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6 Thyroid Vitamins and Supplements You Need for Better Thyroid Health

If you live with a thyroid condition , particularly hypothyroidism, the most common thyroid disorder, chances are you’re dealing with a plethora of symptoms, including weight gain, fatigue , mood changes, and digestive issues. Remember, the thyroid gland is the butterfly-shaped gland that helps keep the brain, heart, muscles, and other organs working, so a problem with your thyroid can affect many different areas of your body.

Diet and lifestyle changes—including taking nutritional supplements and vitamins for thyroid—can be an important step in maintaining a healthy thyroid, but before you reach for a supplement, you need to better understand where your thyroid levels are and how they may be impacting your nutrient levels.

Measuring thyroid hormone and nutrient levels

At Parsley Health, doctors are trained in holistic medicine and conventional medicine to give you a wider scope of the problems you’re dealing with—and it starts with a thyroid test .

“In conventional medicine, when your primary care doctor screens for thyroid function, they often just look at one main lab value called your thyroid-stimulating hormone, otherwise known as your TSH,” explains Jamie Kyei-Frimpong, DNP, FNP-BC , a nurse practitioner at Parsley Health New York. “But that doesn’t give the overall picture of your thyroid health,” says Dr. Jamie. Your doctor should also be assessing the conversion of other thyroid hormones and your nutrient levels of certain vitamins and minerals that impact that thyroid hormones and conversion.

Without looking at these key measures, it’s common to hear from your doctor that your thyroid is fine, even if you still feel kind of wonky, Dr. Jamie explains.

Dr. Jamie explains that you can have normal TSH levels but have poor conversion, which could lead to symptoms of hypothyroidism, aka an underactive thyroid. When you have hypothyroidism, the thyroid gland doesn’t make enough thyroid hormone to keep the body running normally, according to the American Thyroid Association . Understanding your own thyroid hormone conversion can help you determine the right thyroid vitamins and supplements for better thyroid health.

How thyroid hormone conversion works

The pituitary gland, found in your brain, signals to the thyroid how much hormone to produce. This thyroid hormone is what is known as T4, but your body needs to convert T4 into T3, which is the active form of the hormone, Dr. Jamie says. This active version of the hormone is needed in order for your body to be able to use it.

When the conversion from T4 to T3 is poor, or if you don’t have proper levels of vitamins and minerals that enhance or help that conversion process, your body can make enough T3. That’s where pesky symptoms come in.

How nutrient deficiencies affect thyroid hormone conversion

It’s common for people with hypothyroidism or an autoimmune disease that affects the thyroid to be deficient in certain vitamins and minerals that enhance the conversion process, says Dr. Jamie. You may not be getting the nutrients your thyroid needs from your diet alone, or you may have a gut-related issue that impacts the absorption of the vitamins and minerals from your food.

In both cases, supplements can help to fill nutritional gaps—even if you’re following a healthy diet filled with wholesome foods, like vegetables, fruits, lean protein , and healthy fats . Supplements contain easy to absorb versions of key vitamins and minerals so your body can access them quickly. Parsley Health’s Thyroid Balance supplement , for example, contains many of the nutrients that are important for thyroid health. This will help with the conversion of T4 into T3.

It’s worth noting that nutrient status isn’t the only thing that can lead to thyroid issues. Poor gut health or gut dysbiosis or liver function can impact your thyroid hormones, because portions of the hormone transcription process take place in the liver and the gut, explains Dr. Jamie.

That said, if your doctor determines your nutrient levels may be impacting your thyroid health, here’s a breakdown of some of the most important thyroid vitamins you’ll want to focus on.

Vitamin D

Vitamin D has been shown to improve thyroid TSH thyroid levels, explains Dr. Jamie. According to a November 2019 study in Medical Principles and Practices , which evaluated the vitamin B12 and vitamin D levels in 130 patients with autoimmune hypothyroidism, vitamin D and B12 deficiencies are associated with autoimmune hypothyroidism. Moreover, patients with hypothyroidism and a vitamin D deficiency showed significantly higher anti-TPO levels than those without a vitamin D deficiency.

Thyroid peroxidase (TPO) is an enzyme that aids in the production of thyroid hormones, according to the Mayo Clinic . If your doctor suspects you have a thyroid condition, they may order a TPO antibody test, and the presence of TPO antibodies in your blood could indicate that the cause of thyroid disease is an autoimmune disorder, such as Hashimoto’s or Graves’ disease. Parsley Health routinely runs this test.

Foods rich in vitamin D include salmon, trout, and eggs, but Dr. Jamie says the best way to get it is through the sun. “You really only need to be out in the sun for 10 to 20 minutes, but you need to go during the prime hours of 10 a.m. to 2 p.m.,” she says. Your doctor may also recommend a Vitamin D3/K2 supplement .

Iodine

Iodine has also been shown to help improve TSH levels in those with hypothyroidism, Dr. Jamie says, however, it can be tricky to manage. “It’s needed to make T4, but we have to be careful about how much we’re supplementing because too much iodine can actually cause hypothyroidism,” she explains.

In fact, an October 2012 review in Current Opinion in Endocrinology, Diabetes and Obesity shows that overexposure to iodine can induce hypo- or hyperthyroidism in people with pre-existing thyroid conditions or those at high risk for them.

“We really just need 150 micrograms a day,” says Dr. Jamie. You can find iodine in kale, kelp flakes, and seafood, like shrimp, cod, and tuna. Some table salt is also supplemented with iodine. Before taking an iodine supplement, work with a doctor who can closely monitor your levels and ensure you’re not taking too much.

