Tag: thyroid gland

Iodized Salt and Hashimoto’s Disease: Myths Debunked

Does Salt Iodization Cause Hashimoto’s Disease?

When we buy salt, we often reach for the one with the note “iodized”. This means that iodine has been added to the salt. It is a microelement necessary for the proper functioning of the body. Both deficiency and excess of this element have serious health consequences, especially the thyroid gland. Many people are concerned that eating salt with added iodine leads to Hashimoto’s disease. Is it true?

Significant iodine deficiency causes hypothyroidism, including its most common form – Hashimoto’s disease. Long-term exposure to large amounts of iodine can also lead to Hashimoto’s disease. Excess of this element primarily promotes enlargement of the thyroid gland. It causes hyperthyroidism of this gland and increases the risk of developing thyroid cancer. So it turns out that the most important thing in iodine intake is to maintain the “golden mean”.

We acquire iodine from the environment and through our diet. It is present in the air, water, plants, and animals that we consume. The problem is that its amount is not evenly distributed in the environment. Our areas are not very rich in this element. Therefore, in order to improve the health of Poles, in 1997 the obligation to iodize table salt was introduced. It is salt intended for use in households (the obligation does not apply to many types of salt, e.g. Himalayan salt, sea salt, so read the labels, and salt used in the food industry).

Recent research on iodine’s effects on Hashimoto’s thyroiditis highlights its dual role in thyroid health. While iodine is essential for thyroid hormone synthesis, excessive intake may exacerbate autoimmune thyroid conditions like Hashimoto’s. A 2021 study published in Nutrients (https://www.mdpi.com/2072-6643/13/2/515) found that high iodine levels can increase oxidative stress and thyroglobulin immunogenicity, potentially worsening autoimmune responses. Another 2020 review in Frontiers in Endocrinology (https://www.frontiersin.org/articles/10.3389/fendo.2020.00478/full) emphasized the importance of individualized iodine intake, as both deficiency and excess can disrupt thyroid function. Additionally, a 2022 study in Thyroid (https://www.liebertpub.com/doi/10.1089/thy.2021.0667) suggested that moderate iodine restriction might benefit some Hashimoto’s patients by reducing thyroid autoantibody levels. These findings underscore the need for careful iodine management in individuals with Hashimoto’s disease.

Does iodizing salt cause Hashimoto’s disease?

This is a popular myth. Iodizing table salt does not give so much element to the body to cause any harm. Although excess iodine can actually promote the development of Hashimoto’s disease or worsen its course, as research shows. This applies mainly to people who are genetically predisposed to develop the disease, especially with selenium deficiency. Polish experts agree that the benefits of a common salt iodization program outweigh the possible risks.

Is it worth supplementing iodine?

If hypothyroidism is not caused by iodine deficiency, there is no need for supplementation of this element. Do not take high doses of iodine, Lugol’s liquid or other preparations with iodine without consulting a doctor.

The daily requirement for iodine is:

  • children up to 5 years of age: 90 μg,
  • children 6-12 years: 120 μg,
  • children > 12 and adults: 150 μg,
  • pregnant and lactating women: 250 μg.

A simple way to check the level of this microelement in the body is to test urine for iodine concentration. In healthy people, kidneys excrete 90% of it. For adults, urinary excretion of iodine should be at least 100 micrograms per liter. It should not exceed 200-300 micrograms per liter.

Do we take the right amount of iodine with our diet?

Table salt is the main source of iodine in the diet. One teaspoon of iodized salt (5 g) contains about 150 micrograms of potassium iodide. Iodine constitutes about 77% of potassium iodide. This amount does not meet the daily requirement of an adult. The source of iodine is also a diet. Algae, sea fish, and seafood contain a lot of iodine. Plants that grew in soils with high iodine content also contain this element. The closer to the sea, the more iodine is found. The least amount of this element occurs in mountainous areas. Remember that you should not overdo it with salt. The WHO recommends limiting its consumption to 5 g per day…

Everything indicates that many people are at risk of iodine deficiency. The Krakow declaration on iodine was signed in 2018 by scientists from 27 countries. According to this declaration, iodine deficiencies occur almost throughout Europe. Children, pregnant women and pregnant women are particularly exposed to them. Scientists suggest in the document that governments should make it mandatory to add iodine to industrial salt. This salt is used as an additive to food products.

