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In the US, around 4.6 percent of the population aged 12 and above are diagnosed with hypothyroidism. It is a condition where the body does not produce enough thyroid hormones. The thyroid is an important regulator for many functions in the body. This butterfly-shaped organ controls blood pressure and, therefore, the efficiency of the digestive system. Since this hormone controls such important processes, it indirectly controls energy regulation and metabolism. Hypothyroidism can be diagnosed through routine blood tests, or after symptoms start to show. The most common cause of this condition is a disease called Hashimoto's.

Signs and symptoms of hypothyroidism

Since the thyroid hormones are involved in so many functions, there may be many symptoms, and they may be wide-ranging and diverse. 

The main symptoms are fatigue, cold intolerance, joint, and muscle pain. The other signs and symptoms are:

Severe secondary symptoms

If left untreated, this could manifest into more severe symptoms like:

How does hypothyroidism affect weight?

It has been a long-known fact that there is a complex relationship between thyroid, body weight, and metabolism.

Metabolism, determined by measuring the oxygen usage by the body over a specific time, is regulated by the thyroid hormone. 

This measurement, when done in rest, accounts for something called ‘basal metabolic rate’ or BMR. 

A low BMR may have an association with weight gain in certain cases. 

Low thyroid hormone levels is a contributor to low BMR levels, and earlier, this was one of the diagnostic tools for hypothyroidism. 

However, a low BMR could be due to an n number of reasons, and thus, it is not an effective measure of diagnosis anymore.  

In the case of hypothyroidism, weight gain need not always be due to excess fat in the body. 

Accumulation of salt and water being the contributor to weight gain is more plausible here.

Weight gain also depends a lot on the severity of hypothyroidism. In other words, more weight gain may be seen in cases of severe hypothyroidism.

To conclude, if weight gain is the only visible symptom, it’s better to explore the other contributors first before suspecting hypothyroidism.

Losing weight with hypothyroidism

Firstly, it is important to assess whether you’re at risk for the disorder, for quick diagnosis and treatment.

Early detection and treatment can help manage the complications that emerge if hypothyroidism is left untreated.

Identifying the risk factors also can point in the right direction for losing weight with hypothyroidism.

Assessing the risk factors for hypothyroidism

Genetic risk factors

Role of the TSHR gene

The TSHR (Thyroid Stimulating Hormone (TSH) Receptor) gene codes for a receptor protein that is found on the membrane of the cells that span across the thyroid gland.

The receptor binds specifically to TSH and plays a pivotal role in thyroid hormone metabolism.

A part of the receptor is outside the thyroid gland cell, and the rest remains in the cell.

The thyroid-stimulating hormone binds to the receptor, which brings about a series of reactions that control the development of the thyroid gland. 

TSHR gene mutations

TSHR gene mutations can cause congenital hypothyroidism. These mutations change the building blocks that make up the receptor protein.

Moreover, the mutations affect the spread of the receptors across the thyroid gland. Other mutations make the receptors reside completely within the cell or impair the hormone's ability to bind with the receptor.

In conclusion, these mutations don’t allow the receptor to interact with the hormone efficiently. 

When the receptor is unable to interact with the hormone, the hormone production is not stimulated.

This makes the body compensate for the lack of stimulation.

The gland either overproduces the hormone, and functions as normal, or severely under produces the hormone, causing hypothyroidism.  

Mutations in the TSH receptor gene result in resistance to TSH, and therefore, a reduction in thyroid hormone production.

Mutations in TSHR may also cause thyroid hypoplasia, that is, an underdevelopment of the thyroid organ.

Diagnosis and treating hypothyroidism

Clinical symptoms

Firstly, the patient is assessed for symptoms like fatigue, dry skin, constipation, and weight gain.

Above all, the family's and the individual's medical histories are assessed for any previous condition like goiter or any other thyroid problem.

There are increasing reports that correlate the prevalence of thyroid autoimmunity and glycogen storage disease (GSD).

GSD is a condition where stored glucose reserves (stored as glycogen) cannot be degraded efficiently in the body. 

Blood tests

Blood tests are the easiest way to diagnose hypothyroidism.

Usually, the levels of TSH and thyroxine are checked.