Vitamin A

“Vitamin A is also needed for T4 synthesis,” Dr. Jamie says. “It helps regulate T4 metabolism, but it can also inhibit TSH so that the TSH isn’t high.”

An August 2012 trial in the Journal of the American College of Nutrition suggests that vitamin A supplementation may help reduce the risk of hypothyroidism in premenopausal women. In the study, 84 women between the ages of 17 to 50 were put on a randomized, double-blind trial for four months. 56 of the women were obese and were randomly selected to take vitamin A or placebo. The other 28 women who weren’t obese received a vitamin A supplement. At the end of the trial, TSH levels were measured, and researchers found that the vitamin A supplement significantly reduced TSH concentrations in both obese and nonobese women while T3 concentrations increased.

While vitamin A supplementation can help with thyroid function, you can also find this important nutrient in a variety of delicious, healthy foods , like sweet potatoes, spinach, carrots, mangoes, and beef liver.

B Vitamins

“B vitamins have many interactions with thyroid function and hormone regulation, and we need B vitamins for detoxification and all of those processes,” Dr. Jamie says. If you are taking supplements for thyroid function with B vitamins, Dr. Jamie says it’s important to make sure that they are methylated so your body can utilize them more efficiently and support detoxification. Those with the MTHFR gene mutation might find it more difficult to metabolize and process nutrients into active vitamins and minerals that your body can use.

Iron

Along with selenium and zinc, iron is necessary for the version of T4 to T3, Dr. Jamie says. You can get ample amounts of iron from oysters, clams, liver, venison, and beef, but if you’re a vegetarian, you can also get it from spirulina and lentils. Just make sure you consume vitamin C with these plant-based iron sources to enhance their absorption.

Research in a May 2017 review in Thyroid found that people living with Hashimoto’s thyroiditis tend to be iron deficient because they may also have autoimmune gastritis, which impairs their ability to absorb iron.

Rhodiola

Rhodiola is an adaptogen that is commonly used to help treat mild or moderate depression, as well as stress. This is one compound that’s not naturally found in food, so you’ll need to take a supplement.

“You’ll find rhodiola in Parsley Health’s Thyroid Balance supplement to help combat stress because when your body is in times of chronic stress, you release higher amounts of the stress hormone, cortisol ,” Dr. Jamie says. “When this happens, your body’s more focused on cortisol release, so it doesn’t put in the effort that it needs to convert T4 into T3.”

Instead, it directs it to something called reverse T3, another thyroid level that Dr. Jamie says is important to monitor. “We don’t want that to be high because it can result in hyperthyroid symptoms.”

Final thoughts

If you have a thyroid condition or just want to make sure your thyroid health is in order, talk to your doctor and health coach before taking any thyroid supplements. They can help you find the right balance between dietary changes and supplements and vitamins for thyroid health all while monitoring your levels of key thyroid hormones and nutrients.

Thyroid Supplements With a Kick

Feeling sluggish? Having a hard time getting out of bed in the morning? Gaining weight?

Many people with vague symptoms like these turn to dietary supplements that promise to jump-start metabolism by bolstering their thyroids with a mix of vitamins and minerals. Bladderwrack seaweed, iodine and an herb called
ashwagondha are among the
common ingredients.

But these over-the-counter products may also contain something that’s not so natural: thyroid hormones that should only be dispensed by prescription.

Photo

Credit Tony Cenicola/The New York Times

Researchers who tested 10 popular thyroid-boosting products sold online found that nine contained the hormones thyroxine (T4) or triiodothyronine (T3),
sometimes both. The amounts varied, but in some cases the recommended daily dose contained amounts of thyroid hormone as high or higher than delivered by prescription medications, according to the report, published
in November in Thyroid, a scientific journal.

At the recommended daily dose of four capsules, one supplement delivered 91 micrograms of T4 and 16.5 micrograms of T3, the researchers found. In clinical practice, the starting dose of T4 for patients with low
thyroid function is just 25 micrograms a day; some older patients are given half that amount. A dose of 75 micrograms a day is sufficient to restore function in many petite women.

“This supplement could give you as much thyroid hormone as you get in a prescription drug or more,” said Dr. Victor Bernet, chairman of endocrinology at the Mayo Clinic in Jacksonville, Fla., and senior
author of the study. He became interested in so-called thyroid-support supplements after seeing a patient with inexplicable test results. The patient eventually admitted that he had been taking a supplement
that a friend recommended for “low energy.

Thyroid disease is common — and more common in women, affecting one in 10 over age 50. Patients may suffer fatigue, lethargy and weight gain, but not everyone with those symptoms has the illness. Patients taking thyroid hormone should be checked regularly by a physician, Dr. Bernet said.

“Thyroid hormone has a narrow therapeutic window,” he said, and “it’s easy to go over or under” the optimal dosages.

Taking too much can disrupt the body’s ability to regulate hormone levels, and actually may trigger thyroid disease in a healthy person, Dr. Bernet said. Excessive doses of thyroid hormone also can cause
anxiety, insomnia and emotional changes, as well as bone loss and serious heart problems.

Officials with trade groups that represent supplement manufacturers said they were troubled by the study’s findings and would welcome regulatory enforcement against what one called the “few bad actors”
producing adulterated products.

“No dietary supplements should contain prescription drugs, period,” said John Shaw, chief executive officer of the Natural Products Association. “They
are illegal and should be removed from the market,” he said, adding, “We don’t want dangerous products out there.”

Both Mr. Shaw and Duffy MacKay, of the Council for Responsible Nutrition, another supplement trade association, suggested the tested
products did not represent all of them, even though nine of 10 contained detectable levels of medication.

