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Dietitians Dish: Weight management, your thyroid

Stephanie Markman
  • By Stephanie Markman
  • Originally published July 24, 2012 at midnight, updated July 24, 2012 at midnight

Everyone is bound to know someone with a thyroid issue because a whopping 27 million Americans have an underactive (hypothyroid) or overactive (hyperthyroid) thyroid gland. The thyroid is a butterfly shaped gland in the front of your neck that regulates fat and carbohydrate metabolism, body temperature, respiration, cholesterol levels, blood calcium levels, menstrual cycles, skin integrity and brain development.

Hypothyroidism is caused by failure of the thyroid to produce adequate amounts of the thyroid hormones often because of the auto-immune disease called Hashimoto's. Hyperthyroidism is associated with Graves' disease, which is most common in women and usually appears before the age of 40.

Since the thyroid regulates fat and carbohydrate metabolism, most people with hypothyroidism have a hard time losing weight while those with hyperthyroidism have a hard time maintaining it. Keeping your thyroid hormones regulated is essential to weight management and will reduce the risk of further development of cardiovascular disease and diabetes.

It is estimated that about 50 percent of those with an abnormal thyroid are not diagnosed, so please consider these signs and symptoms and contact your primary care physician or endocrinologist if you think you may have abnormal thyroid function.

Hypothyroidism is associated with weight gain, constipation, fatigue, hair loss, depression, difficulty concentration, joint pain, infertility, missed periods, and miscarriage.

On the other hand, hyperthyroidism is associated with weight loss, diarrhea, fatigue, anxiety, nervousness, difficulty concentrating, muscle weakness, infertility, missed periods and miscarriage.

The first step to managing the symptoms and thereby avoiding the health risks of hypo or hyperthyroidism is regulating your thyroid hormones under your physician's supervision with labs and medications.

Once these hormones are regulated, weight loss or gain can be addressed. Since thyroid abnormalities are associated with cardiovascular disease and diabetes it is best to follow similar diet guidelines. These include moderate carbohydrate intake, whole grains, lean meats, lots of fruits and vegetables, heart-healthy fats (focus on oils and avoid animal fats), omega-3s (found in fatty fish, nuts and dietary supplements), high fiber foods and at least 64 ounces of water each day.

Iodine is an important mineral because it is part of the actual thyroid hormone, most Americans get plenty of iodine in their diet because of the use of iodized salt since the '20s.

Approximately 90 percent of people with Hashimoto's disease are deficient in vitamin D and those with Graves' disease will need adequate amounts of vitamin D due to a high rate of bone loss in that population.

Adequate vitamin D can be obtained from getting in direct sunlight, except for in the winter months when the sun is too far away. Make sure you are without sunscreen on part of your body, such as your forearms, for 10-20 minutes so you can actually absorb the vitamin D, which can also be found in fatty fish, dairy products, mushrooms and eggs.

The mineral selenium is essential for thyroid function and can be found in Brazil nuts, tuna, crab and lobster.

Vitamin B12 deficiency is found in about 30 percent of those with abnormal thyroid function. Seafood, such as salmon, sardines and mollusks and organ meats, are a rich source of vitamin B12.

Also be aware that there are some food-drug interactions with thyroid hormone medications. Be sure to take any calcium or chromium picolinate supplements at least four hours apart from your thyroid hormone medication to avoid impaired absorption. Allow at least one hour between drinking coffee, taking a fiber or flavanoid supplement and your thyroid hormone medication because these will diminish the absorption of your thyroid hormone medication as well.

Beyond hormone therapy and a nutritious diet, exercise is also an important part of managing physical and psychological symptoms of hypothyroidism or hyperthyroidism. So, remember, normalizing your thyroid hormones is the place to start, and once that is accomplished, weight management can be accomplished.

Stephanie Markman is a registered and licensed dietitian DeTar Healthcare Systems. Send questions or comments to dietitians@vicad.com.