How to reset thyroid?

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20 Ways to Reboot Your Thyroid

Maybe you’ve noticed the scale is creeping up for seemingly no reason, and you can’t pinpoint why you keep gaining weight. Or maybe you’re more tired than normal or need to wear three layers at all times because you’re constantly freezing. Sound familiar? These are all signs of an underactive thyroid (hypothyroidism), the butterfly-shaped gland located in your throat that’s responsible for your metabolism, important hormones, body temperature, and how you use energy. It also influences the function of vital organs, such as your heart, brain, liver, and kidneys.

On the flip side, an overactive thyroid (hyperthyroidism) is marked by increased nervousness, anxiety, irregular heartbeat, and sudden weight loss. People who have hyperthyroidism are also at risk of developing anemia, which is an iron deficiency that leads to a lack of healthy red blood cells.

If you’re noticing negative symptoms such as the ones listed above, your thyroid might not be functioning as optimally as it could be. Although these lifestyle and dietary changes aren’t a guaranteed cure-all, they can help regulate this important gland. If you believe you are having serious issues with your thyroid, make sure you see a doctor who can administer the proper tests and diagnosis. In the meantime, check these 20 helpful tips, as well as our 25 Best Foods to Eat For Your Thyroid and Metabolism.

1

Eat Brazil Nuts

“I often recommend Brazil nuts because of their high selenium content. Many folks with thyroid issues are deficient in this crucial antioxidant, and Brazil nuts are a potent source of selenium, not to mention extremely delicious and high in fiber, calcium, protein, and magnesium. Selenium helps convert thyroxine to its active hormone form, T3. Brazil nuts are rather large, so try to portion out about six at a time; they have a mild flavor and pair well with berries.” — Monica Auslander, MS, RD, LD/N, founder of Essence Nutrition

2

Sprinkle Iodized Salt

Ashvini Mashru, MA, RD, LDN, recommends adding iodine to boost your thyroid. “This is the most important trace element found in thyroid functioning,” she explains. “Without iodine, our thyroid does not have the basic building blocks it needs to make the necessary hormones to support all of the tissues in the body. Thyroxine (T4) and Triiodothyronine (T3) are the most essential, active, iodine-containing hormones we have.”

One of the easiest ways to get iodine is through iodized salt. But pay attention to how much iodine you’re getting throughout your diet; the National Institutes of Health only recommends 150 micrograms (mcg) of iodine for male and female adults. Too much iodine, categorized as more than 1,100 mcg for adults over the age of 19, could lead to complications similar to iodine deficiency, and mess with your thyroid hormones.

3

Try Sea Veggies

Another great way to get extra iodine is through sea vegetables, more commonly known as seaweed, Mashru suggests. Seaweed such as kelp, nori, kombu, dulse, and wakame have some of the highest concentrations of iodine available. Just be careful how much sea veggies you eat — you can quickly get into iodine-overdose territory if you eat too many.

4

Eat Eggs

“Eggs are a great source of iodine and pack a powerful punch of protein to boot. Eggs are also incredibly versatile and there are so many ways to incorporate it into the diet,” says Chelsea Elkin MS, RD, CD. “Have hardboiled eggs for a snack, whip up a veggie omelet for breakfast, or top avocado toast with a poached egg so that you never get bored. You can get about 16% of your daily iodine from 1 large egg.”

5

Eat Plain Low-Fat Yogurt

“One cup of low-fat, plain yogurt contains 50% of the recommended daily value of iodine. Top with cranberries and strawberries, both of which are rich in iodine, and add a sprinkle of nuts for some healthy fats,” Elkin says. “Many individuals who have thyroid problems are also at an increased risk of osteoporosis (softening of the bones), so incorporating other calcium-rich foods into the diet is key. Think: Low-fat milk and low-fat cheese.”

6

Do Aerobic Exercise

Yep, aerobic exercise is good for your body, mind, can help with weight loss, and it’s also good for your thyroid. A study published in the journal Neuroendocrinology Letters found that moderate aerobic exercise, defined as 70 percent of maximum heart rate, raised the levels of thyroid hormones thyroxine (T4), free thyroxine (fT4), and thyroid stimulating hormone (TSH). So find a workout you enjoy that gets your heart rate pumping: Cycling, jogging, rowing, or swimming are all good cardio exercises.

7

Eat Spinach

“Hyperthyroidism is when your body produces too much of the thyroid hormone thyroxine, which causes bodily functions to speed up and can make someone feel racy and result in weight loss. Many individuals who suffer from hyperthyroidism can also become anemic, meaning your body is deficient in iron,” Elkin explains,” She recommends incorporating spinach into your diet to get adequate amounts of iron.

“Spinach (along with most dark, leafy greens) is rich in iron. One serving of spinach leaves also contains approximately 0.8 milligrams of iron, about 10 percent of the recommended daily intake for men or 4 percent for women,” she adds. “Iron is best absorbed with vitamin C, so consider pairing an omelet loaded with spinach with a glass of orange juice to maximize absorption. If enjoying a spinach salad for lunch, top with strawberries for added vitamin C,” she explains.

8

Eat Beans

“Beans are loaded with iron. In fact, chickpeas contain about 5 mg of iron per cup,” Elkin explains. “Chickpeas are incredibly versatile and are also rich in protein. They can be added to a salad, used to make hummus, simply roasted, added to pasta – the possibilities are endless! I recommend pairing chickpeas with broccoli for a tasty iron and vitamin C combo to maximize absorption.”

9

Eat Oysters

Along with iron, getting enough zinc is essential to thyroid function. “Low levels of zinc can cause T4, T3, and the thyroid stimulating hormone (TSH) to also become low,” Mashru says. Oysters are one of the best sources of zinc, packing in 5.3 mg per medium oyster.

10

Try Alaskan King Crab

In addition to zinc and iron, copper is another important metal necessary for a properly working thyroid, Mashru explains. Alaskan king crab is an excellent source of copper, providing 50% of your daily recommended intake in just 3 ounces. It also packs 6.5 mg of zinc (44 percent of your daily recommended intake) in the same 3-ounce serving.

11

Cut Back on Sugar

Sugar is inflammatory, which can disrupt your thyroid hormones. It also increases the production of cortisol, the stress hormone, which can lead to fat storage and weight gain. Not only will reducing sugar help you lose weight, it will help regulate your thyroid, too. Need help giving up the sweet stuff? Check out our 30 Ways to Stop Eating So Much Sugar.

12

Limit Raw Cruciferous Veggies

Although cruciferous vegetables such as kale, broccoli, cauliflower and are superfoods packed with important vitamins and minerals, eating them raw could be bad for your thyroid. They contain goitrogens, which disrupt thyroid function and interfere with iodine uptake. But you don’t have to cut them out completely (in fact, you shouldn’t — they’re healthy for you!). Since eating them raw delivers the most goitrogens possible, make sure you’re steaming or sautéing your cruciferous veggies before chowing down.

13

Eat Walnuts

Walnuts are high in omega-3 fatty acids, which can help decrease inflammation in the body, says Jessica Patel, RDN, LDN. Just pay attention to serving sizes; 1/4 cup of walnuts has 18 grams of fat and 180 calories.

14

Sprinkle Some Seeds

Patel recommends incorporating chia and hemp seeds into your diet for their anti-inflammatory properties. These fibrous seeds are also chock-full of healthy omega-3 fatty acids.

15

Invest in a Water Filter

Tap water can contain levels of chlorine or fluoride (or both), which can disrupt how much iodine your thyroid ends up getting. Since iodine is essential for thyroid hormone production, this could end up interfering with your thyroid function. Opt for a carbon-block filter, which will reduce levels of chlorine and fluoride.

16

Take Probiotics

“I recommend regularly consuming probiotics from foods or supplements. Since 70% of the immune system is housed in the digestive tract, probiotics (friendly bacteria living in the gut) can strengthen the immune system,” Patel explains. “You can find probiotics in fermented foods like sauerkraut, kombucha, kefir and kimchi. If opting to supplement, look for a high-quality probiotic supplement with a high CFU (colony forming unit) count of 25-50 billion CFUs.”