Mr. MacKay, a naturopathic doctor, said most consumers do not use “obscure”
products like thyroid-support supplements. “This is a real fringe category, the outsiders of the outsiders of the outsiders,” he said.

While the Food and Drug Administration can take action against unsafe supplements once they are on the market, the regulations governing supplements differ substantially from those for conventional medications,
which go through extensive testing before approval. Under the Dietary Supplement Health and Education Act of 1994, supplement manufacturers are required to ensure that products are safe before putting them on the market.

An F.D.A. spokeswoman said the agency has stepped up enforcement in recent years, in one case issuing warning letters about widespread violations of good manufacturing practices at an Atrium Inc. plant in Wautoma, Wis., that makes red yeast rice and other supplements. She declined to say whether the agency would be investigating thyroid-support products.

Doctors are also concerned about iodine, an ingredient in about half the thyroid-boosting supplements. In order for the body to make thyroid hormone, it needs iodine, but excessive amounts of the element may be
harmful, Dr. Bernet noted.

The recent study did not analyze the iodine content in thyroid-support supplements, but labels on five of the products listed it as an ingredient, with amounts of 100 to 240 micrograms in the recommended daily dose.
The recommended daily allowance for adults is 150 micrograms (slightly more for women who are pregnant or breast-feeding). A teaspoon of iodized salt contains 400 micrograms.

For iodine, as for thyroid hormone, Dr. Bernet said, there is a “sweet spot” in the diet; too much or too little may be harmful.

He and his co-authors did not make it easy for consumers who want to avoid supplements contaminated with thyroid hormone: The published paper did not identify the tested products.

Dr. Bernet’s advice was to avoid all of these supplements. “You can’t trust any of these things. You don’t know what’s in them.”

Hyperthyroidism Information | Mount Sinai

Atis G. Hyperthyroidism: a risk factor for female sexual dysfunction. J Sex Med. 2011;8(8):2327-33.

Bagnasco M, Bossert I, Pesce G. Stress and autoimmune thyroid diseases. Neuroimmunomodulation. 2006;13(5-6):309-17.

Bahn R, Levy E, Wartofsky L. Graves’ disease. J Clin Endocrinol Metab. 2007;92(11):2 p following 14A.

Bope ET, Kellerman RD, eds. Conn’s Current Therapy 2014. 1st ed. Philadelphia, PA: Elsevier Saunders; 2013.

Dominguez LJ, Bevilacqua M, Dibella G, et al. Diagnosing and managing thyroid disease in the nursing home. J Am Med Dir Assoc. 2008;9(1):9-17.

Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015.

Ferri FF. Ferri’s Clinical Advisor 2014. 1st ed. Philadelphia, PA: Elsevier Mosby; 2013.

Fumarola A. Therapy of hyperthyroidism in pregnancy and breastfeeding. Obstet Gynecol Surv. 2011;66(6):378-85.

Ho CH, Chang TC, Guo YJ, Chen SC, Yu HJ, Huang KH. Lower urinary tract symptoms and urinary flow rates in female patients with hyperthyroidism. Urology. 2011;77(1):50-4.

Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007;116(15):1725-35.

Nayak B, Hodak SP. Hyperthyroidism. Endocrinol Metab Clin North Am. 2007;36(3):617-56, v. Review.

Nygaard B. Hyperthyroidism. Am Fam Physician. 2007;76(7):1014-6.

Vanderpas J. Nutritional epidemiology and thyroid hormone metabolism. Annu Rev Nutr. 2006;26:293-322.

Van de Ven AC, Erdtsieck RJ. Changes in bone mineral density, quantitative ultrasound parameters and markers of bone turnover during treatment of hypothyroidism. Neth J Med. 2008;66(10):428-32.

Wu P. Thyroid disorders and diabetes. It is common for a person to be affected by both thyroid disease and diabetes. Diabetes Self Manag. 2007;24(5):80-2, 85-7.

Yuan L, Tian Y, Zhang F, et al. Impairment of attention networks in patients with untreated hyperthyroidism. Neurosci Lett. 2014;574:26-30.

Thyroid Health Bundle – A trio of supplements that promote healthy thyroid function*

Thyroid Health Bundle – A trio of supplements that promote healthy thyroid function* | Thorne






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Thyroid supplements are more trouble than they’re worth

Weight gain, fatigue, brain fog. These are all hallmark symptoms of hypothyroidism, a condition in which the thyroid, a small gland at the front of your neck, slows down or stops making the hormone thyroxine, which helps keep your metabolism up to speed.

If you are diagnosed with hypothyroidism, a doctor may give you a prescription for levothyroxine (Levoxyl, Synthroid and generics). This medication contains synthetic thyroid hormone, which can correct the hormone deficiency and improve your symptoms.

“Unfortunately, these unwelcome symptoms are not specific for hypothyroidism, but are also part and parcel of the natural aging process and can affect people with normally functioning thyroid glands,” says Consumer Reports’ chief medical adviser Marvin M. Lipman, an endocrinologist.

Nevertheless, people who are desperate to lose weight and feel more energetic turn to supplements that are marketed to boost metabolism and energy “naturally.” But experts warn that taking these thyroid supplements is a bad idea. Here’s why:

Thyroid supplements might contain unknown quantities of actual thyroid hormones.

It isn’t possible to know from reading the label whether a supplement contains thyroid hormones, but a 2013 study found that 9 out of 10 supplements marketed for thyroid health and support contained real hormones. Four of those that tested positive listed the ingredient “bovine thyroid tissue,” which may naturally contain hormones.

