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    Thyroid Health

    The buzz phrase ‘boost your metabolism’ is catchy, and is often spotted on the cover of weight loss magazines, while in the checkout line at a grocery store. If you have spent time searching for ways to support your metabolism, you likely have come across the importance of supporting thyroid health. As our main metabolism hormone, the thyroid is one that should be explored further, especially if we feel as if ours might be ‘sluggish’.

    How do we know if we have a thyroid concern?  We visit our doctor and discuss going for thyroid blood work. 

    Here is a comprehensive thyroid panel to discuss with your health care practitioner to consider which ones may be beneficial for you:1

    • TSH: Thyroid stimulating hormone is the most common thyroid lab to be tested.
    • Free T4 (inactive hormone): T4 is the hormone most thyroid medications, like Levothyroxine, will target.
    • Free T3 (active hormone): Nutritional deficiencies, stress and inflammation will impact the percent of T4 turning into T3.
    • Anti-TPO & Anti-TG: Thyroid antibodies will determine the presence of autoimmunity, like Hashimoto's.
    • **Reverse T3: **Optional. Tested to determine the level of impact from stress and inflammation.

    Symptoms

    As our main metabolism hormone, the thyroid is in communication with all cells within our body, determining growth and speed at which our natural body processes occur.2  As a result, we can run into an assortment of symptoms, such as:1

    • Unplanned weight gain
    • Brittle hair & nails
    • Fatigue & sensitivity to cold
    • Muscle weakness & stiffness
    • Constipation
    • Forgetfulness & confusion
    • Vocal hoarseness
    • Pale & dry skin with puffy face
    • Irregular or absent periods

    Tracking thyroid symptoms in a journal or phone app, can be a great first step.  Depending on the symptoms you experience and your current health goals, further investigation is often beneficial.  That way, a suitable plan can be put in place to ensure you are fully supported.

    Causes and Prevalence

    Thyroid Health Conditions are considered a worldwide health issues, impacting an estimated 5% of the general population.3  It is estimated that 1 in every 300 people in the US are affected by the concern, with a higher occurrence in women than men.1

    Nutrition

    Chances are, if you have been concerned about your thyroid health for a while, you may have come across conflicting nutrition advice and wondered where the research currently stands. Let’s discuss supplemental and nutritional considerations, first starting with diet:

    • Do you really need to avoid broccoli? You might have been told to avoid brassica vegetables, such as broccoli, cauliflower, kale, and Brussels sprouts, in fear they may somehow play into thyroid functioning concerns.. Although compounds in brassica vegetables have been identified that are known to inhibit iodine uptake by the thyroid gland , we have yet to see a negative human study on the consumption of brassica vegetables and changes in TSH, T3 and T4 levels.4
    • What about going gluten-free?The research into gluten free diets seems to be inconclusive over all.  One of the more recent studies into, found improvement in both TSH and thyroid antibody levels after following a gluten-free diet for 12 months in participants with autoimmune thyroid diseases.5 The researchers did speculate that the improvement may have been from having improved absorption of their thyroid medication.5  The take-home message with gluten-free eating, assuming the absence of Celiac disease, should be that if you feel better being gluten-free, certainly continue with it.  But if you find it difficult to maintain, know that the research is still not totally solid as of yet.
    • What about the Autoimmune Protocol (AIP) diet? It involves restricting grains, legumes, dairy, eggs, alcohol, coffee, nuts and seeds, nightshade vegetables, sugars, and food additives.  One study had participants  with autoimmune thyroid disease start the AIP diet, and provided them with weekly meetings and support, and it did show improvement with their  thyroid health.6  It should come into question whether the food removals were the main beneficial factor, and the degree to which participants simply felt better by having weekly support made available to them.

    What we do know to be true from a dietary perspective, is that what works for one person, will not necessary work for the next.  Listening to your body and finding out what works best for you, will always be the most important take-home message.  When in doubt, return to the basics, including adequate protein, fibre and healthy fat sources, along with plenty of vegetables and fruits, and complex carbohydrates.  Also, consider the help of nutrition experts like dieticians or nutrition practitioners to help understand diet and thyroid health.