17

Eat Yellowfin Tuna

Yellowfin tuna is rich in selenium, which is important for thyroid function. “Selenium-based proteins help regulate hormone synthesis, converting T4 into the more accessible T3,” Mashru says. “These proteins and enzymes help regulate metabolism and also help maintain the right amount of thyroid hormones in the tissues and blood, as well as organs such as the liver, kidneys, and even the brain.”

Just one 3-ounce serving of yellowfin tuna contains 110 percent of the daily value of selenium. Other names for yellowfin tuna are Thunnus albacores, ahi, or Allison tuna.

18

Try Sardines

A one-cup serving of sardines packs a serious thyroid-boosting punch. One cup contains 4.4 mg of iron, almost 25 percent of your daily total. These tiny fish are also a selenium-rich food, packing 87 percent of your daily recommended amount at 48 mcg a serving. Plus, sardines are a good source of omega-3s, especially when they come packed in olive oil. Although they are an acquired taste, sardines are also one of our 30 Cheap Foods That Uncover Your Abs, so it’s worth picking up a can and getting creative.

19

Go For Grass-Fed Beef

Grass-fed beef is almost the perfect food for your thyroid. It’s an excellent source of thyroid-boosting selenium, iron, and zinc. It also has good amounts of the essential amino acid tyrosine, which can help boost the production of thyroid hormones; Triiodothyronine (T3) and Thyroxine (T4) are tyrosine-based.

20

Choose Decaf

We know, it’s tough to give up your beloved morning coffee and beloved caffeine jolt. But while coffee has its own set of health benefits, it can disrupt your thyroid, especially the stress hormone cortisol. If you do opt for something caffeinated, balance it out by eating some animal products (meat, eggs, cheese) to get enough protein and tyrosine.

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How to Reset Your Thyroid to Burn Fat and Activate Your Metabolism

Erika Schwartz, MD, was consulted for a medical advice by an elderly man with serious health issues.

Namely, she examined the medications and treatments he was subjected to, and decided to consult his cardiologist whether he would agree to completely change his therapy.

Namely, the man suffered from excess weight, low testosterone and thyroid levels, sleeping disorders due to an advanced stage of eczema which caused unbearable itching.

She has been trying to reach his cardiologist for three weeks, and eventually, she succeeded. However, after suggesting the elimination of the medications which contributed to the eczema of the patient, she states:

“The guy said to me, ‘I can’t talk to you. You don’t know science.” After stating that they have the same medical degree, she adds “he hung up on me!”

Therefore, after this discussion, she explained all she had to her patient and he decided to change his cardiologist and try the plan she suggested. The treatments she had in mind consisted of boosting the level of the thyroid hormones and eliminating the medication for his cholesterol.

At the beginning, the patient believed that this treatment would lead to a heart attack, but Dr. Schwartz explained that the correction of the hormones naturally maintained the cholesterol low.

Thyroid hormones are a result of the function of the thyroid gland—which is an endocrine gland in the form of a butterfly found in the lower front of the neck.

The two thyroid hormones—triiodothyronine and thyroxine—are also known as T3 and T4. T4 is turned into the active T3 in cells, and it reaches the body organs through the bloodstream.

Its main function is to regulate metabolism and provide energy, but it also has a significant influence on the entire body, as it helps the organs to function optimally.

The most common issue linked to the thyroid is hypothyroidism—which is the state of underactive thyroid, that is the gland does not produce sufficient hormones to regulate the necessary body functions.

It can be a result of numerous internal and external factors, such as Hashimoto’s disease, which is an autoimmune condition in which the thyroid is attacked by the immune system itself.

Hypothyroidism can be manifested by numerous different symptoms, including dry skin, brittle nails, fatigue, hair loss, weight gain, body temperature irregularities, feeling cold, poor reflexes, depression, brain fog, mood swings etc.

However, as these symptoms can also indicate other diseases or ailments as well, doctors mat often prescribe some medications that are not adequate, and do not even consider the thyroid imbalance as a potential cause.

Mary Shomon, a thyroid expert and author of numerous books on the theme, states: “People are going in with high cholesterol or depression and are getting handed cholesterol meds and antidepressants. And no one’s ever checking to see if the thyroid is at the root of the problem.”

She moreover says that there is a critical flaw in the conventional test to diagnose hypothyroidism. This test, known as the thyroid stimulating hormone test or TSH test, actually measures the level of a pituitary hormone, TS, in the blood.

However, this test does not show the amount of T3 or T4 in the blood, as the pituitary hormone directs the thyroid gland to produce and release thyroid hormones.

Hence, this is a flaw as numerous patients experience the symptoms listed above but still have a normal TSH result, so they consequently are prescribed to take medications that do not treat their root problem and even suffer from their side- effects.

Dr. Schwartz claims “At the end of the day, we suffer because we’re treating individual symptoms, and we don’t look at the body—at the person—as a whole. is actually doing a disservice to anybody who wants to take care of themselves, or someone who actually wants to take care of the patient.”

For better results, the levels of T3 and T4 should be individually examined. Moreover, it is of vital importance to be sure that T4 is being turned into active T3 and that the T3 enters cells in order to regulate the function of the body organs.

The holistic treatment of Dr. Schwartz includes alteration of everything, including the diet, hormones, exercise and supplements. Her approach regards the body as a whole and does not examine just the symptoms, and consequently, it has given great results.

She says: “What I also found out was that giving those people thyroid to begin with—giving them T3, let’s say, to begin with, which is the active thyroid hormone—was actually the quickest way to get people to feel better. And once they felt better, then you could tweak their diet, exercise, lifestyle.”

The belief that the way thyroid hormones influence the entire body is a vital part of the successful treatment is also shared by Shomon:

“Our metabolism relies, in large part, on our thyroid’s ability to function properly. If we’re not getting enough oxygen or energy to the cells for digestion, for pancreatic function, for brain function, for all of the other hormone production processes and the glands that are producing those, then everything is going to be slowing down and not working properly,” she explains. “It’s the gas pedal, essentially, for everything.”

Hence, both internal and external factors lead to thyroid disorders, as they may result from a combination of certain aspects like immunity, diet, hormones, the environment, immunity, and the like.

“We’re living in such a toxic world—and our lifestyles have changed so much.And that’s a critical thing for us to realize when we look at our diets and we look at our daily habits. We have to put in place some strategies to compensate for the fact that we’ve moved so far from our natural evolutionary ancestral history.”- says Greg Emerson, MD, founder of the Emerson Health & Wellness Center in Queensland, Australia.

The leading ones on his list of toxins are mold and mycotoxins, which are a result of some fungi types.

“There’s a huge amount of scientific evidence that the poisons that the mold produce are terrible for the thyroid gland. And the other problem is that we’re consuming foods which are also high in mycotoxins.

Or we’re consuming foods that are high in sugar, which makes the mold grow in the body. And we’re also not consuming foods which are protective against those mycotoxins. I don’t think I’ve seen a patient with Graves’ disease—which is an overactive thyroid—who has not had a problem with mold, and then mycotoxins.”

The opposite case is hyperthyroidism, or overactive thyroid, which is the state of excess production of thyroid hormones. This state leads to sudden weight loss due to a revved up metabolism, as well as a rapid or irregular heartbeat.

However, the imbalance of the hormones can be restored to normal by making some important changes in the lifestyle. Initially, eat a diet high in raw foods, regularly exercise, foster healthy relationships; and try to reduce stress.

Dr. Emerson suggests that you ask the following questions to yourself: “Am I eating the right food? Am I drinking the right water? Am I getting enough sun? Am I getting enough sleep? Am I getting enough exercise? Am I getting medicines in my food?”

Dr. Schwartz adds: “Listen to what your body’s saying. If you can’t sleep at night, why don’t you sleep at night? Did you drink too much and it woke you up in the middle of the night? Are you eating too late? Are you eating the wrong foods? Are you exercising too late? Do you have all this electronic equipment sitting right next to you? Do you sleep with the TV on?”

