Hyperthyroidism Diet – Food & Nutrition Guidelines

Thyroid gland is a butterfly shaped gland that is located in the neck (lower front). The main function of thyroid gland is to produce thyroid hormones that are then secreted into the blood stream. From the blood stream, these hormones are transported to different tissues of the body. Two hormones are produced by thyroid gland:

1. Triiodothyronine (T3)
2. Thyroxine (T4)

Hyperthyroidism

Hyperthyroidism is a clinical condition in which excess of thyroid hormones are produced and secreted by the thyroid gland in the body. In other words, thyroid becomes overactive. This in turn accelerates the body’s metabolism, that is, every function of the body speeds up.

How It Works

Pituitary gland and hypothalamus (area at the base of your brain) control the rate at which thyroid hormones (T3 and T4) are released. Signals are sent to the pituitary gland to produce a hormone called thyroid-stimulating hormone. The amount of thyroid stimulating hormone released in the body depends on the amount of T3 and T4 already present in the blood. The level of thyroid stimulating hormone will increase if less amount of T3 and T4 are present but if excess of T3 and T4 are present in the blood (if thyroid gland is releasing more hormones) the level of thyroid stimulating hormone will reduce.

In case of hyperthyroidism or overactive thyroid, the blood levels of Thyroxine or T4 is usually high and the level of thyroid stimulating hormone is low. Low levels of thyroid stimulating hormones indicate that already excess of thyroid hormones are present thus, indicating an overactive thyroid.

Symptoms of Hyperthyroidism

1. Irritability
2. Sudden weight loss
3. Hand tremors
4. Rapid heart beat
5. Nervousness
6. Increased sweating or perspiration
7. Difficulty in sleeping
8. Anxiety
9. Brittle hair- leading to easy hair fall
10. Scaly, dry and rough skin
11. Changes in menstrual cycle
12. Sensitivity to heat increases
13. Muscle weakness
14. Fatigue or easily tired
15. Frequent bowel movements

Causes of Hyperthyroidism

1. Graves’ disease: Graves’ disease is one of the most common causes of hyperthyroidism. During this disease, the production of thyroid hormones increases and thyroid becomes overactive. It is an autoimmune disorder. In this disease, anti-bodies cause the thyroid gland to release excess thyroid hormone. This disease tends to run in families. It is commonly seen in young females.  Graves’ disease is further associated with inflammation of the eyes, bulging of the eyes and swelling of the tissues surrounding the eyes. This condition is known as Graves’ ophthalmology.
2. Toxic nodular goiter or Plummer’s disease: The second most common cause of hyperthyroidism after Graves’ disease is toxic nodular goiter. A low level of iodine is associated with low levels of T4. In order to increase the production of T4, thyroid cells undergo division and multiplication. This leads to the formation of lump in the thyroid gland that grows in size and produces more thyroid hormone that normal.
3. Thyroiditis: Thyroiditis is the inflammation of thyroid gland. A group of disorders may lead to Thyroiditis. Such an inflammation may lead to overproduction of thyroid hormones and thus lead to hyperthyroidism.

Complications of Hyperthyroidism

1. Increased risk of developing cardiovascular diseases: Hyperthyroidism is associated with increased heart rate even at rest and increased left ventricular contractility. This can increase the cardiac output by 50% to 300% as compared to normal. Thus, hyperthyroidism leads to cardiac hypertrophy (heart increases in size). Such a growth is observed because of an increase in the workload that is imposed on the heart. Furthermore, individuals with hyperthyroidism often show signs and symptoms of heart failure. Low levels of thyroid stimulating hormone in individuals who are more than 60 years of age are further at an increased risk of heart failure.
2. Hypertension or high blood pressure: A very common characteristic of hyperthyroidism is widened pulse pressure. Over-production of thyroid hormone causes the systolic blood pressure to increase. Therefore, hyperthyroidism is documented as a common cause of hypertension. Successful treatment of hyperthyroidism will reverse this condition.
3. Increased risk of bone fractures: Correct amount of thyroid hormones are very important for proper function and development of bones. Excess of thyroid hormones (T3 and T4) affects the quality of the bones. These hormones play a very important role in the development of skeleton. However, in adults, overt hyperthyroidism may lead to acceleration of bone turnover and loss of bone mineral density. The bone remodeling cycle (a process in which mature bone is removed and new bone tissue is formed) is disturbed and shortened by approximately 50%. Thus, individuals with hyperthyroidism have reduced bone mineral density and are at an increased risk of bone fractures.
4. Depression: Both deficiency and excess of thyroid hormones is associated with mood abnormalities and may lead to depression. Besides this, anxiety disorders have been found in 60 percent individuals and depressive disorders is commonly found in 40 to 60 percent individuals with hyperthyroidism. Emotional instability, irritability, anxiety, dysphoria and inability to concentrate are some common symptoms observed in individuals with hyperthyroidism.
5. Eye problems: Individuals with Graves’s ophthalmology develop various eye problems such as redness and inflammation of eyes, bulging of eyes, blurred vision and increased sensitivity to light.

Tests & diagnosis

1. Physical examination: Your doctor or health care provider may check some symptoms of hyperthyroidism such as unexplained weight loss, changes in the menstrual cycle, hand tremors, anxiety and depression.
2. Blood test: Your doctor may then advice you to check the blood levels of your thyroid hormones to confirm the diagnosis. Low levels of thyroid stimulating hormone and high levels of T4 indicate hyperthyroidism or an overactive thyroid.
3. Thyroid scan: This test is done to identify the cause behind an overactive thyroid or hyperthyroidism. It is a type of nuclear medicine imaging. A small amount of radioactive material is used to identify the structure and function of thyroid gland. The shape, size and position of thyroid gland are determined through this test. It may also rule out the presence or absence of thyroid nodules.
4. Radioactive iodine uptake test: Radioactive iodine uptake test, also known as thyroid uptake is another test done to identify the cause of hyperthyroidism. A small oral dose of radioactive iodine is given to the patient. After sometime, iodine gets collected in the thyroid gland because thyroid gland uses iodine to produce thyroid hormones. After a certain period of time, the doctor may check how much iodine is absorbed by the thyroid gland. If the absorption is more, it means your thyroid gland is producing more thyroid hormone- T4. The main cause for this could be Graves’ disease. Whereas, if the absorption is less, the person may have Thyroiditis.

