AND LASTLY...

And yeah! This wraps up our little research on hypothyroidism! Hopefully you folks enjoyed reading our blog and we also had a fun time crafting all the posts! We hope that you guys had learnt something about hypothyroidism throughout these few days and yes, we definitely gain alot of insights on hypothyroidism! We would like to thank you all for spending time on our blog and we'll meet again (on this blog hahaha) <3

Diet of a Hypothyroidism Patient

We have talked about the complications of hypothyroidism and what medication can help control it, now we are going to talk about how the food we eat can help control hypothyroidism.

There are 2 main groups of food the person suffering from hypothyroidism needs. They are Iodine-rich food groups and Selenium-rich food groups. Iodine is important in their diet as it is an essential material used by the thyroid gland.

Here are the lists of food that hypothyroid patients are encouraged to eat.

Iodine-rich food

1. Iodized salt
2. Dried seaweed
3. Seafood (Salt water fish)
4. Sushi
5. Dried prunes
6. Celtic sea salt
7. Milk
8. Turkey breast (Baked)
9. Boiled eggs
10. Bananas
11. Plain yogurt
12. Green beans
13. Cranberries
14. White bread
15. Fish sticks

Selenium-rich food

1. Chicken
2. Salmon
3. Tuna
4. Whole grains (Unrefined)
5. Brazil nuts
6. Cheese
7. Garlic
8. Onions
9. Sunflower seeds
10. Octopus 
11. Squid
12. Mushroom
13. Oats
14. Bacon
15. Beef

https://s-media-cache-ak0.pinimg.com/originals/b3/ea/07/b3ea074b3c2e38cb3c19f6074d19d078.gif

Iodine is important in a healthy body and is present in many food products. However, too much iodine present in the body can also have worsen hypothyroidism in a patient. Therefore, it is important to eat in moderation to prevent the lack and overdose of iodine.

The food that hypothyroid patients are discouraged from eating include:

Food that aggravates thyroid glands

1. Peanuts
2. Kale
3. Mustard
4. Cauliflower
5. Peach
6. Coffee
7. Spinach
8. Turnips
9. Cassava
10. Millet

Food that prevents absorption of Iodine

1. Bamboo shoot
2. Soybean food products
3. Canola oil
4. Bok Choy
5. Tempeh
6. Sweet potato

http://www.dotcomwomen.com/wp-content/uploads/2012/07/thyroid-foods-to-avoid-list.gif

Links used:

http://bembu.com/iodine-rich-foods

http://bembu.com/selenium-rich-foods

http://www.thyroid.org/iodine-deficiency/

http://hypothyroidisma.com/hypothyroidism-diet.php

Case Study: Oprah Winfrey

Hi guys!! Here is a magazine article from Oprah that talks about how Oprah Winfrey, a famous American TV host, battled hypothyroidism! We have only extracted out more relevant parts though, we left the link at the end of the post so that you folks can read the full article if you're interested.

https://hypothyroidismsucks.files.wordpress.com/2013/09/oprahwinfrey_071144.jpg

It happened slowly. In February 2007, at 53, I started to have some health issues. At first I was unable to sleep for days. My legs started swelling. My weight started creeping up, first 5 pound, then 10 pounds. I was lethargic and irritable. My internal clock seemed totally out of whack. i began having rushing heart palpitations every time I worked out. Okay, I've never loved daily exercise, but this was different. I actually developed a fear for working out. I was scared that I would pass out. Or worse. I felt as if I didn't know my own body anymore."