Therefore, of you properly take care of the things explained above, you will easily specify the root of your health issue, and thus, find the proper natural treatment.

Dr. Schwartz comments “There are a million reasons why you may not be sleeping at night. And you need to look at them and take responsibility for improving.”

One of the best and most popular American alternative medicine doctors, Joseph Mercola, DO, also agrees with the basic logic of Dr. Schwartz, since he also believes that in order to maintain good health, you need to work on many aspects.

Yet, he believes that the major control of the health is done by research and finding quality resources, as well as consulting experienced individuals, doctors and experts. He also believes that “It’s probably the mindset that you are responsible for your health.”

By restarting your thyroid with the proper nutrients, not only can you keep weight off, but you can also help slow down the aging process, boost your energy, and improve your overall health.

20 Best Ways to Have a Healthier Thyroid

Your thyroid. The hormones it produces are responsible for a lot: your metabolism, the health of your skin and bones, your sleep quality, headache frequency (or infrequency), and your sex drive, to name just a few. Put another way, it’s one of the most essential glands in your body. And yours may be in trouble. According to the American Thyroid Association, an estimated 20 million Americans have a thyroid condition—and of those 20 million, a staggering 60 percent aren’t aware of it.

But despite these figures, there’s no need to worry. Even if your thyroid isn’t in the shape it should be, getting it up to snuff is as simple as trying out a new yoga pose or making a small change to your diet. So read on, and learn how to have a healthy thyroid.

1 Eat Fewer Vegetables

Yes, really—though only when it comes to cruciferous veggies, like cauliflower, broccoli, and Brussels sprouts. If these vegetables are a core part of your diet and you have thyroid issues, you may want to reconsider. A 2016 study published on PubMed found that, because they are harder for you to digest and metabolize than non-cruciferous vegetables, they have been linked to a higher risk of thyroid-related diseases.

2 Hang Up the Phone

Chatty phone-users, beware. A study published in Oman Medical Journal showed that increased cell phone use altered how the thyroid released hormones. With the amount of negative side effects that occur from altered hormone levels—rapid weight gain and dry skin, for example—you might want to cut back on the lengthy phone conversations.

3 Don’t Stop Drinking

Yes, this advice is antithetical to anything any doctor would say. But research in Journal of Thyroid Disorders in 2015 showed that sudden cessation of drinking alcohol can skew the results of thyroid exams, leading to false diagnoses. So, if you’re getting an exam any time soon, keep your drinking habits generally the same for the sake of your thyroid health.

4 Eat More Seaweed

Your thyroid needs iodine to make its essential hormones. Seaweeds—like kelp, dulse, and nori—are packed full of iodine for your body to transform into hormones. They also usually contain a lot of other beneficial nutrients, like calcium, potassium, and Vitamins A through E, so the stuff is truly the superfood you’re missing out on.

5 Stop Using Plastic

Bisphenol A (or BPA) is a monomer commonly found in plastic goods—water bottles, Tupperware, that sort of thing. BPA is bad for your body for a variety of reasons, but it can affect your thyroid health as well. A study published in The Journal of Clinical Endocrinology & Metabolism has found links with this chemical negatively affecting your thyroid. If you’re still regularly using plastic containers or bottles, switch to glass versions, stat.

6 Stay Away From A Thing Called Triclosan

Triclosan is a common ingredient in many soaps and body washes, but it may have an adverse effect on your thyroid heath. A study conducted by the EPA showed that even minor exposure to the chemical can affect how your thyroid releases hormones. Luckily, it’s now easier than ever to avoid the stuff: In December of 2017, the FDA issued a ruling banning over-the-counter products containing triclosan.

7 Avoid Green Tea

Experts at Precision Nutrition found that links between green tea consumption and an exacerbation of pre-existing thyroid problems. However, there is no evidence of those issues from black tea consumption. So if you’re a regular tea drinker, switch to black—or, if you don’t need the caffeine, stick to herbal blends.

8 Stress Less

High stress levels can lead to anxiety, insomnia, and increased blood pressure. But there’s another adverse side effect: According to a review on PubMed, stress can make your thyroid slow down its function, which could result in unwanted weight gain. Stress is also one of the environmental factors that causes hyperthyroidism, which is when your thyroid releases too many hormones at once.

9 Take Up Low-Impact Aerobic Exercises

According to some experts, low-impact aerobic exercise is the best kind of exercise to avoid hurting your thyroid heath. If you’re suffering from a thyroid condition, you can experience joint paint. So centering your workouts around low-impact exercises—like walking or water aerobics—is the way to go. As a bonus, these exercises are low-effort methods for getting your daily cardio in.

10 Or Take Up Yoga

Yogis, rejoice. A study in Yoga Mimamsa found that doing certain yoga poses can help your thyroid hormone release functions. During your next routine, try incorporating poses like boat pose, bridge, and king pigeon pose. These poses help to open up throat circulation and improve energy flow around the thyroid.

11 Up Your B12 Intake

A study by the Journal Of Pakistan Medical Association found that there is a link between a Vitamin B12 deficiency and hypothyroidism. To combat that, stock your food stores with B12-rich foods, such as fish, eggs, and milk.

12 Make Sure to Get Your 8 Hours Of Sleep A Night

Even though fatigue can be a symptom of an unhealthy thyroid, you have to do your best to catch some Zs. Be sure to get 8 hours of sleep a night to keep your thyroid functioning normally and effectively.

13 Eat More Selenium

A study in the Molecular Nutrition and Food Research Journal found that selenium, an element found nutritionally in nuts and mushrooms, can keep your thyroid’s hormone production functioning smoothly and effectively. As a bonus, selenium is excellent for overall endocrine system health. If you can’t stomach nuts or fungi, don’t fret: You can pick up supplements at your local pharmacy.

14 Put the Butts Out For Good

A 2014 study published in the Endokrynologia Polska Journal found that smoking can have various negative effects on your thyroid health, including and especially concerning hormone production. Smoking can cause hormone levels to wildly fluctuate. (As if you needed another reason to quit.)

15 Eat More Blueberries (and Other Antioxidants)

For better thyroid health, slate antioxidant-rich foods—like pomegranates and all manner of berries—into your diet. A study published in the Clinical Chemistry and Laboratory Medicine in 2008 found a link between antioxidant consumption and overall endocrine system health levels; higher levels of one correlated with higher levels of the other. Plus, antioxidant-rich foods are delicious!

16 Go Gluten-Free

A 2002 study published in the Journal of European Endocrinology found that there was a correlation between people who eat a lot of gluten and people who have a less active thyroid. What’s more, the researchers found that, when those people cut gluten out of their diet, their thyroid function balanced out to normal levels.

17 Steer Clear of Flouride

A 2015 study in the Journal of Epidemiology & Community Health found a link between fluoride consumption and a higher rate of inactive thyroids. So check the source of your water—and the ingredients of your toothpaste.

18 Get Tested Regularly

If you think you may be experiencing any symptoms of hyperthyroidism or hypothyroidism, persistently mention it to your doctor. Because of the commonality of the symptoms—lots of issues of thyroid health could be indicative of other problems—they may not assume it is a thyroid problem.

19 Keep Your Adrenal Glands Healthy

Your adrenal glands and thyroid glands are entwined together in your endocrine system. According to Dr. Amy Myers, adrenal gland distress has the ability to affect major metabolic processes, including the ones your thyroid is responsible for. As it so happens, the best way to keep your adrenal glands healthy is one of the ways to keep your thyroid health: Regularly get a good night’s sleep.

20 Stay Sharp

It’s a bit of a no-brainer, but is still a point worth hammering home: If you suspect, even a little, that you’re suffering from a condition, be sure to educate yourself completely. And yes, that includes thyroid conditions. Even the subtlest symptom—loss of sleep, altered bowel movements—can be a sign of something more serious. So stay diligent.

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Can You Boost Your Metabolism If You Have Hypothyroidism?

Metabolism can be increased with cardiovascular and strength training. Adam Kazmierski/iStock

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If you imagine that your metabolism is a revved engine, thyroid hormone would be the gas. When you have hypothyroidism, however, your thyroid gland doesn’t make enough of the hormone, and your metabolism slows down. A slower metabolism can make weight loss difficult, but it causes other symptoms too, such as fatigue and weakness.