Nutrition in Hyperthyroidism

Increase Selenium Intake

Selenium is a very important trace element for human health. Among all the tissues in the body, the highest concentration of selenium is present in thyroid gland. Selenium is a powerful antioxidant that helps to maintain normal thyroid function by protecting the thyroid gland from reactive oxygen species. Research has also shown that consuming selenium supplements or foods rich in selenium along with anti-thyroid treatment may protect the thyroid gland as well as improve the effect of anti-thyroid treatment. ⁽¹⁾

Foods rich in selenium include:

• Brazil nuts
• Cereals
• Nuts and oilseeds

Restrict Your Sodium Intake

Research has shown that hyperthyroidism is associated with hypertension. A study published in 2007 observed that hyperthyroidism increases the systolic blood pressure and thus, increases the overall blood pressure. Therefore, individuals with overactive thyroid must restrict their sodium intake. Such individuals must always read the food label before buying any food product. The sodium content is always mentioned on the food label and this will help an individual to understand if that food is good for his/her health. ⁽²⁾

• If a food label has terms such as ‘unsalted’ or ‘without added salt’ mentioned, it means that no salt is added and the food product contain sodium coming only from the natural food.
• If less than 5 milligrams of sodium is present in one serving of food product, it means that the product is sodium free.
• If 35 milligrams or less sodium is present in one serving of food product, it means that the product contains very low sodium.
• If 140 milligrams of sodium is present in one serving of food product, it means that the product contains low sodium.

In addition to this, there are number of packaged foods that contain high levels of sodium. These foods include:

• Sauces
• Ketchups
• Cheese
• Salted butter
• Fried snacks
• Canned foods
• Salted nuts
• Bread and other bakery products such as biscuits, crackers and so on
• Smoked meat
• Sausages
• Pickles
• Papad
• Chutneys
• Ready-to-cook gravies
• Ready-to-eat snacks

Increase Intake of Calcium

A recent research published in 2014 has showed that individuals with an overactive thyroid have low bone mineral density and are at an increased risk of fractures. Therefore, it becomes very important for such individuals to increase their intake of calcium rich foods. Furthermore, these individuals are also at an increased risk of developing cardiovascular disease, thus low fat milk and milk products should be included. ⁽³⁾

Foods rich in calcium include:

• Sesame seeds
• Bok choy
• Finger millets
• Hemp seeds
• Poppy seeds
• Dark green leafy vegetables
• Nuts and oilseeds
• Calcium fortified plant-based food products

Eat Nutrient-Dense Meals

The most common symptom of hyperthyroidism is unexplained weight loss. In order to prevent further weight loss and to promote weight gain, individuals with overactive thyroid should consume nutrient dense meals. This does not mean that such individuals should consume foods rich in sugar and fat, but must include more of fruits, vegetables, whole grains, pulses, milk and milk products and nuts and oilseeds. Having a healthy diet along with anti-thyroid treatment will surely help to correct the thyroid levels as well as help in weight gain.

Include Healthy Fat

Research has shown that individuals with hyperthyroidism are at an increased risk of heart disease. In addition to this, the rate of mortality increases if an individual has hyperthyroidism as well as cardiovascular disease. Therefore, it is important to include foods in the daily diet that protect the heart. Besides the quantity of oil, individuals should also pay attention towards the quality of oil. Cooking oil rich in monounsaturated fatty acid (healthy fat) should be included. This includes:

• Olive oil
• Avocado oil

Besides this, individuals with an overactive thyroid should also include whole grains, fruit and vegetables in their daily diet and cut down their sugar intake. ^{(4, 5)}

Antioxidant Rich Diet

Individuals with an overactive thyroid are constantly under oxidative stress. Such an oxidative stress may further cause damage to thyroid gland and deteriorate the condition. Such an increase in the production of reactive oxygen species needs to be controlled. Research has also showed that individuals with hyperthyroidism have poor antioxidant status and thus, it becomes difficult for them to fight against oxidative stress. Therefore, foods rich in antioxidants should be included in the daily diet. These antioxidants scavenge the free radicals and lower oxidative stress. (6, 7)

Foods rich in antioxidants include:

• Berries such as blueberries, cranberries, strawberries, raspberry
• Kiwifruit
• Prunes
• Pulses
• Green tea
• Walnuts
• Pecans
• Beans such as red kidney beans, pinto beans and black bean

Sample Diet Plan for Hyperthyroidism

Herbs to Help

There are several medicines used for this purposes. Ashwagandha and its combinations all help gain weight. If appetite is poor and digestion is not proper, then it can be used along with ayurvedic appetizers and digestives. The common medicine used for improving overall digestive function is Bhringraj. If one has a burning sensation, gastritis, or other Pitta symptoms, then Kamdudha Ras along with Mustak (Cyperus Rotundus) and Drakshasava can help. If there are no Pitta symptoms, then Kutki should be taken with Trikatu Churna, Bhringrajasava or Kumaryasava etc. The medicines for appetite and digestion should be taken after food. Ashwagandha preparations can be taken with water keeping an hour gap from the meal, starting with low dosage, and gradually increasing with improvement in digestive capacity. The treatment should be continued at least for 6 months.