Understanding the Misunderstood Thyroid

The thyroid is a small, butterfly-shaped gland located in your lower neck. It has enormous responsibility for the body’s metabolic processes. Specifically, it releases two primary hormones — triiodothyronine (T3) and thyroxine (T4) — that control metabolism.

When working properly, the T3 and T4 hormones travel through our bloodstream and help cells get energy from the food we eat. Thyroid hormones are also responsible for helping to regulate our body temperature and blood calcium levels, helping with growth and development and, during infancy, brain development.

For an estimated 27 million Americans, however, the thyroid produces either too much or too little hormone, which causes an array of health symptoms, some severe. But because thyroid disease is often misdiagnosed or simply overlooked, it’s estimated that more than half of affected Americans don’t know they have a problem.

Women are much more likely to have thyroid problems than men, and may have up to a one in five chance of developing thyroid problems during their lifetime. The risk increases with age and family history, as well as having an autoimmune disease or a close relative with one; through radiation exposure; by going through menopause or perimenopause; or following childbirth.

Understanding common thyroid disease

Hypothyroidism (an underactive thyroid) accounts for the majority of thyroid disease cases. This condition occurs when our body produces too little thyroid hormone, leading to symptoms such as

  • Fatigue and general sluggishness
  • Unexplained weight gain
  • Dry skin
  • Increased sensitivity to cold
  • Constipation
  • Pain, stiffness or swelling in joints
  • Achy muscles and muscle weakness
  • Heavy menstrual periods
  • Depression
  • Elevated blood cholesterol level
  • Puffy face
  • Brittle hair and nails

If left untreated, hypothyroidism can lead to obesity, joint pain, infertility, goiter (thyroid enlargement) and heart disease, but because the symptoms can mimic other diseases, or even be attributed to aging, many people do not realize the thyroid connection. Further, the symptoms may be mild at first, becoming increasingly severe only after a number of years, making them easy to overlook.

In the United States, hypothyroidism is most often the result of an autoimmune disease called Hashimoto’s thyroiditis, which causes our immune system to attack and destroy the thyroid. It’s thought that a virus, bacteria, genetics or a combination of environmental factors may contribute to Hashimoto’s. Worldwide, however, hypothyroidism is most often caused by an iodine-deficient diet.

Other less common causes of hypothyroidism include radiation therapy used to treat head and neck cancers, thyroid surgery, certain medications, pregnancy, pituitary gland disorder, or congenital issues. A blood test that measures our levels of thyroid-stimulating hormone (TSH) is typically used to diagnose hypothyroidism, and treatment usually involves taking a synthetic or natural thyroid hormone daily.

With hyperthyroidism, our body produces too much thyroid hormone, leading to symptoms such as:

  • Weight loss
  • Nervousness, anxiety and irritability
  • Increased perspiration
  • Racing heart
  • Hand tremors
  • Difficulty sleeping
  • Increased bowel movements
  • Fine, brittle hair
  • Muscle weakness, especially in the upper arms or thighs

Most often, hyperthyroidism is caused by an autoimmune disorder called Graves’ disease, in which our immune system produces antibodies that stimulate our thyroid, causing it to produce too much T4 hormone. The exact cause of Graves’ disease is unknown, however it’s suspected that severe emotional stress may trigger the illness in some people. Family history may also be a factor.

A TSH blood test can typically diagnose hyperthyroidism, and the condition is usually treated with anti-thyroid drugs that block the gland’s ability to produce thyroid hormone, surgery, or radioactive iodine, which destroys overactive thyroid cells.

What to eat for improved thyroid health

As with virtually every bodily function, our diet plays a role in the health of our thyroid. There are some specific nutrients that our thyroid depends on and it’s important to include them in our diet:

Iodine: Our thyroid contains the only cells in our body that absorb iodine, which it uses to make the T3 and T4 hormones. Without sufficient iodine, our thyroid cannot produce adequate hormones to help our body function on an optimal level.

Iodine deficiency is typically not widespread in the United States because of the prevalent use of iodized salt. However, according to a nutrition evaluation conducted by the CDC, up to 36 percent of women of childbearing age may not get enough iodine from their diets, and it’s thought that iodine deficiency is on a slow but steady rise.

Because iodized salt is heavily processed, some recommend avoiding iodized salt and instead getting iodine naturally from sea vegetables (seaweed), such as hijiki, wakame, arame, dulse, nori, and kombu. Too much iodine can actually trigger thyroid problems and worsen symptoms, so it’s important to have a healthy balance.

Selenium: This mineral is critical for the proper functioning of our thyroid gland, and is used to produce and regulate the T3 hormone. Selenium can be found in foods such as shrimp, snapper, tuna, cod, halibut, calf’s liver, button and shitake mushrooms and Brazil nuts.

Zinc, Iron and Copper: These metals are needed in trace amounts for healthy thyroid function. Low levels of zinc have been linked to low levels of TSH, whereas iron deficiency has been linked to decreased thyroid efficiency. Copper is also necessary for the production of thyroid hormones. Foods such as calf’s liver, spinach, mushrooms, turnip greens and Swiss chard can help provide these trace metals in your diet.

Omega-3 Fats: These essential fats, which are found in fish or fish oil, play an important role in thyroid function, and many help our cells become sensitive to thyroid hormone.

Coconut Oil: Coconut oil is made up of mostly medium-chain fatty acids, which may help to increase metabolism and promote weight loss, along with providing other thyroid benefits. This is especially beneficial for those with hypothyroidism.

Antioxidants and B Vitamins: The antioxidant vitamins A, C and E can help our body neutralize oxidative stress that may damage the thyroid. In addition, B vitamins help to manufacture thyroid hormone and play an important role in healthy thyroid function.

There are certain foods that should be avoided to protect thyroid function. These include:

Aspartame: There is concern that the artificial sweetener aspartame, sold under the brand name Nutrasweet, may trigger Graves’ disease and other autoimmune disorders in some people. The chemical may trigger an immune reaction that causes thyroid inflammation and thyroid autoantibody production.

Non-fermented soy: Soy is high in isoflavones, which are goitrogens, or foods that interfere with the function of your thyroid gland. Soy, including soybean oil, soy milk, soy burgers, tofu and other processed soy foods, may lead to decreased thyroid function. Fermented soy products, including miso, natto, tempeh and traditionally brewed soy sauce, are safe to eat, as the fermentation process reduces the goitrogenic activity of the isoflavones.

Gluten: Gluten is a potential goitrogen and can also trigger autoimmune responses (including Hashimoto’s thyroiditis) in people who are sensitive. Gluten is found in wheat, rye and barley, along with most processed foods.

The isothiocyanates found in cruciferous vegetables like broccoli, cauliflower, cabbage and Brussels sprouts are goitrogens as well. While it’s true that large amounts could interfere with thyroid function, especially if eaten raw, these veggies offer a myriad of other health benefits that make the benefits outweigh the risks for most people. If you know you have thyroid disease and want to be especially careful, steaming these vegetables will negate the goitrogenic effect, making them a healthy addition to your diet.

If you suspect you have thyroid disease, you should visit your health care practitioner for a full thyroid hormone panel. In fact, even if you don’t suspect you have a problem it’s a good idea to get tested as part of your regular checkups.

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