Hypothyroidism and Metabolism: What’s the Connection?

Metabolism is the process by which your body converts the food and nutrients you consume into the energy you need to breathe, think, digest, circulate blood, regulate your body temperature, and perform other functions necessary to sustain life, according to the U.S. National Library of Medicine.

While it’s not the only component involved in metabolism, “thyroid hormone is essential and is needed to run nearly every organ system in the body,” says Amber Champion, MD, an endocrinologist and assistant professor of medicine at the University of Nevada, Las Vegas.

A properly functioning thyroid helps your body maintain the level of hormones it needs to keep your metabolism running at a satisfactory rate, according to the Cleveland Clinic. But if your thyroid doesn’t produce enough thyroid hormone, your metabolism and your body processes can slow down. You may experience symptoms such as fatigue, sleepiness, muscle weakness, constipation, sensitivity to cold, cognitive problems, dry skin, a hoarse voice, lower appetite, joint pain, and menstrual changes, says Antonio Bianco, MD, PhD, a professor of medicine at the University of Chicago.

When people think of metabolism, though, they generally think of weight. One of hypothyroidism’s most familiar symptoms is difficulty with weight loss. Though some blame extra pounds on hypothyroidism, the condition doesn’t cause as much weight gain as they may think. “If you’ve gained more than 5 to 10 pounds,” Dr. Champion says, “something other than thyroid may be to blame.”

Can You Boost Your Metabolism to Help With Weight Loss?

People with a slower metabolism may have difficulty losing weight because they tend to burn fewer calories, which means that more get stored in the body as fat, according to Harvard Health. A faster metabolism causes calories to be burned at a higher rate.

How fast or slow your metabolism works is determined for the most part by your genes. But a number of other factors can play a role, including your age, your gender, your body size and composition, and your level of physical activity.

While you can’t control all the elements that affect your metabolism, there are steps you can take to burn more calories and lose or maintain weight. Try these tips:

Take thyroid hormone. If you have hypothyroidism, which can be diagnosed with a blood test, your doctor will prescribe synthetic thyroid hormone. “Once thyroid hormone levels are normalized,” Dr. Bianco says, “the metabolic rate should be normalized as well.”

Rev up with exercise. “We all have the ability to increase metabolism with exercise,” says Elizabeth McAninch, MD, an assistant professor of medicine in the division of endocrinology and metabolism at Rush University Medical Center in Chicago. Both cardiovascular and strength-training exercises are important for boosting metabolism. Strength-training exercises, like weightlifting, build muscles, which help burn more calories. Cardio exercises, including walking, jogging, biking, swimming, and aerobics, also help boost metabolism. Higher-intensity cardio exercise is more effective at improving metabolism than lower-intensity exercise, so try a more intense class at your gym or incorporate interval training into your exercise routine.

Avoid skipping meals and starvation diets. “Starvation is a very well known cause of low metabolism,” Dr. McAninch says. The signs and symptoms of starvation can also look a lot like hypothyroidism. If you’ve been eating a low-calorie diet and experiencing symptoms of a slowed metabolism, like fatigue, go back to normal eating, McAninch says. Talk to your doctor or registered dietitian to develop a meal plan that works for you.

Choose protein. You should be eating throughout the day, but your food choices should be healthy ones that will keep your metabolism running strong. That starts with including lean protein in your meals, says McAninch, and avoiding refined carbohydrates.

Stay hydrated. It’s unclear whether the consumption of water can increase metabolism. While some research has found that water may increase the amount of energy you burn at rest by as much as 30 percent, a study published in 2015 in Nutrition & Diabetes found no connection between water and energy burned. However, your body needs enough water to work well, and that means getting about 2.7 to 3.7 liters of water per day, according to the U.S. National Library of Medicine.

See your doctor before starting any supplements. Doctors don’t know of any supplement that can mitigate the effects of hypothyroidism, McAninch says. And some supplements, such as those that contain iodine, can worsen hypothyroidism. Also, McAninch says, if you’re taking thyroid hormone, it’s important to take it alone, on an empty stomach — and not at the same time as other pills, including supplements.

Some studies have suggested a connection between hypothyroidism and vitamin D deficiency. For instance, research published in 2013 in the International Journal of Health Sciences found that people with hypothyroidism were deficient in vitamin D. Yet a 2016 analysis of the U.S. population published in the Journal of Pediatric Endocrinology and Metabolism found no such link. A good rule of thumb is to take a supplement like vitamin D only if you’ve been tested and shown to be deficient, McAninch says. A simple blood test can establish whether or not you’re deficient.

Get enough shut-eye. Not getting enough sleep can lower your metabolic rate, according to the National Sleep Foundation, which recommends that most adults get about seven to nine hours of sleep a night.

Making these changes in your life can help you manage hypothyroidism and overcome the effects of slow metabolism that accompany it.

Additional reporting by Julie Stewart

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It’s futile to drive a car without gas in the tank. Sure, you may last on fumes for a few miles, but in the end it will be very difficult to get to your destination. When it comes to weight loss, your thyroid is no different than that car. According to the Thyroid Foundation of Canada, an estimated that 200 million people around the world have some form of thyroid disease, and 30 percent of Canadians — over 10 million people — may suffer from a thyroid condition of one type or another, with as many as 50 percent of them undiagnosed.

Thyroid hormones regulate our metabolism and organ function. They directly affect body functions such as heart rate, cholesterol levels, body weight, energy, muscle contraction and relaxation, skin and hair texture, bowel function, fertility, menstrual regularity, memory and mood. Without enough thyroid hormones, every system in the body slows down. Those who suffer from hypothyroidism feel tired and tend to sleep a lot. Their digestion is slow and weight gain typically occurs. They can also experience extremely dry skin, hair loss, even slower mental processes. In fact, without enough thyroid hormones, attaining your perfect weight is almost impossible.

What’s really slowing your thyroid down?
In order to boost your thyroid, we need to understand what’s causing the problem in the first place. Hypothyroidism is a complex disorder that can stem from a number of different causes, including:

  • The thyroid may fail to produce enough thyroid hormones as a result of an autoimmune response against the thyroid (Hashimoto’s thyroiditis) or other problems with the function of the thyroid gland itself.
  • Toxic levels of mercury, typically resulting from mercury fillings in the mouth or consuming large amounts of mercury-laden ocean fish, may inhibit thyroid gland function.
  • High levels of estrogen, or a converse deficiency of progesterone, inhibits thyroid function. Many menopausal women using estrogen-replacement therapy may develop the symptoms of an underactive thyroid. Menopausal women who are already taking medication for hypothyroidism may also need to increase their dosage if they choose to use hormone-replacement therapy (HRT).
  • Excess consumption of soy-based foods and beverages may decrease the activity of thyroid hormones in the body.
  • Nutritional deficiencies may prevent the proper manufacture or function of thyroid hormones in the body. For example, iodine and tyrosine are necessary for the formation of thyroid hormones, while selenium is necessary for the normal function of thyroid hormones. Many individuals with decreased thyroid-hormone levels also have a zinc deficiency.

What are the symptoms to watch out for?
The symptoms of underactive thyroid disease can vary, and not all individuals will show the same signs. However, you should consult your doctor for a blood test if you experience two or more of the following symptoms:

  • Frequently feeling cold or having an intolerance of cold temperatures
  • Dry skin, brittle hair and splitting nails
  • Lack of or diminished ability to sweat during exercise
  • Hair loss
  • Irregular menses or heavy menstrual bleeding
  • Poor memory
  • Depression
  • Decreased libido
  • Constipation
  • Unexplained fatigue or lethargy
  • Unexplained weight gain or an inability to lose weight
  • Many individuals with hypothyroidism have associated iron-deficient anemia and/or high cholesterol

How is hypothyroidism diagnosed?
Four tests — thyroid-stimulating hormone (TSH), Free T3, Free T4 and thyroid antibodies — are required to accurately assess the function of the thyroid gland, our master gland of metabolism. An optimal TSH level should be less than 2.0, not the currently accepted 4.7 reported by most labs. T3 and T4 should be in the middle of your lab’s reference range, and your thyroid antibodies should be negative. It’s almost impossible to have a low body fat with an improperly diagnosed or managed case of hypothyroidism.