    Let’s now get into the research for specific supplementation:

    • Iodine: We need adequate iodine for optimal thyroid functioning, which is why many foods are now fortified with iodine, such as our salt.  Caution should be given with additional iodine supplementation for those already exposed to foods fortified with iodine. Speak with your primary health care practitioner to see if iodine supplementation is right for you.7
    • Vitamin D:There is some research to support people who have sub-optimal thyroid function, may also present with lower Vitamin D levels,9 and there are two studies of note, supporting the use of vitamin D for reducing antibody levels. One study showed a 20% decrease in anti-TPO levels after supplementing with vitamin D for 4 months in participants with autoimmune thyroid disease.8Another study showed a 45% decrease in anti-TPO levels, after 8 weeks of vitamin D supplementation in a population with autoimmune thyroid disease.9 The amount of vitamin D we would get from being outside in the sunshine, would not be enough to match the therapeutic dosing seen within these studies.  Speak to your health care provider about assessing Vitamin D levels on your blood work.
    • Selenium: Selenium supplementation has also shown to lower both anti-TPO and anti-TG levels in people with poor thyroid function over the span of 3 and 6 months.10,11
    • Ashwagandha: Ashwagandha has benefits with reducing stress levels,12as well as benefits on thyroid health.  It has been shown to significantly improve TSH, T4 and T3 levels in people with low functioning thyroid, 8 week span.13

    Thyrosmart by Smart Solutions is a combination of research-backed vitamins, minerals and herbs that directly support optimal thyroid health and function.1Thyrosmart is specially formulated to support the optimal function of the thyroid.14Please always consult with your health care practitioner to see if this product is right for you.

    Lifestyle

    Let’s highlight some research in support of lifestyle adjustments:

    • Ensuring quality sleep.There is an association with sleep quality, providing benefit on optimizing thyroid function.15
    • Using a mobile application to track symptoms. There is research looking at supporting quality of life with thyroid concerns, using mobile applications like BOOST thyroid.  Out of 380 participants with a thyroid concern, 95.8% reported the mobile application to be a useful tool, with 68% reporting it had improved their quality of life, and 70% suggesting it had a positive impact on health.16
    • Benefits of exercise on sub-optimal thyroid function.Women with sub-optimal thyroid function who either biked or used the treadmill for 60 minutes, 3 times per week for 16 weeks, showed improvement in quality of life, and emotional, mental and physical health, related to their thyroid concern.17
    • Support for weight management with an under-active thyroid. Obesity and metabolic abnormalities are both associated with an increased risk of thyroid-related concerns, with increasing anti-TPO levels to be associated with obesity.18 This speaks to the need for adequate support with weight loss interventions, on overall thyroid health.