What salt should I use for Hashimoto’s disease?

Nutritionists currently recommend that you choose iodized salt regardless of whether you have Hashimoto’s disease or not. The Institute of Institute’s research shows that a diet without iodized salt lacks adequate iodine. This amount is too little compared to recommended standards. This increases the risk of deficiencies of this element.

The obligation to iodize salt has been introduced. Since then, the number of goiter of the thyroid gland has decreased significantly. The incidence of thyroid cancer has also decreased significantly. Of course, it is worth remembering not to exceed the recommended amount of salt. Its excess also promotes other diseases, such as hypertension. A reasonable approach seems to be to check the level of iodine in the body. It is also important to consult an endocrinologist who can professionally assess our need for additional iodine.

What are the facts and myths about Hashimoto’s disease?

Hashimoto’s disease is an autoimmune disorder that affects the thyroid gland and can cause an underactive thyroid (hypothyroidism). Some facts and myths related to Hashimoto’s disease are:

Facts

  • It is more common in women than in men.
  • It is often diagnosed through a combination of physical examination, blood tests, and imaging studies.
  • Hashimoto’s disease can be treated with medication and lifestyle changes.
  • The symptoms of Hashimoto’s disease can include fatigue, weight gain, depression, constipation, and joint pain.

Myths

  • Myth: Hashimoto’s disease can be cured.
    • Fact: There is no cure for Hashimoto’s disease, but it can be managed with medication and lifestyle changes.
  • Myth: A gluten-free diet can cure Hashimoto’s disease.
    • Fact: While some people with Hashimoto’s disease may benefit from a gluten-free diet, it is not a cure and should not be followed without consulting a doctor.
  • Myth: Hashimoto’s disease only affects the thyroid gland.
    • Fact: Hashimoto’s disease is an autoimmune disorder that can affect other parts of the body, including the liver and the skin.
  • Myth: If you have Hashimoto’s disease, you will need to have your thyroid removed.
    • Fact: Not everyone with Hashimoto’s disease will require thyroid removal. Treatment options will depend on the individual’s symptoms and health status.

It is important to consult a healthcare provider for personalized information and guidance regarding Hashimoto’s disease.

Hypothyroidism can cause dry skin, fatigue, and a cold feeling.

The thyroid gland is located in the front center of the neck, between the trachea and the larynx. It is the organ that produces the hormones triiodothyronine (T3), thyroxine (T4), and calcitonin. The thyroid requires iodine from food and the environment to produce them. The pituitary gland produces the hormone TSH, which regulates thyroid function.

Thyroid hormones affect many different processes and organs throughout the body, including:

  • metabolism,
  • energy use,
  • muscular strength,
  • fertility and potency,
  • heart work,
  • the functioning of the nervous system,
  • mental well-being,
  • condition of skin, hair and nails.

A deficiency of thyroid hormones therefore adversely affects many processes in the body. both adults and children, who can also get sick.

Causes of hypothyroidism

A variety of factors can contribute to hypothyroidism. They can be primary (caused by thyroid gland damage) or secondary (resulting from abnormalities in the functioning of the pituitary gland or hypothalamus).

The primary causes of hypothyroidism  are:

  • Hashimoto’s disease, otherwise chronic autoimmune thyroiditis,
  • postpartum thyroiditis,
  • radioiodine treatment,
  • neck radiotherapy,
  • significant iodine deficiency,
  • the use of certain medications (so-called drug-induced hypothyroidism), e.g. lithium salts, interferon, amiodarone,
  • surgical removal of the thyroid gland,
  • damage to the thyroid gland as a result of a disease, e.g. cancer,
  • congenital hypothyroidism.