Natural options for thyroid support
If you are experiencing thyroid symptom even after your doctor has told you your thyroid is “normal,” there are natural ways you can support thyroid function — especially if your TSH is between 2.0 and 4.7. I also recommend consulting a naturopathic doctor with a specialty in hormonal concerns if your TSH is 4.0 or higher.

1. Ashwaganda: This supplement may increase both thyroxine (T4) and its more potent counterpart, active thyroid hormone (T3). Ashwaganda appears to boost thyroid function without influencing the release of the TSH, indicating that it works directly on the thyroid gland and other body tissues. This is good news, since thyroid problems most often occur within the thyroid gland itself, or in the conversion of T4 into T3 in tissues outside the thyroid gland. Take 750-1,000 mg twice a day. Ashwaganda is my favourite choice for supporting the thyroid when stress is also a concern.

2. L-Tyrosine: The amino acid tyrosine is necessary for the production of thyroid hormone in the body. It takes four weeks to reach full effectiveness, so starting this at the beginning of a weight-loss program is a good idea. Seeing as tyrosine increases the production of both dopamine and thyroid hormone, it could give you just the boost you need to push past your plateau. The recommended dose is 1,000 mg on rising, before breakfast. Do not take this supplement if you have high blood pressure.

3. Coconut oil: Not all fats are created equal and by the same token, not all fats are unhealthy. One way to boost a sluggish thyroid is to consume non-hydrogenated coconut oil. This is a medium-chain saturated fat that promotes healthy weight loss and is thought to naturally stimulate the thyroid. Unlike olive oil, it has a high heat tolerance so you can actually use it to cook your food, or include a tablespoon in your morning smoothies for a summer-fresh taste.

Natasha Turner, N.D. is a naturopathic doctor and author of the bestselling books The Hormone Diet and her newest release, The Supercharged Hormone Diet, now available across Canada. She is also the founder of the Toronto-based Clear Medicine Wellness Boutique.

How to Eliminate Thyroid Disruptors (1:57)

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We know that driving a car without gas in the tank is futile. Sure, you may last on fumes for a few miles, but in the end it will be very difficult to get to your destination. Your thyroid is no different when it comes to weight loss. According to the Canadian Thyroid Association, an estimated that 200 million people in the world have some form of thyroid disease and more than 20 million Americans have a thyroid disorder, with less than half being properly diagnosed.

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Thyroid hormones regulate our metabolism and organ function. They directly affect heart rate, cholesterol levels, body weight, energy, muscle contraction and relaxation, skin and hair texture, bowel function, fertility, menstrual regularity, memory, mood and other bodily functions. Without enough thyroid hormone, every system in the body slows down. Those who suffer from hypothyroidism feel tired and tend to sleep a lot. Their digestion is slow and weight gain typically occurs. They can also experience extremely dry skin, hair loss, and slowed thinking. In fact, without enough thyroid hormone, attaining your perfect weight is almost impossible.

How is hypothyroidism diagnosed?

Four tests – TSH, Free T3, Free T4 and thyroid antibodies – are required to accurately assess the function of the thyroid gland, our master gland of metabolism. An optimal TSH should be less than 4.0, not the currently accepted 4.7 reported by most labs. T3 and T4 should be in the middle of your lab’s reference range and your thyroid antibodies should be negative. It’s very challenging to lower your body fat if you have an undiagnosed case of hypothyroidism.

What are the symptoms to watch out for?

The symptoms of underactive thyroid disease can vary, and not all individuals will show the same signs. However, if you experience two or more of the following symptoms, you should consult your doctor to see if a blood test may be needed:

  • Frequently feeling cold or having an intolerance of cold temperatures
  • Dry skin, brittle hair and splitting nails
  • Hair loss
  • Irregular menses or heavy menstrual bleeding
  • Poor memory
  • Depression
  • Decreased libido
  • Constipation
  • Unexplained fatigue or lethargy
  • Unexplained weight gain or an inability to lose weight
  • Many individuals with hypothyroidism have associated iron-deficient anemia and/or high cholesterol.

What’s really slowing our thyroid down?

In order to boost your thyroid, we need to understand what’s causing the problem in the first place. Hypothyroidism is a complex disorder that can stem from a number of different causes, including:

  • The thyroid may fail to produce enough thyroid hormone as a result of an autoimmune response against the thyroid (Hashimoto’s thyroiditis) or other problems with the function of the thyroid gland itself.
  • Toxic levels of mercury, typically resulting from mercury fillings in the mouth or consuming large amounts of mercury-laden ocean fish, may inhibit thyroid gland function.
  • High levels of estrogen or a converse deficiency of progesterone inhibits thyroid function. Many menopausal women using estrogen replacement therapy may develop the symptoms of an underactive thyroid. Menopausal women who are already taking medication for hypothyroidism may also need to increase their dosage if they choose to use hormone-replacement therapy (HRT).
  • High stress hormone cortisol may interfere with the conversion of thyroid hormone into the active form that closely regulates metabolism.
  • The excess consumption of soy-based foods and beverages may decrease the activity of thyroid hormone in the body.
  • Nutritional deficiencies may prevent the proper manufacture or function of thyroid hormone in the body. For example, iodine, zinc and tyrosine are necessary for the formation of thyroid hormone, while selenium is necessary for the normal function of thyroid hormone.

The 4-Step Plan to Power Your Thyroid

If you think you may be experiencing thyroid symptoms, there are natural methods that may help supporting thyroid function in some people while working with your doctor to address your symptoms.

Step 1: Eliminate Thyroid Disruptors for 14 Days

You need to remove foods that keep your thyroid from running like a well-oiled machine – and optimal hormonal balance. Some foods may be forcing your thyroid to work harder. Avoiding them for two weeks may help with some of your symptoms:

Soy/flaxseed oil: These oils can act like estrogen and may force the thyroid to make more thyroid hormone than usual.

Raw cruciferous veggies: These vegetables can contain compounds known as goitrogens that may interfere with the thyroid’s ability to use iodine. Only eat these veggies if they are steamed.

Peanuts and peanut butter: This common legume is very acidic and contains goitrogens.

High-mercury fish: Mercury is a known thyroid disruptor. The worst offenders are swordfish, king mackerel, tilefish, shark and most tuna

Make sure you avoid the forbidden foods. Please remember not to overly restrict your calories. If you cut your food intake too much, you’ll simply hamper your metabolism by creating (or aggravating) imbalances in your stress and blood sugar hormones.

The following food groups should be removed from your diet during your body detox because they are inflammatory or allergenic:

Dairy products: Yogurt, cheese, milk, cream, sour cream, cottage cheese, casein and whey protein concentrate. However, 100% pure whey protein isolate and goat milk cheeses are allowed.

All grains that contain gluten: Wheat, spelt, rye, kamut, amaranth and barley. Note that most breads, bagels, muffins, pastries, cakes, pasta, durum semolina, couscous, cookies, flour and cereals are off limits, unless they are gluten-free.

Corn: Popcorn, corn chips, corn breads or muffins, fresh corn, canned or frozen niblets. White and sweet potatoes must be avoided during week one.

Oils: Hydrogenated oils, palm kernel oil, trans fatty acids, soy bean oil, corn oil, cottonseed oil, vegetable oil, shortening and margarine. Limit your intake of safflower and sunflower oil. Olive oil is allowed.

Alcohol and caffeine: During your detox I recommend you cut these out completely. Too much of either one will elevate stress hormones and contribute to hormonal imbalance.

Sugar or artificial sweeteners: Table sugar (sucrose) and all products with sugar added must be cut out completely. Foods to avoid include rice syrup, maple syrup, honey, foods/drinks containing high-fructose corn syrup, packaged foods, candies, soda, juice, etc.

Citrus fruit: Oranges, tangerines and grapefruit. Lemons are allowed.

