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Diet for Hyperthyroidism - Essential Knowledge
Table of Contents
1. How does the thyroid gland operate?
The thyroid gland is one of the hormone-secreting glands located within the body. It is responsible for regulating the function of most tissues that affect the body's metabolism, thermogenesis (heat production), and calcium-phosphorus economy. The thyroid's function is monitored by the pituitary gland, which releases the thyroid-stimulating hormone (TSH), thereby stimulating the thyroid to produce T3 and T4 hormones. The synthesis of these hormones also requires the intake of iodine and amino acids through food. The function of the thyroid and pituitary glands are interdependent, a phenomenon known as feedback regulation. This mechanism operates on the principle of effective information exchange: an elevated level of thyroid hormones leads to a decrease in the signal from the brain (release of TSH by the pituitary gland), while a deficiency of these hormones results in an increase in TSH production, which in turn encourages the thyroid to produce more T3 and T4.2. What is hyperthyroidism?
Hyperthyroidism affects 1-2% of Poles, primarily women aged 20-40 years (P. Miśkiewicz, T. Bednarczuk, mp.pl). The disease involves the overproduction of hormones triiodothyronine and thyroxine by the thyroid gland. As a result, there is more hormone in the body than necessary. The most common causes of hyperthyroidism include Graves-Basedow disease and thyroid nodules. There are also cases of hyperthyroidism caused by postpartum and subacute thyroiditis, which are associated with a history of viral infection.3. Hyperactivity of the thyroid gland - Symptoms
Hyperactivity of the thyroid gland can be described as the maximum functioning of the body. As a result, symptoms such as feeling hot, excessive sweating, trembling of the hands, heart palpitations, and increased metabolism are observed, leading to unintentional weight loss despite increased appetite. Those affected by hyperactivity of the thyroid gland often experience restlessness, anxiety, irritability, difficulty sleeping, and muscle weakness, and stimulated intestinal peristalsis results in more frequent bowel movements and diarrhea. Although the symptoms associated with increased metabolism may initially be perceived as beneficial, untreated hyperactivity of the thyroid gland can lead to dangerous complications such as heart rhythm disorders, heart failure, osteoporosis, or a thyroid storm, which is a life-threatening condition of exacerbated hyperactivity of the thyroid gland.4. Diet in case of hyperthyroidism – energy value
The primary objective of nutrition in the case of hyperthyroidism, when hormone levels are not yet balanced, is to prevent weight loss. Due to accelerated metabolism, the body is in a phase of catabolism, i.e., an increased breakdown of molecules or tissues with the release of chemical energy. This results in increased utilization of all available resources and consequently higher energy requirements, but when these are not met, uncontrolled weight loss occurs. For patients with a BMI below the norm, a diet with higher energy content is recommended (on average, 15-25%, i.e., 300-500 kcal), and in cases where weight loss is accompanied by muscle wasting, even up to 50-80% (D. Wolańska-Buzalska, ncez.pzh.gov.pl). To meet the high energy requirements, it may be helpful to spread the nutritional plan over 6-7 small meals. It is worth including high-energy products such as nuts, seeds, oils, nut pastes, coconut milk or dried fruits. In cases of significant malnutrition, the diet should be supplemented with preparations available in pharmacies - these are ready-made mixtures resembling drinking yogurt, used in medical nutrition. However, after achieving hormonal balance, it is necessary to return to a normocaloric diet due to the risk of overweight.5. The diet in hyperthyroidism – the ratio of nutrients
It is assumed that protein should constitute 12–15% of the energy value of the diet (according to D. Wolańska-Buzalska on ncez.pzh.gov.pl). However, for individuals with weight loss, a higher protein intake of approximately 90–100 g (according to P. Tuchendler and Z. Zdrojewicz, 2017) is recommended. The primary source of protein should be lean meats, eggs, seeds of leguminous plants, and occasionally fish (no more than 2–3 times a week due to its iodine content, as an excess of this element in the diet can exacerbate the condition). Fat should constitute 20–35% of the energy value of the patient's diet and be of plant origin. The polyunsaturated omega-3 fatty acids present in plant fats exhibit a protective effect on nerve cells and have an immunostimulatory effect (according to D. Wolańska-Buzalska on ncez.pzh.gov.pl). The source for this nutrient in the diet includes freshly ground or soaked flax seeds, rapeseed oil, olive oil, walnuts, pumpkin and sunflower seeds, avocado, and olives. It is also important to consume the appropriate amount of dietary fiber (20–40 g daily) and carbohydrates (at the level of 50–70% of the energy value of the diet) (according to D. Wolańska-Buzalska on ncez.pzh.gov.pl). For this reason, whole-grain products, vegetables, and fruits should be the primary source of carbohydrates in the diet.6. Is this even a diet related to hyperthyroidism? What else is there to pay attention to?