It seemed as if the struggle I'd had with weight my entire adult life was now officially over. I felt completely defeated. I thought, "I give up. I give up. Fat wins." All these years I'd had only myself to blame for lack of willpower. Now I had an official, documented excuse. 
The thyroid diagnosis felt like some kind of prison sentence. I was so frustrated that I started eating whatever I wanted—and that's never good. My drug of choice is food. I use food for the same reasons an addict uses drugs: to comfort, to soothe, to ease stress.
I switched doctors and still gained weight. At one point I was on three medications: one for heart palpitations, another for high blood pressure, another to moderate my thyroid. Who knew this tiny butterfly gland at the base of the throat had so much power? When it's off, your whole body feels the effects. [For more information about thyroid disorders, see The Truth About the Thyroid.] I followed my doctor's orders to the letter (except for the part about working out). I took the prescribed medication religiously at the same time each day. 
Being medicated, though necessary, made me feel as if I were viewing life through a veil. I felt like an invalid. Everything was duller. I felt like the volume on life got turned down. 
I realized this to some extent, but I wasn't fully aware of the effect of the medication until I had a conversation with my friend Bob Greene. He'd given up lecturing me about working out and eating well, but we were walking together one day and he said, "I think something's wrong. You're listless. Your movements are slower, even when you're just doing normal stuff. Twice I've told you something and you don't remember it. There's no sparkle in your eyes. I think you're in some sort of depression." "
From the January 2009 issue of O, The Oprah Magazine. "So here I stand, 40 pounds heavier than I was in 2006. (Yes, you're adding correctly; that means the dreaded 2-0-0.) I'm mad at myself. I'm embarrassed. I can't believe after all these years, all the things I know how to do, I'm still talking about my weight. I look at my thinner self and think, "How did I let this happen again?"

After many trips to carious doctors, I received a diagnosis. I had hyperthyroidism (an overactive thyroid that can speed up metabolism and cause weight loss - but of course didn't make me lose a single pound) and then gradually started moving into hypothyroidism (a sluggish metabolism that can cause fatigue and weight gain). My doctor prescribed medication and warned me that I must "learn to embrace hunger" or I would immediately gain weight. Believe me, no part of me was prepared to embrace hunger. 

Read more: http://www.oprah.com/spirit/Oprahs-Battle-with-Weight-Gain-O-January-2009-Cover#ixzz3s0KNIIoW

Hypothyroidism Statistics

Hypothyroidism is a disease that occurs worldwide.

According to the American Thyroid Association (ATA), about 20 million Americans have a thyroid disease and at least 60% of them are not detected. The chance of women contracting this disease is 5 to 8 times more than men. Out of the USA female population, an eighth of them would develop a thyroid disease.

http://payitforwardday.com/wp-content/uploads/2010/04/USA-Flag-Liberty-01-A-Lakeland-copy.jpg

In UK, females aged between 40 to 50 are more prone to hypothyroidism. The percentage population of people being diagnosed with hypothyroidism is 2%. However, this value 2% is highly debated by doctors as some of them believe that the value such be higher.

In Australia, research has taken place to find out the percentage population with hypothyroidism and hyperthyroidism.

Females are more prone to hypothyroidism and hyperthyroidism in general. However, in the category of females, women aged over 80 have the highest chance of getting these diseases.

There are no exact values that show the number of cases of hypothyroidism in Singapore. However, hypothyroidism and hyperthyroidism are the most common thyroid disorders locally. It is also most common in women aged 20 to 50, these women are 5 times more prone to these diseases compared to men.



Links used:
http://www.thyroid.org/media-main/about-hypothyroidism/
http://www.thyroiduk.org.uk/tuk/about_the_thyroid/hypothyroidism.html
http://www.thyroid.org.au/Information/doodle.html
https://www.singhealth.com.sg/PatientCare/ConditionsAndTreatments/Pages/Thyroid-Disorders.aspx

Levothyroxine

Levothyroxine is a replacement for a hormone normally produced by your thyroid gland to regulate the body's energy and metabolism. Levothyroxine treats hypothyroidism or prevent goiter which can be caused by hormone imbalances, radiation treatment, surgery, or cancer.

Levothyroxine should not be used to treat obesity or weight problems even though it helps people with hypothyroidism lose weight. If you do not have hypothyroidism, do not eat levothyroxine to lose weight. Dangerous side effects or death can occur from the misuse of levothyroxine, especially if you are taking any other weight-loss medications or appetite suppressants.

