassava)

CASSAVA FLOUR

CASSAVA LEAVES

Any dish with cassava

WHY: You had thyroid surgery. Cassava contains chemicals (goitrogens) that block your thyroid medication and make your body unable to use thyroid hormone. This causes severe fatigue, weight gain, bloating, muscle weakness, and can make you very sick. WITH NO THYROID, CASSAVA IS LIKE POISON.

2. ALL FRIED FOODS

Fried plantain (kelewele)

Fried yam

Fried chicken

Fried fish

Puff-puff / Bofrot

Chinchinga (if fried)

Akara (fried bean cakes)

WHY: Fried foods sit in your stomach for 12-16 hours (normal is 2-4 hours). Your Ozempic medication already slows digestion. Fried food causes SEVERE bloating, pain, nausea. This is why you feel like you're going to explode after eating.

3. SUGAR & SWEET DRINKS

Soft drinks (Coke, Fanta, Sprite, Malta)

Fruit juice (all types)

Sweetened tea

Ice cream

Candy / Sweets

Chocolate

Pastries / Cakes / Donuts

Cookies / Biscuits

Honey (still sugar)

WHY: You have diabetes. Sugar sends your blood sugar to 250+ (dangerous). Causes weight gain, blocks Ozempic from working, damages kidneys, nerves, eyes. Plus you're ALLERGIC to chocolate (causes nausea).

4. HIGH SALT FOODS

Maggi cubes / Knorr cubes

Salted fish (koobi, momoni)

Smoked fish (if very salty)

Canned soups

Processed meats (hot dogs, sausages)

Restaurant jollof rice (very high salt)

Chips / Crackers

WHY: You take Lasix (water pill) for fluid retention. High salt makes Lasix not work. Your legs swell, you can't walk, you feel bloated. Salt makes your blood pressure go up and makes walking harder.

5. ALCOHOL

Beer

Wine

Spirits

Palm wine

All alcoholic drinks

WHY: Blocks thyroid medication, drops blood sugar dangerously low with Ozempic, causes liver damage, interacts with pain medications. Can make you very sick or cause emergency.

TIER 2: Severely Limited (Tiny Portions Only or Eliminate for 3 Months)

Large Starch Portions

White rice (max 1/2 cup)

Jollof rice (max 1/2 cup)

Waakye (max 1/2 cup)

Fried rice (avoid - fried)

Ripe plantain (yellow/black - max half)

Yam (max 1-2 small pieces)

Bread (max 1 slice whole grain)

Kenkey (max 1 small piece)

High-Fat Meats

Goat head / Cow foot

Fatty beef

Pork (unless very lean)

Chicken skin (remove it)

RAW Cruciferous Vegetables (OK if cooked)

Raw cabbage (COOK IT - then it's safe)

Raw broccoli (COOK IT - then it's safe)

Raw cauliflower (COOK IT - then it's safe)

