Nutrition for patients with hypothyroidism

16/02/2024

Partial or complete removal of the thyroid gland is an effective treatment for people with thyroid disorders, however, patients will be at high risk of developing hypothyroidism, accompanied by a number of possible symptoms that may affect the patient’s health and life.

In addition to complying with treatment regimens, patients can adjust their nutritional regimen to reduce complications and improve quality of life.

Hypothyroidism and changes in the patient’s body

The thyroid is an important butterfly-shaped endocrine gland located at the bottom of the neck. The thyroid gland’s job is to make thyroid hormones, which are secreted into the blood and then transported to every tissue in the body. Thyroid hormones T4 and T3 allow the body to use energy, increasing basal metabolic rate; regulates lipid synthesis and breakdown to help maintain a stable weight; Stimulates glucose metabolism and regulates blood sugar; Supports growth and maintains normal functioning of other organ systems such as the nervous system and reproductive organs[1]

If for some reason, the thyroid gland becomes less active, the amount of thyroid hormone in the blood is low due to insufficient amount hormones produced to keep physiological activities in the body functioning normally, this condition, according to the American Thyroid Association, is called hypothyroidism. Some common causes of hypothyroidism include iodine deficiency, autoimmune diseases such as Hashimoto’s thyroiditis, or thyroid surgery or radiation therapy to remove the thyroid gland. People with hypothyroidism will experience symptoms such as fatigue, hair loss, weight gain, constipation, poor cold tolerance, and mood swings.

People with hypothyroidism may experience symptoms that greatly affect their health (Pic: Freepik)

In addition, people with hypothyroidism also face the risk of hypocalcemia[3]. To treat and relieve symptoms of hypothyroidism, in addition to medication, dietary and lifestyle modifications could be efficient in reducing certain symptoms and improving overall quality of life in people with hypothyroidism.

Recommended nutritional regimen for patients with hypothyroidism

Many studies have shown that dietary changes can provide benefits for people with hypothyroidism including improving thyroid function, maintaining a healthy weight, and easing other symptoms of hypothyroidism. .

The thyroid gland is the organ most affected by autoimmune processes, a condition that arises when the body’s defenses confuse foreign invaders with the body’s own cells, thereby attacking these healthy body cells. Therefore, nutritional regimes such as a gluten-free diet, a diet that eliminates factors that cause autoimmune reactions, allergies or an anti-inflammatory diet are suitable diets for people with hypothyroidism, especially especially for patients with Hashimoto’s thyroiditis, the regime may help patients reduce drug dependence, slow down the disease process and relapse[5]. For people with hypothyroidism experiencing symptoms of unusual weight gain, a diet that limits calorie intake is also effective in helping patients control their weight more easily. 

Recommended nutritional regimen for patients with hypothyroidism (Pic: Freepik)

In addition, hypothyroidism patients should pay attention to nutritional supplements because deficiencies of some micronutrients such as iodine, selenium, calcium, and vitamin D make some symptoms of hypothyroidism more severe.

– Iodine deficiency: According to the American Thyroid Association, Iodine is an essential mineral needed to make thyroid hormones and an iodine deficiency can lead to hypothyroidism. This is also the most common cause of hypothyroidism worldwide. Therefore, iodine supplementation is a good supplement for patients during the treatment of hypothyroidism. In a 2011 study by Takako Takeuchi and colleagues, iodine supplementation of about 200 – 400 µg/day was effective in restoring thyroid function and reducing I- Urine to normal range. Thus, people with hypothyroidism have to pay attention to supplementing with iodine-rich food sources such as seaweed, seafood, aquatic products, eggs, dairy products or iodized salt.

– Selenium: According to the European Food Safety Authority EFSA, Selenium is also an essential mineral for thyroid health and thyroid hormone production by protecting the thyroid from damage caused by oxidative stress, hence, supplementing enough Selenium according to recommended needs is extremely important for thyroid health. In a 2022 study, supplementing 100 µg of Selenium/day in hypothyroid patients was effective in improving thyroid function, enhancing immunity and improving patient quality of life through mechanism of decreased gamma interferon levels and increased interleukin-1β levels.

– Calcium: After undergoing surgery to completely remove the thyroid gland, the patient will experience hypocalcemia with symptoms such as muscle spasms, numbness in the limbs, weak and brittle nails, and poor memory, hallucinations… Therefore, it’s necessary for patients to be promptly supplemented with calcium to prevent complications due to hypocalcemia. In a study in the journal The Oncologist of Oxford Publishing, patients undergoing thyroidectomy were supplemented with 3g of oral calcium/day for 2 weeks after surgery to help reduce hypocalcemia. 

People with hypothyroidism should supplement foods rich in calcium to prevent complications due to hypocalcemia (Pic: Freepik)

– Vitamin D: Thyroid surgery patients are also at high risk of Vitamin D deficiency in the blood due to poor absorption of Vitamin D in these subjects, and their bodies do not properly activate Vitamin D from the precursor of Vitamin D. Vitamin D deficiency also causes patients to experience symptoms similar to hypocalcemia such as muscle pain and cramps as Vitamin D plays an important role in supporting calcium absorption from the intestines into the blood and blood into bones. Vitamin D also plays an important role in the production of thyroid hormones. Therefore, hypothyroid patients after thyroid removal treatment need to supplement Vitamin D. In a clinical study conducted on 201 hypothyroid patients aged 20 – 60 in India, after 12 weeks of interventional treatment, the group of patients supplemented with 50,000 IU of Vitamin D had higher thyroid hormone and blood calcium levels than the group using placebo.

