Hypothyroidism

This a condition in which the thyroid gland is under-active and produces too little of its hormones which, along with body’s metabolism, also help regulate cell growth and repair which is why people suffering from hyperthyroidism face symptoms like lethargy, weight gain, hairloss and mental issues like depression. There are four main causes due to which a person can develop hypothyroidism:

  1. Autoimmune disease: sometimes, our body confuses its own cells as foreign bodies and triggers an immune response to eradicate those cells; this is known as autoimmune disorder. In case of hypothyroidism, an autoimmune disorder known as Hashimoto’s thyroiditis develops probably due to genetic and/or environmental factors.

  2. Medication: certain medicines used in the treatment of cancer, heart diseases and psychological condition tend to lower thyroid activity.

  3. Radiation therapy: Radiation used to treat cancers of the head and neck can slow or stop proper thyroid functioning.

  4. Removal of the gland: partial or complete surgical removal of thyroid gland due to various reasons may lead to hypothyroidism.

  5. Iodine deficiency: ingestion of right amount of iodine is crucial for a healthy functioning of thyroid gland. Too much iodine may result in hyperthyroidism and too little or lack of it may result on hypothyroidism.

  6. Postpartum thyroiditis: occurs during or after pregnancy due to autoimmune response.

  7. Congenital disease: rarely, some new born babies have either partially developed or no thyroid gland since birth.

  8. Pituitary disorder: in this case the pituitary gland fails to produce enough Thyroid Stimulating Hormone (TSH) which results in diminished thyroid activity.

Symptoms:

  1. Fatigue

  2. Increased sensitivity to cold

  3. Constipation

  4. Dry skin

  5. Weight gain

  6. Puffy face

  7. Hoarseness

  8. Muscle weakness

  9. Elevated blood cholesterol level

  10. Muscle aches, tenderness and stiffness

  11. Pain, stiffness or swelling in your joints

  12. Heavier than normal or irregular menstrual periods

  13. Thinning hair

  14. Slowed heart rate

  15. Depression

  16. Impaired memory

  17. Enlarged thyroid gland (goiter)

Complications:

  1. Heart disease: under-active thyroid is linked to increased LDL (bad) cholesterol levels in blood which increases risks for cardiovascular diseases.

  2. Mental issues: people suffering from hypothyroidism usually face depression and slow mental functioning which can become sever overtime.

  3. Goiter: over-stimulation of thyroid by medicines or other intervention can cause enlargement of the thyroid gland.

  4. Infertility: Low levels of thyroid hormone can interfere with ovulation, which impairs fertility.

  5. Birth defects: Babies born to women with untreated thyroid disease may have a higher risk of birth defects compared to babies born to healthy mothers. These children are also more prone to serious intellectual and developmental problems.

  6. Peripheral neuropathy: Long-term uncontrolled hypothyroidism can cause damage to your peripheral nerves. These are the nerves that carry information from your brain and spinal cord to the rest of the body.

  7. Myxedema: long-term, undiagnosed hypothyroidism results in this life threatening condition. Its signs and symptoms include intense cold intolerance and drowsiness followed by profound lethargy and unconsciousness. A myxedema coma may be triggered by sedatives, infection or other stress on the body.


Diet recommendations:


Foods to have: People suffering from hypothyroidism are at risk of obesity and diseases like type 2 diabetes hence having a wholesome and healthy diet should be paramount as these foods are help reduce risks of obesity and other lifestyle disorders. Certain nutrients such as iodine, selenium and zinc are vital for healthy functioning of the thyroid gland.

  1. Vegetables: all vegetables can be eaten. Cruciferous veggies (cauliflower, cabbage, kale, bok choy, broccoli, Brussels sprouts) have tendency to worsen hypothyroidism but not if taken in moderation and in cooked form. Even so, I would strongly recommend that you consult your doctor or dietitian before adding them in your diet.

  2. Fruits: all fruits.

  3. Grains: gluten free whole grains such as quinoa, oats, amaranth, corn and brown rice.

  4. Meats: all meats.

  5. Seafood: all sea food.

  6. Dairy: all forms of dairy but I would recommend that you avoid highly processed ones such as flavored yogurt and ice-cream due to them having high amounts of sugar and other additives.

Foods to avoid: Certain foods contain Goitrogens which disrupt uptake of iodine which leads to poor production of thyroid hormone therefore, foods containing Goitrogens should be avoided. As mentioned earlier, hypothyroidism increases risk of obesity so highly processed foods and sugar rich foods should be reduced or eliminated from the diet.

  1. Vegetable: cruciferous veggies (cauliflower, cabbage, kale, broccoli, Brussels sprouts).

  2. Soy- based foods: tofu, soy milk, soy beans etc.

  3. Highly processed foods: all sorts.

  4. Millets: all types.

  5. Beverages: coffee, green tea, and alcohol.

Superfoods for hypothyroidism:

  1. Nuts: nuts like brazil nuts and cashews are a great source of selenium which helps in activating the thyroid gland.

  2. Sea food: shell fish, sea weed and salmon are naturally rich sources of iodine and healthy omega- 3 fats.

  3. Eggs and meats: contain abundant amounts of zinc and selenium.



References and further reading:


Doerge DR, Sheehan DM. Goitrogenic and estrogenic activity of soy isoflavones. Environ Health Perspect. 2002;110 Suppl 3(Suppl 3):349-353. doi:10.1289/ehp.02110s3349


Garber JR, Cobin RH, Garib H, et al. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice. 2012;18(6):988–1028.


Johnson, S., 2019. Best Diet For Hypothyroidism: Good Foods, What To Avoid, And Meal Plan. [online] Medicalnewstoday.com. Available at: <https://www.medicalnewstoday.com/articles/324819> [Accessed 18 October 2020].


Krysiak R, Szkróbka W, Okopień B. The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto's Thyroiditis: A Pilot Study. Exp Clin Endocrinol Diabetes. 2019;127(7):417-422. doi:10.1055/a-0653-7108


Mayo Clinic. 2019. Hypothyroidism - Symptoms And Causes. [online] Available at: <https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284#:~:text=Hypothyroidism%20(underactive%20thyroid)%20is%20a,symptoms%20in%20the%20early%20stages.> [Accessed 18 October 2020].


Maxwell, Christy, and Stella Lucia Volpe. "Effect of zinc supplementation on thyroid hormone function." Annals of Nutrition and Metabolism 51.2 (2007): 188-194.


Raman, R., 2019. Best Diet For Hypothyroidism. [online] Healthline. Available at: <https://www.healthline.com/nutrition/hypothyroidism-diet> [Accessed 18 October 2020].


Rao PS, Lakshmy R. Role of goitrogens in iodine deficiency disorders & brain development. Indian J Med Res. 1995;102:223-226.


Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017;2017:1297658. doi:10.1155/2017/1297658


Wartofsky, L., 2016. Hypothyroidism (Underactive Thyroid) | NIDDK. [online] National Institute of Diabetes and Digestive and Kidney Diseases. Available at: <https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism> [Accessed 18 October 2020].


Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol. 2015;3(4):286-295. doi:10.1016/S2213-8587(14)70225-6