Since thyroid hormone occurs naturally in the body, almost anyone can take levothyroxine. However, you may not be able to take this medication if you have:

• Thyrotoxicosis;
• Heart disease, coronary artery disease, or a history of blood clot
• Diabetes 
• Anemia 
• Osteoporosis
• Problems with your pituitary gland
• An untreated or uncontrolled adrenal gland disorder

If you are taking levothyroxine, you should avoid:

• Alka-Mints, Calcium Oyster Shell, Caltrate, Os-Cal, Oyster Shell Calcium, Rolaids Soft Chew, Tums. They contain calcium carbonate
• Cholestyramine, Colestipol;
• Ferrous sulfate iron supplement;
• Sucralfate;
• Sodium polystyrene sulfonate (Kalexate, Kayexalate, Kionex)
• Antacids that contain aluminum or magnesium - Acid Gone, Gaviscon, Maalox, Milk of Magnesia, Mintox, Mylanta, Pepcid Complete, and others).

Avoid the following food products, which can make your body absorb less levothyroxine: infant soy formula, cotton seed meal, walnuts, and high-fiber foods.

Certain medicines can make levothyroxine less effective if taken at the same time. If you use any of the following drugs above, avoid taking them within 4 hours before or 4 hours after you take levothyroxine.

Some side effects can occur can taking Levothyroxine. You should consult your doctor if these are serious They include:

• Fast or irregular heart rate
• Fever, hot flashes, sweating
• Sleep problems
• Changes in your menstrual periods
• Vomiting, diarrhea, appetite changes

Common levothyroxine side effects may include mild hair loss. Get emergency medical help if you have any of these signs of an allergic reaction to levothyroxine: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Link used:


http://www.drugs.com/levothyroxine.html

Mechanism of Hypothyroidism

The chief stimulator of thyroid hormone synthesis is thyroid-stimulating hormone from the anterior pituitary part of the brain. Binding of TSH to receptors on thyroid epithelial cells induce synthesis of the iodide transporter, thyroid peroxidase and thyroglobulin, which is used to produce the thyroid hormone.

The magnitude of the TSH signal also sets the rate of endocytosis of colloid - high concentrations of TSH lead to faster rates of endocytosis, and hence, thyroid hormone release into the circulation. Conversely, when TSH levels are low, rates of thyroid hormone synthesis decreases.

The thyroid gland is part of the hypothalamic-pituitary-thyroid axis, and control of thyroid hormone secretion is by negative feedback. Thyroid-releasing hormone (TRH) from the hypothalamus stimulates TSH from the pituitary, which stimulates thyroid hormone release. As blood concentrations of thyroid hormones increase, they inhibit both TSH and TRH. Later, when blood levels of thyroid hormone have declined, the negative feedback signal fades, and TSH and TRH starts producing.

A number of other factors have been shown to influence thyroid hormone secretion. In rodents and young children, exposure to a cold environment triggers TRH secretion, leading to enhanced thyroid hormone release. As thyroid hormone controls metabolism, and increased body heat production.

Thyroid Hormone Receptors and Mechanism of Action

Receptors for thyroid hormones are found in the cells. Thyroid hormones enter cells through membrane transporter proteins. After entering the cell, it reaches the nucleus. The hormone will then bind to its receptor and this leads to signal transduction in the nucleus. This modulates gene expression, either by stimulating or inhibiting transcription of specific genes.

One of the function that thyroid hormones control is the strength of contraction of the heart. Cardiac contractility depends on the ratio of different types of myosin proteins in cardiac muscle. Transcription or inhibition of some myosin protein genes is controlled by the binding of thyroid hormones. This leads to alteration of the ratio toward increased contractility.

Disorders of Thyroid Hormone Receptors

People whose thyroid hormone receptors are not functioning have hypothyroidism. They will have elevated serum concentrations of T3 and thyroxine and normal or elevated serum concentrations of TSH. More than half of affected children show attention-deficit disorder, which is intriguing considering the role of thyroid hormones in brain development. In most affected families, this disorder is transmitted as a dominant trait, which suggests that the mutant receptors act in a dominant negative manner.

Mice with targeted deletions in thyroid receptor genes have provided additional understanding of the possible roles of different forms of thyroid hormone receptors.

Physiologic Effects of Thyroid Hormones

Most cells in the body has receptors for thyroid hormone, meaning that many physiological processes such as development, growth and metabolism depend on the thyroid hormone in a way or another. Deficiency in this hormone may cause adverse health effects. 

