hyperthyroidism Diet and Physical Activity

Mr. Efren F. Alvarez Jr.
Ms. Joy H. Nidar

MSN – AHN

DIET

HYPERTHYROIDISM is associated with weight loss. Establishing proper treatment, diet, exercise and management can essentially help to regain weight loss. (Jacobsen, Lundsgaard, Lorenzen, Toubro, Perrild, Krog-Mikkelsen, & Astrup, 2005)

The primary problem in the patient having thyroid problems is metabolism. Cells of our body use thyroid hormone to convert foods and oxygen into energy, heat and living tissue. (Dieting And Exercise With Thyroid Disorders, 2009)

“The earlier they are diagnosed and treated appropriately, the less likely they will develop other complications or more serious conditions”. (Koumourou, 2006)

Each individual should have to follow an ideal balance diet, but still there is an exemption. Like in cases of thyroid problems, there are some of nutritious foods that a person having thyroid problems must be avoided. (Dieting And Exercise With Thyroid Disorders, 2009)


There are two categories that affect thyroid hormone production. First was the category that includes soy-bean related foods. Second are foods including broccoli, cabbage, cauliflower, and turnips. While some other foods can affect the essential function of thyroid gland. (e. g. peaches, strawberries, peanuts, radishes, tofu, and spinach. These foods should not be included in your diet if you have thyroid disease.). You should also avoid iodine-containing foods including red food dyes, and iodine in dairy products, shellfish, multivitamins, and metabolic boosters if you are diagnosed of having hypothyroidism. (Dieting And Exercise With Thyroid Disorders, 2009)

Hyperphagia is associated with hyperthyroidism. (RIIS, HANSEN, MØLLER, WEEKE, & JØRGENSEN, 2003)

Hyperthyroid patients are often craving for carbohydrate rich foods. Stimulation of sympathetic nervous system and decreases Trp for brain 5-HT synthesis, contributes the eating behavior in these patients. (Wellspan Endocrinology, n.d.).

Hyperthyroid patients increase carbohydrate consumptions. Diminished Plasma [Trp]/[NAA] ratio observed while SNS activity increased in hyperthyroid vs. euthyroid conditions. These neuroendocrine changes potentially hamper 5-HT synthesis and activate adrenoceptors in the brain respectively. Therefore, energy intake was higher. (PIJL et al., 2001)

There are some nutritional guidelines that may reduce hyperthyroidism symptoms.
• Eliminate suspected food allergens, such as dairy (milk, cheese, and ice cream), wheat (gluten), soy, corn, preservatives, and chemical food additives. Your health care provider may want to test you for food allergies.
• Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), fresh vegetables, and sea vegetables.
• Avoid foods that interfere with thyroid function, including broccoli, cabbage, brussels sprouts, cauliflower, kale, spinach, turnips, soybeans, peanuts, linseed, pine nuts, millet, cassava, and mustard greens.
• If you take thyroid hormone medications, talk to your doctor before consuming soy products. There is some evidence soy may interfere with absorption of thyroid hormone.
• Iron may also interfere with the absorption of thyroid hormone medication.
• Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell pepper).
• Avoid refined foods, such as white breads, pastas, and sugar.
• Eat fewer red meats and more lean meats, cold-water fish, or beans for protein. Limit your intake of processed meats, such as fast foods and lunch meats.
• Use healthy cooking oils, such as olive oil or vegetable oil.
• Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid alcohol, and tobacco. Talk to your doctor before using caffeine containing products, such as teas and soft drinks.Caffeine impacts several conditions and medications.
(University of Maryland Medical Center, 2008)

Management of anti-thyroid and radioactive therapy can interfere by some food supplements, seaweed tablets, expectorants, and radiographic contrast dyes. An excess amount of iodine was found. (Lee & Ananthakrishnan, 2009)

Ghrelin is newly discovered peptide hormone secreted by gastric endocrine cells that stimulates Gastric hormone. Gastric hormone is involved in the regulation of energy balance causing increased food intake, decreased fat oxidation, and weight gain Hyperthyroidism is associated with decreased levels of circulating serum ghrelin (RIIS, HANSEN, MØLLER, WEEKE, & JØRGENSEN, 2003)

Diuretics increase excretion of many minerals, including iodine. Diuretic treatment essentially may be an alternative for low-iodine diet especially when enhancement of Radio Iodine uptake is desired. (Kapucu, Azizoglu, Ayvaz, & Karakoc, 2003)



EXERCISE

Regular exercise, prevention of stressors and maintaining ideal body weight is essential to help patients with hyperthyroidism. (Dieting And Exercise With Thyroid Disorders, 2009)

Thirty minutes with in five days a week of daily exercise is useful, if possible. (University of Maryland Medical Center, 2008)

Monitoring of physical activity level, diet and the dosage of medications is extremely important in maintaining a healthy weight especially having hyperthyroidism. Planning your nutrition plan with your doctor is essential. (Jain, 2009)

Activity that needs too much exertion must be avoided. People having hyperthyroidism will experience dyspnea and long recovery of heart rate after doing activities that requires body exertion. (Jain, 2009)

