Thyroid hormones are hormones produced by the thyroid gland in the neck. The two main thyroid hormones are triiodothyronine (T3) and thyroxine (T4). These hormones play a crucial role in regulating the body’s metabolism, as well as brain development and function. The thyroid gland produces these hormones in response to signals from the pituitary gland, which releases thyroid-stimulating hormone (TSH) to stimulate the thyroid gland to produce more hormones.
An imbalance in thyroid hormone levels can lead to conditions such as hypothyroidism (too little thyroid hormone) or hyperthyroidism (too much thyroid hormone). It is estimated that women are more likely to develop a thyroid disorder than men
As mentioned, hypothyroidism is when the thyroid gland becomes underactive and produces lesser amount of hormones – T3 & T4. Pituiary gland hence produces more amount of Thyroid Simulating Hormone (TSH) to simulating the thyroid gland. Hypothyroidism is thus characterised by elevated TSH in the Thyroid function test.
‘Hypothalamus – Pituitary – Thyroid’ axis is responsible to regulate the thyroid hormone levels through a series of positive and negative feedback mechanism, making this balance highly complex and delicate.
The thyroid gland can become hypo or underactive for a variety of reasons. Some common causes of hypothyroidism include:
- Hashimoto’s thyroiditis: an autoimmune disorder in which the immune system attacks the thyroid gland, resulting in inflammation and damage to the gland. Presence of TPO Antibodies is checked to detect hashimoto’s
- (Thyroidectomy) Surgical removal of the thyroid gland: Usually done to treat thyroid cancer or other thyroid disorders. This means that the thyroid gland can no longer produce hormones.
- Radiation therapy: Radiation therapy to the neck or head can damage the thyroid gland, leading to hypothyroidism.
- Medications: Some medications, such as lithium, used to treat bipolar disorder, depression etc can interfere with the thyroid gland’s ability to produce hormones.
- Iodine deficiency: Iodine is an essential mineral that is necessary for the production of thyroid hormones. A deficiency of iodine can lead to hypothyroidism.
- Pituitary gland disorders: The pituitary gland releases thyroid-stimulating hormone (TSH) to stimulate the thyroid gland to produce hormones. If the pituitary gland is not functioning properly, it may not release enough TSH to similate thyroid gland, leading to hypothyroidism.
In all these cases, the thyroid gland is not able to produce enough thyroid hormones, leading to an overall slowdown of the body’s metabolism, which can manifest in symptoms such as fatigue, weight gain, cold intolerance and hair loss.
There are several different types of hypothyroidism, based on the underlying cause of the condition:
- Primary hypothyroidism: This is the most common type of hypothyroidism and is caused by a problem with the thyroid gland itself. Examples include Hashimoto’s thyroiditis, surgical removal of the thyroid gland, and radiation therapy.
- Secondary hypothyroidism: This type of hypothyroidism is caused by a problem with the pituitary gland, which is responsible for releasing thyroid-stimulating hormone (TSH) to stimulate the thyroid gland. This can be due to a pituitary tumour, injury, or other disorders.
- Tertiary hypothyroidism: This type of hypothyroidism is caused by a problem with the hypothalamus, which is responsible for releasing thyrotropin-releasing hormone (TRH) to stimulate the pituitary gland to release TSH.
- Congenital hypothyroidism: This is a rare form of hypothyroidism that is present at birth and is caused by a problem with the thyroid gland or the hormones that control it.
- Iatrogenic hypothyroidism: This form of hypothyroidism is caused by medical treatments, such as medications or radiation therapy.
- Subclinical hypothyroidism: This type of hypothyroidism is characterized by normal levels of thyroid hormones but elevated levels of TSH.
Hyperthyroidism is when the thyroid gland become hyper or overactive for a variety of reasons. Pituitary gland thus produces much lesser amount of thyroid simulating hormone (TSH). Here are the reasons for hyper thyroidism –
- Graves’ disease: This is an autoimmune disorder in which the immune system produces antibodies that stimulate the thyroid gland to produce excessive amounts of thyroid hormones.
- Toxoplasmosis: A parasitic infection caused by a protozoan called Toxoplasma gondii. It can cause the thyroid gland to become enlarged and overactive.
- Multinodular goiter: A noncancerous enlargement of the thyroid gland that can cause the gland to become overactive.
- Thyroiditis: Inflammation of the thyroid gland can cause the gland to release stored thyroid hormones into the bloodstream, leading to hyperthyroidism.
