Hypothyroidism (low thyroid function) is believed to be one of the most underdiagnosed health conditions in the United States. Many of its symptoms—lethargy, depression and weight gain—can be easily attributed to other factors, making hypothyroidism difficult to diagnose. Some reports estimate that around 15 percent of the population suffers from the condition; other reports estimate more than twice that. Risk increases with age, particularly in menopausal women. Hyperthyroidism (overactive thyroid), the opposite of hypothyroidism, is considerably less common and is characterized by extreme nervousness and restlessness.
The association between hypothyroidism and energy expenditure was suspected clinically, and the discovery of lower O2 consumption in myxedema provided an early diagnostic tool (19). The development of a device to assess energy expenditure through measurement of the basal metabolic rate (BMR) in humans proved to be useful for not only diagnosis but also titration of therapy (20). The scale was calibrated so that a normal BMR reference range would be around 0%, whereas athyreotic individuals could have a BMR of about −40% (21). Because of lack of specificity (for example, low BMR in malnutrition), BMR was used in conjunction with the overall clinical impression; a low BMR in the setting of high clinical suspicion would secure a diagnosis and justify treatment (21, 22).
In the past, doctors weren't able to detect hypothyroidism until symptoms were fairly advanced. But by using the sensitive TSH test, doctors are able to diagnose thyroid disorders much earlier — often before you experience symptoms. Because the TSH test is the best screening test, your doctor will likely check TSH first and follow with a thyroid hormone test if needed. TSH tests also play an important role in managing hypothyroidism. They help your doctor determine the right dosage of medication, both initially and over time.
Soy? If you have hypothyroidism, yes. Eating too much soy causes problems only for those with hypothyroidism, which occurs when your thyroid gland does not make enough thyroid hormones, Dr. Nasr says. The main problem is that soy hinders absorption of the hormones such patients are taking. “Some studies show that if you eat a lot of soy, or drink a big glass of soy milk, within one hour of taking a thyroid hormone, it might affect absorption,” he says. “A lot of people depend on those hormones to achieve a steady state.
Pill Systems: Natural ingredients combined together to help maintain the functioning of the thyroid gland are available in the form of pill systems. A thyroid supplement called 'thyromine' is used to increase production, thereby combating hypothyroidism. Thyromine supplements are made from natural and herbal ingredients, such as Nori (seaweed rich in iodine) and thyroid bovine powder (maintains functioning of endocrine system).
If that’s not enough to calm your concerns, some experts suggest that eating cruciferous vegetables may actually be beneficial if you have autoimmune hypothyroidism since the thiocyanates may slow the absorption of iodine in people getting too much, which is possible if you are eating a typical Western diet of fast foods, French fries, and other processed products, that contain iodized salt, and you are heavy-handed with the salt shaker.
60 patients with borderline hypothyroidism were given either 2 mg of soy isoflavones (the amount found in the typical omnivore’s diet) or 16 mg of soy isoflavones (the amount found in the typical vegetarian’s diet). The “vegetarian” dose of soy isoflavones was 3 times more likely to cause patients to convert from borderline (“subclinical”) hypothyroidism to full-blown (“overt clinical”) hypothyroidism.
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To find out if you have hypothyroidism, your doctor will run blood tests to check for levels of the hormones known as T4 (thyroxine) and TSH (thyroid-stimulating hormone). Hypothyroidism is diagnosed in your thyroid test when TSH is high. Sometimes, TSH can be high, but the thyroid is still producing enough hormones. This condition is referred to as subclinical (or mild) hypothyroidism.
In humans, a factor associated with response to combination therapy in a large clinical trial is the Thr92Ala polymorphism in the type 2 deiodinase gene (DIO2), wherein the subpopulation of patients with this genetic alteration had improved well-being and preference for combination therapy (7). This has led investigators to consider whether this polymorphism could confer a defect in the D2 pathway, but normal Thr92AlaD2 enzyme kinetics have been demonstrated (73). Only recently has the Thr92AlaD2 protein been found to have a longer half-life, ectopically localize in the Golgi apparatus, and significantly alter the genetic fingerprint in cultured cells and in the temporal pole of the human brain without evidence of reduced thyroid hormone signaling (74). The significance of these studies transcends the thyroid field—this polymorphism has now been associated with a constellation of diseases, including mental retardation, bipolar disorder, and low IQ (75). If hypothyroid carriers of Thr92AlaD2 benefit from alternate therapeutic strategies in replicate studies, then personalized medicine—based on genotype— may have a role.
One of the most powerful things you can do to help your health and metabolism is to drink enough water. Water helps your metabolism function more efficiently and can help reduce your appetite, get rid of water retention and bloating, improve your digestion and elimination, and combat constipation. Some experts even say that we should drink one ounce of water per pound of scale weight.
Kale reigns supreme in the land of leafy green vegetables that we often eat raw, but beware if you have an iodine deficiency. “Kale gets a big baddy,” Blum says. “Eat it cooked.” When raw, this dark green leaf steals the iodine from the thyroid gland. If you must, it’s ok to nosh on the green veggie in your salad, but stop at two servings a day. No need to get extra credit on the superfood.
High-fat fried foods, like mozzarella sticks, jalapeno poppers and um…fried chicken and French fries can contribute to inflammation in the body, says Blum. Inflammation from Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, often leads to an underactive thyroid gland. Hypothyroidism primarily affects middle-aged women, according to the Mayo Clinic, but it can target anyone at any age.
Stress can also be caused by chronic digestive issues. When the small or large intestine is in distress (ywhen you are always constipated, bloated, suffer from gas, pain, loose stool etc.), the body sees it as a state of stress. Cortisol is a potent hormone we won’t function without. However, when in excess, it can have a detrimental impact on the thyroid and the immune system (one of the functions of cortisol is to modulate the immune system).
This can lead to low T3 levels (58). In addition, elevated cortisol will cause thyroid hormone receptor insensitivity meaning that even if T3 levels are high enough, they may not be able to bind normally to receptor sites. And when this happens it doesn’t get into the cells. Cortisol will also increase the production of reverse T3 (rT3), which is inactive (11).
Supplements may also mess with your treatment and can be harmful. Iodine supplements, for example, can cause your thyroid to make too much or too little hormone. Too much of a healthy vitamin isn't good for you. Fiber supplements can absorb medication and keep the full dose from working in your body. Herbs may interfere with your medication and may not be safe or effective.
Those with hypothyroidism may want to consider minimizing their intake of gluten, a protein found in foods processed from wheat, barley, rye, and other grains, says Ruth Frechman, RDN, a dietitian in the Los Angeles area and a spokesperson for the Academy of Nutrition and Dietetics. And if you have been diagnosed with celiac disease, gluten can irritate the small intestine, and may hamper absorption of thyroid hormone replacement medication.
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