Thyroid disorders affect the thyroid gland, an endocrine gland located at the front of the neck. The thyroid gland plays a crucial role in managing numerous metabolic processes of the body. Various kinds of thyroid disorders affect either the functioning or structure of thyroid gland. They are Hypothyroidism, hyperthyroidism, goitre, thyroid cancer and thyroid nodules. 

The thyroid gland creates two key thyroid hormones, namely - 

Triiodothyronine (T3) and Thyroxine (T4). Hypothyroidism is a condition in which the thyroid gland fails to produce sufficient amounts of thyroid hormone. It is hence also known as an under-active thyroid. If you are having medications such as thyronorm, eltroxin etc, then you have hypothyroidism

Hyperthyroidism on the other hand occurs when the thyroid gland produces excessive amounts of thyroid hormones.

Hypo and hyper hypothyroidism are more commonly seen in women, then in men

Symptoms of Hypothyroidism

• Feeling Tired: Feeling worn out is one of the most typical symptoms of hypothyroidism. T3 and T4 hormones regulate energy balance and can affect whether you feel ready to sleep, tired etc. People with underactive thyroid gland (hypothyroid) feel tired, even if they are sleeping and resting enough. Feeling sleepier than normal without a good reason could be a symptom of hypothyroidism. 
• Gaining Weight: Another typical symptom of this condition is unexpected weight gain. When a person has low thyroid levels, their metabolism changes. Rather than burning calories for activity and growth, the amount of energy they utilise in a day reduces substantially. This in turn makes the calories spent in a day lower than the calorie intake, which means, the body will store those extra calories as fat leading to excessive weight gain. This is why when you gain weight in spite of not overeating, doctors often ask you to check for your thyroid levels

• Muscle Pain or Muscle Cramps: Imbalance of thyroid hormones can causes myalgia (hypo/hyperthyroid myopathy) characterized by weakness and wasting of the shoulders and hips muscles, followed by severe muscle cramps. In some cases it can even cause grave issues like rhabdomyolysis where muscle tissues rapidly disintegrate.

• Heavy or Irregular Periods: Both irregular and heavy periods are associated with hypothyroidism. T3 and T4 hormones interact with the rest of the hormones which regulate menstruation and abnormal thyroid hormones can disrupt their signals. Added to that, T3 and T4 hormones directly impact the uterus and ovaries. 

• Trouble Remembering or Concentrating: A lot of people suffering from hypothyroidism complain of trouble concentrating and mental haziness. The way this problem manifests itself differs from one individual to another. But this problem usually improves with low thyroid hormone treatment. And difficulty concentrating or remembering can happen to all, however if it is severe or unexpected, then it can be a manifestation of hypothyroidism. 
• Depression: Hypothyroidism is also associated with depression. The grounds for this is vague, but it can be a mental symptom of a complete decrease in health and energy. Even though both are separate conditions, depression is sometimes a sign of hypothyroidism. This is when your thyroid doesn’t produce sufficient thyroid hormone. 

• Hair loss: Just as the majority of cells, the thyroid hormones regulate hair follicles. As hair follicles have stem cells with a quick turnover and less lifespan, they are very sensitive to low thyroid levels when compared to the rest of the tissues. This causes hair follicles to stop regenerating, which lead to hair loss. Thinning of eyebrows and losing hair from the router one-third portion of the eyebrows is yet another common symptom of hypothyroidism. After the thyroid problem is treated, these symptoms will mostly improve.

• Itchy and dry skin: Similar to hair follicles, skin cells are marked by rapid turnover. So, they are sensitive to not getting growth signals from T3 and T4 hormones. Skin can take more time to regrow, when the normal cycle of skin renewal is disrupted. This implies that the outer layer of skin is around longer, accumulating damage. It also implies that dead skin can take more time to shed, which results in dry, flaky skin. 

Thyroid Weight Gain

Weight gain is one of the typical symptoms of hypothyroidism. This is what eventually leads a lot of them to the diagnosis of thyroid disease. 

For long, hypothyroidism has been linked to weight gain (and vice versa for hyperthyroidism). But the accurate biochemical cause of this connection is not absolutely clear. So there are numerous mechanisms which can elucidate this link in case of low thyroid function. 

