According to the American Association of Clinical Endocrinologists, over 27 million Americans have been diagnosed with a thyroid disorder. The larger percentage of this population is made up of women. It is estimated that for every ten thyroid patients, eight are women. The hypothesis formed behind this statistical data is that women experience hormonal imbalance, especially after pregnancy, which will often develop into thyroid disease. A statistical projection states that about 18% of pregnant women develop a postpartum thyroid disorder, and out of the 18%, 5% of the cases develop to a permanent thyroid disorder.
On the other hand, although men are at a lower risk of developing thyroid disorders, their numbers are certainly on the rise. To get a deeper understanding of thyroid disorders, we must first understand the functioning of the thyroid gland.
The thyroid gland is a butterfly-shaped gland located on the anterior part of the neck, just below Adam’s apple. Its function is primarily the regulation of the body’s metabolism via interaction with various organs like the liver and the pancreas. The thyroid gland produces thyroid hormones, known as triiodothyronine, also known as T3 and thyroxine, commonly known as T4. The thyroid gland also produces calcitonin, which is a hormone that regulates blood calcium levels.
Thyroid hormones are made from iodine and tyrosine. The release of thyroid hormones into the blood circulation is regulated by Thyroid Releasing Hormone (TRH), which is released from the hypothalamus in response to low blood T3 and T4 levels. Conventionally, the amount of T4 released is four times the amount of T3 released. However, the active thyroid hormone is triiodothyronine. This depicts that there is a deiodination activation reaction that converts T4 to T3.
Thyroid disorders can be classified broadly into three: hyperthyroidism, hypothyroidism, and a malignant thyroid gland. The main indicator of thyroid malfunction is the development of goiter, which is a large mass found on the neck. Other symptoms vary depending on whether it is hypothyroidism or hyperthyroidism.
What is the relationship between thyroid activity and weight?
As earlier stated, the thyroid gland plays a vital role in the body’s metabolism. Hyperthyroidism is associated with high Basal Metabolic Rate (BMR), which may potentiate weight loss. The cause of hyperthyroidism is primarily due to the over-proliferation of the thyroid cells, which may potentiate malignancy.
Hypothyroidism is associated with a low basal metabolic rate, which may potentiate weight gain, the cause hypothyroidism due to iodine deficiency, Hashimoto’s diseases, or surgical removal of the thyroid gland. Hashimoto’s disease is an autoimmune disorder that targets and destroys the thyroid gland. Iodine is used in the production of thyroid hormones, therefore reduced intake of iodine results in reduced levels of T3 and T4.
Endocrinologists have tried coming up with theories to explain the relationship between thyroid hormone levels and weight. A study conducted on over 6000 people for six years tried to assess the correlation between the levels of thyroid-stimulating hormone (TSH) and body mass index (BMI). The results were published in the International Journal of Obesity, which revealed a direct correlation between high BMI and high TSH levels, as seen in hypothyroidism cases.
Another study was conducted in 2004 that was investigating sleep-related disorders and obesity. The study revealed that 12% of its patients had subclinical symptoms of hypothyroidism. In addition, 25% of a group of patients comprised of 72 members scheduled for a gastric bypass had subclinical symptoms of hypothyroidism. Furthermore, they discovered a direct relationship between neck circumference and BMI. However, these studies did not reveal a direct relation between TSH levels and BMI.
Although fat accumulation is the primary cause of weight gain, it is not the major culprit in the case of hypothyroidism. Weight gain in hypothyroidism is attributed to the accumulation of body fluids due to reduced kidney function. Therefore, it is quite difficult for patients with hypothyroidism to lose weight. On average, a patient with hypothyroidism can gain about 5-10 pounds or more depending on its severity.
Patients with hyperthyroidism recorded increased levels in the basal metabolic rate, which leads to significant weight loss. To maintain one’s healthy weight, it demanded that one eats food rich in calories to counter the metabolic demand. The effect on weight in hyperthyroidism is much predominant than in hypothyroidism.
What is the effect of the dramatic changes in weight due to thyroid disorders?
Drastic weight gain may have a direct impact on a person’s self-esteem, especially if they cannot point out the cause. Low self-esteem can lead to anxiety and depression. On the other hand, dramatic weight loss may be a cause of concern and anxiety. All these may potentiate mood swings, depression, and anxiety disorders.
What are the measures are taken to deal with the drastic changes in weight?
For weight loss, a patient diagnosed with hypothyroidism needs to be on thyroid hormone supplementation in the form of levothyroxine. This will increase the basal metabolic rate and improve kidney function.
It is also recommended that such patients adopt a lifestyle change by incorporating more calorie deficient foodstuffs like fruits, vegetables, and whole grain. They should be more active by engaging in regular exercises like jogging, swimming, or cardio workout. This will help keep the BMI at the average standard range and counteract the fatigue associated with hypothyroidism.
For patients diagnosed with hyperthyroidism, the medical intervention involves symptomatic management and the use of drugs to reduce thyroid hormone formation. In severe cases, surgical removal of the thyroid gland is recommended.
With therapy, significant weight gain will be noticed.
For more information or questions about the thyroid function and its effect, contact Bay Area Endocrinology Associates in Tampa.