With severe thyrotoxicosis, systolic and diastolic cardiac dysfunctions are often manifested by dyspnea upon exertion. (Lee & Ananthakrishnan, 2009)

Elderly and cardiopulmonary patients must also reduce physical activities. (Lee & Ananthakrishnan, 2009)


Breathing exercise is recommended and doing exercise that your body can tolerate. (Jain, 2009)
Beta-blockers can help to tolerate exercise. (Lee & Ananthakrishnan, 2009)
In some healthy hyperthyroid patients, reducing physical activities has no significant effect. (Lee & Ananthakrishnan, 2009)

Depressive patients with hyperthyroidism may consult a specialist and treated accordingly. (Koumourou, 2006)

Diuretics increase excretion of many minerals, including iodine. Diuretic treatment essentially may be an alternative for low-iodine diet especially when enhancement of Radio Iodine uptake is desired. (Kapucu, Azizoglu, Ayvaz, & Karakoc, 2003)

* PREGNANT

In pregnant women, there were rarely experience hyperemesis gravidarum (HG). The presence of thyrotoxicosis may contribute in developing HG. chorionic gonadotrophin (hCG) act as a thyroid stimulator in pregnancy. It was observed that there are similarities of TSH and hCG.

There is reduction in TSH serum level and an elevation of free T3 was recognized in early trimester of pregnancy then normalized at second trimester. This indicates that hyperthyroidism might be one of the cause of experiencing morning sickness or HG.

In case of severe HG, TPN is suggested to regain weight and nutritional status. (Hiroi, Kugu, Hoshino, Kozuma, & Taketani, 2001)



Reference:
Dieting And Exercise With Thyroid Disorders. (2009). Retrieved on February 16, 2010 from 3FC website: http://www.3fatchicks.com/dieting-and-exercise-with-thyroid-disorders/
Hiroi, H., Kugu, K., Hoshino, H., Kozuma, S., and Taketani, Y. (2001). Hyperemesis gravidarum associated with thyrotoxicosis and a past history of an eating disorder. Arch Gynecol Obstet, 265:228–230. http://web.ebscohost.com/ehost/pdf?vid=1&hid=13&sid=a3794a22-7e8f-4924-93e0 f5b73cbfe8c4%40sessionmgr14

Jacobsen, R., Lundsgaard, C., Lorenzen, J., Toubro, S., Perrild, H., Krog-Mikkelsen, I., and Astrup, A. (2005). Subnormal energy expenditure: a putative causal factor in the weight gain induced by treatment of hyperthyroidism. Diabetes, Obesity and Metabolism, 8, 2006, 220–227. doi: 10.1111/j.1463–1326.2005.00486.x

Jain, N. (2009). Hyperthyroidism – exercises to keep your metabolism stable. Retrieved on February 16, 2010 from TimesWellness website: http://www.timeswellness.com/index.aspx?page=article&sectid=8&contentid=2009011620090116171339616be5d9685

Kapucu, L.O., Azizoglu, F., Ayvaz, G., and Karakoc, A. (2003). Effects of diuretics on iodine uptake in non-toxic goitre: comparison with low-iodine diet. Eur J Nucl Med Mol Imaging, 30:1270–1272. DOI 10.1007/s00259-003-1251-9

Koumourou, R. (2006). Diet, Nutrition and Exercise for the Thyroid Patient. Thyroid Australia, Volume 7 No 2. Retrieved on February 16, 2010 from http://www.thyroid.org.au/Download/Flyer_2006.2_Diet.pdf
Lee, S. and Ananthakrishnan, S. (2009). Hyperthyroidism: Treatment & Medication. Retrieved on February 16, 2010 from Medscape website: http://emedicine.medscape.com/article/121865-treatment
PIJL, H., DE MEIJER, P. H. E. M., LANGIUS, J., COENEGRACHT, C. I. G. M., VAN DEN BERK, A. H. M., CHANDIE SHAW, P. K., BOOM, H., SCHOEMAKER, R. C., COHEN, A. F., BURGGRAAF, J., AND MEINDERS, A. E. (2001). Food Choice in Hyperthyroidism: Potential Influence of the Autonomic Nervous System and Brain Serotonin Precursor Availability. The Journal of Clinical Endocrinology & Metabolism, 86(12):5848–5853. Retrieved on February 16, 2010 from http://jcem.endojournals.org/cgi/reprint/86/12/5848

RIIS, A.L.D., HANSEN, T.K., MØLLER, N., WEEKE, J., AND JØRGENSEN, J.O.L. (2003). Hyperthyroidism Is Associated with Suppressed Circulating Ghrelin Levels. The Journal of Clinical Endocrinology & Metabolism, 88(2):853–857. doi: 10.1210/jc.2002-021302
University of Maryland Medical Center. (2008). Hyperthyroidism. Retrieved on February 16, 2010 from http://www.umm.edu/altmed/articles/hyperthyroidism-000088.htm
Wellspan Endocrinology. (n.d.). Caring for your child hyperthyroidism. Retrieved on February 16, 2010 from https://www.wellspan.org/workfiles/PhysicianHealthPlans/EndoPE_Hyperthyroidism.