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Recently, I was asked about hypothyroidism and weight management. Since this condition is a concern to many, I thought I would pass along my response as an FYI just in case there are others out there with a shared concern.
The thyroid is a small, butterfly-shaped gland located in the front of the neck, which produces thyroid hormones, or chemical messengers, that signal cells throughout the body to increase oxygen use. The two key thyroid hormones are L-triiodothyronine (T3) – the more biologically active thyroid hormone – and thyroxine (T4).
Hypothyroidism occurs when there is an inadequate secretion of thyroid hormones, resulting in a slowing down of the body’s metabolism. While low production of these hormones results in hypothyroidism (an underactive thyroid), high production of these hormones results in hyperthyroidism (an overactive thyroid).
The goals of thyroid hormone replacement therapy are to normalize thyroid hormone levels and to provide symptomatic relief. Although there are several types of thyroid hormone replacement available, not any one type is optimal therapy for everyone. As a result, treatment options may vary from person to person.
The thyroid gland plays a crucial role in regulating weight. Patients with hypothyroidism (a condition in which the thyroid gland does not produce sufficient thyroid hormone) gain weight – in fact, that’s one of the primary symptoms of hypothyroidism.
Thyroid hormone has many effects on the human body; one of its most important roles is in regulating the basal metabolic rate (BMR), the rate at which our bodies expend calories while at rest. If you have a high BMR, you will “burn calories off” at a greater rate than an imaginary friend (call him John) with a low BMR. If you and John weigh the same and eat an identical diet, your weights will diverge. For example, if this diet is very fattening, John will tend to gain more than you will. On a restricted calorie diet, you will lose weight faster than John.
Finding the appropriate dose of medication can be tricky, so a doctor may have to check an individual’s thyroid hormone level frequently (via a simple blood test) in order to tinker with medicinal dosage. If a person is not taking enough medication, they could be hypothyroid, and this would certainly make weight loss challenging. Nevertheless, this is a solvable problem.
Once thyroid hormone levels have stabilized within a normal range, an individual can no longer blame any fat weight gain on a lack of a thyroid gland. Genetics is, arguably, the most important factor in determining the presence or absence of obesity. Habits are certainly important, too.”Eat less, exercise more” has always been good advice for weight loss.
Two other key points: A hypothyroid individual must make a permanent change in his/her habits (with respect to diet and exercise). Weight loss should be gradual so aim for a loss of 0.5 – 1 lb per week. This is an achievable and sustainable target.
Crash diets fail because it is impossible for most humans to maintain such a radical alteration in their dietary habits. Rapid weight loss is treacherous for a number of reasons – one can lose muscle mass (which is definitely counterproductive!) and one’s body can “go into starvation mode,” in which the body clings to calories.
If you have hypothyroidism, you should try to avoid goitrogenic foods as these can act like an antithyroid drug in disabling the thyroid function. They prevent the thyroid from using available iodine. It is made worse if you use a lot of salt because that causes the thyroid to swell. Do not eat these in large amounts if you are taking thyroid hormone replacement. It is thought that the enzymes involved in the formation of goitrogenic materials in plants can be destroyed by cooking, so cook these foods thoroughly if you want to eat them:
• Brussels sprouts, turnips, cauliflower, cabbage
• almonds, peanuts and walnuts
• sweet corn and millet
• soya – this combined with a high fibre diet causes too much thyroid hormone and iodine to be excreted from the body
NOTE: A person should first find out from their doctor if their thyroid hormone level is normal. If there is any doubt, then they need to be tested and your condition taken into account when planning a weight loss strategy.