Hypothyroidism x Hyperthyroidism

Key Nutrients and Recommendations for Hypothyroidism

1. Iodine

Role: Essential for the synthesis of T3 and T4 hormones.

Sources:

Natural: Iodized salt (half teaspoon daily covers RDA), seaweed (kelp, nori), seafood (shrimp, cod).

Local Example: Fish curry with iodized salt.

Caution: Excessive iodine can exacerbate autoimmune hypothyroidism, so intake should remain moderate.

2. Selenium

Role: Required for deiodinase enzymes, which convert T4 to active T3.

Sources:

Natural: 2 Brazil nuts daily (over 100% RDA), eggs, sunflower seeds.

Local Example: Sunflower seeds as a snack or sprinkled on salads.

3. Zinc

Role: Essential for thyroid hormone metabolism and immune support.

Sources: Beef, lentils, chickpeas, and pumpkin seeds.

Local Example: Incorporate lentil soup or beef curry into meals.

4. Goitrogens

Sources: Found in raw cruciferous vegetables (broccoli, cauliflower, cabbage, kale), soy, millet.

Recommendation: Cooking these foods reduces goitrogenic effects. Moderate intake is

acceptable.

5. Fiber

Role: Addresses constipation, which is common in hypothyroidism.

Sources: Whole grains (barley, brown rice), fruits (guava, apples), and vegetables (spinach, carrots).

Local Example: Chapati made from whole wheat flour with spinach curry.

6. Caloric Management

Weight gain is common due to reduced metabolism. Focus on nutrient-dense, low-calorie foods like vegetables, lean proteins, and whole grains.

Local Example: Grilled chicken with steamed vegetables and brown rice.

7. Hydration

Adequate water intake (8-10 glasses/day) to manage dry skin and constipation.

Foods to Include:

Fortified dairy products, lean meats, oily fish, walnuts.

Medical Nutrition Therapy for Hyperthyroidism

Objectives:

Manage increased energy needs and weight loss.

Mitigate symptoms like muscle wasting and fatigue.

Prevent complications such as osteoporosis and micronutrient deficiencies.

 

Key Nutrients and Recommendations for Hyperthyroidism

Dietary Guidelines:

1. Energy and Protein Needs

Energy: Due to increased metabolism, energy needs are higher. Provide calorie-dense meals to

prevent excessive weight loss.

Example: Peanut butter on whole-grain bread, milkshakes.

Protein: Muscle wasting is common. Aim for 1.2–1.5 g protein/kg body weight/day.

Example: Boiled eggs, lentil soup, or chicken curry.

2. Calcium and Vitamin D

Role: Prevent bone loss and osteoporosis caused by hyperthyroidism.

Sources: Fortified milk, yogurt, cheese, spinach, fish.

Local Example: Fish tikka with yogurt dip.

3. Iodine

Caution: Excessive iodine can exacerbate Graves’ disease. Avoid iodine-rich supplements and

foods like kelp.

4. Vitamin B12

Role: Hyperthyroidism often depletes B12 levels, leading to fatigue and neurological symptoms.

Sources: Eggs, dairy, meat, fortified cereals.

Local Example: Paratha with an omelet and milk.

5. Antioxidants

Role: Reduce oxidative stress caused by hyperthyroidism.

Sources: Citrus fruits (oranges, lemons), berries, green tea.

Local Example: Lemon water or green tea in the evening.

6. Hydration

Increased sweating and heat intolerance require proper hydration. Include electrolyte-rich drinks if needed.

Foods to Include:

Energy-dense foods: Nuts, seeds, full-fat dairy, avocados.

Small frequent meals to prevent fatigue.

Lifestyle and Behavioral Interventions

For both hypothyroidism and hyperthyroidism, the following lifestyle changes complement dietary modifications:

1. Stress Management:

Stress exacerbates thyroid dysfunction by impacting hormone levels.

Incorporate yoga, meditation, or breathing exercises.

Example: Daily 15-minute meditation or guided relaxation exercises.

2. Regular Physical Activity:

For Hypothyroidism:

Low-impact exercises like walking or swimming can counter fatigue and weight gain.

Start with 20–30 minutes of moderate activity, gradually increasing as energy improves.

For Hyperthyroidism:

Focus on light exercises like stretching and yoga to avoid overexertion due to fatigue.

Avoid high-intensity workouts, as they may worsen symptoms.

3. Smoking Cessation:

Smoking negatively affects thyroid function, especially in autoimmune thyroid disorders like Graves' disease.

Reference: Bartalena et al., 2018.

4. Adequate Sleep:

Address insomnia or fatigue with a consistent sleep routine and sleep hygiene practices.

Recommendation: 7–8 hours of uninterrupted sleep.

5. Medication Compliance:

Patients should strictly adhere to prescribed medications like levothyroxine (for hypothyroidism) or anti-thyroid drugs (for hyperthyroidism).

Reference: American Thyroid Association Guidelines, 2023.

Foods to Avoid for Hypothyroidism and Hyperthyroidism

For Hypothyroidism:

Limit raw goitrogenic foods (broccoli, cauliflower, cabbage, kale, soy) as they interfere with iodine absorption.

Avoid high-fat and sugary foods that contribute to weight gain.

Caution with caffeine (coffee, energy drinks), which can worsen fatigue and anxiety.

For Hyperthyroidism:

Avoid iodine-rich foods (seaweed, kelp, iodized salt) in Graves' disease.

Limit caffeine and alcohol to reduce jitteriness and palpitations.

Spicy foods may aggravate heat intolerance.

General Monitoring and Follow-Up

1. Lab Tests:

Regular monitoring of TSH, T3, and T4 levels to adjust dietary and medical interventions.

Frequency: Every 6–8 weeks initially, then every 6 months or as advised.

2. Anthropometric Measurements:

Track weight, BMI, and muscle mass regularly, especially in hyperthyroid patients prone to weight loss and muscle wasting.

3. Bone Health Assessment:

Screen for osteoporosis risk in hyperthyroidism with DEXA