The two major thyroid hormones, Triiodothyronine (T3) and Thyroxine (T4) circulate in the blood and they impact your metabolism by their interaction with your:

• Liver
• Pancreas
• Muscle
• Hypothalamus
• Fat cells

T3 and T4 typically aid your body break down fat and they also aid the pancreas and liver function to break down stored calories to be utilised for energy. Thyroid hormones also aid all your muscles to utilise energy. And when there is a sufficient level of T3 and T4 circulating in the blood, the hypothalamus lowers the amount of TRH (hormone produced by neurons in the hypothalamus) secretion. 

When you have a low thyroid function or reduced thyroid hormones, all of the actions can be disrupted. Besides the signs of low energy, the body also holds on to calories and stores them as fat, that is particularly hard to break down and burn off. 

Losing weight with hypothyroidism

If you’re suffering from hypothyroidism, shedding weight can be hard. A lot of people believe that after you begin thyroid hormone replacement medicines, the weight starts to drop. Even though treatment can aid you to lose weight, it takes planning, exercise, diet, hard work and getting sufficient sleep to shed a few kilograms. 

• Diet - An optimal diet emphasises lean proteins and vegetables as well as reduces simple carbohydrates and sugars. A meal plan for the condition can keep you on track as to calorie goals. Centre your diet around vegetables and fruits, which are loaded with nutrition and are low in calories. Include a lean protein source as well, such as tofu, poultry or fish.  One of the best ways to trim calories is to reduce consumption of energy-dense foods. You should also be careful when it comes to goitrogenic foods that can disrupt your thyroid functioning. If you are trying hard to shed weight, think of working with a nutritionist to get a dietary plan which works well for you.

• Exercise - Exercise can aid with weight loss. It is recommended that every week, adults should engage in moderate exercise for about 150 minutes and also in two sessions of muscle-building. But, hypothyroid patients should go beyond this recommendation to shed weight. Choose an exercise you like, which is convenient for you, so that you will rather stick to it. You can go for a walk every morning around your neighbourhood or show up at a local gym and take a spin class.  

• Sleep - Both sleep deprivation and weight gain are strongly associated with each other and that link is evident whether or not you have thyroid disease. Sleeping enough regularly can aid hinder weight gain and aid you keep body weight off. 

Should you stop eating cabbage and other leafy greens?

Those suffering from hypothyroidism are usually asked to stay away from vegetables like cabbage, spinach, cauliflower, kale etc. This is because they contain certain sulfur based compounds substances called goitrogens (glucosinolates) that could inhibit the iodine absorption, which is important for healthy thyroid functioning. Such vegetables are hence also known as goitrogenic or cruciferous vegetables.

However, it is also important to note that these green leafy vegetables also come loaded with a lot of nutrients and vitamins and have their benefits too! These vegetables, once cooked well enough, lose most of their goitrogenic properties and hence can be included in moderation in the diet for its benefits. 

Hypothyroid Treatment

Balanced Diet

People with hypothyroidism should ensure that they consume a well-balanced diet with every vitamins and nutrients which are needed by the body. In fact, it is the prerequisite to aid with the symptoms of hypothyroidism. Primarily, the diet needs to be natural, without any preserved, canned or processed foods. 

You can’t heal hypothyroidism by changing the food you have. However, sticking to a right hypothyroidism diet can aid your thyroid function well and alleviate your symptoms.

Since hypothyroidism is also characterized by excessive weight gain, it is important to not consume excessive amounts of calories and calorie dense foods. Be physically active and make sure you burn those extra calories. Often hypothyroidism causes Weight gain, which inturn causes many other health issues. Therefore it is extremely important to maintain a healthy weight, if you are hypothyroid

Eat Healthy Fats

Insufficient intake of good or wholesome fats has proven to bring about hormonal imbalance. Women often omit or reduce fat from their diet, in fear of gaining weight. Fat as a macronutrient is indeed dense in calories, however cutting off fat completely from the diet can have a highly detrimental impact on health and especially hormonal balance. Dietary fat (fat in the diet) is extremely important to aid our body absorb certain vitamins such as - Vit A, D, E & K. Dietary fat is also important to maintain hormonal balance as they are regarded as the building blocks for the majority of hormones. 

