The thyroid and weight management

2014-02-19T06:30:00Z 2014-02-19T08:59:56Z The thyroid and weight managementJane Ammeson nwitimes.com
February 19, 2014 6:30 am  • 

It’s tiny gland, but when our thyroids get out of whack, it’s big trouble. According to the American Thyroid Association, more than 12 percent of the U.S. population will develop a thyroid condition during their lifetime and an estimated 20 million Americans have some form of thyroid disease. Of those, up to 60 percent of those with thyroid disease are unaware of their condition.

“Thyroid diseases are generally more common in females than in males,” says Akbar Rahmani, M.D., board certified in internal medicine with a subspecialty in endocrinology with an office in Tinley Park who is on staff at Ingalls Health System. “People can have an overactive or underactive thyroid but underactive is more common.”

People with an underactive thyroids, also called hypothyroidism, tend to experience abnormal weight gain and difficulty losing weight until hormone levels stabilize, says Kristal Markovich, a registered dietitian at Methodist Hospitals.

Symptoms can also include, changes in the menstrual cycle for women, constipation, depression, dry hair and hair loss, dry skin, fatigue, greater sensitivity to cold, slow heart rat and swelling of the thyroid gland.

“That’s why a healthy diet and exercise plan for long term weight loss and maintenance are essential,” she says noting that going on a severe calorie restriction may only leave a person more tired. “Choose lean protein, whole grains, fruits/vegetables and low fat dairy products and follow a healthy diet plan.”

Fortunately treating underactive thyroids is relatively straightforward says Rahmani.

“Underactive thyroids have many causes,” he says. “Someone can be born without a thyroid gland, and so it’s underactive from the get go. Sometimes patients have their thyroids surgically removed because of cancer or part of their thyroids were removed because of other types of surgery or use of radiation. The most common reason is people lose their thyroid function as they grow older or you could have been treated. We treat underactive thyroids with medicine--very simple and natural. You just take one pill a day and have your blood levels monitored regularly.”

Overactive thyroid symptoms include an inability to maintain proper weight and are less easy to treat. On the surface, that sounds like the way to go. After all, doesn’t it mean you can eat whatever you want? But in reality hyperthyroidism is a serious disease.

“Medical management is a must with hyperthyroidism,” says Woodruff who refers to the Mayo Clinic Website in suggesting that in cases of patients experiencing severe weight loss or muscle wasting, it may help to add extra protein at least until hyperthyroidism is under control.

Symptoms of hyperthyroidism include feeling nervous, moody, weak, or tired, fast heartbeat, shaky hands, difficulty concentrating and frequent bowel movements

Treatment is complex and requires consultation with an endocrinologist, a physician specializing in diagnosing and treating conditions that are related to the endocrine system.

“There are basically three treatments,” says Rahmani, “each with pros and cons since it’s a chronic disease. There are only a few types of medicine to treat overactive thyroids and they are not simple pills, they can damage the bone marrow and the liver, plus those pills controls rather than treat overactive thyroid, temporarily bring patient down to the right range.”

Other options are to mechanically destroy the thyroid by removing it through surgery or radiation says Rahmani.

“There’s medicine to take for a few years to control, a percentage of the thyroid can be surgically removed or there are pills containing radiation iodine that shrink the thyroid,” he says.

There are times, says Rahmani, when patients will insist they have an underactive thyroid which is the cause of their weight gain.

“If you’re obese from an underactive thyroid your obesity will decrease to a certain degree,” he says. “But if part of the obesity is due to underactivity and overeating, if you are 40 pounds overweight and ten pounds of that because of your thyroid, then ten pounds is what you’ll lose. One thing patients don’t always like is that after treatment, when their thyroid is back to normal, they still have the old habit of eating too much. So if the patient doesn’t watch the diet, they will gain weight.”

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