#6 Do You Think It’s My Thyroid? The Thyroid Nutrition Connection
In the last episode we started to get into the nutritional influences and deficits of our current patient population. This episode I want to continue down our path of nutritional influence. The focus however, is on a topic that you may not commonly connect to dietary influences. The thyroid. I have some insights into the connection between food intake and thyroid function that may surprise you. AND, I can almost guarantee that most of you haven’t heard it before.
This topic is VERY important to your daily clinical practice. My journey in thyroid knowledge came from my quest to find answers to a recurring observation in my practice. --- You see, I can’t stand to “not” know the answer to a question or have information to offer a patient. I will do everything in my power to get that answer or information. And I’ll be darned if the information I found hasn’t led me further into this path to improve function with lifestyle management.
In my 20-40 year old patient population, one of the most common questions I get is, “do you think there’s a problem with my thyroid?” A question that I am sure you too get in your practice daily! Weight gain and fatigue are the top 2 symptoms that bring people in for that question and the requested thyroid check. Everyone wants to think to think that you can draw a thyroid panel and get a quick and “easy” fix of thyroid replenishment to reverse weight gain and fatigue. Not so easy though! Yes, I know there are MANY reasons for weight gain and fatigue. The part that was perplexing me was the REST of the scenario.
I would ask all of the appropriate questions and get a positive review of systems suggesting hypothyroidism. Dry skin, cold intolerance, constipation, foggy brain…You know, the classic presentation.
I would of course, as any good clinician would do, follow that interview and symptom review up with an exam. Again and again, I would find a diffusely enlarged thyroid. The remainder of the exam may or may not include an elevated BMI, dry skin, diminished reflexes and decreased bowel activity. Side Note: If you don’t regularly palpate the thyroid, you need to. You may be surprised at how many enlarged glands you find. Which, should in turn trigger you to a take a closer look at the review of symptoms.
To continue:
Feeling pretty confident I had clinically made the diagnosis of hypothyroidism, I would draw the thyroid panel expecting to confirm that suspicion prior to initiating treatment. The surprise was to find in many cases the thyroid panel was fairly unremarkable. How could this be? And yes, I checked the whole panel, not just a TSH. You might be thinking subclincal, but I am not happy with that because I already have a different view on normal ranges for thyroid levels. I want to know data and initiate the appropriate therapy. If they are symptomatic watch and wait isn’t the answer. To prescribe thyroid medications for potential “symptomatic relief” based on “suspected” subclinical hypothyroidism is not acceptable either. There are potential risks associated with such an action.
So what would you do in this situation? What should you do? Ha! You know I can’t just tell you the answer! What’s the fun in that??
I prefer to give you some fun facts to learn from that you can tell your patients in a way that makes sense to them in hopes of increasing compliance with treatment. I do go deeper into the evaluation of the appropriate diagnostic studies, interpretation, management and the role of thyroid function in overall wellness and weight management in my online course for successfully adding weight management to your practice! For this we keep it real and keep it light.
As a simply stated review, the thyroid moderates metabolism, bodily functions, growth and development. Every cell of the body is ran by thyroid regulation. If the thyroid is not functioning correctly the evidence of malfunction can be seen in weight, heart rate, GI motility, skin, hair, nails and cognitive function. EVERY cell, every system.
The pituitary gland produces and sends out TSH to signal the thyroid to produce T3 and T4 based on the body’s needs. The thyroid uses iodine to make this happen.
NOW, this is where we are start to get into the nutrition connection piece.
If you do not have enough iodine to produce T3 and T4 effectively, the thyroid will enlarge. This is because the pituitary gland continues to increases production of TSH to send signal for more T3 and T4. As a result the thyroid gland starts to enlarge, and there you have the goiter.
A little historical factoid for you.... Iodine was added to Morton’s salt in 1924 to supplement thyroid function and reduce the incidence of goiters. The use of iodized salt in and on food was very effective. That was, until the American Heart Association recommended a low sodium diet to combat hypertension and cardiac dysfunction. Another factor was way back to the industrial revolution when foods became mass-produced with additives to preserve their shelf life. As a nation we started eating less homecooked meals and more prepackaged convenience foods, with less nutritional value. I am going to say that we probably should’ve just left the saltshaker on the table. The mass production of convenience foods, with the addition of preservatives, including sodium which is not the same as iodized table salt, has us in worse shape than we ever were.