However, fat is also a double edged sword. Since it is high in calories, a bit of extra fat will add more and more to calorie intake. Further, bad fat such as transfat, excessive amount of saturated fat (still contested) is claimed to increase serum cholesterol leading to CAD (Coronary artery diseases).

Include more of healthy fat, especially unsaturated fat in your diet. Food such as avocado, almonds, fish oil etc are good and helps in maintaining hormonal balance and are heart healthy too

Exercise

Exercise can supplement your thyroid treatment plan by aiding you lower depression symptoms (a plausible after effect of hypothyroidism), control stress, and maintain a healthy waistline. 

Regular exercise also comes with a lot of benefits:

• Makes sure the proper functioning of important organs in the body
• Regulates the functioning of endocrine glands
• Boosts metabolism
• Removes body toxins
• Improves mood

Some symptoms that people with hypothyroidism experience, such as appetite loss and tiredness, can be fought with a daily half an hour exercise regime. 

Both physical inactivity and stress aren’t great for anyone’s health. Considering the slowed metabolism, depression and fatigue that comes with hypothyroidism, overlooking healthy habits may make your hypothyroid symptoms worse. You should never overlook exercise and should not be considered as a punishment. 

There are different types and varieties of exercises that have a different impact on the body. Choose your exercise wisely - based on your physical abilities and medical conditions. For example, if you are extremely overweight then running or other exercises that involve jumping etc may not be a great idea as it can cause knee pain and even osteoarthritis. Similarly, if you have piles or haemorrhoids, lifting weights can cause flares again!

Exercise for a minimum of 150 minutes every week. It aids with healthy weight maintenance. If you were inactive for a while or are absolutely new to exercise, begin gradually with an exercise regimen. Some energy-boosting, low-impact activities can also help. 

Manage Stress 

Stress is a key element in distorting normal functioning of thyroid. Easing stress in your regular life can bring about a firmer balance in your hormonal levels and can even reverse the condition. There are some ways to relieve stress, such as:

• Meditation: One easy way to ease stress and lower the symptoms of hypothyroidism is by practising meditation.
• Enough sleep: A full eight hours of sleep is vital to manage stress. To get quality sleep, you can cut out blue light exposure (emitted by smartphone and television) one hour prior to sleep. 
• Engage in a hobby: Taking up a hobby is another way to alleviate stress.

Hypothyroid Medications -  Thyronorm, Eltroxin, Levothyroxine

Hypothyroidism medications are nothing but synthetic (Artificial) forms of T4 (Thyroxine) hormone. For a hypothyroid person, his/her thyroid gland is under-active and is not producing enough thyroid hormones. The medications are nothing but artificial T4 hormones to compensate for the deficient amount! 

Thyroid Diet

In general, there is no specific diet which fights hypothyroidism. But sticking to a balanced diet loaded with nutrients and vitamins aids assure proper thyroid function and combat the underlying reasons for thyroid disorders. 

Here are some of the nutrients and vitamins, which are found in a lot of foods and are vital in aiding your body to create sufficient thyroid hormones, which is crucial for managing hypothyroidism. 

Iodine: In order to function properly, your thyroid requires iodine. Most adults require 150 mcg of this essential nutrient a day. Iodised salt may aid your thyroid to develop the hormones essential for growth and development. Eggs, Dairy, fish, etc., are some of the iodine-rich foods. 

Selenium: This nutrient is vital for healthy thyroid function as it helps thyroid hormone synthesis and metabolism. A great way to raise your selenium levels is by adding selenium rich foods to your diets, such as eggs, nuts, garlic, tuna, sardines and legumes. But you should get not more than 200 mcg in a given day. 

Vitamin B: All types of B vitamin are vital for hormonal balance and thyroid function. For example, Vit B12, present in meat, fish and poultry, aids combat fatigue by turning food to energy. Vit B6, present in dairy products, pork and whole grains, aids the thyroid in utilising iodine to create hormones. 