Metabolism: Thyroid hormones stimulate diverse metabolic activities most tissues, leading to an increase in basal metabolic rate. One consequence of this activity is increased body heat production, which seems to result, at least in part, from increased oxygen consumption and rates of ATP hydrolysis. A few examples of specific metabolic effects of thyroid hormones include:

• Lipid metabolism: Increased thyroid hormone levels stimulate fat mobilization, leading to increased concentrations of fatty acids in plasma. They also enhance oxidation of fatty acids in many tissues.

• Carbohydrate metabolism: Thyroid hormones stimulate almost all aspects of carbohydrate metabolism, including enhancement of insulin-dependent entry of glucose into cells and increased gluconeogenesis and glycogenolysis to generate free glucose.

Growth: Thyroid hormones are clearly necessary for normal growth in children and young animals,evident in the growth-retardation observed in thyroid deficiency. Not surprisingly, the growth-promoting effect of thyroid hormones is intimately intertwined with that of growth hormone, a clear indication that complex physiologic processes like growth depend on thyroid hormone.

Development: An experiment in endocrinology demonstrated that tadpoles deprived of thyroid hormone fail to undergo metamorphosis. This shows that normal levels of thyroid hormone are essential to the development of the fetal brain.

Other Effects: As mentioned above, there do not seem to be organs and tissues that are not affected by thyroid hormones. A few additional, well-documented effects of thyroid hormones include:

• Cardiovascular system: Thyroid hormones increases heart rate, cardiac contractility and cardiac output. They also promote vasodilation, which leads to enhanced blood flow to many organs.
• Central nervous system: Both decreased and increased concentrations of thyroid hormones lead to alterations in mental state. Too little thyroid hormone, and the individual tends to feel mentally sluggish, while too much induces anxiety and nervousness.
• Reproductive system: Normal reproductive behavior and physiology is dependent on having essentially normal levels of thyroid hormone. Hypothyroidism in particular is commonly associated with infertility

To people out there who needs help with the visualisation of this hormone function, here are 2 videos that you can watch!!

Complications of Hypothyroidism

After discussing the causes of hypothyroidism and the lifestyle of a person suffering from hypothyroidism, we are going to discuss about the complications that rise due to hypothyroidism.

People with hypothyroidism have a higher chance of having these health issues - Heart problems, Peripheral neuropathy, Myxedema, Infertility and Birth defects.

People with hypothyroidism have a higher chance of contracting heart diseases due to the presence of low-density lipoprotein (LDL) cholesterol in large amounts. LDL is a type of cholesterol bad for the body. This increases the total cholesterol level and would affect the heart's ability to pump blood. And soon, it can cause an enlarged heart and heart failure.

http://www.vikramhospital.com/blog/wp-content/uploads/2014/05/heart-disease-1.jpg

Hypothyroidism causes mental issues. One of them is depression. This depression would worsen over time. It also causes a decrease in mental function.

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Hypothyroidism cases Peripheral neuropathy. Peripheral neuropathy is where the peripheral nerves are damaged. Peripheral nerves carry information from our brain to our entire body through our spinal cord. Symptoms include pain, numbness, muscle weakness, loss of muscle control or a tingling sensation at the damaged area.

http://www.healthcentral.com/common/images/8/8679_7821_5.jpg

Myxedema is a life-threatening condition caused by hypothyroidism. Symptoms of myxedema includes serious cold intolerance, drowsiness followed by lethargy and unconsciousness. Sedatives, infections and stress can cause myxedema coma which requires immediate medical attention.

Lack of thyroid hormone can affect ovulation which impairs fertility. Hypothyroidism is also caused by some autoimmune disorders. This can also cause infertility.

https://s3.amazonaws.com/lowres.cartoonstock.com/medical-infertility-rip_offs-clinics-cashing_in-infertility_clinics-gri0042_low.jpg

Women who suffer from hypothyroidism and are not treated would have a higher probability of conceiving a child with birth defects. Such birth defects include intellectual problems and developmental problems. Infants who have hypothyroidism but are not given medical treatment would have a problem with mental and physical development. 

Websites Used:

http://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/dxc-20155382

http://www.endocrineweb.com/conditions/hypothyroidism/complications-hypothyroidism

Lifestyle of people with hypothyroidism

Attached is a video of the lifestyle of an American mum before she was diagnosed with hypothyroidism.