    References

    1. Wilson, S. A., Stem, L. A., & Bruehlman, R. D. (2021). Hypothyroidism: Diagnosis and Treatment. American family physician103(10), 605–613.
    2. Brent G. A. (2012). Mechanisms of thyroid hormone action. The Journal of clinical investigation, 122(9), 3035–3043. https://doi.org/10.1172/JCI60047
    3. Chiovato, L., Magri, F., & Carlé, A. (2019). Hypothyroidism in Context: Where We've Been and Where We're Going. Advances in therapy36(Suppl 2), 47–58. https://doi.org/10.1007/s12325-019-01080-8
    4. Babić Leko, M., Gunjača, I., Pleić, N., & Zemunik, T. (2021). Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels. International journal of molecular sciences22(12), 6521. https://doi.org/10.3390/ijms22126521
    5. Pobłocki, J., Pańka, T., Szczuko, M., Telesiński, A., & Syrenicz, A. (2021). Whether a Gluten-Free Diet Should Be Recommended in Chronic Autoimmune Thyroiditis or Not?-A 12-Month Follow-Up. Journal of clinical medicine10(15), 3240. https://doi.org/10.3390/jcm10153240
    6. Abbott, R. D., Sadowski, A., & Alt, A. G. (2019). Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto's Thyroiditis. Cureus11(4), e4556. https://doi.org/10.7759/cureus.4556
    7. Farebrother, J., Zimmermann, M. B., & Andersson, M. (2019). Excess iodine intake: sources, assessment, and effects on thyroid function. Annals of the New York Academy of Sciences1446(1), 44–65. https://doi.org/10.1111/nyas.14041
    8. Mazokopakis, E. E., Papadomanolaki, M. G., Tsekouras, K. C., Evangelopoulos, A. D., Kotsiris, D. A., & Tzortzinis, A. A. (2015). Is vitamin D related to pathogenesis and treatment of Hashimoto's thyroiditis?. Hellenic journal of nuclear medicine18(3), 222–227.
    9. Chaudhary, S., Dutta, D., Kumar, M., Saha, S., Mondal, S. A., Kumar, A., & Mukhopadhyay, S. (2016). Vitamin D supplementation reduces thyroid peroxidase antibody levels in patients with autoimmune thyroid disease: An open-labeled randomized controlled trial. Indian journal of endocrinology and metabolism20(3), 391–398. https://doi.org/10.4103/2230-8210.179997
    10. Wang, L. F., Sun, R. X., Li, C. F., & Wang, X. H. (2021). The effects of selenium supplementation on antibody titres in patients with Hashimoto's thyroiditis. Endokrynologia Polska72(6), 666–667. https://doi.org/10.5603/EP.a2021.0074
    11. Wichman, J., Winther, K. H., Bonnema, S. J., & Hegedüs, L. (2016). Selenium Supplementation Significantly Reduces Thyroid Autoantibody Levels in Patients with Chronic Autoimmune Thyroiditis: A Systematic Review and Meta-Analysis. Thyroid : official journal of the American Thyroid Association26(12), 1681–1692. https://doi.org/10.1089/thy.2016.0256
    12. Choudhary, D., Bhattacharyya, S., & Joshi, K. (2017). Body Weight Management in Adults Under Chronic Stress Through Treatment With Ashwagandha Root Extract: A Double-Blind, Randomized, Placebo-Controlled Trial. Journal of evidence-based complementary & alternative medicine22(1), 96–106. https://doi.org/10.1177/2156587216641830
    13. Sharma, A. K., Basu, I., & Singh, S. (2018). Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. Journal of alternative and complementary medicine (New York, N.Y.)24(3), 243–248. https://doi.org/10.1089/acm.2017.0183
    14. Government of Canada. Product information. Accessed on January 29th, 2022 at http://health-products.canada.ca/lnhpd-bdpsnh/info.do?licence=80078180
    15. Wu, K., Zhou, Y., Ke, S., Huang, J., Gao, X., Li, B., Lin, X., Liu, X., Liu, X., Ma, L., Wang, L., Wu, L., Wu, L., Xie, C., Xu, J., Wang, Y., & Liu, L. (2021). Lifestyle is associated with thyroid function in subclinical hypothyroidism: a cross-sectional study. BMC endocrine disorders21(1), 112. https://doi.org/10.1186/s12902-021-00772-z
    16. Högqvist Tabor, V., Högqvist Tabor, M., Keestra, S., Parrot, J. E., & Alvergne, A. (2021). Improving the Quality of Life of Patients with an Underactive Thyroid Through mHealth: A Patient-Centered Approach. Women's health reports (New Rochelle, N.Y.)2(1), 182–194. https://doi.org/10.1089/whr.2021.0010
    17. Werneck, F. Z., Coelho, E. F., Almas, S. P., Garcia, M., Bonfante, H., Lima, J., Vigário, P., Mainenti, M., Teixeira, P., & Vaisman, M. (2018). Exercise training improves quality of life in women with subclinical hypothyroidism: a randomized clinical trial. Archives of endocrinology and metabolism62(5), 530–536. https://doi.org/10.20945/2359-3997000000073
    18. Wang, Y., Lin, H., Li, Q., Guan, L., Zhao, M., Zhong, F., Liu, J., Yuan, Z., Guo, H., Song, Y., Gao, L., & Zhao, J. (2021). Association between different obesity phenotypes and hypothyroidism: a study based on a longitudinal health management cohort. Endocrine72(3), 688–698. https://doi.org/10.1007/s12020-021-02677-2

     

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