Calcium and vitamin D are particularly important in the diet of people with thyroid disorders because they are involved in bone homeostasis (D. Wolańska-Buzalska, pzh. gov. pl). Hyperthyroidism causes calcium imbalance, which predisposes to osteopenia and osteoporosis. Women are particularly susceptible to these disorders, as the risk of bone loss increases with age and they are more likely to experience hyperthyroidism. Vitamin D also plays a key role in many processes in the body, including blood pressure regulation and the functioning of the nervous and muscular systems. Calcium and vitamin D can be found in large amounts in sardines, herring and sprat. It is also important to note that the intake of vitamin D from the diet is often insufficient, so a year-round supplementation is recommended. The calcium requirement can be met by consuming dairy products, green leafy vegetables, white beans, soy, sesame and poppy seeds. It is also important to consider vegetables that contain goitrogens, such as raw broccoli, cauliflower, cabbage and turnip. These compounds can prevent the incorporation of iodine into the precursor molecules of thyroid hormones and thus reduce the amount of hormones produced. An overproduction of thyroid hormones can also lead to an increased proportion of free radicals, so it is important to provide natural antioxidants such as vitamins A, C and E as well as certain elements such as selen.7. Is this a hypothyroid diet to avoid at all?
Salted snacks and fast food are particularly high-energy foods that may seem desirable in hyperthyroidism. However, they are definitely not recommended due to their pro-inflammatory trans fat content. Energy drinks - caffeine provides an additional boost which may exacerbate symptoms such as anxiety, heart disturbances, concentration difficulties, and insomnia in patients. In cases of hyperperistalsis leading to discomfort, a light diet is recommended, including the avoidance of frying and grilling and the restriction of fiber. In the case of radioiodine therapy, a low-iodine diet is recommended (thyroid.org). Iodine is used in animal care and feeding as well as a stabilizer and safety component in food processing, therefore it can be found in varying amounts in nearly all food and beverages. In this type of treatment, the largest sources of iodine must be strictly avoided, such as iodized salt, certain bakery products (according to the European Parliament regulation, the iodine content must be listed on the packaging), seafood, shellfish, beef, poultry, milk and dairy products, eggs, seaweed, and algae.8. Diet for hypothyroidism – long-term consequences
In addition to the obvious symptoms of hypothyroidism, which significantly reduce the comfort of life, there are also other long-term effects of the disease that are not immediately apparent. Among the patients with hyperthyroidism, half of the patients have impaired glucose tolerance, and about 3% of them are already battling diabetes (M. Gierach, J. Gierach, R. Junik 2014). Scientific research indicates that an abnormal metabolism of carbohydrates is the consequence of liver insulin resistance, which manifests itself in increased organ activity – synthesis of lipoprotein and triacylglycerol fractions, glycogenolysis, and gluconeogenesis (P. Tuchendler, Z. Zdrojewicz 2017). As a result of accelerated tissue metabolism, the body also processes glucose, leading to a hyperthyroidism-specific postprandial hyperglycemia (M. Gierach, J. Gierach, R. Junik 2014). Glucose requires insulin as a key to enter the cell. At high glucose concentrations, driven by the disease, the pancreas is constantly stimulated to produce insulin, which can ultimately lead to insulin resistance in the tissues.9. Brief Summary
A diet is not a cure for thyroid dysfunction, but it enhances well-being and quality of life. A nourished body is better equipped to combat the disease. A suitable diet is particularly significant prior to achieving hormonal balance amid substantial weight loss. Throughout the entire treatment, applying the principles of a balanced diet averts long-term health consequences such as chronic diseases.