People who are diagnosed with hypothyroidism can lead a normal life so long their T4 blood levels are brought back to normal. All the symptoms before treatment can be cured after starting their levothyroxine medication.

Diagnosis and Treatment of Hypothyroidism

Diagnosis and Treatment of Hypothyroidism

Thyroid function test

If you have normal levels of TSH, your test score will be from 0.4 to 2.5. A score between 0 and 0.4 is hyperthyroidism. Between 2.5 and 4 means you are at risk for hypothyroidism, and should be retested within a year. Above 4 means you have a mild case. 

How is hypothyroidism diagnosed? After checking that you have the symptoms of hypothyroidism, the doctor will ask you to do a:  

The test looks at levels of thyroid-stimulating hormone (TSH) and thyroxine (T4) in the blood. A high TSH level indicates that the thyroid gland is failing because it reflects a low level of T4. The opposite situation, in which the TSH level is low, usually indicates that the person has an overactive thyroid which causes hyperthyroidism. 

To accurately determine this disease, a T4 test is also done. T4 circulates in the blood in two forms:

T4 bound to proteins and free T4, which enters the tissues to do its function. The free T4 level is used to determine how the thyroid is functioning. Individuals who have hypothyroidism will have a low level of T4. 

Blood tests are also sometimes used for other measurements, such as checking the level of a hormone called triiodothyronine (T3). However, this isn't routine, because T3 levels can often remain normal, even if you have a significantly underactive thyroid.

Radioactive Iodine Uptake
Because T4 contains iodine, the thyroid gland must get iodine from the blood for the gland to produce the required amount of T4. Therefore to perform this test, individuals are asked to swallow a liquid or capsule containing radioactive iodine. After 4 to 6 hours and again 24 hours later the amount of radioactivity in the thyroid gland is measured. This is done using a device called a gamma probe where it is moved back and forth over the area of your neck where the thyroid gland is located.

The radioactivity allows the iodine molecules to be tracked. By measuring the amount of radioactivity that is taken up by the thyroid gland, it can then be determined whether the gland is functioning normally. A low radioactivity is seen in individuals with hypothyroidism. 

(Graves' disease is due to an overactive thyroid gland. As seen from the picture, there is higher radioactivity in the thyroid gland, which shows increased uptake of the radioactive iodine. The opposite is true for those with hypothyroidism)

After diagnosis of hypothyroidism, what comes next?

Treatment, of course. Currently there are no cures for hypothyroidism, but there are treatments to replace the levels of T4 in the body. Most hypothyroid patients take a drug called levthyroxine daily. They will have regular blood tests until the correct dose of levothyroxine is reached. A low dose of levothyroxine is first started on the patient, which may increased depending on their body response. Once the suitable dose is found, blood test is done about once a year to monitor the hormone levels.

References:

http://www.nhs.uk/Conditions/Thyroid-under-active/Pages/Treatment.aspx

http://www.thyroid.org/thyroid-function-tests/

http://www.hormone.org/diseases-and-conditions/thyroid/hypothyroidism

www.oprah.com

Images used:

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Causes of Hypothyroidism

Sooo.... What exactly causes hypothyroidism?

1. Hashimoto's disease

It is an immune-system disorder that causes antibodies to attack the thyroid gland, causing chronic inflammation. This is the most common cause of hypothyroidism. The thyroid gland cannot function as effectively as before and thus cannot produce proper levels of T4. 

2. Iodine deficiency.

 Iodine is needed for the production of thyroid hormone. The body does not make iodine, thus it is taken from the diet. If you do not have enough iodine in your body, you cannot make enough thyroid hormone. Thus, this can lead to enlargement of the thyroid gland. If the patient is pregnant and has untreated hypothyroidism, it may cause mental retardation in the child.

3. Pituitary Disease

The pituitary is the master gland that signals the thyroid how much hormone it needs to produce. If the pituitary is damaged by trauma, stroke, or tumor, the signal to release thyroxine can stop. This causes the thyroid to stop making thyroid hormone. 

4. Thyroid treatment

If a person has hyperthyroidism or thyroid cancer and had surgeries done to the thyroid, it may cause hypothyroidism. 