🇬🇭 Ghanaian Foods Guide

Complete A-Z Ghanaian Food List

Food	Status	Notes
Fufu (cassava)	❌ NEVER	Contains cassava - blocks thyroid medication
Fufu (yam only)	✅ OK	Small portion (fist-size). No cassava mixed in
Fufu (plantain)	✅ OK	Small portion (fist-size). Good alternative
Banku	❌ NEVER	Contains cassava - avoid completely
Kenkey	⚠️ LIMITED	1 small piece max. Mostly corn, some cassava
Jollof Rice	⚠️ LIMITED	1/2 cup max. Restaurant versions too salty - avoid
Waakye	⚠️ LIMITED	1/2 cup max. Choose more protein sides, less rice
Red-Red	✅ OK	Beans are good! But NO fried plantain with it
Gari (cassava)	❌ NEVER	Made from cassava - avoid
Konkonte	❌ NEVER	Dried cassava - avoid
Kelewele (fried plantain)	❌ NEVER	Fried - causes severe bloating
Plantain (boiled)	✅ OK	Green/yellow only (not ripe). Half a plantain max
Puff-puff / Bofrot	❌ NEVER	Fried + sugar - very bad
Groundnut soup	✅ EXCELLENT	High protein, filling. Eat with small yam fufu
Light soup	✅ OK	Must have plenty of fish/chicken. Not watery
Palm nut soup	✅ EXCELLENT	Healthy fats, filling, good for you
Kontomire (cocoyam leaves)	✅ EXCELLENT	Very healthy! High in iron, potassium. Eat often
Okra (fresh or dried)	✅ EXCELLENT	Helps with constipation, blood sugar. Very good
Garden eggs	✅ EXCELLENT	Low carb, filling, good for diabetes
Chinchinga (fried)	❌ NEVER	If fried - avoid
Chinchinga (grilled)	✅ OK	If grilled (not fried), lean meat - good
Grilled tilapia	✅ EXCELLENT	Perfect protein. Eat often
Sardines	✅ EXCELLENT	You love these! Healthy, cheap, good for you
Smoked fish	⚠️ LIMITED	OK if not too salty. Rinse before using
Fresh fish	✅ EXCELLENT	Grilled, steamed, or baked - very good
Fried fish	❌ NEVER	Fried - causes bloating
Beans (all types)	✅ EXCELLENT	High protein, fiber. Very good for diabetes
Groundnuts	✅ OK	Small handful. Good protein/fat
Yam (boiled)	⚠️ LIMITED	1-2 small pieces max
Yam (fried)	❌ NEVER	Fried - avoid
Cocoyam (boiled)	✅ OK	Small portions. Good alternative to cassava
Sweet potato	⚠️ LIMITED	Small portions. Better than regular yam for blood sugar
Malta / Milo drinks	❌ NEVER	High sugar - avoid
Water	✅ EXCELLENT	Drink 6-8 glasses daily
Omo tuo (rice balls)	⚠️ LIMITED	Small portion. Still rice (high carb)
Tuo Zaafi	⚠️ LIMITED	Small portion. Corn-based - OK in moderation
Hausa koko	⚠️ LIMITED	Small bowl. Don't add sugar
Millet porridge (plain)	✅ OK	Small bowl. No sugar. Add groundnut paste
Sobolo (sweetened)	❌ NEVER	High sugar - avoid
Sobolo (unsweetened)	✅ OK	No sugar added - hibiscus tea is healthy

Restaurant Ordering Guide

✅ GOOD Restaurant Order Example:

"Grilled tilapia with kontomire and 2 small pieces of boiled yam. No Maggi cube please. Extra vegetables."

❌ BAD Restaurant Order Example:

"Fufu with light soup" - WRONG! Fufu has cassava

"Jollof rice with fried chicken and fried plantain" - WRONG! All fried, high salt, large rice portion

🍽️ Sample Meals - What Your Plate Should Look Like

The Perfect Plate Formula:

1/2 PLATE = Vegetables (kontomire, okra, salad, garden eggs)

1/4 PLATE = Protein (fish, chicken, eggs, beans)

1/4 PLATE = Small Starch (yam, plantain, brown rice)

BREAKFAST Option 1:

2 boiled eggs
Half an avocado
1 slice whole grain bread
Tea (no sugar)

BREAKFAST Option 2:

Small bowl millet porridge (no sugar)
2 tablespoons groundnut paste mixed in
1 boiled egg on the side

BREAKFAST Option 3 (You'll Love This - Sardines!):

Canned sardines (in water or oil, not fried)
Sliced tomatoes and onions
1 slice whole grain bread OR 1 small boiled plantain

LUNCH Option 1 (Traditional):

SMALL yam fufu (size of your fist, NO CASSAVA)
Groundnut soup (thick, lots of protein)
Large piece of chicken or fish
Kontomire (1-2 cups)

LUNCH Option 2:

Palm nut soup
Grilled tilapia (large piece)
Garden eggs
2 small pieces boiled yam

LUNCH Option 3 (Lighter):

1/2 cup brown rice (NOT white rice)
Chicken stew (with lots of chicken)
Large salad (lettuce, tomatoes, cucumbers, avocado)
Steamed vegetables

LUNCH Option 4 (With Sardines - Your Favorite!):

Sardines (1 can, grilled or heated)
Kontomire stew (2 cups)
2 pieces boiled yam
Sliced tomatoes and peppers

DINNER (Should Be Lighter Than Lunch):