But five supplements that tested positive listed only herbal ingredients, such as ashwagandha, guggul and Coleus forskohlii. “Since plants cannot produce the hormones the researchers found, thyroid hormones from an animal or synthetic source must have been deliberately added to these supplements,” says Consumer Reports’ senior scientist Michael Hansen.

That is concerning because healthy thyroid hormone levels are very precise, and taking supplements that contain these hormones can alter those levels in unpredictable ways. “Thyroid hormone levels even slightly above or below where they should be can lead to health complications,” Lipman says. “For example, taking more thyroxine than you need can cause erratic heartbeats and bone thinning.”

They can contain iodine.

We need only 150 micrograms, or mcg, of iodine per day in our diet, according to the Institute of Medicine. “That tiny amount of iodine enables the thyroid to manufacture just the right amount of the thyroid hormone thyroxine,” Lipman says.

But ingesting excess iodine can cause health problems. “Even a slight excess of iodine can cause your thyroid to go into overdrive and produce excess thyroxine,” Lipman says. “An overactive thyroid can cause sudden weight loss, a rapid or irregular heartbeat, sweating, and nervousness or irritability.”

Conversely, too much iodine can cause the thyroid to slow down or even stop producing hormones in certain people — the opposite effect of what many people hope these supplements will do for them. That can result in weight gain and fatigue, and can increase your risk of cardiovascular disease, Lipman says.

Thyroid supplements may have kelp in them.

Kelp, a type of seaweed that is often marketed for thyroid health, is loaded with iodine. For example, a serving (one drop) of Liquid Kelp, a dietary supplement promoted for “thyroid gland support,” contains 800 mcg of iodine.

“Most people get enough iodine from their regular diet,” Lipman says. But if you take a supplement that contains kelp, plus a multivitamin such as GNC Women’s Ultra Mega One Daily containing 150 mcg of iodine and also use iodized salt that contains 400 mcg of iodine per teaspoon, it’s easy to consume far more iodine than your thyroid needs — and far more than is healthy.

They might also contain cow “glandulars.”

Glandular organs — such as thyroid, liver, pancreas, heart and spleen — can be found on the ingredients list of some thyroid and metabolic support supplements. For example, Natural Sources’ Raw Thyroid supplements contain raw thyroid, adrenal, pituitary and spleen bovine tissue. But Consumer Reports’ experts say that ingesting such ingredients is not wise. “Supplements that contain pituitary or brain products from cows could theoretically pose a risk for Creutzfeldt-Jakob, a rare disease that occurs in humans and causes brain tissue to degenerate rapidly,” Hansen says.

Thyroid supplements can hinder treatment for a thyroid condition.

Thyroid problems can be diagnosed easily through blood tests, but taking supplements that can alter the level of thyroid hormones in your blood can mask thyroid issues. “If your doctor can’t establish how much thyroid hormone your body needs, he can’t prescribe the correct amount, and that can cause health problems,” Lipman says.

In addition, Duffy MacKay, senior vice president for science and regulatory affairs at the Council for Responsible Nutrition, a trade association that represents the dietary supplement industry, acknowledges that thyroid supplements can interact with prescription medications.

Bottom line: Do not take thyroid supplements. If you suspect that you have a thyroid condition, head to your doctor’s office instead of the vitamin or natural-foods store.

Copyright 2016. Consumers Union of United States Inc.

Levothyroxine (Synthroid) Supplement Interactions — Supplements To Avoid While Taking Thyroid Hormones

Answer:

Levothyroxine (Synthroid, Levoxyl), liothyronine (Cytomel), and other thyroid hormone drugs for hypothyroidism (underactive thyroid), can be affected by taking supplements and can affect your ability to absorb certain vitamins and minerals. Care must be taken with regard to using these supplements, which include calcium, iron, and soy (including soy protein powders and soy isoflavones — found in some menopause supplements) (which can affect absorption of thyroid hormone drugs), alpha-lipoic acid (which may lower levels of thyroid hormone T3 and increase levels of TSH) and L-carnitine and acetyl-l-carnitine (which can inhibit the activity of thyroid hormones — and may help people with hyperthyroidism, or overactive thyroid).

Antacids containing aluminum hydroxide and magnesium hydroxide  (such as Maalox) should be taken at least four hours before or after taking levothyroxine, as they may delay or prevent the absorption of the drug (Synthroid Prescribing Information 2017).

There is some evidence that kelp supplements (such as tablets and capsules) can increase levels of TSH (thyroid-stimulating hormone).

Although often promoted for thyroid health, iodine supplements will not help your thyroid work better, and may even cause problems, unless you have an iodine deficiency.

Preliminary evidence suggests ashwagandha may increase thyroid hormone levels, and so should be used with caution in people taking thyroid hormones, or people with hyperthyroidism.

Be aware that high doses of biotin (as found in some B-complexes or supplements for hair and nails) may interfere with certain thyroid laboratory tests.

Resveratrol has been shown to increase TSH levels and cause thyroid enlargement in animals, although it’s not known whether it effects thyroid function in people. 

Long term exposure to high or even moderate amounts of lithium can affect thyroid function.

Also, be aware that some thyroid-boosting supplements, including herbal supplements, have been found to contain thyroid hormones at significant levels, which are not listed and may be due to drug spiking. See the details in our Warnings section.