Causes of secondary hypothyroidism  include:

  • hypothalamic or pituitary tumors,
  • injury or inflammation in the hypothalamus or pituitary gland,
  • Sheehan’s syndrome
  • neurological disorders in which there is a deficiency of nerve impulses that stimulate the pituitary gland and hypothalamus to produce thyroid hormones.

It should be added that iodine deficiency is an increasingly rare cause of the development of hypothyroidism, because iodine deficiencies in the diet are less frequent than in the past.

Hypothyroidism and Hashimoto’s disease

Hashimoto’s disease is the most common cause of hypothyroidism today. As the immune system malfunctions and attacks its own tissues, in this case the thyroid, thyroid problems are becoming more and more autoimmune. Hashimoto’s disease can develop latently or in its early stages, causing hyperthyroidism symptoms for a short period of time. However, it usually progresses to hypothyroidism, and treatment focuses on that.

Symptoms of hypothyroidism

Symptoms of hypothyroidism are most often the result of slowing down the activity of the body. Symptoms often associated with hypothyroidism include a tendency to gain weight , but the list of typical ailments is much longer.

The main symptoms of hypothyroidism are:

  • constant fatigue – inadequate to the effort,
  • drowsiness that does not go away despite drinking coffee or energy drinks,
  • problems with concentration and memory , and even memory loss or intellectual disorders that resemble dementia,
  • muscle weakness,
  • chronic  constipation ,
  • mood swings – especially despondency, indifference,  depression , apathy,
  • feeling cold – even when he is warmly dressed or in heated rooms,
  • decreased sweating, 
  • swelling of the face, eyelids, hands, resulting from the accumulation of mucous substance in the intercellular spaces (myxoedema),
  • pain, redness and burning of the eyes – the symptoms often resemble conjunctivitis,
  • decrease in immunity – the result is frequent infections,
  • problems with getting pregnant  or carrying it to term,
  • easy bruising,
  • tingling and numbness of the hands,
  • hair loss, paleness and dry skin.

If you notice that your neck circumference has increased for unknown reasons, go to your doctor and ask for a referral for thyroid tests..

The symptoms of hypothyroidism in the elderly are more difficult to spot because they are atypical. For this reason, hypothyroidism in the elderly is often misdiagnosed as atherosclerosis or depression.

Diagnosis

The diagnosis of hypothyroidism involves measuring the blood level of TSH and FT4, which are hormones produced by the pituitary gland. If the TSH level is too high, the body is trying to stimulate the thyroid gland to work more intensively.

TSH standards

TSH parameters vary from laboratory to laboratory, but normal values are usually between 0.4 and 4.0 mIU/l. However, a doctor must evaluate the result on an individual basis. Because an infection or chronic illness can artificially lower or increase a single result’s reliability, it is also crucial. If symptoms typical of hypothyroidism are present, it is worth repeating the examination or extending the current diagnostics.

Treatment of hypothyroidism

Treatment for hypothyroidism is the oral administration of synthetic hormones, such as levothyroxine. Levothyroxine is taken every morning on an empty stomach and should not be eaten for 30–60 minutes. The effectiveness of the therapy is high, and many symptoms disappear in a short time, but some patients still report some symptoms. To ensure the effectiveness of the therapy, TSH levels should be measured regularly, and in some 30–60 T4.

Thyroid : Untreated Hashimoto’s disease can lead to male fertility impairment and infertility.

Men are five times less likely than women to get Hashimoto’s disease, according to statistics. Experts believe this is due to testosterone, which “protects” the male body from thyroid problems. If the level of testosterone in the male body declines for any cause, the probability of having Hashimoto’s disease increases.

