Search
Language
Is it truly Hashimoto's disease and weight loss - is it feasible?
Table of Contents
1. Causes and symptoms of Hashimoto's disease
Hashimoto's disease is a chronic autoimmune inflammation of the thyroid gland, which is influenced by genetic and environmental factors. The onset of Hashimoto's disease can be promoted by a combination of bacterial or viral infections, stress, smoking, pregnancy, selenium deficiency, iodine excess, ionizing radiation, and the co-occurrence of other autoimmune diseases such as type 1 diabetes, celiac disease, psoriasis, anemia, hair loss, etc. The main symptoms of Hashimoto's disease include: – hair loss, – dry and flaky skin, – facial swelling, – hoarseness, – weight gain, – feeling cold, – constipation, – depression, – drowsiness and fatigue, – difficulty concentrating, – goiter, – menstrual irregularities, – infertility. One of the main symptoms that people with Hashimoto's disease struggle with is excessive weight gain. This is due to a decrease in basal metabolic rate (BMR) of up to 30% as a result of damage to the thyroid gland, which stops producing adequate amounts of tetraiodothyronine (FT4) and triiodothyronine (FT3).2. Diagnosis and therapy of Hashimoto's disease
Hashimoto's disease is much more commonly diagnosed in women, particularly in their reproductive years, than in men. It is also one of the most common thyroid diseases in children and adolescents. In order to diagnose this condition, the levels of a) hormones in the blood must be determined: - TSH (thyroid-stimulating hormone, a hormone released by the pituitary gland that affects thyroid function), - FT3 (triiodothyronine, a thyroid hormone), - FT4 (thyroxine, a thyroid hormone); b) antibodies in the blood: - Anti-TPO (antibodies against peroxidase, an enzyme of the thyroid), - Anti-TG (antibodies against thyroglobulin, a protein of the thyroid). A high level of anti-TPO antibodies is found in almost 80% of people with Hashimoto's disease. In addition, an ultrasound examination of the thyroid is also recommended. Hashimoto's disease cannot be cured, but it can be brought into a state of remission, i.e. a state of suppression. The treatment consists of a combination of medication, a balanced diet, and physical activity. The medication therapy aims to compensate for the deficiency of thyroid hormones by administering L-thyroxine. Among the most commonly used preparations containing this hormone, we distinguish: Euthyrox, which contains lactose, and Letrox, which does not contain lactose. This is an important difference between these two preparations, especially important for people with lactose intolerance. The diet should provide the necessary nutrients that are required for the synthesis of thyroid hormones. We should avoid products that can disrupt this process.3. Weight loss in Hashimoto's disease
The thyroid is responsible for approximately 30% of the resting metabolic rate, so in the case of a deficiency of Hashimoto's thyroid hormones, the energy provided by the diet is stored in the form of fat tissue, leading to obesity and overweight. Problems with maintaining normal body weight in turn have an impact on the normalization of the hormonal economy. Studies show that people with a hypothyroidism condition have a higher BMI and waist circumference than healthy people. In addition, it has been observed that TSH in the range of 2.5−4.5 mg/dl increases the risk of obesity and metabolic syndrome compared to a lower TSH level. However, weight loss is possible by normalizing the thyroid hormone economy and introducing an individualized diet therapy tailored to gender, age, current weight, comorbidities, lifestyle, and physical activity. The diet not only supports pharmacological treatment but also allows for the reduction of the inflammatory process. The introduction of an appropriate caloric deficit promotes weight loss in people simultaneously affected by Hashimoto's disease and overweight or obesity. However, it is important to note that excessive caloric restrictions can lead to an increase in TSH levels, which can further slow down the rate of metabolism and hinder weight loss. The caloric intake should not be lower than the basal metabolic rate, which can be calculated using the Harris-Benedict formula. The formulas depend on gender: PPM (women) = 655.1 + (9.563 × body weight [kg]) + (1.85 × height [cm]) − (4.676 × [age]), PPM (men) = 66.5 + (13.75 × body weight [kg]) + (5.003 × height [cm]) − (6.775 × [age]).4. Nutritional deficiencies in individuals with Hashimoto's disease
Individuals with Hashimoto's disease often experience deficiencies in: protein, vitamins A, C, B6, B1, minerals such as magnesium, potassium, phosphorus, sodium, chromium. Additionally, most individuals with Hashimoto's also have low levels of vitamins B12, E, selenium, zinc, ferritin, and glutathione. Furthermore, they often have insufficient calorie intake from food (despite frequent overweight), a lack of intake of polyunsaturated fatty acids (including omega-3 fatty acids) and dietary fiber, and an excess of carbohydrates consumed in relation to dietary standards. Therefore, it is important to ensure an adequate amount of vitamins and minerals in meals to prevent nutritional deficiencies and thyroid dysfunction.5. Nutritional guidelines for Hashimoto's disease
