Soy sauce, Worcestershire Sauce, Thyroid and the Low Iodine Diet

For the majority of our population, Thyroid Cancer is not something you deal with and it never gets the big airtime of the pink ribbon. But for those of us that have received that diagnosis, it is a life changing disease. Although your doctor, surgeon and endocrinologist will tell you that it is one of the “good cancers” because it is highly treatable, there is nothing good about it.

Think about it. The treatment for thyroid cancer is usually to remove your thyroid. Not that big a deal, right? Wrong! Do you even know what your thyroid does? Your thyroid is a butterfly shaped gland located in the base of your neck. It produces hormones that basically run your body. Thyroid hormones control how your body turns food into energy. Thyroid hormones affect your metabolism rate, which means how fast or slow your brain, heart, muscles, liver, and other parts of your body work.

So when they take your thyroid and toss it into the waste cup, you are forever changed. The one little thing that makes your engine run is gone, and the battle to replace those missing hormones with something synthetic begins. You gain weight, you are tired, can feel too hot or cold, lose your hair and have trouble sleeping.

And then there is the Low Iodine Diet and Radioactive Iodine Treatment.

The thyroid is the only organ in the body that absorbs iodine. When you have been diagnosed with thyroid cancer, the usual treatment is to remove the thyroid gland, then follow with Radioactive Iodine Treatment (RAI). To prepare for RAI, you must go on a diet that has minimal iodine, usually for 2-3 weeks, so that your body is depleted of iodine and any residual thyroid cells are hyper accepting of any iodine introduced. When you take radioactive iodine, it then works like a Trojan Horse. The starved thyroid cells ‘uptake’ the radioactive iodine and BAM, they are killed off before they know what hit them.

Now for those 2-3 weeks that you are on the Low Iodine Diet (LID), you are not allowed to eat anything that contains dairy, egg yolks, seafood or anything that comes from the sea (like nori, kelp, or products like carrageenan, which is in lots of stuff), iodized or sea salt and soy. Since I am a pretty good home cook, I do pretty well on this diet, but I do miss my cream in my coffee, and I miss, of all things, soy sauce.

Soy sauce is an Umami ingredient.  It has a saltiness and rich mouth feel that adds a depth of flavor to recipes. Its cousin, Worcestershire sauce works much the same way. And when I was searching for this week’s new recipe (see yesterday’s post), I found that what I wanted to make needed both and there just was no substitute. So what did I do? I went looking for recipes for these two ingredients that I could use instead.

SoyFree Soy Sauce and Worcestershire Sauce
Soy and Worcestershire Sauces

I found recipes for both that could be used with safe stuff for my LID, but neither one of them actually gave me the results that I was looking for. So I reworked what I found online and both came out far better than I expected. I actually liked the results of the Worcestershire sauce best, because I read the label on the bottle in my fridge and added the much needed tamarind paste that was missing from every recipe I found online. This one addition turns this from ehhh, to wow.

So if you have sensitivity to soy, are doing the LID for RAI prep, or are just looking for a cool substitute for these ingredients, I present my recipes and hope they will be helpful. I know I will be using them for the rest of my time on my restricted diet.


Soy Free Soy Sauce
Soy Free Soy Sauce

Recipe for ‘no-soy’ Soy Sauce

2 c unsalted beef broth
1-2 tablespoons non iodized salt
3 teaspoons balsamic vinegar
3 teaspoons apple cider vinegar
2 teaspoons molasses
¼ teaspoon ground ginger
1 pinch white pepper
1 pinch garlic powder

In a saucepan over medium heat, stir together all ingredients. Bring to a gentle boil and cook until the liquid is reduced to about 1 cup, about 15-20 minutes. Adjust salt to your personal taste. It should be quite salty to imitate soy sauce. Cool and store in refrigerator.


Soy and Seafood Free Worcestershire Sauce
Soy and Seafood Free Worcestershire Sauce

Recipe for ‘no soy, no seafood’ Worcestershire Sauce

½ c apple cider vinegar
2 tablespoons homemade soy sauce
2 tablespoons water
2 teaspoons tamarind paste
1 tablespoons light brown sugar
¼ teaspoon ground ginger
¼ teaspoon mustard powder
¼ teaspoon onion powder
¼ teaspoon garlic powder
1/8 teaspoon cinnamon
1/8 teaspoon black pepper
small pinch cloves

In a saucepan over medium heat, stir together all ingredients. Bring to a gentle boil and cook until the liquid is reduced slightly, about 7 minutes. Cool and store in refrigerator.




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