You now know we are again iodine deficient from removing the Morton’s Iodized salt shaker and not eating enough real food which contains iodine, but there’s more. Bromide. Bromide is a chemical that was once used in many sedatives and anti-epileptics. (Thinking about chronic fatigue?) Bromide is similar in structure to iodine and like a big bully, takes over and blocks the iodine receptors. Now the iodine we really need is being excreted because the big bully is taking over. TSH production continues to increase, as does the size of the thyroid gland. Along with this comes all of the signs of hypothyroidism. The fatigue, weight gain, the G.I. distress, the mental fog.
One of the biggest sources of bromide ingestion is through brominated vegetable oil. This brominated vegetable oil is added to sodas, beverages and other products to keep additives from separating on the shelf.
Another form of bromide is potassium bromate. This form is added to flour. Flour that is used in breads and other baked goods, which we know are well loved staples in the standard American diet. For example, think white bread, hot dog and hamburger buns, twinkies, pop tarts and donuts. How do you think they can stay on the shelf for so long?
And last up is methyl bromide, found in pesticides. Pesticides are commonly sprayed on strawberries and other produce. So, please wash your fruits and veggies!
In case this doesn’t really hit home with you, think about the fact that bromide components are also used in the chemicals that clean your hot tub and to produce flame retardants in carpets and furniture. It has been banned in other countries, but we still put in our food here in the United States.
And, another point of interest.. or distress.. is that bromide can pass to the fetus in utero and the infant through breast milk. This infusion into our children can alter neural development and impair growth.
These types of revelations are what have helped to fuel my desire to do this podcast and to offer the wellness weight management courses that I have produced. It isn’t a course to for you to get rich quick if you to add your practice, but a true way to make a difference in the lives of your patients. It is true education that you are not going to get just anywhere, all in one resource. That will have you in high demand and in a lucrative way. None of this was taught to us in this manner.
Educating yourself and your patients about the hidden dangers to their health is crucial to health and it is going to save our next generation if we can impact our current population with education. They may be impacted enough to think about this information before they reach for a soda or buy a box of little Debbie’s.
There are a few other nutritional pieces to this situation. We have minimal nutrients in our diet of processed foods. Whole Foods and vegetables are severely lacking. A few vital nutrients that come from whole foods are required to keep T3 and T4 production running smoothly. Zinc and Selenium at the top of the list, along with Vitamin D, Vitamin A and Iron.
So, how do we manage this thyroid situation? Let’s look at some lifestyle interventions. We can’t throw thyroid replacement at this. If the underlying cause isn’t addressed, it will do no good. The first step is to start to eliminate bromide sources and replenish iodine supply to get the thyroid gland back to efficient hormone production. That is by getting rid of sodas and processed baked goods. There is going to be a cellular shift when this happens that causes flulike symptoms, headache and lethargy. But, I know a trick to making it easier! Since chloride is one of the biggest shifts, you can have your patients put a little iodized salt into a glass of water and drink it once or twice a day to balance electrolytes and reduce symptoms. The Thyroid will also need support with supplementation of zinc and selenium. These 2 elements are vital to thyroid function and can often help improve thyroid function and reduce thyroid size alone if the patient starts to remove sources of bromide from the diet. Foods high in these elements can be added into the diet. There is also a great supplement by Metagenics called Thyrosol with iodine, selenium and zinc that I like. Of course, I will add the link for you. Results will not happen overnight. It will take several weeks, or months even to detoxify and replenish, but the fatigue will improve, the fog will lift, the weight will come off, the menstrual cycles regulate and the bowels resume function.
So, as I said last time, carbs in general have gotten a bad rap as being the source of metabolism dysfunction. The processed foods, filled with CHEMICALS and no nutritional value, are the source of the problem. Yes, they most often are in the form of carbohydrates, but they are made with chemicals. Once you make the shift to eating real foods again and go back to a honey bun, it will taste like a flame retardant rug!
Remember, that if you take a good history, get a thorough review of systems and do an exam you will have a pretty good idea of what’s happening...
You are ready to heal those thyroids and educate! To get a PDF of the optimal thyroid levels I referred to, some common bromide containing foods that effect thyroid function and the vitamins, minerals and foods that support thyroid function click below. I will even make it pretty so you can have it out to discuss with patients!