Caitlin Johnson, RD, CLT
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Hypothyroidism

12/16/2016

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The thyroid gland is a 2-inch butterfly shaped organ located at the front of the neck. This is often times the gland a physician is checking during an exam when they are touching your neck. It is small in size compared to other organs, however it is a major command center in terms of hormone health and metabolic health. It affects nearly every organ in the body. It helps to regular fat and carbohydrate metabolism, breathing, body temperature, brain development, blood calcium levels, menstrual cycles, skin, integrity, cholesterol levels, and MORE.

The thyroid gland is often one of the big players wreaking havoc in my patients’ bodies as an underactive thyroid has a profound impact on the ability to lose weight. It is an important organ to pay attention to as those with underactive thyroids are at an increased risk of heart disease and diabetes. 27 million americans have one form or another of thyroid disease. The most common condition being hypothyroidism, or an underactive thyroid. In the US this is most commonly caused by an autoimmune response known as Hashimoto’s disease. Essentially, your body creates antibodies that target the thyroid and decrease thyroid function significantly. Other conditions include hyperthyroidism (overactive), goiters (not enough iodine intake), or thyroid cancers. Since hypothyroidism is the most common we will focus on lifestyle and nutrition factors that can help an individual with hypothyroidism.

How do I know if I have an underactive thyroid?
This requires blood testing and is a diagnosis your physician will provide for you. Often physicians will check TSH (thyroid stimulating horomone), T3 and T4 levels. I always recommend a patient ask their physician to also check for the thyroid antibodies such as TPO antibody, Anti thyroid globulin antibodies and thyroid stimulating immunoglobulin. Often times if the thyroid is underperforming, there is a link to adrenal function so checking DHEA-S and cortisol levels is helpful. If your physician is ordering labs, ask them to include these adrenal markers as well.

What symptoms accompany an underactive thyroid?
  • Dry skin
  • Fatigue
  • Cold intolerance (chronically cold hands and feet)
  • Hair loss
  • Concentration problems
  • Constipation
  • Weight gain and difficulty with weight loss
  • Menorrhagia – painful menses
  • Elevated LDL cholesterol
  • Muscle cramps/weakness
  • Infertility
  • Depression

Potential causes of hypothyroidism
Inflammation that goes haywire causing an immune response that leads to an attack on your bodies own organ.
Poor diet
Leaky gut syndrome
Genetics
Pregnancy (causes postpartum thyroiditis)
Certain medication interactions
High levels of stress (persistent)
Toxic burden (heavy metals)

What medications will a physician prescribe?
Typically the first line of treatment is with a synthetic drug called synthroid. This supplies only T4. Many, many people are on this drug and see some benefits in symptoms and ability to lose weight, increased energy levels, etc. There are more “natural” forms of medication, the most popular is called Armour, it is sourced from porcine (pig) thyroid glands. It contains both T4 and T3 in a ratio more similar to what a human produces. It is worth asking your physician why they prescribe one over the other. Most will not even consider Armour. 

Lifestyle and diet are two of the biggest factors that contribute to healing your thyroid, and if healing it is no longer available, we can support it allowing the most optimal functioning.

Let’s consider lifestyle factors first.
SLEEP MORE, aim for at least 8 hours of sleep at night. I know this sounds like a lot, but your body needs it when your thyroid is underperforming. It will allow for optimal healing.
AVOID STIMULANTS, caffeine in any form is best to be avoided. If you can’t avoid it, I recommend choosing a green tea, so that you get the antioxidant benefits.
MOVE YOUR BODY, but not too much. Choose gentle exercise activities until your medication and stress levels are lowered. Try longer low impact walks or an activity like yoga.
Be patient with yourself and inform your family members what you are dealing with so they can be patient and understanding with you too.

Food and Nutrition
You can do a lot in terms of supporting your thyroid with the right food. Let’s get down to it.

AVOID EXCESS SUGAR. I am serious. Your body doesn’t need it, and your immune system most importantly, doesn’t need it. Cut out cakes, cookies, candy, soda, sugary coffee beverages, etc. A little maple syrup in the oatmeal is fine, but really, take this seriously. It’s the most important food choice to help you recover.

COOK CRUCIFEROUS VEGETABLES (goitrogenic foods). Your body needs iodine for optimal thyroid function, however these vegetables in the raw form have an incredible ability to block iodine from being absorbed. To combat that, cook these vegetables. Broccoli, Kale, Cauliflower, Brusell sprouts, Bok Choy, Kohlrabi, Mustard and Mustard greens, Cabbage. If you are one to add greens to your smoothie, choose something other than Kale, like spinach or arugula.

ADD SEA VEGETABLES OR NATURAL SEA SALT. This will help increase your mineral and iodine intake.

CHOOSE ORGANIC PRODUCE WHEN POSSIBLE. These have higher levels of trace minerals and significantly lower levels of pesticides, which are known endocrine disruptors.

INCORPORATE FOODS RICH IN TRACE MINERALS AND VITAMINS YOUR THRYOID NEEDS TO CREATE THRYOID HORMONE AND CONVERT FROM T4 to T3.
                ZINC: red meat, poultry, beans, nuts, seafood
                VIT E: liver, eggs, nuts, seeds, sweet potatoes and avocados
                B2, B3, B6: meat, seafood, green vegetables, mushrooms, eggs, almonds
                Selenium: brazil nuts
                Vit C: veggies and citrus

STICK TO WHOLE FOODS. Avoid processed foods as much as possible. Choose fruits and vegetables as snacks throughout the day with a handful of nuts.

What about supplementation?
There are some antioxidants that research has shown improve thyroid function, they include vit C, vit E, turmeric(curcumin) and glutathione. There is a place for supplementation with thyroid issues. However, it’s important to seek the help of a qualified professional. For instance, if you have Hashimoto’s you do not want to supplement with iodine, it can increase the rate of thyroid destruction. This is not the condition to play around with, I would not consult the vitamin clerk at your local healthfood store, speak with a physician or dietitian to get evidence based, proven solutions.
​
If you suspect Hashimoto’s you most likely have leaky gut and would benefit from food sensitivity testing and an immunocalm diet. You would also consider as a first line of defense, decreasing gluten in your diet as it has been shown to affect hashimoto’s thyroiditis.
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    Caitlin Johnson is a dietitian, wife, lover of ice cream, chef wannabe, California-girl, Christian, liver eating, "food-avore." 

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