Hypothyroidism

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Of all thyroid diseases, hypothyroidism is the most common. It is more common in older people, but the biggest threat is for pregnant women, because it can lead to many complications. Find out if you can suspect hypothyroidism and how to diagnose it.

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What is hypothyroidism?

Hypothyroidism is a clinical condition resulting from an insufficient number of hormones of the thyroid gland. Thyroid produces mainly thyroxine (T4) and triiodothyronine (T3). T3 is a more active version and is mainly made of T4. Underactivity can be primary or secondary.

Primary hypothyroidism is associated with abnormal work of the gland itself, its insufficiency or damage. In turn, the secondary one results from the deficiency of TSH, a hormone produced by the pituitary gland, which reaches the thyroid receptors and stimulates it to work. The most common cause of primary hypothyroidism is Hashimoto’s disease.

This is a disorder that is the result of an abnormal work of the immune system, in which antibodies to thyroidoperoxidase (an enzyme involved in the synthesis of thyroxine) and thyroglobulin (which is a storage of hormones in the thyroid gland) are produced. Hence, to assess whether hypotension is associated with Hashimoto’s disease, anti-TPO measurements, or levels of antibodies, are made. This disease is accompanied by inflammation. Primary underactivity can also be caused by drug-induced damage, e.g. during treatment with radioactive iodine or amiodarone – an antiarrhythmic drug containing a high dose of iodine. Whatever the reason, the clinical symptoms are the same.
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What are the symptoms of hypothyroidism?
The main symptoms of hypothyroidism should be mentioned
– decrease in the rate of basic metabolism, which leads to weight gain,
– low body temperature,
– concentration and memory disorders,
– weakness in muscle strength,
– breathing difficulties due to the weakening of the upper airway muscles,
– increase in LDL cholesterol,
– anemia,
– constipation,
– dry, cool skin,
– a hoarse voice,
– hair loss,
– yellow-orange color of the skin resulting from disturbance of carotene to vitamin A,
– milking in women, breast enlargement in men.
The above symptoms are ambiguous and we can not make a diagnosis solely on their basis. It is necessary to carry out laboratory measurements.

Diagnostics
Essential in the diagnosis of hypothyroidism is the level of TSH, FT4 (free thyroxine) and FT3 (free triiodothyronine). The FT4 level is lowered, FT3 is usually normal. In primary hypothyroidism, we usually observe an elevated level of TSH, in the secondary hypothyroidism.

In addition, the test for the presence of anti-TPO antibodies (antibodies directed against thyreoperoxidase) allows you to determine if you are dealing with Hashimoto’s disease. Auxiliary studies can also be performed, e.g., triglyceride concentration, LDL cholesterol, as well as morphology to assess the occurrence of anemia.

Research into hypothyroidism is worth carrying out before the planned pregnancy, if there were cases of thyroid dysfunction in the family of a woman and if the woman suffers from auto-aggressive diseases, where the body produces antibodies against its own tissues (eg type 1 diabetes). The TSH test is also carried out between the 4th and 8th week of pregnancy. Always remember that the doctor makes the diagnosis.
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Treatment of underactivity
The treatment of overt hypothyroidism in most cases is based on the lifetime use of synthetic levothyroxine. It is usually taken in the morning on an empty stomach, at least 30 minutes before the first meal. It is important to remember that the first meal after taking the medicine is not rich in fiber and calcium, because the high content of these ingredients may interfere with absorption. The effectiveness of treatment of primary hypotension is assessed on the basis of serum TSH from 4 to 6 weeks after the start of a specific dose of thyroxine. In the case of secondary hypotension, the concentration of FT4 is the determinant of a well-chosen dose.

What should a menu look like in hypothyroidism?
The menu in hypothyroidism should be properly calibrated in terms of calorie content, it should be taken into account that before starting effective treatment the rate of basic metabolism is slightly lower. It should be constructed on the basis of the principles of rational nutrition, with particular emphasis on providing food with adequate doses of iron, vitamin B12, zinc and selenium. Absorption of iron and vitamin B12 from the intestines in case of hypothyroidism may be disturbed, therefore the supply of these components should be increased.

It is also very important to provide the right amount of protein, which firstly stimulates the metabolic rate, and secondly is the source of tyrosine (an amino acid) necessary for the synthesis of thyroxine. Therefore, the daily diet should include at least 3 dairy portions, preferably in the form of fermented dairy products, white cheeses.

The most energy should be provided by carbohydrates with a low GI, so it is extremely important to include thick cereal groats, grains and wholemeal bread as excellent sources of magnesium and zinc in the menu. The diet should also include unrefined vegetable oils, avocados, and seeds and seeds. Unsaturated fatty acids facilitate the conversion of FT4 to biologically active FT3 in the liver and have a positive effect on the lipid profile, which in hypothyroidism is usually impaired. With regard to current scientific sources, elimination diets (eg gluten elimination) are not justified in the majority of patients. Below is an example menu.

Breakfast scrambled eggs steamed with fresh chives, slice of white bread, fresh orange juice.
II Breakfast cocktail based on kefir with blueberry and cinnamon.
Dinner stewed turkey breast, buckwheat, tomato salad with linseed oil.
Afternoon tea, banana ice cream, homemade, pumpkin seeds.
Dinner of brown rice casserole with broccoli and mozzarella.

Physical activity and hypothyroidism
Regular physical activity may improve the functioning of the thyroid gland. This is confirmed by a study conducted in India a few years ago, in which 20 patients treated for hypothyroidism took part. 10 of them took physical activity (minimum 1 hour a day). After 3 months in the group of exercisers, a significant decrease in TSH concentration and an increase in T3 and T4 secretion was observed, which indicates a better thyroid function without increasing the dose of the drug. There were no changes in the control group. It should be noted that these were exercises of moderate intensity (at the level of 70% of maximum heart rate).

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Not all studies prove the effect of physical activity on thyroid hormone levels. However, due to many other health benefits, daily physical activity at the aerobic level is recommended to all of us, people with hypothyroidism are no exception.

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