Grilled fish (tilapia, mackerel, or sardines)
Okra soup OR light soup
Steamed vegetables
VERY small starch (1 piece yam) OR no starch

SNACKS (If Hungry Between Meals):

Small handful of groundnuts
1 boiled egg
Half an avocado
1 small orange
Cucumber slices

Weekly Shopping List

Buy These Every Week:

✅ Fresh fish (tilapia, mackerel) - 3-4 pieces
✅ Canned sardines - 5-7 cans (since you love them!)
✅ Chicken (skinless) - 2-3 lbs
✅ Eggs - 1-2 dozen
✅ Kontomire (cocoyam leaves) - large bunch
✅ Okra - fresh or dried
✅ Garden eggs - 10-15
✅ Tomatoes - 10-15
✅ Onions - 5-6
✅ Peppers - assorted
✅ Spinach or lettuce - 2 bunches
✅ Yam - 2-3 small yams (for yam fufu or boiled)
✅ Green plantain - 4-6 (not ripe)
✅ Avocados - 3-4
✅ Groundnuts/groundnut paste
✅ Beans (black-eyed peas)
✅ Brown rice - 1 bag
✅ Whole grain bread - 1 loaf

❓ Why This Diet Matters - Your Medical Conditions

Your Health History:

2015: Thyroid surgery (removed thyroid because it was choking you)
2015: Larynx surgery (to save your airway)
Hashimoto's disease: Your immune system attacked your thyroid
Riedel's thyroiditis: Rare aggressive thyroid disease with fibrous tissue
2017: Prediabetes diagnosed
2022: Full Type 2 diabetes (because diet didn't change)
Current weight: 267 lbs (need to lose 40-60 lbs)
Both parents: Died from diabetes and high blood pressure complications

Why You MUST Follow This Diet:

1. Cassava = Poison for Your Thyroid

You have NO working thyroid. You are 100% dependent on thyroid pills (Levothyroxine + Liothyronine). Cassava contains chemicals called goitrogens that BLOCK your thyroid medication from working.

Result if you eat cassava: Extreme fatigue, cannot walk, severe bloating, constipation, muscle weakness, weight gain, depression, pain everywhere.

The surgery removed your thyroid to save your life in 2015. Don't undo that by eating cassava.

2. Fried Foods = Why You Can't Walk and Feel Bloated

You're on Ozempic 2 mg (maximum dose). This slows your stomach. Your thyroid surgery also slows digestion. You also take codeine (Tylenol #3) which slows your gut.

When you eat fried food: It sits in your stomach for 12-16 hours (normal is 2-4 hours). This causes SEVERE bloating that makes you feel like you're going to explode.

This is why you can't walk - your stomach is so full you can barely move.

3. Sugar = Destroying Your Body With Diabetes

You went from prediabetes (2017) to full diabetes (2022) in 5 years. Your parents both died from diabetes complications.

If you keep eating sugar and large starches:

Nerve damage (can't feel feet, more pain)
Kidney failure (dialysis 3x per week)
Vision loss (blindness)
Amputations (lose toes, feet, legs)
Heart attack, stroke
Same fate as your parents

You're on the maximum Ozempic dose. If this doesn't work with diet changes, you're out of options.

4. High Salt = Why Your Legs Swell and You Can't Walk

You take Lasix (water pill) to remove excess fluid. When you eat high salt (Maggi cubes, salted fish, restaurant food), the salt cancels out the Lasix.

Result: Legs swell up, can't walk, fluid in lungs (can't breathe), high blood pressure, heart strain.

Current Medications (22 items):

You're on 22 medications. Many of them are treating SYMPTOMS of your diet:

Ozempic - fighting diabetes from high-carb diet
Lasix - fighting fluid retention from high salt
Tylenol #3, Baclofen - fighting pain from excess weight on joints
Thyroid meds - blocked by cassava consumption
Lasix - not working because of high salt intake

If you change your diet, you can reduce medications and feel 1000x better.