Red meats: Pork, beef, lamb, all types of cold cuts, bacon and all types of sausages.

Step 2: Consume Anti-Inflammatory Foods for 14 Days

Eat one serving of thyroid pick-me-up foods per day and consume anti-inflammatory foods for 14 days.

Vitamin A: Activates thyroid hormone.

Get it with: Sweet potatoes or tomato juice.

Iodine: Essential for healthy thyroid function because it helps the thyroid gland produce the hormone thyroxin- or T4- one of the metabolic hormones produced by the thyroid

Get it with: Sea vegetables like kelp, seaweed or fish.

Tyrosine: The thyroid gland combines tyrosine and iodine to make thyroid hormone, so this is an essential amino acid for thyroid hormone production.

Get it with: Turkey, egg whites and spirulina.

Selenium: Necessary for the normal function the thyroid.

Get it with: Brazil nuts. They rank highest in selenium content and the count is so high that it’s virtually off the chart.

Bonus tip: Low-fat dairy is shown to lower cortisol. Cortisol blocks the conversion of one of your thyroid hormones into the kind that control metabolism so we never want too much cortisol when we’re trying to power up our thyroid. Try incorporating a low-fat yogurt (my favorite is sheep’s milk Greek yogurt).

Other foods you can freely consume include:

One serving of grains and potatoes, the size of your fist (during the second week only): Millet, rice and rice products, buckwheat, rice pasta, rice cakes, rice crackers, potatoes or sweet potatoes. Have just one serving, the size of your fist, per day, at lunch or dinner, .

Vegetables: Unlimited amounts of all vegetables except corn. Potatoes including sweet potatoes and white potatoes are allowed during the second week only. All other starchy vegetables including squash, turnip, pumpkin, beets, carrots and peas are freely allowed in both weeks.

Fruits: All fruits except oranges, tangerines, grapefruit, canned fruits, raisins, dates and other non-organic dried fruits.

Beans: All beans are allowed.

Two handfuls of nuts and seeds: All nuts except for peanuts and all seeds are fine. Or have a tablespoon of nut butter (excluding peanut butter).

Fish and meat: All poultry (chicken, turkey, duck, etc.), fish and seafood are fine.

One serving of dairy (made from sheep or goat’s milk): Feta (made from sheep’s or goat’s milk), goat cheese or small amounts of butter.

Oils: Canola oil, flax oil, hemp oil, coconut oil and extra virgin olive oil are the only oils you should consume.

Eggs: Both yolks and whites are allowed.

Milks: Oat, almond and rice milk fine, but avoid those with added sugar.

Sweeteners: Sugar alcohols and stevia are allowed.

Step 3: Eat a Cheat Meal on Day 14

While one part of this process involves becoming calorie conscious, studies have shown that eating a “cheat meal” about once a week is essential for people suffering from an underactive thyroid. It prevents the body from going into starvation mode when dieting, keeping your thyroid hormone T3 (the active type) high and boosting metabolism. I recommend having your cheat meal at the end of 10 to 14 days of my clean eating plan and then ongoing once a week.

For the complete plan, recipes and more visit drnatashaturner.com

This plan was originally created for Dr. Oz’s Truth Tube. Get past expert Truth Tube plans here.

Does Underactive Thyroid Lead To Weight Gain—Or Vice-Versa?

with Arthur Schneider, MD, PhD

Low thyroid functioning is often blamed for weight gain. Your thyroid gland, a butterfly-shape organ in the front of your neck, makes hormones that control metabolism, weight, breathing, heart rate and many other functions.

But new research has raised questions about whether the link could go the other way, according to Cari Kitahara, PhD, MHS, an epidemiologist at the National Cancer Institute.

Some study findings suggest that excess weight may be behind the slowing down of thyroid function instead of a sluggish thyroid leading to an increase in unanticipated weight gain. Dr. Kitahara presented findings of her investigation regarding the interrelationship between obesity, thyroid function and weight at the 86th annual meeting of the American Thyroid Association in Denver, Colorado.1

Understanding the link between weight and thyroid is crucial, she and others say, because obesity raises your risk of getting thyroid cancer. And if her research and that of others bears out, treating an overweight person with thyroid medication may be the wrong course of action, she says, if in fact the weight gain is what made the thyroid sluggish. The better approach, in some cases, may be weight loss.1

Unraveling the Thyroid Cancer-Obesity Links

Excess weight and thyroid cancer risk are linked, experts know. Dr. Kitahara and her team reconfirmed this recently, looking at 22 studies that had been published in medical journals and reanalyzing the results, publishing them in Thyroid. These studies included more than 830,000 men and more than 1.2 million women; all had submitted information on height, body mass index (BMI) and waist circumference. 2

The higher the BMI throughout adulthood, the higher the risk of getting thyroid cancer and dying from it, the new analysis found. 2

Experts have long thought that thyroid stimulating hormone (TSH), which tells your thyroid to make and release thyroid hormones, plays a role in thyroid cancer, since it influences the growth of thyroid cells. According to Dr. Kitahara, if someone has low thyroid function, their TSH is high, and the thyroid hormones known as T3 and T4 are low—and weight gain often occurs.

If someone has an overactive thyroid or hyperthyroidism, TSH is usually low, the T3 and T4 are high, and weight loss occurs.

For more clues about which way the link goes, Dr. Kitahara’s team has looked at those with normal thyroid function (known medically as euthyroid patients). “Research on euthyroid individuals has produced conflicting results, which suggests a bi-directonality,” she says.

Small variations in weight in persons with normal thyroid function can affect levels of thyroid hormones, Dr. Kitahara has found. “In euthyroid patients, weight loss lowers TSH and T3, while weight gain raises TSH and T3,” she says.1

How small of a gain or loss might have an effect on thyroid hormones levels? Dr. Kitahara tells EndocrineWeb that an increase in body mass index (BMI) of about 5 units can be enough to affect thyroid hormones. For instance, a person 5’8″ whose weight goes from 140 to 170 pounds would increase their BMI from about 21 to 26 (25 and above is termed overweight). 1,4

Another finding of interest that lends support to the idea that the weight affects the thyroid hormones levels: There is limited evidence that thyroid hormone treatment leads to weight loss or other benefits in obese patients who have normal thyroid function, Dr. Kitahara says.1

Understanding Impact of Obesity on the Thyroid Gland

If an obese person with normal thyroid function has a higher TSH, Dr. Kitahara says, ”it may be a consequence of excess weight,” she says. Research also suggests that weight loss interventions may be best to reduce the risk of developing a high TSH level.

Reducing TSH to normal levels may also lower thyroid cancer risk, she says, since TSH fuels the growth of thyroid cells and TSH levels are found to be high in thyroid cancer patients with aggressive tumors, she says. More research is needed in this area, however, she says.1,3

Perspective & Action Plan for Patients

The concept of excess weight leading to an underactive thyroid may sound backwards, says Arthur Schneider, MD, PhD, professor emeritus at the University of Illinois College of Medicine at Chicago, who is familiar with the new research. However, he says that physicians should consider the possibility that ”some subtle changes in thyroid may be the result of obesity, not the cause of it.”

In Dr. Kitahara’s view: If you are obese with an elevated TSH, weight loss may be a better course of action if testing does not turn up any underlying thyroid disorders. She points to other research finding that when obese patients with normal thyroid function lose weight, their TSH and T3 levels decline—among other health benefits.1

Last updated on 12/16/2019 Continue Reading Thyroid Cancer: Epidemic or Overdiagnosis? View Sources

1. Cari Kitahara presented: Adiposity, Weight Gain, and Thyroid Disease at the American Thyroid Association 86th annual Meeting, September 24, 2016, Denver, Colorado.

Weight Loss after Therapy of Hypothyroidism Is Mainly Caused by Excretion of Excess Body Water Associated with Myxoedema

Context: In hypothyroidism, resting energy expenditure (REE) is reduced and weight gain is common. Physical activity contributes to the total daily energy expenditure, and changes in physical activity might contribute to hypothyroid-associated weight changes.