Certain foods and drinks may also interfere with absorption or bioavailability of levothyroxine. Soybean flour, cottonseed meal, walnuts, and dietary fiber may bind and decrease the absorption of levothyroxine from the gastrointestinal tract; grapefruit juice may delay the absorption and reduce its bioavailability (Synthroid Prescribing Information 2017). There is also some evidence that coffee may bind to and reduce the absorption of levothyroxine; the evidence suggests it may be best to wait one hour after taking this medication before drinking coffee (Benvenga, Thyroid 2008; American Thyroid Association). [Note: It is not known which compound/s in coffee are responsible for this effect. Therefore, it is possible (but not proven) that decaffeinated coffee may also reduce absorption (Wegrzyn, J Acad Nutr Diet 2016).] Green tea may also interfere with thyroid hormones, so it may be best to consume green tea, as well as green tea supplements, at least one hour apart from thyroid medication.

Cruciferous vegetables such as broccoli, brussels sprouts and cabbage contain compounds that can interfere with thyroid function. However, these compounds are typically found in only very small amounts in these vegetables, and they appear to be deactivated upon cooking (McMillan, Hum Toxicol 1986; Felker, Nutr Rev 2016). See our Answer about supplements and thyroid function for details.

Many reviews have investigated a possible association between fluoride exposure and thyroid dysfunction (including risk of hypothyroidism). However, best available evidence suggests that fluoride intake from drinking water does not have an adverse effect on the thyroid gland or its function. There is no evidence that fluoride intake from other sources such as toothpaste (which is less than the amount from drinking water) affects thyroid function.

About generic versions of levothyroxine:

The reason why it’s particularly important to consider possible supplement interactions when taking thyroid medication is that it has a “narrow therapeutic index.” This means that drug levels must be maintained within a relatively narrow range to be effective and not cause side effects. For this same reason, switching from a branded thyroid medication to a generic, or from one generic to another, can be problematic if the two drugs are not closely bioequivalent or are formulated differently — causing one to release its active ingredient at a different rate than the other under certain circumstances, such as when taken with food or without food.

Due to historic concerns with generic versions of thyroid medication, the FDA tightened the bioequivalency requirements on generics in 2007. Nevertheless, many physicians have continued to prescribe the branded versions. In a study funded by the FDA to validate the equivalency of generic drugs, researchers reviewed the medical records of thousands of people newly started on generic (Mylan, Sandoz, or Lannett) or branded (primarily Synthroid or Levoxyl) levothyroxine for mild hypothyroidism between 2008 and 2017. They found similar attainment of normal thyroid status regardless of whether generic or brand-name medicine had been administered (Britto, JAMA Network Open 2020). While this is encouraging, it should be noted that the study did not evaluate the effects of switching from branded to generic (or generic to branded) products, nor did it include patients with moderate or severe hypothyroidism. In addition, there have been recalls of generic thyroid medication found to be subpotent or superpotent.

January: Thyroid Month | Beware of Biotin

More patients are taking the dietary supplement biotin, which could be throwing off a number of test results from thyroid cancer to Graves’ disease.

The thyroid test results made no sense, so the patient’s primary care physician sought help from an endocrinologist. The physician had been treating the patient’s hypothyroidism successfully with levothyroxine for some time, when suddenly her free T4 levels spiked despite a normal thyroid stimulating hormone (TSH) level.

The physician referred the patient to Cary N. Mariash, MD, professor of clinical medicine at Indiana University in Indianapolis, where additional laboratory tests had inconsistent results: her free T4 and total T3 were elevated, but her total T4, T4 index, and TSH were normal.

Fortunately, Mariash could clear up the confusion by asking the patient a simple question: “Are you taking biotin?”

Yes, she replied, she had recently started taking 10 mg a day in hopes of improving her hair and nails. Her tests returned to normal when she stopped taking biotin. The problem had nothing to do with the patient’s thyroid — the biotin was interfering with the tests.

Mariash presented this case at the recent International Thyroid Congress because he has recently encountered several patients whose abnormal thyroid test results were caused by taking biotin and “most endocrinologists don’t know about this problem.”

Carol Greenlee, MD, an endocrinologist practicing in Grand Junction, Colo., concurs that she is encountering an increasing number of confounding lab results caused by patients taking large doses of biotin.

“I saw somebody just yesterday who has had an extensive workup for hyperthyroidism. A lot of her tests look like she has Graves, but she is taking massive doses of biotin. She probably doesn’t have any thyroid problem. We could be treating people for Graves’ disease who don’t have it, and that’s really scary.” — Carol Greenlee, MD, endocrinologist, Grand Junction, Colo.

“I saw somebody just yesterday who has had an extensive workup for hyperthyroidism. A lot of her tests look like she has Graves’, but she is taking massive doses of biotin. She probably doesn’t have any thyroid problem. We could be treating people for Graves’ disease who don’t have it, and that’s really scary,” Greenlee says.

An Unregulated Supplement
Many people have begun taking biotin mainly in the belief that it is a key contributor to keratin, and therefore can improve hair, nails, and skin. It is marketed under a number of names, including vitamin B7, vitamin H, and coenzyme R, and sometimes may be listed only as an unnamed supplement to improve hair and nails.

It is a B vitamin, and the Institute of Medicine recommends a daily intake of 30 mcg. That’s what a multivitamin such as Centrum Silver contains. But some patients, like the one Mariash treated, are taking milligram amounts, and might not consider it a medication, so not worth mentioning. It is marketed over the Internet, and Mariash recently saw a television advertisement for it, so its popularity could continue to grow.

An Issue with Assays
The problem is that almost all immunoassays today contain biotin because they rely on the biotin–streptavidin attraction to either anchor the assay’s antibodies to a capture surface or capture them once they have reacted with a patient sample, according to Stefan K. Grebe, MD, PhD, professor of laboratory medicine & pathology and co-director of the endocrine laboratory at the Mayo Clinic in Rochester, Minn.

