While living with a fast-paced less healthy lifestyle, stressful competitive demands, personal and financial insecurity, higher exposure to a toxic environment, and an unstable anxious mind make us more prone to autoimmune diseases. This becomes more detrimental when one of the crucial glands of the body, the thyroid gets affected. Thyroid disease is triggered by the immune system, initiating an attack on its molecules due to the deterioration of immunologic tolerance to auto-reactive immune cells. Abnormality in the fine balance of the thyroid gland disrupts the entire body system, like body temperature control, vital organ functioning and metabolism.
What is hypothyroidism?
It is characterized by low levels of thyroid hormones T3 and T4 leading to a slowdown in thyroid-controlled functions of the body. In subclinical hypothyroidism, T3 and T4 levels are normal but TSH (Thyroid-stimulating hormone) concentration increases with or without non-specific symptoms. To be specific TSH raised above 5-6 mU/L is considered an abnormal condition. Hypothyroidism affects up to 7% of the general population.
Overt hypothyroidism is present in 0.1-2% of all adults, with 15% of older women meeting the criteria for subclinical hypothyroidism. Worldwide, iodine deficiency is the most common cause of hypothyroidism. The second leading cause of hypothyroidism includes situations like surgery, medications, or radiation. Because the thyroid affects many different physiologic processes in the body, the clinical signs of hypothyroidism are variable from one individual to another.
Some patients present with mild symptoms despite having low levels of circulating thyroid hormones, while some patients have more significant symptoms despite only mildly abnormal lab testing. Thyroid diseases are caused by an abnormal immune response to autoantigens present in the thyroid gland. Thyroid problems seem to be more prevalent these days with an increase in the number of cases of thyroid cancer.
Known and unknown symptoms
Hypothyroidism develops slowly, so many people don’t notice symptoms of the disease.
- Unexplained fatigue and tiredness
- Weight gain
- A puffy face
- Cold intolerance
- Joint and muscle pain
- Dry skin
- Dry, thinning hair
- Decreased sweating
- Heavy or irregular menstrual periods and impaired fertility
- Slowed heart rate
- Frequent infections
- Stumbled slow speech
- Nausea and loss of appetite
- Increases risk of high cholesterol level
Which are the risk factors?
Women are more prone to thyroid disorders. It is mostly due to the female hormones such as oestrogen, progesterone and prolactin which influence the different aspects of immune system functions.
Active and passive smoking-
it is one of the potential risk factors for thyroid disease. Smoking causes tissue damage and increases cell destruction through the high production of free radicals and provokes inflammation.
Heavy metal contamination-
Heavy metals such as mercury, cadmium, lead, arsenic, nickel, and other metals can stimulate antibodies which leads to thyroid diseases. Mycotoxins produced by heavy metals ruin the immune system. In addition, chemical toxins such as pesticides, industrial chemicals, hair dyes and some household cleaners can also be linked to thyroid diseases.
Gluten contributes to thyroid disease in three ways. First, it is the primary cause of a leaky gut. Second, gluten is highly inflammatory, and it stresses the immune system. Thirdly, the gluten protein has a similar chemical structure to some thyroid tissues, which can lead to molecular mimicry, where the body mistakes thyroid tissues for gluten and attacks it.
Stress affects the immune system either directly or indirectly through the nervous and endocrine systems. Stressful situations cause the body to release cortisol and activate an acute phase response, which is a part of the innate immune inflammatory response. To maintain homeostasis during stress, activation of the hypothalamic-pituitary-adrenal system leads to increased secretion of glucocorticoids and catecholamines, respectively. The neuroendocrine hormones triggered during stress lead to immune dysregulation, resulting in thyroid disease. Stress also prevents the body from healing itself and encourages more of an autoimmune inflammatory response.
How does nutrition affect thyroid function?