- Tumors: Rarely, a tumor on the thyroid gland can cause it to produce excessive amounts of thyroid hormones.
- Excess Iodine: Consuming excessive amounts of iodine can cause the thyroid gland to produce excessive amounts of thyroid hormones.
In these cases, the thyroid gland is producing too much thyroid hormone, leading to an overall speedup of the body’s metabolism, which can manifest with symptoms such as weight loss, anxiety, tremors, rapid heartbeat, and heat intolerance. Treatment for hyperthyroidism may include medications to reduce thyroid hormone production, radioactive iodine to shrink the thyroid gland, and surgery to remove part or all of the thyroid gland.
Medical Treatment (Therapeutic)
Your doctor will prescribe the medicines or course of treatment for hypothyroidism/hyperthyroidism based on the underlying cause, as well as the severity of symptoms.
Treatment for hypothyroidism typically involves taking a daily hormone replacement medication, such as levothyroxine, which is a synthetic form of the thyroid hormone T4. The dosage of levothyroxine will be adjusted to bring the thyroid hormone levels to the normal range and to keep it stable. This treatment is usually lifelong, and regular blood tests are needed to monitor the thyroid hormone levels and adjust the dosage if needed.
Treatment for hyperthyroidism can include:
- Medications to reduce thyroid hormone production: such as methimazole or propylthiouracil. These medications block the production of thyroid hormones by inhibiting the activity of an enzyme called thyroid peroxidase.
- Radioactive iodine: This treatment uses a small amount of radioactive iodine to shrink the thyroid gland and reduce the production of thyroid hormones. This treatment is usually irreversible and may lead to hypothyroidism in future.
- Surgery: This option is typically reserved for patients with large goiters or those who are unable to take medications. Surgery involves removing part or all of the thyroid gland.
Additionally your doctor may also give beta-blockers to control the symptoms of hyperthyroidism such as tremours, rapid heart beat, anxiety and elevated blood pressure. In some cases, steroids also may be used to reduce the inflammation and control the symptoms
Lifestyle Changes for Thyroid Disorders
In general, eating healthy and reducing inflammatory food is important irrespective of it being a hypo or hyper thyroid. Routine exercises and adequate sleep also will improve the over all health and the thyroid function too.
Always go for a balanced diet with a variety of nutrient-dense foods including fruits, vegetables, lean proteins, whole grains, and healthy fats to ensure that you’re getting all the nutrients your body needs to function properly. Avoid processed foods, added sugar and unhealthy fats that can lead to weight gain, inflammation and worsen thyroid disorders.
Diet for Hypothyroidism
- Adequate intake of iodine: Iodine is essential for the production of thyroid hormones, so it’s important to make sure you’re getting enough iodine in your diet. Good dietary sources of iodine include seafood, dairy products, and iodized salt.
- Adequate intake of selenium: Selenium is important for the proper functioning of the thyroid gland and a deficiency in selenium may lead to an increased risk of developing autoimmune thyroid disorders. Good dietary sources of selenium include brazil nuts, fish, seafood, meats, eggs, dairy, and some types of grains.
- Adequate intake of tyrosine: Tyrosine is an amino acid that is needed for the production of thyroid hormones. Good dietary sources of tyrosine include dairy products, meats, fish, nuts, and beans.
- Adequate intake of zinc, iron, and copper: These minerals are important for the proper functioning of the immune system and the production of thyroid hormones.
- Limit goitrogenic foods: Some foods such as cruciferous vegetables, soy, and cassava can interfere with the normal functioning of the thyroid gland. However, moderate consumption of these foods should not be a concern, and cooking them can reduce their goitrogenic effects.
- Avoid processed foods, added sugar and saturated fats: These foods can lead to weight gain, inflammation and can worsen symptoms of hypothyroidism.
- Eating a balanced diet with a variety of nutrient-dense foods: Eating a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats can help ensure that you’re getting all the nutrients that your body needs for its proper functioning.
Diet for Hyperthyroidism
- Limit iodine intake: Hyperthyroidism is often caused by an overproduction of thyroid hormones, and excess iodine can aggravate this condition. It is important to limit the intake of iodine-rich foods such as seafood and iodized salt.
- Limit caffeine and alcohol consumption: These substances can increase the risk of hyperthyroidism and can worsen symptoms such as anxiety, tremors, and heart palpitations.
- Limit high-sugar foods: Consuming high amounts of sugar can cause blood sugar spikes and crashes, which can exacerbate symptoms of hyperthyroidism such as anxiety and irritability.