Biotin At A Glance

  • Many patients are taking megadoses of biotin that can cause falsely high and falsely low results in a variety of laboratory tests, including thyroid tests.
  • Patients are taking these supplements mainly to improve their hair, skin, and nails — and might not consider them medications to report on their list.
  • Biotin interference with lab tests could be causing misdiagnoses — and even mistreatment — in an unknown number of patients. [/pullout-wide]

Large amounts of biotin in a patient sample can interfere with this process. However, the effects can be confusing because, depending on the particular assay, biotin can skew the results to be either falsely high or falsely low. In the case of competitive immunoassays — usually used for low molecular weight targets (such as T4, T3, and cortisol) — biotin interference causes a falsely high result. In immunometric (sandwich) assays, it gives a falsely low result.

Other characteristics of the assay can also make a difference. For instance, a longer incubation time increases the opportunity for interference. Different assays for various analytes, even from the same manufacturer, can therefore vary in their susceptibility to biotin interference.

At the laboratory Mariash uses, the free T4 and total T3 assays use a biotin-streptavidin fluorescent detection system, so biotin can cause falsely elevated results, but the TSH and total T4 assays are not affected. In contrast, at Greenlee’s lab, biotin can lead to falsely low TSH results, but free T3 and free T4 tests are not affected. Biotin can also cause her lab’s assay for thyrotropin receptor antibodies (TRAb) to be falsely positive, which could lead to a misdiagnosis of Graves disease.

Mariash says that even though he suspected what was causing the questionable results, getting to the bottom of the problem was not easy: “I had to make a lot of phone calls to our laboratory. Finally a supervisor told me what platform they were using. Then I called the test manufacturer to get additional details, and they gave me enough information to know what was going on. But of course, they don’t give you every detail because some of it is proprietary.” Mariash’s laboratory director was unaware that biotin could be a problem.

Grebe says it may fall to the physician ordering the test to be vigilant: “When your lab results don’t make sense in terms of the clinical picture, or in terms of the constellation of lab results you have received, you should always think first of an assay interference — one of which is biotin — before you think of really exotic reasons for this to have happened, such as TSH-secreting pituitary tumors.”

Puzzling Tests and a Revelation
Greenlee had an example of these confusing results when a patient was referred to be evaluated for a possible diagnosis of adrenal carcinoma. The patient had presented complaining of fluid retention and weight gain. Her face was red and she was growing hair on her face while losing hair on top of her head. Her cortisol and testosterone test results were elevated off the charts. Her thyroid tests were also confusing, with low TSH but normal T4 and T3.

“When your lab results don’t make sense in terms of the clinical picture, or in terms of the constellation of lab results you have received, you should always think first of an assay interference — one of which is biotin — before you think of really exotic reasons for this to have happened, such as TSH-secreting pituitary tumors.” — Stefan K. Grebe, MD, PhD, professor, laboratory medicine & pathology; co-director, endocrine laboratory, Mayo Clinic in Rochester, Minn.

A normal adrenal CT scan ruled out cancer. Greenlee asked the woman to come back the next morning for fasting blood tests. This time her tests were normal. Greenlee thought that perhaps there was some mix-up at the lab, and the original tests were not this patient’s.

The solution to the mystery only emerged over time. The patient’s problems stemmed from her home remedies for her hair loss — minoxidil and biotin. Not knowing her hair loss was not unusual for an older woman, and despite warnings that it should not be used by women, she was putting minoxidil on the top of her head — resulting in a red, hairy face.

The final piece of the puzzle fell into place when Greenlee was preparing a talk and came across a reference to biotin interfering with a parathyroid hormone assay. Her research following up this clue led her to literature reports of other biotin interferences. In the case of this patient, because she had been told to fast before she was tested again, she had not taken biotin, so those results reflected her true status. The biotin interference contributed to her out-of-kilter cortisol, testosterone, and TSH results. In unraveling the mystery, Greenlee consulted with Grebe to learn more about the ins and outs of immunoassays and worked closely with her lab — making them aware of the potential interference.

Biotin Vigilance
Greenlee is now making sure her practice identifies any patients taking the supplement: “We have huge signs in my office that ask people if they are taking biotin — in each exam room, over the phlebotomy chair, and at the front desk. We had all these nice pictures on our walls, but the biotin thing alarmed us so much that we don’t care about our decorations in our office anymore.”

“It can be dangerous not to recognize it,” Mariash agrees. He also notes that clinicians need to be vigilant because laboratories can change the test platform without notice.

For the interference to occur, the patient’s biotin level needs to be high — at least three times the upper limit of the healthy adult reference range, according to Grebe. But that level is easy to achieve with the megadoses many are taking.

Grebe suggests that a clinician can ask the lab to try using another manufacturer’s test, but an easier route is to ask the patient to stop the biotin then get retested. Biotin is water soluble, so it washes out of the body quickly — even a single day can make a big difference in the test results.

And although literature reports mostly focus on problems with parathyroid and thyroid hormone tests, biotin interference could be considered as a potential contributor to almost any suspicious immunoassay result.

Published by the Endocrine Society, Endocrine News is a monthly publication that offers an in-depth look at endocrinology trends and research, from reproductive issues to biotin concerns to thyroid problems. When you’re looking for the latest studies, interviews and commentary on endocrinology, you can find it on our site. With that in mind, if you’re interested in reading additional content with timely, accurate information on thyroid issues, check out our other articles such as “Fairytales: Dispelling Pediatric Thyroid Cancer Myths” and “Thyroid Cancer and Radioiodine.”