Objective: The objective of the present study was to evaluate mechanisms involved in body weight changes associated with hypothyroidism.

Design, Setting, and Participants: We conducted a 1-yr controlled follow-up study on outpatients newly diagnosed with hypothyroidism (n = 12) and a euthyroid measurement control group (n = 10).

Main Outcome and Interventions: Changes in body mass and composition (dual-energy x-ray analysis scan), REE (indirect calorimetry), and spontaneous physical activity (pedometers and two different questionnaires) were studied before and after 12 months of l-T4 therapy or observation (control group).

Results: TSH changed from 102 (85) to 2.2 (2.1) mU/liter mean (SD) and free T4 from 4.5 (2.1) to 18 (3.3) pmol/liter after 1 yr of treatment. Body weight decreased from 83.7 (16.4) to 79.4 (16.0) kg (P = 0.002) due to change in the lean mass subcompartment only (P = 0.001) because fat and bone mass was virtually unchanged. Significant increase was observed in REE and in physical activity measured with questionnaires but not measured as daily steps. No significant changes were observed in the control group.

Conclusion:l-T4 therapy of hypothyroidism associated with significant decrease in body weight and increase in REE. Physical activity measured with questionnaires increased significantly, but not number of daily steps. Despite changes in REE and body weight, fat mass was unchanged during the study. We propose that total body energy equilibrium is maintained during treatment of hypothyroidism and that weight loss observed during such treatment is caused by excretion of excess body water associated with untreated myxoedema.

Changes in body weight are common in patients with hypothyroidism (1). In general, weight changes are due to either a mismatch between energy intake and energy expenditure leading to accumulation or loss of body fat or a change in body water content secondary to disease or medication. The total daily energy expenditure is a sum of the basal metabolic rate (on the order of 60%), the energy required for physical activity (on average 10–30%), and the thermogenic effect of food (usually 10%) (2).

The thyroid hormones are important determinants of the basal metabolic rate (3), which is a likely cause for the correlation between biochemical thyroid function and body mass index that has been observed even in euthyroid subjects (4). Another possible weight-increasing mechanism in hypothyroidism is a decreasing level of spontaneous physical activity level. In man, hypothyroidism has been shown to influence skeletal muscle metabolism and function (5, 6), and psychomotor slowing and impaired cardiac output has also been shown (7, 8). It may thus be speculated that hypothyroidism is associated with a reduced physical activity level that may contribute some of the body weight changes often observed in this disease.

Finally, hypothyroidism is associated with accumulation of water-binding glycosaminoglycans which led to the term myxoedema (9). It is conceivable that changes in body water content might be involved in the weight changes in hypothyroidism.

To clarify mechanisms involved in body weight changes associated with hypothyroidism, we assessed the body composition, resting energy expenditure (REE) and physical activity level in patients with overt hypothyroidism before and after 12 months of L-T4 replacement therapy.

Patients and Methods

We consecutively included patients with newly diagnosed autoimmune overt hypothyroidism referred to our unit by their general practitioner. Exclusion criteria were previous thyroid disease, hypothyroidism treated for more than 1 wk, use of medication that could interfere with thyroid function tests, a psychiatric diagnosis, physical incapacity, pregnancy within 12 months or age under 18 or above 80 yr.

Twelve patients were included and underwent physical investigation, measurement of body composition, REE, and evaluation of physical activity. During the study, the patients’ general practitioner regularly monitored thyroid function and adjusted the l-T4 treatment accordingly. Blood samples for the study were obtained at baseline and after 1 yr of l-T4 treatment. The patients were also investigated after 1, 2, 3, and 6 months with pedometers and the physical activity questionnaire. The patients attended the investigational sessions after an overnight fast.

Informed consent was signed before entering the study, which was approved by the Regional Ethics Committee for North-Jutland and Viborg County, Denmark.

Body composition

Resting energy expenditure

REE was measured with indirect calorimetry on an open-circuit system using a Deltatrack II metabolic monitor (Datex, Helsinki, Finland). Flow and gas concentration measurements were performed every minute for 30 min, and the last 20 recordings were used for calculation of REE, expressed as kilocalories per 24 h.

Physical activity

Physical activity was studied using three different methods: step counting and two different questionnaires.

Sealed pedometers (SW-200; Yamax, Tokyo, Japan) worn on the waistband were used for step counting. The patients were asked to ambulate as usual and to wear the pedometer during all waking hours. Measurements were performed on days of ordinary life, not weekends or holidays (10). Measurements with daily step counts fewer than 1000 were considered measurement failures and discarded. The mean of 3 d of pedometer measurements was used for the calculations.

In the physical activity questionnaire, the participants reports how many hours per day they are engaged in nine different levels of physical activity (11). This yields a total physical activity score reflecting physical activity level during an average working day the previous month.

The physical component summary from the general quality-of-life questionnaire Short Form 36 (SF-36) version 1 in Danish was used (12). In both questionnaires, a higher score is better.

Evaluation of constancy of the measurements

A control group was included concurrently to validate the constancy of the measurement methods. Ten patients treated with radioactive iodine for euthyroid goiter more than 1 yr previously was included. All participants were euthyroid throughout the study, two harbored thyroid peroxidase autoantibodies, and none received l-T4 treatment or antithyroid drugs at any point in time. Apart from a minimal increase in TSH, no significant changes were observed in any of the variables listed in Table 1 in the control patients after 1 yr.

TABLE 1.

Characteristics, hormone levels, body composition, REE, and physical activity in hypothyroid patients at inclusion and after 1 yr

For working status, working means employed and retired means unemployed or retired. REE was measured with indirect calorimetry. Body mass index (BMI) is body weight divided by height squared. Physical activity (PA) score was evaluated by questionnaire (11 ). The physical component summary (PCS) is from the SF-36 questionnaire (12 ). P values are for differences between baseline values vs. after 1 yr. A paired t test was used for all variables except fT4 (Wilcoxon test). NA, Not applicable.

TABLE 1.

Characteristics, hormone levels, body composition, REE, and physical activity in hypothyroid patients at inclusion and after 1 yr

For working status, working means employed and retired means unemployed or retired. REE was measured with indirect calorimetry. Body mass index (BMI) is body weight divided by height squared. Physical activity (PA) score was evaluated by questionnaire (11 ). The physical component summary (PCS) is from the SF-36 questionnaire (12 ). P values are for differences between baseline values vs. after 1 yr. A paired t test was used for all variables except fT4 (Wilcoxon test). NA, Not applicable.

Hormone assays

Serum TSH, free T4 (fT4), and free T3 (fT3) were measured in duplicate in random order using an electrochemiluminescence immunoassay method on a Modular Analytics E170 (Roche, Germany).

Statistical evaluation

Conformation to normal distribution was tested with quintile-quintile normal distribution plots and the Shapiro-Wilks test. Except for fT4 hormone levels, where nonparametric tests were used, data followed the normal distribution, and parametric tests were used. A P value <0.05 was considered statistically significant. The Statistical Package for Social Sciences version 11.0 (SPSS, Chicago, IL) and Excel 2003 (Microsoft Corp., Redmond, WA) were used for the calculations.

Results

Patients’ characteristics and thyroid function tests at inclusion and after 12 months are shown in Table 1. All hypothyroid patients harbored thyroid peroxidase autoantibodies.

Body composition and REE

Body weight decreased on average 4.3 kg after 1 yr of l-T4 therapy. This decrease in total body weight was caused by a significant decrease of 3.8 kg in the lean mass subcompartment (Table 1). A small and insignificant decrease was observed in the fat mass subcompartment, and bone mass was equal between the two measurements. At study entry, the patients were asked about their weight 6 months earlier. This recalled weight was 82.1 (14.4) kg, with an estimated increase in weight during the 6 months before inclusion of 2.8 kg. Recalled weight was significantly different from the weight at inclusion (P = 0.03) but not after 12 months (P = 0.37).

Physical activity level

The step counts varied widely from day to day in all the participants. No significant trend (Friedman, P = 0.99) or change (P = 0.55) occurred in number of daily steps during the year (Fig. 1, upper panel).

