Is your thyroid keeping you fat? Myths and facts about thyroid health

By Susan Burke March, MS, RDN, LDN, CD

A low-functioning thyroid is often blamed for weight gain and/or the inability to lose or maintain a healthy weight. Take this quiz to see how much you know about your thyroid and health.

Answer True or False, then check your answers below:

1. Your thyroid gland is located at the base of the skull.
2. The thyroid gland primarily regulates your blood glucose levels and cholesterol.
3. Weight gain and fatigue are often a problem for people with an under-active thyroid gland.
4. Women are only slightly more likely than men to have a thyroid imbalance.
5. The most important nutrient to play a role in healthy hormone function is iodine.
6. The most common cause of under-active thyroid is cancer.
7. Synthetic thyroid hormone is the preferred treatment rather than from animals.
8. If you don’t like to take drugs, you can deal with hypothyroid with a better diet and more exercise.
9. There are some foods that can help or hurt your thyroid.

Answers to the Quiz

1. False: The thyroid is a butterfly-shaped gland that sits low on the front of the neck with two side lobes, connected by a bridge (isthmus) in the middle. When the thyroid is its normal size, you can’t feel it. The pituitary gland, located at the base of the skull, is often dubbed the “master gland” because its hormones control other parts of the endocrine system, namely the thyroid gland, adrenal glands, ovaries, and testes.
2. False: The thyroid gland primarily governs your metabolism and releases hormones that regulate how fast or slowly your organs perform. Too fast – hyperthyroidism – is when your thyroid is overactive and producing excess hormone; too slow – hypothyroidism – is when your thyroid is under-active, producing less than normal thyroid hormone. Click here for a symptom checklist.
3. True: People with an under-active thyroid gland often gain weight and feel tired; the metabolism slows significantly and you retain salt, water, and fat. Besides unreasonable weight gain, symptoms include constipation, dry skin and hair, peeling nails, and muscle cramps. Irregular menstrual symptoms can be associated with hypothyroidism, but is often misdiagnosed.
4. False: It’s estimated that in the US, at least 18 million women and 2 million men have Hashimoto’s thyroiditis, the most common cause of hypothyroidism; by some estimates, only half have been diagnosed. Since it’s much less common in men it is often missed. Read more about men here. Approximately 10% of women over age 30 have Hashimoto’s. You’re more likely to have a thyroid disorder if a family member has the disorder too.
5. True: Iodine is the chief component of the thyroid hormones. In most areas of the world, people get sufficient iodine from their foods and water, but in some areas iodine is added to prevent deficiencies. According to the American Thyroid Association, prior to the1920s, deficiency was common in the Great Lakes, Appalachian, and Northwestern U.S. regions, and in most of Canada. Treatment of iodine deficiency by the introduction of iodized salt has virtually eliminated the “goiter belt” in these areas but iodine deficiency continues to be an important public health problem globally. Approximately 40% of the world’s population remains at risk for iodine deficiency. Since the food additive potassium bromate interferes with the absorption of iodine, The Center for Science in the Public Interest recommends cautionary consumption of brominated vegetable oil and suggests avoiding potassium bromate. You can easily avoid these additives by looking for “bromated flour,” “potassium bromate” or “brominated vegetable oil” in the list of ingredients, especially in commercial breads and sodas.
6. False: Autoimmune conditions are the most common cause of both under- and over-active thyroid; if you have one autoimmune disease you’re a greater risk for others, such as type 1 diabetes. Evidence links type 2 diabetes and hypothyroidism too. Other causes include radiation and/or surgery, certain medications to treat heart problems and cancer, too little iodine, and more. According to WebMD, thyroid cancer is uncommon, and since it’s usually found early, treatments work well. After it is treated, thyroid cancer may come back even years after treatment, so keep on top of it with regular testing.
7. True: According to EdocrineWeb.com, pig-derived thyroid has been replaced by the more consistent, safer and more effective synthetic thyroxine. The great majority of physicians believe synthetic thyroid hormones are the safer treatment option. Animal thyroid hormones, however, can still help manage hypothyroidism for patients who prefer that alternative – read more here.
8. False: Untreated hypothyroidism is quite dangerous – it can lead to goiter (enlargement of the thyroid gland), heart problems, osteoporosis and rheumatoid arthritis, mental health issues, peripheral neuropathy, infertility, birth defects, and more. Untreated over a long period of time, it can result in a life-threatening condition called myxedema. Diet is critical to good health, and exercise is a big plus, but without medical treatment you cannot achieve a normal, healthy life. Read more here.
9. True: Magnesium helps the thyroid do its job. Leafy greens such as spinach and lettuce, and nuts, including cashews, almonds, and pumpkin seeds are excellent sources. Brazil nuts are rich in magnesium and selenium. Seafood is a great source of iodine. However, kale, and other members of the brassica family (broccoli, bok choy, Brussels sprouts, all cabbage, cauliflower, etc.), contain goitrogens, which is an iodine blocker – it is not advised to blenderize and consume mass quantities, especially if you have a low thyroid to begin with. When brassicas are cooked the enzymes involved in goitrogenic materials in plants are at least partially deactivated by heat – so steam or sauté with olive oil. An excess of organ meats (kidneys, liver) could mean its lipoic acid might interfere with thyroid medications. Some studies have shown that soy foods might interfere with the absorption of thyroid supplement, but the MayoClinic.org says that there is no evidence that people with hypothyroidism have to avoid soy completely. Choose whole soy foods like soybeans and tofu, not soy protein isolates. The same guidelines apply to other products that may impair the body’s ability to absorb thyroid medication, including concentrated iron and calcium supplements, and antacids that contain calcium or aluminum hydroxide.