An underactive thyroid gland would produce high levels of TSH and low levels of thyroxine.

This is because the body is putting in extra efforts to produce the thyroid hormone.

Treatment

The most common way to treat this condition involves the use of a synthetic thyroid hormone, levothyroxine.

This is an oral medication that reverses the signs and symptoms of the disorder.

Six to eight weeks after the medication, doctors recheck the TSH levels.

Excessive amounts of the hormone can cause increased appetite, insomnia, heart palpitations, and shakiness. 

Other medication that you’re taking, as it can affect how the synthetic hormone work, and therefore, it is important to mention them.

This includes diabetes, antidepressants, estrogen, warfarin, heart medication, and supplements like magnesium, aluminum, iron, or soy.

Other treatments include diet supplements, surgery, and herbal remedies. 

Diet for weight loss

With regard to diet, it is important to note that conventional weight loss diets need not help in losing weight with hypothyroidism.

Make sure you eat the correct amount of calories that match your BMR as well as your physical activity levels.

Eating too little can slow down metabolism to the extent that any weight loss effort would be sabotaged.

Try to stick to a consistent meal plan and preferably stick to small but frequent meals.

Calorie counting, or keeping a food journal would help in understanding what foods you tend to eat more of, and this can provide an overview of your diet.

What to eat

Thyroid patients experience tend to constipation and slow metabolism. So losing weight with hypothyroidism can be challenging.

Typically, diets consist of fiber-rich foods to aid in weight loss.

The following have a significant impact on the diet of a thyroid patient:

  1. Zinc-rich foods: Meat, nuts, avocado, garlic, mushrooms, and pumpkin seeds
  2. Selenium: Chia seeds, brown rice, chicken, eggs
  3. Iodine: Iodised salt, fish, potato, yogurt
  4. Fat-burning supplements: There is some evidence that supplements with Conjugated Linoleic Acid (CLA) can help reduce fat storage in the body. Natural supplements like Caralluma and Hoodia Gordonii, and drinking green tea in moderation, can help suppress appetite. 
  5. Water: Water is such an essential component to allow the body to metabolize efficiently. Drinking the required amount can also help in reducing bloating, and improve digestion. 

These components are essential in maintaining an anti-inflammatory diet.

This helps to calm the immune system and reduce excessive inflammation.

This diet also reduces the pressure on the liver and allows the body to metabolize the nutrients efficiently.

What to avoid

Do thyroid medications help in weight loss?

Although an underactive thyroid gland is associated with significant weight gain, treating the root cause with supplementing synthetic thyroid hormones does not aid in significant weight loss in patients.

In a study conducted by the American Thyroid Association, the synthetic thyroid hormone, levothyroxine, aided in losing weight in only half the volunteers with hypothyroidism.

Tips and Hacks for losing weight with hypothyroidism

Home remedies for hypothyroidism

The basis for natural remedies for hypothyroidism includes focusing on a balanced diet, curbing stress, and incorporate missing nutrients.

An optimal diet plan for patients with hypothyroidism has been explained in the section above.

Other supplements that can be added are as follows:

1. Vitamin B

Low thyroid hormones affect the body's vitamin B levels.

Taking vitamin B supplements can help tackle the fatigue that the body faces.

Foods that are rich in this vitamin are peas, beans, sesame seeds, tuna, milk, and eggs. 

2. Probiotics

Adding probiotics to your diet can help maintain live, helpful bacteria in the gut- preventing serious conditions like chronic diarrhea.  

3. Coconut oil

In its raw form, it helps in the optimal functioning of the thyroid gland.

This helps in losing weight, increasing metabolism, and balancing body temperature.

4. Apple Cider Vinegar

It helps in maintaining a balanced production of hormones in the body.

It helps in removing body toxins and regulate body fat. 

5. Vitamin D

A deficiency of vitamin D can lead to thyroid problems.

Ensure that you get at least 15 minutes of sunlight daily for optimal vitamin D production.

Foods that are rich in this vitamin are mackerel, orange juice, egg yolks, and dairy products.

References

  1. https://ghr.nlm.nih.gov/gene/TSHR#normalfunction
  2. https://www.sciencedaily.com/releases/2013/10/131016095849.htm

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Published 08, June 2020

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