Vitamin D also plays an important role in the production of thyroid hormones

– In addition, patients also need to pay attention to supplementing enough micronutrients of great significance to the thyroid such as Magnesium, Iron, Zinc, Vitamin A and Folate to maintain thyroid health as well as general health.

– At the same time, a soft, liquid, easy-to-swallow, and easy-to-digest diet that provides adequate essential nutrients to help restore health and thyroid function is essential. Therefore, nutritional milk is considered a food that meets the “criteria” that thyroid cancer patients should use during and after treatment. Currently, on the market, Leanpro Thypro and Leanpro Thyro LID are two specialized nutritional products of Nutricare for thyroid cancer patients that are trusted by experts and patients. Each type of product is suitable for patients at different periods. In which:

  •     Leanpro Thyro LID: This product has had up to 88% of its iodine content removed and is supplemented with Calcium, Omega-3, Magnesium, and Vitamin B6, so it is suitable for people with thyroid cancer before radioactive iodine I-131 treatment.
  •     Leanpro Thypro: Product that supplements Iodine and Selenium with appropriate levels to help regulate thyroid hormones, rich in Calcium to regulate blood calcium, EPA and DHA to help reduce inflammation, fiber to improve absorption, so suitable for patients Thyroid cancer after surgery, after radioactive iodine treatment.

Thus, besides treating hypothyroidism with medication, patients can also improve their nutrition by energy adjustment, macronutrients and micronutrients such as Iodine, Selenium, Selenium, Calcium, Vitamin D, and additional specialized nutritional products to alleviate symptoms caused by hypothyroidism and improve quality of life.

References:

1. Shahid, Muhammad & Sharma, s. (2018). Physiology, Thyroid Hormone.

2. https://www.thyroid.org/hypothyroidism/

3. Patil N, Rehman A, Jialal I. Hypothyroidism. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

4. Shahid MA, Ashraf MA, Sharma S. Physiology, Thyroid Hormone. [Updated 2023 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

5. Modi, Anuj S and Nita Sahi. “Effect of thyroid hormones on serum calcium and phosphorous.” International Journal of Clinical Biochemistry and Research (2018): n. pag.

6. Abbott RD, Sadowski A, Alt AG. Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis. Cureus. 2019 Apr 27;11(4):e4556. doi: 10.7759/cureus.4556. PMID: 31275780; PMCID: PMC6592837.

7. Danailova Y, Velikova T, Nikolaev G, Mitova Z, Shinkov A, Gagov H, Konakchieva R. Nutritional Management of Thyroiditis of Hashimoto. Int J Mol Sci. 2022 May 5;23(9):5144. doi: 10.3390/ijms23095144. PMID: 35563541; PMCID: PMC9101513.

8. Ostrowska L, Gier D, Zyśk B. The Influence of Reducing Diets on Changes in Thyroid Parameters in Women Suffering from Obesity and Hashimoto’s Disease. Nutrients. 2021 Mar 5;13(3):862. doi: 10.3390/nu13030862. PMID: 33808030; PMCID: PMC8000220.

9. Takeuchi T, Kamasaki H, Hotsubo T, Tsutsumi H. Treatment of Hypothyroidism due to Iodine Deficiency Using Daily Powdered Kelp in Patients Receiving Long-term Total Enteral Nutrition. Clin Pediatr Endocrinol. 2011 Jul;20(3):51-5.

10. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of health claims related to selenium and protection of DNA, proteins and lipids from oxidative damage (ID 277, 283, 286, 1289, 1290, 1291, 1293, 1751), function of the immune system (ID 278), thyroid function (ID 279, 282, 286, 1289, 1290, 1291, 1293), function of the heart and blood vessels (ID 280), prostate function (ID 284), cognitive function (ID 285) and spermatogenesis (ID 396) pursuant to Article 13(1) of Regulation (EC) No 1924/2006 on request from the European Commission. EFSA Journal 2009; 7(9):1220. [24 pp.].

11. Kryczyk-Kozioł J, Prochownik E, Błażewska-Gruszczyk A, Słowiaczek M, Sun Q, Schomburg L, et al.. Assessment of the effect of selenium supplementation on production of selected cytokines in women with hashimoto’s thyroiditis. Nutrients (2022) 14(14):2869. doi:  10.3390/nu14142869

12. Alhefdhi A, Mazeh H, Chen H. Role of postoperative vitamin D and/or calcium routine supplementation in preventing hypocalcemia after thyroidectomy: a systematic review and meta-analysis. Oncologist. 2013;18(5):533-42.

13. Talaei A, Ghorbani F, Asemi Z. The Effects of Vitamin D Supplementation on Thyroid Function in Hypothyroid Patients: A Randomized, Double-blind, Placebo-controlled Trial. Indian J Endocrinol Metab. 2018 Sep-Oct;22(5):584-588.

 

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