Vitamin D: The lack of Vit-D is associated with hypothyroidism. Vitamin D deficiency can also lead to brittle, thin and deformed bones. Even though it's difficult to find in most foods, some of the natural sources of this vitamin are fatty fish, some mushrooms and egg yolks. In some countries like Canada, USA, Sweden etc, some foods like orange juice, yoghurt and milk are legally mandated to be fortified with vitamin-D. Yet another method to get enough vitamin D is through sunlight. In large cities, this too becomes a problem because the Ultraviolet-B rays that facilitates Vit D synthesis is often reflected back from earth’s atmosphere due to pollution and does not reach the ground!

Foods to eat

There are manifold food choices for people having hypothyroidism, such as:

• Meats: All kinds of meat, like chicken, beef, lamb etc.
• Fish: All kinds of seafood, like tuna, salmon, shrimp, halibut.
• Vegetables: All vegetables, and when it comes to cruciferous vegetables (cabbage, broccoli, cauliflower) they are fine to consume in moderation, particularly after being cooked.
• Eggs: Having a whole egg is the best since egg white is loaded with protein, whereas the yolk contains selenium and iodine. 
• Fruits: All kinds of fruits, like oranges, bananas, berries etc. 
• Grains and seeds: Rice, flax seeds, chia seeds. 
• Beverages: Water and rest caffeine free beverages.

Complications of Hypothyroidism

Cardiovascular Problems- The level of your thyroid hormones can affect the health of your heart and blood vessels. You can have weakened, slow pulse and abnormal heartbeats. The condition can reduce the amount of blood pumped by the heart by thirty to fifty per cent. Low T3 levels are also linked with heart failure. 

Renal Complications- Severe hypothyroidism can bring down the functioning of kidneys. This is especially because of the reduced blood flow to the kidneys. People with hypothyroidism have reduced ability to eliminate water and absorb sodium. Owing to that, blood levels of sodium can be abnormally low. 

Nervous System Complications- The condition can also cause issues with the nervous system, like nerve injury or muscle weakness. This results in:

• Difficulty in breathing
• Pain in feet and hands
• Trouble talking
• Trouble walking
• Abnormal voice change

Pregnancy Complications- Studies show that not having sufficient T3 and T4 hormones during pregnancy can bring about problems. It can raise the odds of miscarriage or other problems, such as premature birth or preeclampsia(a pregnancy complication marked by high blood pressure). 

Infertility- When the thyroid hormone levels are very low, it can reduce a woman's possibilities of conceiving as well as impact ovulation. Still, with the right treatment for hypothyroidism, there is no assurance that the woman will be completely fertile. 

What do we do at NuvoVivo?

At NuvoVivo, we help our clients deal with Hypothyroidism and also reduce body weight . We will help you with diet planning, exercise planning according to your eating habits, medical conditions and preferences. Besides this, we also provide necessary follow-ups to aid them to attain their goals. The program is online in nature and so you can join us no matter where you are. 

Nutrition Planning: Includes creating a diet plan to suit your goals, specifically carbohydrates/protein/fat ratio. Based on the plan (high touch or low touch), the plan will be reviewed on a regular basis. According to your progress, the diet plan will change periodically. We never sell any kind of supplements and we prefer that you have normal food made at home. For most of the foods, your diet plan will be flexible with food alternatives. For example, one can substitute three dosas with a certain number of idlis, chapatis, breads etc.

Exercise Planning: You will be provided with an exercise plan, which includes video explanations based on what you want to achieve and our evaluation of your ability to do it. Based on your goals, the exercise can either be home based or gym based. From a beginner, we expect at least thirty minutes of home-based activity for atleast five days per week. Also, we will review the exercise plan every one or two months, based on your choice of plan. 

Followup and Support: When you go ahead with the program, you would have a lot of questions in your mind and require regular guidance. This will be done via a combination of telephonic calls, emails and whatsapp. For a low touch plan, we will contact you every three days via whatsapp besides occasional phone calls. Whereas for the high touch plan, we will call you every alternate day to clear your queries and to check on you

Remember, the goal is not really losing weight. Rather, to become healthy and improve metabolic parameters. And, as you improve your metabolic parameters, weight loss is just a happy byproduct!