Dietary intake, as well as lifestyle and environmental factors, play a huge role in overall wellness. Diet and lifestyle factors formed a key component in the overall treatment of a patient with thyroid diseases. Many nutritional factors play a role in optimizing thyroid function. However, both nutrient deficiencies and excesses can trigger or exacerbate symptoms. Working in collaboration with a physician is ideal to determine nutritional status for optimal thyroid health. Dietary interventions improve the symptoms of autoimmune thyroid dysfunction and may eliminate the symptoms and the disease. Timely early hypothyroidism detection, following a freshly prepared simple diet of minimally processed foods and consuming adequate amounts of thyroid-supportive nutrients is the essential remedy for hypothyroidism therapy along with medication.
What are the thyroid-supportive nutrients?
- Vitamin D -fatty fish, fish oil and chicken eggs
- Vitamin B12 -meat, fish, chicken eggs, wholegrain cereal products
- Vitamin A- carrot, pumpkin, liver, spinach, egg yolk, butter, and dried apricot
- Vitamin C-black currant, kiwi, strawberry, orange, mango, lemon, melon, kale, spinach, tomatoes, peppers, vegetables, and fruit
- Vitamin E- avocado, fish oil, whole-grain cereal products, and vegetable oils
- Magnesium- bitter chocolate, pumpkin seeds, avocado, nuts, whole-grain cereal products, some fatty fish (salmon), green vegetables and yoghurt
- Zinc- yoghurt, pumpkin seeds, nuts, spinach, mushrooms, and whole-grain cereals
- Iron -spinach, sardines, seafood, pumpkin seeds
- Iodine-iodized salt, fish (cod, tuna) and seafood as well as seaweed, iodized milk, and dairy products
- Selenium-Brazilian walnut, fish (sardines, halibut, salmon, tuna) and spinach
- Good fats- olive oil, avocado oil, avocado, rapeseed oil, walnut oil or walnuts, and seafood
- High-quality protein- low-fat fish and chicken, dairy products, lentils, nuts, seeds, eggs
- Increase the intake of soluble fibre from fresh fruits and vegetables to prevent constipation
- Limit the consumption of processed products, including sweets, chilled beverages and other sources of sucrose or simple sugars
- In case of gluten intolerance eliminate gluten
- Adopt a diet that restricts food allergens
- Have 30 min to a one-hour gap between thyroid medication and meals
What to avoid or limit?
- Soy – Inhibits thyroid enzyme activity. Source: Soy protein, peas, and beans.
- Cyanogenic glycosides- Promote iodine deficiency and hypothyroidism. Source: Cassava, sorghum, maize, and millet
- Gluten- Associated with autoimmune thyroid disease. Source: Wheat, rye, barley, spelt, and non-gluten-free oats
- Isothiocyanates- Interferes with iodine uptake and enzyme activity in the thyroid gland. Source: Cabbage, broccoli, kale, cauliflower, turnips, and mustard
What is the physical activity advice?
Engage in regular physical activity to improve thyroid hormone levels. Physical activity needs may vary based on age and other factors. Refer to the physical activity potential and consult the healthcare provider for a customized plan.
How to handle stress?
Reducing stress increases cortisol levels and decreases stress-induced thyroid imbalance. Learn to recognize signs of stress symptoms, such as low energy, changes in mood, and difficulty sleeping. Incorporate stress-reduction techniques which incorporate positive mindfulness, like yoga, meditation, reading books and listening to light music. Try to set realistic goals to reduce overwhelm. Interact with family, friends, loved ones and like-minded people not only virtually but physically also.
There is no cure for hypothyroidism, and most people have it for life. No universal diet exists for patients with diseases of the endocrine system. Over time, hypothyroidism may become severe, and the thyroxine dose may change. One must make a lifetime commitment to treatment, medication, doctors’ advice, and lifestyle modifications to keep hypothyroidism completely controlled throughout their life. For early detection and keeping regular analysis of thyroid levels, annual health check-ups and blood tests are important. With serious dedication and adherence, it is possible to see the positive synergic effects of a healthy diet and healthy lifestyle factors in addressing thyroid disease.
- J Nutr Disorders Ther 2018, 8:1
- Acta Scientific Nutritional Health 3.4 (2019): 28-30
- Annals of Agricultural and Environmental Medicine 2020, Vol 27, No 2
- Rom J Diabetes Nutr Metab Dis,2020; volume 27, issue 4, pages 381-385