The diet of people with Hashimoto's disease should consist of four or five meals taken at regular intervals. The first meal should be eaten within an hour of waking up, but within 30 minutes of taking the medicine, and the last about 3 hours before bedtime. It is important to drink the medicine with water, preferably unsweetened, source or low-fat. Calcium and iron (containing in the meal or given as a dietary supplement) can weaken the hormone. Between taking the medication and eating meals that are rich in these ingredients, we should maintain a healthy diet for about two hours. It is also important to pay attention to products that can reduce the absorption of the drug - e.g. soy. Particular attention in the diet should be paid to high-quality protein, the supply of which should be increased and should constitute about 15-20% of the diet's energy. Thanks to this, we can prevent hair loss, which is a common symptom in people with thyroid disorders. Additionally, high-quality protein (mainly from animal products - meat, fish, eggs, milk, cheese, as well as plant products - amaranth, rice bran, algae) is a good source of tyrosine, which is a substrate for the production of thyroxine. To support the functioning of the immune system, it is worth supplementing the diet with polyunsaturated fatty acids, especially omega-3. They have anti-inflammatory properties and have a positive effect on the lipid profile.6. It is also important to provide adequate amounts with your diet
: iron as an essential component of the enzymes involved in the synthesis of thyroid hormones; zinc, whose low intake (meat intake, eggs and dairy products) affects the normal intake of triiodothyronine (fish, liver, pumpkin); selenium, essential for thyroid hormone syntheses and inflammatory conditions, whose good sources are meat, fish, egg, fat, cereals and sprouts; ?? zinc, which has a lower intake rate (e.g. meat, egg and milk products) affecting the proper intake.7. The efficacy of a reduction diet in cases of Hashimoto's disease
Based on studies evaluating the effectiveness of a reduction diet with increased fiber intake (30 g/day) in patients with a BMI > 25 kg/m2 and Hashimoto's disease, it was found that a diet enriched with dietary fiber increases the rate of weight loss, which significantly improves the efficacy of dietary treatment. Research has shown that weight loss in individuals with well-treated Hashimoto's disease (normalized hormonal balance) remains within the recommended limits of the weight-loss process (on average 0,8 kg/week). It is also worth noting that unhealthy lifestyles - lack of physical activity, sedentary work - and unhealthy eating habits are environmental factors associated with the occurrence of overweight and obesity in individuals with thyroid diseases.8. Elimination diets in case of Hashimoto's disease
The popularity of restrictive and eliminative diets among individuals with Hashimoto's disease is alarming. A significant number of people with this chronic condition eliminate gluten, lactose, dairy products, eggs, and nightshade vegetables from their diet. However, such elimination is not necessary for everyone, as there is no clear scientific evidence supporting its effectiveness. In certain cases, such as when co-occurring with celiac disease or milk protein allergy, the exclusion of certain products from the diet can be beneficial. However, most patients will not benefit from this type of diet, but will unnecessarily expose themselves to malnutrition risks. The primary priority in the treatment of Hashimoto's disease is the normalization of the hormonal balance through pharmacotherapy, and the diet should support thyroid function and improve the absorption of medication.9. Removal of gluten
Individuals with Hashimoto's disease have a five to ten times higher likelihood of having celiac disease compared to healthy individuals. To confirm or rule out co-existing celiac disease, intolerance or allergy to gluten, it is recommended to carry out specialized tests. If the results confirm these suspicions, gluten-containing products should then be eliminated from the diet. A gluten-free diet may also aid in weight reduction, but only in individuals who are negatively impacted by gluten, e.g., through exacerbating inflammation of the thyroid gland. In healthy individuals without celiac disease, allergies or intolerances, adhering to a gluten-free diet will not affect weight loss.10. Removal of lactose
In individuals with Hashimoto's disease, lactose intolerance often also occurs. In such cases, it is also recommended to perform tests to confirm or exclude a possible intolerance. If you have worrying symptoms after consuming dairy products, it is worth carrying out such tests. Intervention in people with co-existing lactose intolerance and Hashimoto's disease taking L-thyroxine is necessary because lactose intolerance reduces the absorption of the drug and higher doses may be recommended. A holistic approach to treating Hashimoto's disease, including supplementing hormone deficiencies with medication, introducing a suitable diet and physical activity, and changing one's lifestyle, is the best method.