Learn more at Munaeem’s blog

Inflammation of the thyroid gland: investigations and diagnosis

To determine the cause of thyroid gland inflammation, the doctor will first conduct a thorough interview with the patient to gather medical history. An important point here is the occurrence of symptoms. They can provide valuable information to the doctor about the type of thyroid inflammation. Information from the past, such as a sore throat, radiation therapy, drug therapy, or injury, can also be useful.

A physical examination and the drawing of a blood sample come next. When inflammation values (such as C-reactive protein and blood sedimentation rate) are elevated, the latter can quickly confirm the suspicion of a thyroid gland inflammation. Acute thyroiditis results in an increase in white blood cell count, but subacute thyroiditis does not.

The thyroid hormone levels are also measured. In this way, the doctor can determine whether the thyroid gland is overactive or underactive. You can read more about this in the article Thyroid values .

Ultrasound is a crucial imaging technique when thyroid inflammation is suspected (sonography). On ultrasound, an inflamed thyroid gland will appear dark and have a loose structure (a healthy thyroid gland will appear more uniform). A smaller-than-normal thyroid gland is a symptom of Hashimoto’s thyroiditis.

The physician performs a fine-needle biopsy on the thyroid gland to obtain tissue samples for a more thorough examination. Under a microscope, the typical Langhans’ giant cells can be seen in the case of subacute Quervain thyroiditis.

If necessary, further examinations are carried out, for example, an antibody determination in suspected autoimmune thyroid inflammation (such as Hashimoto’s thyroiditis) or a scintigram.

Thyroiditis: treatment

Antibiotics are used to treat acute purulent (bacterial) inflammation of the thyroid gland. A cooling pad, such as an ice tie, can ease the discomfort. Drugs like acetylsalicylic acid and diclofenac also have an anti-inflammatory and pain-relieving effect. Pus must be removed from an abscess that has developed in the thyroid gland as a result of the inflammation through a puncture or surgical procedure.

Acute non-purulent thyroid gland inflammation that occurs after radiation therapy typically goes away on its own. Anti-inflammatory medications are given to patients when they are in pain. De Quervain thyroiditis that is subacute almost always resolves on its own. In severe cases, cortisone medications like prednisolone and anti-inflammatory medications like acetylsalicylic acid may be administered.

Usually mild and not requiring treatment, postpartum thyroiditis. Thyroid hormones are used if the inflammation resulted in hypothyroidism. Beta blockers may be administered for transient hyperfunction.

The treatment for drug-induced thyroid inflammation depends on the underlying dysfunction: When the thyroid is underactive, thyroid hormones are administered. A low-iodine diet, surgical thyroid gland removal, or radioiodine therapy are all options for treating hyperfunction, depending on its severity. If amiodarone is to blame for the thyroid inflammation, the medication should be stopped as soon as possible.

Inflammation of the thyroid gland: course of the disease and prognosis

With the right care, acute thyroid inflammation completely resolves. However, hypothyroidism may manifest either temporarily or permanently if the inflammation has severely damaged the thyroid tissue. In about 80% of cases, subacute de Quervain thyroiditis resolves spontaneously within three to six months. Rarely does hypothyroidism develop, necessitating the administration of thyroid hormones. 

Silent thyroiditis typically resolves on its own. Additionally, post-partum thyroiditis typically resolves naturally. However, in some patients, the hypothyroidism is persistent and needs to be treated with thyroid hormones. The drug may be discontinued on a trial basis after approximately six months. 

Within a year of giving birth, thyroid function returns to normal for the majority of women. However, chronic thyroid inflammation, specifically Hashimoto’s thyroiditis, develops in about 10% of cases of post-partum thyroiditis. Following post-partum thyroiditis, the risk of goiter (goiter) in the thyroid also rises. Therefore, those who are affected should routinely have their thyroid levels checked by a physician. Additionally, there is a high likelihood that postpartum thyroiditis will return following a subsequent pregnancy.