Underactive thyroids are often underdiagnosed

Health & Nutrition  with Rosie Shelley, BA, SAC.Dip, ITEC.Dip

WORLD Thyroid Day is on May 25th and aims to raise awareness of all aspects of thyroid health. Hypothyroidism, or underactive thyroid, is by far the most common form of thyroid disease, but it is undoubtedly a hugely underdiagnosed condition. 

Statistics suggest that up to 10 times more women than men are affected, which isn’t properly understood except to say that all autoimmune disorders are more common in females, and an estimated 90% of cases of hypothyroidism are due to an inflammatory, autoimmune condition that causes the immune system to attack its own tissues—in this case those of the thyroid gland. 

In the genes

There is a strong genetic predisposition to hypothyroidism, but it will be triggered by the immune/inflammatory response originating in the gut (sometimes a viral infection), that characterises all autoimmune diseases. In fact if you have an underactive thyroid you are statistically far more likely to have or develop another autoimmune disorder such as coeliac disease, type 2 diabetes, and rheumatoid arthritis.    

The thyroid gland works like a motor in your body, affecting metabolic processes almost everywhere. Not just how fast we burn calories for energy but also our heart rate, breathing, brain function and mood, body temperature, the movement of food/waste through the digestive system, bones/skin/hair, muscle strength and menstrual cycles. 

If it’s underperforming, the result will be varying degrees of a raft of symptoms: extreme fatigue, unexplained weight gain, cold hands and feet, poor concentration, constipation, irregular or heavy periods and fertility issues in women, and dry/brittle/thinning skin, hair and nails. 

Also possibly allergies, digestive disturbances, low libido, candida (thrush), depression, dizziness, pins and needles, slow movements/speech/thought processes, dry/gritty eyes, hoarse voice, swallowing difficulties, shortness of breath, carpal tunnel syndrome, muscle/joint aches, frequent colds and ‘flu, low blood pressure, elevated cholesterol or other blood fats, elevated homocysteine levels, and elevated levels of inflammatory markers. 

These last are especially important because they raise the risk of serious issues such as type 2 diabetes and cardiovascular disease, so seeing your GP is a must.

 A blood test will determine whether your thyroid gland is failing to produce enough of its hormone, thyroxin. If it is, you will simply be prescribed a synthetic form of thyroid hormone, which needs to be taken for the rest of your life. 

Food plan

Diet is key for people with hypothyroidism, and a relatively high protein, low carbohydrate plan has been found the most effective in terms of addressing weight, energy levels and other issues. 

After filling half your plate with vegetables, for necessary fibre and nutrients, focus then on healthy proteins such as fish, organic meat and poultry, beans and lentils, nuts and seeds, eggs and some dairy. 

The thyroid gland depends on particularly on iodine, selenium, and healthy fats including omega 3 (which also helps to burn stored body fat), so include lots of fish including some oily fish, dairy, beans, eggs and berries for iodine, as well as nuts and seeds, nut and seed butters, avocadoes, wheatgerm, and organic, cold pressed olive or coconut oils.

 If you want to eat grains, stick to small portions of the most nutrient dense options, and new research suggests avoiding them at breakfast as they can interfere with your medication. 

Gluten sensitivity can be an issue for people with poor thyroid function, so try cutting out wheat products. 

Given the central gut bacteria/inflammation/ immune response connection, to control and/or prevent further autoimmune complications it would be very important to take steps to repopulate your gut with good bacteria. Take a good probiotic, and cut out the junk. 

It’s worth noting that there are some compounds that can interfere with the production of thyroid hormones, such as those in raw veg of the cabbage/broccoli family, and in millet, peanuts, and soya. 

If you are taking medication for hypothyroidism, you shouldn’t eat more than a teaspoon or so of seaweed at a time, as while iodine is vital here the high concentration in things like kelp may actually worsen matters. 

Take your medication as soon as you wake up, and well away from anything that interferes with its absorption—calcium supplements, antacids and fibre supplements. 

Fluoride and chlorine disrupt iodine metabolism—one study showed that water fluoridation above a certain level is linked to a 30% higher rate of hypothyroidism-- so avoid commercial toothpastes (get yours from the healthfood shop) and an excess of regular tea, which is another major source of fluoride.

Pregnancy issues

AN underactive thyroid can  sometimes develops during pregnancy (or after childbirth, when it can be mistaken for postnatal depression), and if you already have it your thyroxin levels will need to be closely monitored. 

If there is a family history it’s vital that you ask your doctor to test your levels, as hypothyroidism can cause serious problems for the pregnancy (preeclampsia, premature birth, miscarriage) and for the growing baby in terms of its cognitive development. 

Iodine itself is crucial for that development, and it would be wise for all pregnant (and breastfeeding) women to get their levels of the mineral checked as well, and to take a tailored prenatal supplement that includes iodine (take it at least three hours after any thyroid medication). Nearly 70% of our teenage girls are deficient in iodine.