References:
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https://blogger.googleusercontent.com/img/proxy/AVvXsEjJzlyt_BRRxntjvUdSHFvCdd-xrkVY06-bOTC3vl7qVKBx1QlFl71rKBx-sPPyQtKN0b-s87F80p2z87sEgClcxZfzFD_u7QiOsi41s8bY_RMMPYWgtdW5gBy3uVt0E1O5fIGXdKhUeThyphenhyphen8V9OyJ5FTrD96_nJBHyZH8jk2XSGW7LGVE0pJTF3kDRo4BrgqZ-7uDYcwIAh1WobYCMqTakyWvH3=

https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfQ8cM5RFe0nPU1RuLNvxS9SLlVpKOPo0Bh2wRLF3n-_FF5f9VrVkpS0YqZgyb7l-scf2OIOVIDcQTUe5LhD71_g7W9jKqP8BsoZPHsHhTK5u0pVMgGAfn2ryaoCh6FizGP-19bVMibFQ/s320/autoimmune-01.png

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http://www.healthline.com/health/hypothyroidism
http://www.hormone.org/diseases-and-conditions/thyroid/hypothyroidism
http://www.thyroid.org/iodine-deficiency/
http://www.nhs.uk/Conditions/Thyroid-under-active/Pages/Causes.aspx

Symptoms of Hypothyroidism

Symptoms 

There are no symptoms that are unique and specific only to hypothyroidism. Symtoms may be very mild at the early stages and are often undetected. However, as time goes by, untreated hypothyroidism can cause obesity, joint pain, heart disease, and infertility. Other symptoms can include:

1. increased sensitivity to cold

2. Constipation


3. Depression



4. Fatigue

5.Weakness

6. Heavier menstrual flow

7.brittle hair and nails



Elderly people with an underactive thyroid may develop memory problems and depression. Children may experience slower growth and development. Teenagers may start puberty earlier than normal.


This is an interesting video i would like to share about hypothyroidism symptoms

Links used: http://lovelace-media.imgix.net/uploads/843/b829d810-0e90-0133-f4c7-0e18518aac2f.gif?
http://ourlittlesmarties.com/wp-content/uploads/2010/07/constipation.jpg
https://i.ytimg.com/vi/J3L6Nwr8fp8/hqdefault.jpg
http://pa1.narvii.com/5737/4f631a0c927f20af9e7655b482dca851aa6786f1_hq.gif
http://d26j9nk90wf3d1.cloudfront.net/wp-content/uploads/brittle_hair_a.jpg

http://www.healthline.com/health/hypothyroidism

Thyroid and Hypothyroidism

What is Thyroid?

http://previews.123rf.com/images/logos2012/logos20121405/logos2012140500036/28500777-Structural-chemical-formulas-of-thyroid-hormones--Stock-Vector.jpg

Thyroid is a hormone secreted by thyroid glands. The thyroid gland is the largest gland in the body located at the front of the neck. This gland ressembles a butterfly and wraps around the trachea. The thyroid hormone is important as it affects almost the entire body's tissues as it controls cellular activity. The thyroid hormone helps regulate metabolism.

http://cf.ydcdn.net/1.0.1.42/images/main/thyroid%20gland.jpg

The thyroid gland can lead to many common health issues. These health issues are categorized under 4 groups, which are level of hormone production, the growth of the gland, formation of nodules in the gland, and cancer. Examples of these health issues include goiters, thyroid cancer, solitary thyroid nodules, thyroiditis, hyperthyroidism, hypothyroidism.

Hypothyroidism

Hypothyroidism is a disease caused by low activity of the thyroid gland.There is not enough thyroid hormone present in the bloodstream. This can affect the person's heart, brain muscles and skin. Since thyroid controls the metabolism, hypothyroidism affects body temperature, heartbeat and burning of calories.With low production of thyroid, metabolism is slowed down, which means  energy supply is cut down and metabolism is slowed down. 

Links used:

http://www.endocrineweb.com/conditions/thyroid/your-thyroid-gland

http://www.webmd.com/women/hypothyroidism-underactive-thyroid-symptoms-causes-treatments