Fig. 1.

Mean (±sem) of the measured number of steps per day (upper panel, Friedman P = 0.41) and physical activity score (lower panel, Friedman P = 0.018) at baseline and during 12 months of l-T4 replacement therapy.

Fig. 1.

Mean (±sem) of the measured number of steps per day (upper panel, Friedman P = 0.41) and physical activity score (lower panel, Friedman P = 0.018) at baseline and during 12 months of l-T4 replacement therapy.

Discussion

Changes in body weight during treatment of hypothyroidism

As expected, therapy of hypothyroidism was followed by a moderate decrease in body weight. Intuitively, it might be speculated that such weight loss was mainly caused by loss of body weight due to an increase in energy expenditure. The average increase in REE after 1 yr of therapy was 215 kcal/24 h. If this increase in REE was effective during 6 months of the treatment period, this transforms to combustion of 4.4 kg of fat tissue. This theoretical estimate contrasts the virtual absence of change in body fat observed. We did not quantify the energy intake during the study, but it may be hypothesized that increased energy intake had efficiently counteracted the energy loss from an increase in REE and spontaneous physical activity level in the hypothyroid patients studied. In rats, low doses of T3 has orexigenic effects without interfering the REE or the locomotor activity (13).

Changes in physical activity during treatment of hypothyroidism

The spontaneous physical activity level has not previously been studied in patients with hypothyroidism. We found that during treatment, physical activity increased as evaluated with questionnaires, but not as daily steps taken. The coefficient of variation during the year was 27% in the physical activity questionnaire compared with 42% for the pedometer measurements. The large variation in the pedometer measurements is a major drawback to detect changes. In keeping with this, we found no significant changes in step count during the year.

Another possible explanation for the lack of difference in step counts is that the measured numbers of steps represent a necessary minimum to maintain the everyday lifestyle habits of the individual, and this may be largely unaffected by the fact that the patients were hypothyroid. The questionnaires, on the other hand, may reflect the self-experienced burden of the necessary physical activity and may also be influenced by the difference between what the individual actually does and assumes he or she should be able to do.

Possible mechanisms of weight loss during treatment of hypothyroidism

The only significant predictor of the 5% decrease in body weight during l-T4 therapy in hypothyroid patients was baseline fT4 level. The weight change was caused by a change in lean body mass, because fat mass was largely unaltered. A dual-energy x-ray analysis scan provide a two-component soft tissue model consisting of fat mass and lean mass subcompartments, the latter comprising water, proteins, glycogen, and minerals not tied to bone (14). Hypothyroid patients have reduced capacity of renal free-water excretion (15), increased antidiuretic hormone level (16), and increased amount in tissues of glycosaminoglycans, which have large water-binding capacity (17). Other water-retaining mechanisms from increased protein extravasation to a decreased lymphatic drainage have also been described (18). The high water content of the skin, observed in severe hypothyroidism, originated the term myxoedema (9). Soon after the description of myxoedema, it was noted that therapy with thyroid hormones was followed by an increase in urine output in such patients (19).

Strengths and limitations

Strengths of this study are the evaluation of the spontaneous level of physical activity using three different methods and the addition of a measurement control group. Limitations are the lack of registration of energy intake and of measurement of the thermogenic effect of food.

Conclusion

One year of l-T4 treatment of hypothyroidism was associated with decreased body weight attributable to a decrease in lean mass because total fat mass was largely unchanged. REE increased during treatment as did the physical activity level measured with two different questionnaires, but not when measured as daily steps taken. We hypothesize that during l-T4 replacement therapy of hypothyroidism, the total body energy equilibrium is maintained, and the weight loss often observed during such treatment is predominantly due to loss of excess body water accumulated during the state of myxoedema.

We are indebted to laboratory technicians Ingelise Leegaard, Anne-Mette Christensen, and Anette Godsk for invaluable assistance with thyroid ultrasound investigations and biochemical analyses.

The kits for the hormonal analyses were kindly provided by Roche. Speciallæge Heinrich Kopps legat provided financial funding for the study.

Disclosure Summary: All authors have nothing to declare.

Abbreviations:

  • fT4,

    Free T4;

  • REE,

    resting energy expenditure;

  • SF-36,

    Short Form 36.

1 Zulewski H , Müller B , Exer P , Miserez AR , Staub JJ 1997 Estimation of tissue hypothyroidism by a new clinical score: evaluation of patients with various grades of hypothyroidism and controls. J Clin Endocrinol Metab 82:771–776 2 Toth MJ 1999 Energy expenditure in wasting diseases: current concepts and measurement techniques. Curr Opin Clin Nutr Metab Care 2:445–451 3 Kim B 2008 Thyroid hormone as a determinant of energy expenditure and the basal metabolic rate. Thyroid 18:141–144 4 Knudsen N , Laurberg P , Rasmussen LB , Bülow I , Perrild H , Ovesen L , Jørgensen T 2005 Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population. J Clin Endocrinol Metab 90:4019–4024 5 Visser WE , Heemstra KA , Swagemakers SM , Ozgür Z , Corssmit EP , Burggraaf J , van Ijcken WF , van der Spek PJ , Smit JW , Visser TJ 2009 Physiological thyroid hormone levels regulate numerous skeletal muscle transcripts. J Clin Endocrinol Metab 94:3487–3496 6 Simonides WS , van Hardeveld C 2008 Thyroid hormone as a determinant of metabolic and contractile phenotype of skeletal muscle. Thyroid 18:205–216 7 Klein I , Ojamaa K 2001 Thyroid hormone and the cardiovascular system. N Engl J Med 344:501–509 8 Dugbartey AT 1998 Neurocognitive aspects of hypothyroidism. Arch Intern Med 158:1413–1418 9 Ord WM 1878 On myxoedema: a term proposed to be applied to an essential condition in the “cretinoid” affection occasionally observed in middle aged women. Med Chir Trans 61:57–74 10 Tudor-Locke C , Burkett L , Reis JP , Ainsworth BE , Macera CA , Wilson DK 2005 How many days of pedometer monitoring predict weekly physical activity in adults? Prev Med 40:293–298 11 Aadahl M , Jørgensen T 2003 Validation of a new self-report instrument for measuring physical activity. Med Sci Sports Exerc 35:1196–1202 12 Bjorner JB , Damsgaard MT , Watt T , Groenvold M 1998 Tests of data quality, scaling assumptions, and reliability of the Danish SF-36. J Clin Epidemiol 51:1001–1011 13 Kong WM , Martin NM , Smith KL , Gardiner JV , Connoley IP , Stephens DA , Dhillo WS , Ghatei MA , Small CJ , Bloom SR 2004 Tri-iodothyronine stimulates food intake via the hypothalamic ventromedial nucleus independent of changes in energy expenditure. Endocrinology 145:5252–5258 14 Pietrobelli A , Formica C , Wang Z , Heymsfield SB 1996 Dual-energy x-ray absorptiometry body composition model: review of physical concepts. Am J Physiol 271:E941–E951 15 Sahún M , Villabona C , Rosel P , Navarro MA , Ramón JM , Gómez JM , Soler J 2001 Water metabolism disturbances at different stages of primary thyroid failure. J Endocrinol 168:435–445 16 Park CW , Shin YS , Ahn SJ , Kim SY , Choi EJ , Chang YS , Bang BK 2001 Thyroxine treatment induces upregulation of renin-angiotensin-aldosterone system due to decreasing effective plasma volume in patients with primary myxoedema. Nephrol Dial Transplant 16:1799–1806 17 Smith TJ , Bahn RS , Gorman CA 1989 Connective tissue, glycosaminoglycans, and diseases of the thyroid. Endocr Rev 10:366–391 18 Parving HH , Hansen JM , Nielsen SL , Rossing N , Munck O , Lassen NA 1979 Mechanisms of edema formation in myxedema: increased protein extravasation and relatively slow lymphatic drainage. N Engl J Med 301:460–465 19 Fenwick EH 1891 The diuretic action of fresh thyroid juice. BMJ 2:798–799 Copyright © 2011 by The Endocrine Society

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