What Happens If You Follow This Diet:

Next 1-2 Weeks:

✅ Bloating reduces by 50-70%
✅ Can walk more easily (less stomach pressure)
✅ Less constipation
✅ More energy
✅ Less pain

Next 1-3 Months:

✅ Lose 10-20 lbs
✅ Blood sugar drops to normal range
✅ Can walk without severe pain
✅ Leg swelling reduces
✅ Sleep better
✅ Thyroid medication works properly

Next 6-12 Months:

✅ Lose 40-60 lbs (Ozempic + diet working together)
✅ Diabetes under control (A1C below 7%)
✅ Walk normally, no walker needed
✅ Reduce or eliminate some medications
✅ Knee and back pain reduced 50-70%
✅ Avoid kidney damage, nerve damage, vision loss
✅ Break the cycle that killed your parents

Emergency Contacts:

Hospital: Parkland Health

Call doctor if:

Blood sugar over 250 or under 70
Severe bloating/pain for more than 24 hours
No bowel movement for 5+ days
Cannot walk at all
Extreme muscle weakness
Chest pain, shortness of breath
Vomiting for more than 24 hours

💊 Your Medications - What You Need to Know

Complete Medication List (What Each One Does)

Medication	What It's For	Main Side Effects
Levothyroxine 50 mcg	Thyroid hormone replacement (T4)	Hair loss if too high, fatigue if too low
Liothyronine 5 mcg	Thyroid hormone replacement (T3)	Heart racing if too high, tiredness if too low
Ozempic 2 mg weekly	Diabetes + weight loss	SEVERE BLOATING, nausea, constipation, slowed stomach
Furosemide 20 mg (Lasix)	Remove excess fluid (water pill)	Low potassium (dangerous!), weakness, frequent urination
Rosuvastatin 10 mg	Lower cholesterol	Muscle pain, weakness (especially with low potassium)
Tylenol #3 (codeine)	Pain relief	SEVERE CONSTIPATION, drowsiness, addiction risk
Baclofen 10 mg	Muscle relaxant for pain	Drowsiness, weakness, dizziness
Jinteli	Hormone replacement (menopause)	Bloating, breast tenderness, mood changes
Ergocalciferol 50,000 units	Vitamin D (severe deficiency)	None usually, unless too much (nausea)
Albuterol inhaler	Breathing/asthma	Shaky hands, fast heartbeat
Azelastine nasal spray	Allergies	Bitter taste, drowsiness
Fluticasone nasal spray	Allergies/inflammation	Nosebleeds, sore throat
Chlorhexidine rinse	Gum disease/mouth infection	Tooth staining (temporary)
Lidocaine viscous	Mouth pain (numbing)	Numbness, altered taste
Mupirocin ointment	Skin infection (bacterial)	Burning at application site
Terbinafine cream	Fungal infection (skin)	Redness, itching
Triamcinolone ointment	Rash/inflammation	Skin thinning if used too long
Blood sugar supplies	Monitor diabetes	None (testing supplies)

🚨 DANGEROUS COMBINATIONS - Never Take Together

1. Tylenol #3 (Codeine) + Baclofen = EXTREME DROWSINESS

The Problem: Both make you very sleepy and weak. Together = dangerous drowsiness, can't think clearly, risk of falling.

What To Do:

DO NOT take both at the same time
If you take Tylenol #3 for pain, wait 6-8 hours before taking Baclofen
NEVER drive or walk stairs after taking both
Better: Ask doctor to switch Tylenol #3 to non-drowsy pain med (like Tylenol regular)

2. Lasix + Low Potassium = MUSCLE DAMAGE WITH STATIN

The Problem: Lasix flushes potassium out of your body. Low potassium + Rosuvastatin (statin) = severe muscle pain, weakness, muscle breakdown (rhabdomyolysis - DANGEROUS).

Symptoms of Low Potassium:

Severe muscle weakness (can't stand up)
Leg cramps
Irregular heartbeat
Constipation
Extreme fatigue

What To Do:

Get potassium blood test EVERY 3 MONTHS (not optional!)
You may need potassium supplement pills
Eat high-potassium foods: Avocado, oranges, kontomire, spinach, beans
Tell doctor IMMEDIATELY if you have unexplained muscle pain

3. Ozempic + Thyroid Issues = DOUBLE GASTROPARESIS (Why You're So Bloated)

The Problem: You have NO thyroid = slow digestion. Ozempic = slows digestion MORE. Codeine = slows it EVEN MORE.