- Adequate intake of protein: Hyperthyroidism can lead to muscle weakness and weight loss, so it is important to consume enough protein to maintain muscle mass. Good dietary sources of protein include lean meats, fish, eggs, and dairy products.
Food to avoid
Should you avoid certain vegetables and food if you have thyroid disorders? It is best to reduce the goitrogenic food incase of thyroid issues – especially hypothyroid.
Goitrogens are substances that can interfere with the normal functioning of the thyroid gland by inhibiting the production or uptake of iodine by the thyroid. Some examples of goitrogens include:
- Gluten: Gluten, a protein found in wheat, barley, and rye, may cause or worsen the autoimmune thyroid disorders such as Hashimoto’s thyroiditis.
- Soy: Soy products contain compounds called isoflavones that is thought to interfere with thyroid function. Although, this is still a debated topic, it is best to reduce the consumption of soy in you are hypothyroid
- Cruciferous vegetables: Vegetables such as broccoli, cauliflower, cabbage, and Brussels sprouts contain compounds called glucosinolates that can interfere with thyroid function. These compounds can block the absorption of iodine, which is necessary for the production of thyroid hormones. However, it’s important to note that these vegetables are also rich in nutrients, so moderate consumption should not be a concern. Also, cooking cruciferous vegetables (heat) can reduce the goitrogenic compounds and help to make them safe to consume.
- Cassava: Cassava is a root vegetable that is a staple food in many parts of the world. It contains cyanide compounds, which can interfere with thyroid function if consumed in large amounts.
- Goitrogens can also be found in some medications, such as lithium and amiodarone.
It’s important to note that while these foods and substances can interfere with thyroid function, they do not necessarily cause goiter or hypothyroidism. The effect of goitrogens can vary depending on the individual and the amount consumed.
Hypothyroidism & Weight Gain
Thyroid hormones play a crucial role in regulating the body’s metabolism, including how the body converts food into energy. When the thyroid gland is not producing enough hormones, the metabolism slows down, leading to an overall decrease in the number of calories the body burns. This results in the body storing more calories as fat, which can lead to weight gain.
Also Read: How to lose weight?
Other symptoms that can occur with hypothyroidism, such as fatigue and muscle weakness, can also contribute to weight gain by making it harder for people to be physically active and burn calories.
It’s important to note that weight gain is not always a symptom of hypothyroidism, and other factors such as poor diet and lack of physical activity can also contribute to weight gain.
It is hence extremely important to stay active and exercise regularly, to improve the metabolism and also prevent weight gain. A combination of resistance training and cardiovascular exercises, based on the physical conditions of a person is recommended.
Also Read: Will you gain weight, if you stop exercises?
Selenium & Thyroid function
Selenium is a mineral that is essential for the proper functioning of the thyroid gland. Selenium is a component of an enzyme called deiodinase, which is responsible for converting the thyroid hormone thyroxine (T4) into the active form of the hormone, triiodothyronine (T3). This conversion is important for maintaining normal thyroid hormone levels in the body.
Selenium also plays a role in the production of thyroid hormones by the thyroid gland. Selenium is needed for the production of thyroid peroxidase, an enzyme that is responsible for the synthesis of thyroid hormones.
Studies have shown that a deficiency in selenium may lead to an increased risk of developing autoimmune thyroid disorders, such as Hashimoto’s thyroiditis and Graves’ disease, which may lead to either hypo or hyperthyroidism.
Selenium is found in various food sources such as brazil nuts, fish, seafood, meats, eggs, dairy, and some types of grains, and the recommended daily intake of selenium is 55 mcg. However, it’s important to consult with a healthcare professional before taking any selenium supplements, as high doses can be toxic.
Lithium & Thyroid Glands
Lithium is a mostly used as a medication to treat bipolar disorder, but it has also been used to treat other conditions such as depression and schizophrenia. Lithium can affect the thyroid gland by inhibiting the release of thyroid hormones and by altering the levels of thyroid-stimulating hormone (TSH) in the blood.
Long-term use of lithium can lead to hypothyroidism, which is characterized by low levels of thyroid hormones and high levels of TSH. The mechanism by which lithium causes hypothyroidism is not fully understood, but it is thought to be related to its effect on the hypothalamus and pituitary gland, which regulate the release of TSH.
The risk of lithium-induced hypothyroidism is higher in women, older adults, and people who have a history of thyroid disease or are taking other medications that can affect the thyroid gland.
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