Navigating Hypothyroidism: What You Need to Know

Inadequate production of thyroid hormone by the thyroid gland results in Hypothyroidism. Another name for this condition is Underactive Thyroid. At first, hypothyroidism might not show any symptoms at all. If left untreated, hypothyroidism can eventually cause heart disease and high cholesterol, among other health issues.

Causes

Iodine deficiency is the primary cause of hypothyroidism, or underactive thyroid, worldwide. Globally, one in three people are considered deficient in iodine. As a result, many get thyroid nodules or goiters, or enlargements of the thyroid.

A study published in Endocrine Reviews found that whereas iodine insufficiency is frequent in Africa and South Asia, it is also mildly inadequate in 50% of the European population.

Because they regularly consume seaweeds like wakame (undaria), nori (porphyra), and kombu (laminaria), people in Japan typically consume more iodine than people in other countries. It serves as a preventive measure.

An autoimmune attack on the thyroid gland is the second most common cause of an underactive thyroid. In this case, the thyroid gland is attacked by specific antibodies, which prevents the thyroid from producing enough T4 thyroid hormone. Hashimoto’s thyroiditis is the most frequent autoimmune disease.

Adequate thyroid production can also be hindered by stress, trauma, infection, exposure to pesticides, fluoride, and celiac disease.

Other individuals may also be at higher risk such as the following:

• Pregnant women
• Women older than 60 years
• Patients with type 1 diabetes or other autoimmune disease
• Patients with a history of neck irradiation/ radiotherapy

Signs and Symptoms

Fatigue and weight gain are two signs of hypothyroidism that you might not even notice at first. Or you may think they are just part of getting older. However, if your metabolism slows down further, you can experience more noticeable issues.

Symptoms of hypothyroidism can include:

•     Tiredness
•     More sensitivity to cold
•     Constipation
•     Dry Skin
•     Weight gain
•     Puffy face
•     Hoarse voice
•     Brittle or thinning hair
•     Muscle weakness
•     Muscle pain, soreness and joint stiffness
•     Irregular or heavier than normal menstrual periods
•     Bradycardia or a slowed heart rate.
•     Depression   
•     Impaired Memory

How to Diagnose Hypothyroidism

Thyroid-stimulating hormone (TSH) assays are often the most sensitive test for detecting primary hypothyroidism.  The next step is to test free thyroxine (T4) or the free thyroxine index (FTI), which acts as a proxy for the free hormone level.

The following outcomes are seen in hypothyroidism patients:

• High TSH accompanied by low T4 or FTI
• Mild or subclinical hypothyroidism is defined as elevated TSH (often 4.5–10.0 mIU/L) with normal free T4 or free thyroid index.

Managing Hypothyroidism

Preventing the clinical progression of hypothyroidism and addressing metabolic disturbances are the main objectives of treatment, by maintaining normal blood levels of free thyroxine (T4) and thyroid-stimulating hormone (TSH).

Generally, Levothyroxine (LT4) (Synthroid), at a regular daily dose is sufficient to treat hypothyroidism.

Managing  Symptoms Naturally

Nutrition and Supplements for Healthy Thyroid Function

According to a 2017 study, those who consumed more fruits, vegetables, and seeds had a decreased risk of thyroid disease caused by autoimmune factors. This kind of diet also promotes balance and the health of  the microbiome in the intestines.

The synthesis of thyroid hormones is aided by the following vital nutrients.

Selenium

A cofactor for two enzymes that aid in the production of thyroid hormones. Selenium is also required for the conversion of T4 into T3, the active hormone. About 200 mcg dose per day is advised.

Iodine

A diet high in iodine is recommended. Some people consume kelp or iodine supplements to help keep their iodine levels in check. A daily intake of at least 150 mcg of iodine is recommended. Dosages over 500 mcg per day have to be avoided. Iodine overuse may make thyroid conditions worse.

Iron

Menstruating women are more likely to be iron deficient. Thyroid metabolism is hampered by iron shortage.  In order to replenish any iron deficit, experts advised measuring iron levels. The objective should be to reach a normal ferritin level ranging from 12 to 300 ng/ mL (males) or 12 to 150 ng/mL (females).  For recommended dosage of iron supplements, follow your doctor’s instructions or the directions listed on the package.

Vitamin D

Worldwide, the prevalence of vitamin D insufficiency is 80%. Research has indicated that low levels are associated with a higher risk of thyroid autoimmune diseases as well as a number of malignancies and autoimmune disorders. According to a 2018 study, those who have lower vitamin D levels are more likely to get Hashimoto’s thyroiditis. The recommended daily dosage for supplements is 1,000-5,000 IU.

Zinc

Globally, more than 15 percent of individuals are zinc deficient.

The body’s ability to absorb vital minerals like zinc might decline with age.  Chronically low zinc levels can also be caused by habitual alcohol consumption or inadequate dietary intake of foods high in zinc. Zinc deficiency is linked to blood, skin, and thyroid problems as well as an elevated risk of infection. The health of the brain, where zinc levels are ten times higher than in the blood, is another vital function of zinc.

The following essential nutrients must be included in one’s diet in addition to the ones listed above for a healthy thyroid. Taking a B-complex supplement is another way to get the B vitamins.

•     Tyrosine
•     Vitamin B2 (riboflavin)
•     Vitamin B3 (niacin)
•     Vitamin B6 (pyridoxine)
•     Vitamin C (ascorbic acid)
•     Vitamin E (tocopherol)

Lifestyle Strategies to Better Manage Underactive Thyroid

Stress as well as a lack of exercise aren’t favourable for anyone’s overall wellness. Ignoring healthy lifestyle practices can exacerbate hypothyroid symptoms, such as depression, sluggish metabolism, and fatigue.

Reducing the symptoms of stress and depression requires self-care. You might try yoga or meditation for extra benefits.

Don’t forget to exercise either. At least 150 minutes of cardio per week is recommended, especially in maintaining one’s weight. Whether you’ve never worked out before or haven’t been active in a long time, the secret is to begin slowly with any fitness program. Some low-impact, energy-boosting regimens, like tai chi or leisure swimming, may also be helpful.

References:

Pub Med Central. The History and Future of Treatment of Hypothyroidism. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980994/

Mayo Clinic. Hypothyroidism (Underactive Thyroids). https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

Endocrine Reviews. Iodine Deficiency. https://academic.oup.com/edrv/article/30/4/376/2355070

Medscape. Hypothyroidism. https://emedicine.medscape.com/article/122393-overview?form=fpf

American Thyroid Association. Complementary and Alternative Medicine in Thyroid Disease (CAM).  https://www.thyroid.org/thyroid-disease-cam/