Women’s thyroid function should be tested starting at age 35, then every 5 years afterwards. According to Endocrineweb.com, “In diagnosing hypothyroidism, your doctor will take into account both your symptoms and the results of a thyroid stimulating hormone (TSH) test. In essence, hypothyroidism is the result of diminished levels of thyroid hormones, known as T3 and T4. Your pituitary gland stimulates the release of these hormones into the bloodstream through TSH, so it makes sense that the first line of testing for hypothyroidism is based on your levels of TSH. Your doctor will measure your TSH levels with a blood test.”

Hypothyroidism occurs most frequently in women who are entering menopause, but experts aren’t sure why this group is more susceptible to hypothyroidism. It may be related to fluctuating hormones.

Getting on the right kind of thyroid medication, given at the right dose and at the right time, and taking in in the right way can make a tremendous difference in your symptoms, especially in energy, weight and hair appearance. For example, you cannot take certain other medications at the same time as your thyroid supplement. By taking it with grapefruit (juice or fruit) it is rendered useless. Make sure you doctor knows about all the medicines, herbs, and supplements you take, including over-the-counter products. This is very important!

Things change, so regular blood tests to check your thyroid hormone levels are essential to your continued care. Your doctor may need to adjust your medication and/or dose from time to time.

Resources:

A tireless thyroid patient advocate and personal friend and colleague is Mary Shomon, who writes for About.com – also check out her information and forum on her Facebook page.

How Your Thyroid Works: http://www.endocrineweb.com/conditions/thyroid/how-your-thyroid-works

Causes of Hypothyroidism: http://www.endocrineweb.com/conditions/hypothyroidism/causes-hypothyroidism

Thyroid UK: Hypothyroidism: Signs & Symptoms: http://www.thyroiduk.org.uk/tuk/about_the_thyroid/hypothyroidism_signs_symptoms.html

Hypothyroidism Diagnosis: http://www.endocrineweb.com/conditions/hypothyroidism/hypothyroidism-diagnosis

Top 11 Things You Need To Know About Thyroid Medications: http://www.thyroidpharmacist.com/blog/top-11-things-you-need-to-know-about-thyroid-medications

Foods that Help or Hurt Your Thyroid: http://www.webmd.com/women/ss/slideshow-foods-thyroid

Medical Disclaimer: Our website contains general medical information and is not advice and should not be treated as such. You must not rely on the information on our website as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter, you should consult your doctor or other professional healthcare provider.

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Susan Burke March, a Cuenca expat, is a Registered and Licensed Dietitian, a Certified Diabetes Educator who specializes in smart solutions for weight loss and diabetes-related weight management. She is the author of Making Weight Control Second Nature: Living Thin Naturally—a fun and informative book intended to liberate serial dieters and make healthy living and weight control both possible and instinctual over the long term. Do you have a food, nutrition or health question? Write to me at SusanTheDietitian@gmail.com