Result: Food sits in stomach for 12-16 hours (normal is 2-4 hours). Severe bloating, nausea, constipation, can't eat.

What To Do:

Eat SMALL meals (5-6 times daily, not 3 large)
NO fried foods (sits in stomach forever)
Walk 10 minutes after eating (helps stomach empty)
Stop eating 3-4 hours before bed
Ask doctor: "Should we reduce Ozempic from 2 mg to 1.5 mg to help bloating?"

4. Tylenol #3 (Codeine) = SEVERE CONSTIPATION (Getting Worse)

The Problem: Codeine causes SEVERE constipation. You already have slow gut (thyroid + Ozempic). Adding codeine = bowel obstruction risk.

What To Do:

Take Miralax DAILY (not just when constipated)
Take Docusate (Colace) 100mg twice daily
Drink 8 glasses of water daily
Eat okra daily (helps move bowels)
If no bowel movement for 3 days → call doctor
If no bowel movement for 5 days → GO TO ER (bowel obstruction)
Ask doctor to switch to non-constipating pain med

⏰ CRITICAL TIMING RULES

Thyroid Medications MUST Be Taken Alone

CURRENT PROBLEM: If you're taking thyroid meds with food or other medications, they're NOT WORKING. This could be why you feel so tired and can't lose weight.

CORRECT SCHEDULE:

Time	What to Take	Notes
6:00 AM (or when you wake up)	• Levothyroxine 50 mcg • Liothyronine 5 mcg • ONLY with water	NOTHING ELSE! No food, no coffee, no other pills
7:00-7:30 AM (60 minutes later)	NOW you can eat breakfast and take other morning meds	Must wait full 60 minutes
7:00-7:30 AM (with breakfast)	• Furosemide (Lasix) • Rosuvastatin • Jinteli • Nasal sprays • Any other morning meds	Take with food to avoid upset stomach
Bedtime	• Chlorhexidine rinse • Any evening meds	At least 4 hours after thyroid meds
Weekly (same day)	• Ozempic 2 mg injection (subcutaneous - under skin)	Pick same day each week (e.g., every Sunday)
Monthly	• Vitamin D 50,000 units	Same date each month (e.g., 1st of month)

🍽️ FOODS THAT BLOCK YOUR MEDICATIONS

Foods That Block Thyroid Medication (Don't Eat Within 4 Hours)

❌ CASSAVA (blocks iodine, prevents thyroid hormone from working)
❌ Calcium supplements (blocks absorption by 50%)
❌ Iron supplements (blocks absorption)
❌ Coffee (reduces absorption by 30% - wait 60 minutes after thyroid med)
❌ Soy products (large amounts interfere with thyroid)
❌ Raw cabbage/broccoli (goitrogens - COOK them and they're safe)

Foods That Block Rosuvastatin (Statin)

❌ Grapefruit juice (increases statin levels = muscle damage risk)
❌ Seville oranges (same as grapefruit)
❌ Pomelos (same as grapefruit)

Foods That Make Lasix Not Work

❌ High salt foods (Maggi cubes, salted fish, restaurant food)
❌ NSAIDs like ibuprofen/Advil (reduces Lasix effectiveness)

⚠️ SIDE EFFECTS CAUSING YOUR SYMPTOMS

Your Symptom	Which Medication Causes It	What To Do
SEVERE BLOATING	1. Ozempic (slows stomach) 2. Hypothyroidism (no thyroid = slow gut) 3. Codeine (stops gut movement)	• Eat tiny meals (5-6 per day) • NO fried food • Walk after eating • Ask doctor to reduce Ozempic dose
SEVERE CONSTIPATION	1. Tylenol #3 (codeine) - MAIN CAUSE 2. Ozempic 3. Hypothyroidism	• Miralax DAILY • Docusate 2x daily • Magnesium supplement • Eat okra daily • Ask to switch from codeine
MUSCLE WEAKNESS (can't walk)	1. Low potassium (from Lasix) - DANGEROUS 2. Hypothyroidism (thyroid not optimized) 3. Rosuvastatin (statin side effect) 4. Baclofen (muscle relaxant)	• URGENT: Get potassium blood test • Get thyroid levels checked • Tell doctor about muscle weakness • May need potassium supplement
LEG SWELLING	1. Lasix not working (too much salt in diet) 2. Jinteli (hormone causes fluid retention)	• STOP all high-salt foods • No Maggi cubes • Elevate legs 3-4x daily • Compression stockings • May need higher Lasix dose
EXTREME DROWSINESS	1. Tylenol #3 (codeine) 2. Baclofen 3. Azelastine nasal spray	• NEVER take codeine + baclofen together • Don't drive after taking these • Ask for non-drowsy pain med
NAUSEA	1. Ozempic (very common at 2 mg) 2. Chocolate allergy (you have this!)	• Avoid chocolate completely • Eat small meals • Ginger tea helps • If severe, ask to reduce Ozempic

