The Unexpected Weight Gain of Cancer Treatment: A Journey Through Iodine Restriction and Beyond
A diagnosis of thyroid cancer can trigger a cascade of unexpected challenges, extending far beyond the initial surgery and treatment. For one individual, the path to recovery has involved a paradoxical struggle: gaining weight while undergoing a specialized diet designed to combat the disease. This is the story of navigating the complexities of iodine restriction, the frustrating limitations of a flavorless diet, and the emotional toll of a body seemingly rebelling against the healing process.
The journey began with a lifetime of avoiding diets. “I’ve never dieted in my life,” the author reflects, recalling a youth spent observing friends obsess over weight loss in a South Korea heavily influenced by appearance-based standards. While friends embraced restrictive eating habits – from aggressive fasting to single-food plans – the author prioritized enjoyment and physical activity, believing a balanced approach was key. This perspective shifted dramatically in September of this year with a diagnosis of papillary thyroid cancer, complicated by metastasis.
Fortunately, the cancer was surgically removed, including affected lymph nodes. However, the lingering threat of microscopic cancer cells necessitated a unique follow-up treatment: a period of intentionally restricting thyroid hormone medication and, crucially, iodine intake.
The rationale is rooted in the biology of thyroid cancer. These cells “love” iodine, absorbing it to produce thyroid hormones. By halting medication and limiting dietary iodine, any remaining cancer cells are forced to seek out iodine, making them vulnerable to a subsequent dose of radioactive iodine – a targeted therapy designed to destroy the lingering threat.
This leads to the “iodine diet,” a regimen dreaded by many thyroid cancer patients. As the author explains, “It sounds simple, but it’s incredibly difficult.” South Korea’s cuisine, deeply rooted in seafood and fermented products, is a minefield of iodine. Staples like dashima (kelp) used for broth, saeujeot (fermented shrimp), miyeok (seaweed), and gim (roasted seaweed) are all high in iodine. Even seemingly innocuous ingredients like salt – specifically, cheonilyeom (sun-dried sea salt) – contribute to the intake.
The restrictions extend beyond seaweed. Kimchi, fermented soybean paste (doenjang), soy sauce (ganjang), and chili paste (gochujang) – cornerstones of Korean cuisine – are largely off-limits if made with traditional sea salt. Eggs and dairy products are also problematic due to iodine-based disinfectants used in livestock management. “If you can happily eat a diet excluding all of that, you’re not Korean,” the author wryly observes.
While past patients endured a truly austere diet of food seasoned only with refined salt, options have improved. Low-iodine versions of traditional condiments are now available online, and pre-made low-iodine meal kits offer convenience. However, a significant challenge remains: taste. “Food made with refined salt is…empty,” the author describes. “It lacks umami, that savory deliciousness. It tastes like flavor, but it doesn’t have flavor. And adding more salt just makes it…salty.”
The physical and emotional consequences are mounting. The author, already battling the fatigue induced by hormone withdrawal, finds preparing bland, unsatisfying meals a daily struggle. The lack of energy makes even basic tasks feel monumental. “I’m tired all the time. I don’t even want to turn my head when someone calls my name. I’m becoming apathetic, even depressed,” they confess.
Adding insult to injury, the diet is contributing to weight gain. Deprived of satisfying flavors, the author craves sugar, indulging in matbam (sweet potato snacks) and goguma mattang (candied sweet potatoes). As of this writing, 11 days into the 14-day restriction, the author anticipates reaching an all-time high weight. The body, deprived of thyroid hormone, is slowing down, retaining water, and stubbornly clinging to calories.
The author acknowledges the necessity of the diet, understanding that it’s a crucial step in eliminating any remaining cancer cells. Yet, the daily grind is exhausting. “It feels like I’m constantly fighting against inertia and laziness,” they write. “Like a phone battery flashing red, desperately needing a charge, but unable to even reach for the charger.”
Despite the challenges, small comforts persist. A daily cup of Americano provides a much-needed caffeine boost, and the author continues to prepare their own meals, finding them more palatable than those made by their spouse. But as the final days of the iodine restriction approach, a sense of uncertainty looms. The author doesn’t know what the future holds, only that each day is a battle against fatigue, frustration, and the unexpected weight gain that accompanies the fight against cancer. “I just want to sleep, knowing that tomorrow will come,” they conclude, a sentiment echoing the quiet desperation of a journey far from over.
