Diet, exercise and thyroid trouble

In an earlier story, we looked at what a thyroid does. Here's more of what you need to know.

Thyroid Eye Disease (TED)

Many people with autoimmune thyroid diseases such as Graves or, in a few cases, Hashimoto's, develop TED. It is an autoimmune disease of the orbit (eye socket) and eye muscles, characterised by inflammation, swelling and possible scarring (rare/ occasional), with swollen eyelids and 'poppy' eyes. The treatment for TED may involve two parts – first treating the thyroid disorder, then possible eye surgery.

Thyroid nodules

These are lumps or abnormal growths on the thyroid gland, that are either benign (non-cancerous) or malignant (cancerous). They are generally asymptomatic (i.e. have no symptoms), although some people experience tenderness and pain in their thyroid. Treatment for such patients will vary on a case-to-case basis, depending on the doctor's advice and therapy.

Goitre

This is an enlarged thyroid gland that causes a large swelling in the neck. All people suffering from thyroid disorders can develop goitre.Treatment depends on the case, a doctor's advice and therapy.

Thyroid cancer

There are different types of thyroid cancer (papillary, follicular, anaplastic, medullary, and lymphoma), the vast majority of which are readily treatable. Treatment for patients suffering from any kind of thyroid abnormalities will depend on individual cases, a doctor's advice and therapy. However, in all cases of thyroid abnormalities, it is imperative to control goitrogen food items in one's daily diet.

Causes of thyroid disease

These can be due either to an abnormal thyroid gland, inadequate levels of thyroid hormone replacement (the treatment for hypothyroidism), iodine deficiency disorder (IDD -- remedied by the use of iodised salt), not enough hormones released by the pituitary gland to the thyroid, or the treatment for hyperthyroidism, thyroid nodules or thyroid cancer.

Some individuals are more likely than others to have a thyroid problem. These include those with high cholesterol, those who have lost or gained more than 2 kilos in 2-3 months, those who feel exhausted, those suffering from infertility, and those with a family history of thyroid disease. It affects 1.5 per cent of the population and its incidence is higher in women than men (4:1). Also, women in their reproductive age are more vulnerable. The menstrual cycle, pregnancy, delivery and related hormonal, immunological and other stresses make women more prone to these problems.Thyroid related diseases can also be hereditary. Hashimoto's thyroiditis and Grave's disease may run in families.

Symptoms of thyroid disease

The signs and symptoms of thyroid problems can be wide ranging from person to person. Some that make doctors suspect thyroid problems are:

~ weight loss/ weight gain
~ hair loss, coarse/ dry hair
~ excessive dryness/ moist skin
~ anaemia, fatigue/ weakness
~ palpitations, tremors, extreme heat or cold intolerance
~ muscle cramps and aches
~ anorexia/ increased appetite
~ constipation/ increased bowel movements
~ abnormal menstrual cycles
~ decreased libido, infertility/ miscarriages,
~ exophthalmic eyes or a starting gaze (protrusion of the eyes in Grave's Disease)
~ hoarse voice, deafness
~ high cholesterol levels
~ memory loss, poor concentration, depression, insomnia, irritability, restlessness and
~ family history/ thyroid problems

Diet for thyroid patients

Goitrogens are naturally-occurring substances in food that can interfere with the functioning of the thyroid gland. There are two general categories of foods that have been associated with disrupted thyroid hormone production in humans: soybean-related foods and cruciferous vegetables like broccoli, cabbage, cauliflower, turnips, mustard etc. Other foods not included in these categories -- such as peaches, strawberries, peach, peanuts, radish, tofu, spinach and millet -- also contain goitrogens. Patients with hypothyroidism should avoid the intake of iodine containing foods such as red food dyes, iodine in multivitamins and metabolic boosters, dairy products, shellfish, and processed foods that can block iodine absorption.

Exercise for patients

Regular exercise is very important. Early diagnosis and subsequent weight loss programmes are also important for overweight hypothyroid patients. The longer it takes to diagnose hypothyroidism, the more weight an individual may gain. There are also lifestyle changes a patient may have to make. For instance, toxins in cigarette and alcohol directly injure thyroid cells during their passage through the body. Immune system cells within the thyroid gland react to these compounds by producing thyroid antibodies or inflammation. People with Graves' disease who smoke are 7.7 times more likely to develop TED. By avoiding cigarettes and chemical additives, we can help restore immune function and thyroid health.

Part I: What exactly does a thyroid do?