🚨 EMERGENCY WARNING SIGNS - Go to ER Immediately

Call 911 or Go to ER If You Have:

❌ Extreme muscle weakness - can't stand up (low potassium emergency)
❌ Irregular heartbeat, heart racing, chest pain (low potassium or heart issue)
❌ Dark brown urine + muscle pain (muscle breakdown from statin - EMERGENCY)
❌ Severe abdominal pain (could be bowel obstruction from constipation)
❌ No bowel movement for 5+ days with pain (bowel obstruction)
❌ Vomiting for 24+ hours (can't keep down fluids)
❌ Blood sugar under 70 (hypoglycemia - dangerous with Ozempic)
❌ Blood sugar over 400 (diabetic emergency)
❌ Can't urinate or very dark urine (kidney failure from Lasix + Ozempic)
❌ Confusion, dizziness, fainting (low potassium, low blood sugar, dehydration)
❌ Sudden severe leg swelling in ONE leg only (blood clot - DVT)
❌ Chest pain + shortness of breath (heart attack, fluid around heart)

📋 Questions to Ask Your Doctor at Next Appointment

Print This and Bring to Appointment:

"What were my last potassium levels? When was it tested? I need it checked every 3 months with Lasix."
"What are my current thyroid levels (TSH, Free T4, Free T3)? Are they optimized?"
"My thyroid doses seem low (50 mcg levothyroxine) for someone with no thyroid. Should we increase?"
"Can we switch Tylenol #3 to regular Tylenol? The codeine causes severe constipation and bloating."
"Should I take potassium supplements with Lasix? I have history of low potassium."
"My Ozempic dose (2 mg) causes severe bloating. Can we reduce to 1.5 mg temporarily?"
"Do I need calcium supplements after thyroid surgery? Could low calcium cause my muscle weakness?"
"Should I avoid cassava completely with my thyroid condition?"
"I need prescriptions for: Miralax, Docusate, Compression stockings, Walking cane."
"Can I get referrals for: Endocrinologist, Gastroenterologist (bloating), Sleep study (sleep apnea), Physical therapy?"

💊 Medication Checklist - Daily Tracking

Print This - Check Off Daily:

Time	Medication	✓ Done
6:00 AM	Levothyroxine 50 mcg (ALONE, just water)	☐
6:00 AM	Liothyronine 5 mcg (ALONE, just water)	☐
7:00 AM	WAIT 60 MINUTES - No food, no coffee	☐
7:00-7:30 AM	Furosemide 20 mg (with breakfast)	☐
7:00-7:30 AM	Rosuvastatin 10 mg (with breakfast)	☐
7:00-7:30 AM	Jinteli (with breakfast)	☐
Morning	Azelastine nasal spray (2 sprays each nostril)	☐
Morning	Fluticasone nasal spray (2 sprays each nostril)	☐
Morning	Blood sugar test (fasting)	☐ _____
Evening	Azelastine nasal spray (2 sprays each nostril)	☐
Evening	Chlorhexidine rinse (15 mL, spit out)	☐
Bedtime	Chlorhexidine rinse (15 mL, spit out)	☐
Daily	Miralax (for constipation prevention)	☐
Twice daily	Docusate/Colace 100mg (stool softener)	☐ ☐
As needed	Tylenol #3 (pain) - MAX 4 per day	☐
As needed	Baclofen (muscle pain) - NOT with codeine	☐
As needed	Albuterol inhaler (breathing)	☐