Seaborg is a freelance writer based in Charlottesville, Va. He wrote about expanding the definition of osteoporosis in the December issue.

Thyroid health

The thyroid gland is a small but extremely important organ. It is she who is the main producer of hormones that affect metabolic processes in the body.

Our energy, weight, mood and general well-being directly depend on it, therefore, possible violations of its functioning should not be ignored.

Here are some symptoms that may indicate that you should visit an endocrinologist and get tested for thyroid hormones:

1.Visual enlargement of the thyroid gland

The thyroid gland is located in the neck in front of the thyroid cartilage of the larynx and has the shape of a butterfly. Ideally, it shouldn’t be visible at all. Also, problems may be indicated by a feeling of a lump in the throat and difficulty swallowing.

2. Nervousness, irritability, tearfulness

Do not rush to consider a changeable mood a sign of a bad character. This may be the first symptom of hyperthyroidism, in which the thyroid gland produces excessive amounts of thyroid hormones, an excess of which is as harmful as a deficiency.In women, hyperthyroidism occurs 10 times more often than in men due to frequent hormonal fluctuations. As a rule, the disease develops between the ages of 20 and 50 years.

3. Rapid heartbeat, trembling hands, sweating

Also referred to symptoms of hyperthyroidism. By speeding up the metabolism, thyroid hormones cause increased excitation of the nervous system, which affects the state of health.

4. Weakness, low blood pressure, fainting

And these symptoms occur, on the contrary, with hypothyroidism – insufficient production of thyroid hormones.When the metabolism slows down, the patient complains of constant lethargy, high fatigue. Sex drive is often reduced.

5. Weight and appetite disorders

Since our weight is directly dependent on metabolism, its unusual changes may indicate problems with the thyroid gland. With hyperthyroidism, appetite increases, but at the same time, stools become more frequent, and weight becomes less. And hypothyroidism leads to a lack of appetite and constipation. At the same time, body weight can increase, despite a meager diet.

6. Disorders of heat transfer

Hyperthyroidism leads to increased sweating, hot flashes and intolerance to high temperatures. And hypothyroidism, on the contrary, causes a feeling of chilliness. The limbs remain cold even in a warm room. In some people, body temperature may be above or below average and in normal condition. But if you feel drastic and at the same time long-term changes, then it is worth getting tested.

7. Deterioration of appearance

With insufficient production of thyroid hormones, dry skin, brittle nails, hair loss, swelling of the face and extremities are characteristic.Don’t worry, these problems will go away as soon as you level the hormones in your body.

If you have any of the above symptoms, see your doctor. To establish a diagnosis, a specialist will prescribe tests, as well as conduct an ultrasound of the thyroid gland.

Diseases of the thyroid gland develop slowly and can almost always be stopped. However, treatment should only take place under the supervision of a physician! Choosing your own medications can only make the situation worse.

90,000 Which 3 foods should you avoid for Hurthle cell thyroid cancer?

Highlights

No two cancers are the same, and your diet shouldn’t be the same either. All over the world, nutritionists and oncologists are most often asked the question: “What do I eat?” Answer: “It depends on the circumstances.” It depends on the type of cancer, current treatment and supplements being taken, age, gender, BMI, lifestyle, and any available genetic information.In short, the answer to the question “What should I eat” in Hurthle Cell thyroid cancer needs to be personalized to minimize adverse interactions between nutrition (food / diet) and treatment, and to improve symptoms.

Foods such as bamboo and banana should be consumed during Sorafenib treatment for Hurthle Cell thyroid cancer. Similarly, foods such as amaranth and cumin should be avoided when treating with sorafenib for this cancer.

Black Seed contains an active ingredient called Thymoquinone.Thymoquinone interacts with the CYP (drug metabolizing enzyme) Sorafenib and should be avoided.

You got the point – your nutrition should be individual, and it needs to be revised as soon as any of the conditions change. Create and follow a personalized meal plan to minimize the adverse effects of nutrition on cancers such as Hurthle Cell Cancer.



What is Hurthle Cell Thyroid Cancer?

Hertle cell thyroid cancer is a rare cancer that develops in the thyroid gland.It accounts for about 3-10% of all differentiated types of thyroid cancer. This cancer is usually diagnosed in people around the age of 55, but it can occur in people of any age. It is more common in women than in men.

Hurthle thyroid cell carcinoma has a predominance of certain genetic changes. Several of the genes, such as TERT, TP53, NF1, and PTEN, are known to have genetic abnormalities in this cancer, leading to altered function.

Genetic abnormalities found in this cancer can interfere with certain biochemical pathways, causing these cancer cells to actively grow and survive with ongoing treatment. In addition, lifestyle conditions or habits such as smoking, drinking alcohol, and BMI (body mass index) can have a big impact on the response to thyroid cancer treatment prescribed by a doctor. Numerous studies consistently show that your diet / diet – both food and nutritional supplements – can adversely affect treatment, be supportive, or play no role.Hence, the triangulation of the genomics of this thyroid cancer from Hurthle cells, planned or current treatments, and lifestyle needs to be carefully considered in order to decide which foods and supplements should be considered and avoided when developing a diet / meal plan. In addition, it is important to note that changing any of these conditions, such as treatment, lifestyle, or cancer diagnosis, can affect nutrition, and your diet / diet plan may need to be revised for this cancer.

Why does good nutrition matter in Hurthle thyroid cancer?

In Hurthle cellular thyroid cancer, activation or inhibition of several biochemical pathways is important, including P53 signaling, Wnt-beta-catenin signaling, Myc signaling, oxidative stress, PI3K-AKT-MTOR signaling, epithelial to mesenchymal transition, metabolism amino acids and the cell cycle. role in the spread of the disease. All food and nutritional supplements contain active ingredients that have specific molecular effects on various biochemical pathways.Therefore, while consuming certain foods and supplements as part of the diet may support a specific treatment for this thyroid cancer, consuming small amounts of other foods and supplements may lead to adverse interactions with treatment or may accelerate the progression of cancer.

Examples of foods that should not be eaten or eaten with Sorafenib for the treatment of Hurthle cell thyroid cancer

Nutrition for cancer always depends on the type of cancer, the treatments and supplements taken (if any), age, sex, BMI, lifestyle, and any genetic information available.Here we show an example of a nutrition / diet for Hurthle thyroid cancer with only the specific treatment sorafenib in mind.

Foods to Avoid

Amaranth: Amaranth contains active ingredients such as citric acid, isoquercitrin, stigmasterol and others. Citric acid interferes with sorafenib’s effect on Hurthle Cell thyroid cancer by blocking a biological process called oxidative stress. Hence, do not eat Amaranth with Sorafenib to treat this cancer.(Omar M.E., Abdel-Salam et al., J Med Food., 2014; Romain Coriath et al., Mol Cancer Ther., 2012; Nigel Fleeman et al., Health Technol Assess., 2020)

Cumin: Cumin contains active ingredients such as D-limonene, myrcene, linalool and others. D-limonene interferes with the action of sorafenib in Hurthle cell cancers by blocking a biological process called oxidative stress. Hence, do not eat cumin with Sorafenib to treat this cancer. (Ji Bai et al., Oxid Med Cell Longev., 2016; Romain Coriath et al., Mol Cancer Ther., 2012; Nigel Fleeman et al., Health Technol Assess., 2020)

Food products

Bamboo and Banana: Bamboo and Banana contain active ingredients such as beta-sitosterol, oleic acid and others. Taking beta-sitosterol along with sorafenib treatment for Hurthle Cell thyroid cancer causes a decrease in a certain biochemical pathway called the cell cycle, and this is a very positive effect.Hence, bamboo and banana should be consumed along with Sorafenib to treat this cancer. (Shanti Shri Wundrue et al., BMC Complement Altern Med., 2013; Katrin Schult et al., BMC Cancer., 2010; Nigel Fleeman et al., Health Technol Assess., 2020)

Should I Take This Hurthle Cell Thyroid Cancer Supplement?

Black Seed: Black Seed Supplements contain active ingredients such as thymoquinone that interact with CYP3A4 with sorafenib treatment and should therefore not be used.In addition, black seed supplementation does not appear to have beneficial effects on other biochemical pathways that could improve the efficacy of sorafenib treatment in this thyroid cancer. (Ahmed A. Albassam et al., Saudi Pharm J., 2018; Eric I. Zimmerman et al., Clin Cancer Res., 2012)

Foods to Eat After Cancer Diagnosis!

No two cancers are the same. Go beyond general dietary guidelines for everyone and make individual decisions about food and supplements with confidence.

What are the symptoms of Hurthle cell thyroid cancer?

In the early stages, most cancers, including Hertle thyroid cancer, may not cause any signs or symptoms. However, as the disease progresses, Hertle cell thyroid cancer may begin to show symptoms.

Below are some of the signs and symptoms that can be caused by Hurthle Cell thyroid cancer.

  • Vocal changes / hoarseness
  • Painful lump on the neck
  • Difficulty breathing and swallowing
  • Shortness of breath
  • Swollen lymph nodes

Although many of these symptoms can also be caused by various other health conditions, consult your doctor are experiencing these symptoms to rule out the possible chances of Hurthle Cell thyroid cancer.

What are the treatment options for this cancer?

The decision to treat Hurthle thyroid cancer can be made based on a variety of factors, including the stage and extent of the cancer, characteristics of the cancer, symptoms, the patient’s general health and medical history, whether the cancer can be removed completely by surgery, and whether the cancer is present. just diagnosed or returned. Treatment options for this thyroid cancer include:

  • Surgery
  • Radioactive Iodine Therapy
  • Targeted Therapy
  • Radiation Therapy

As part of your diet, avoid foods and additives that may interfere with the treatment of this thyroid cancer.

Which 3 foods should you avoid for Hurthle cell thyroid cancer?

Watch this video on YouTube

In conclusion

The two most important things to remember is that cancer treatment and nutrition are never the same for everyone. A nutrition / diet that includes food and nutritional supplements is an effective tool to manage when you are faced with cancers such as Hurthle Cell thyroid cancer.

What food you eat and what supplements you take is your decision.Your decision should include consideration of cancer gene mutations, type of cancer, ongoing treatments and supplements, any allergies, lifestyle information, weight, height, and habits.

Nutrition planning for cancer from the add-on is not based on Internet searches. It automates the molecular science decision making process implemented by our scientists and software developers. Whether you want to understand the underlying biochemical molecular pathways or not, this understanding is essential for cancer nutrition planning.

Get started NOW with meal planning by answering questions about cancer name, genetic mutations, current treatments and supplements, any allergies, habits, lifestyle, age group and gender.

Foods to Eat After Cancer Diagnosis!

No two cancers are the same. Go beyond general dietary guidelines for everyone and make individual decisions about food and supplements with confidence.


Cancer patients often have to deal with various side effects of chemotherapy that affect their quality of life and are looking for alternative cancer treatments.Taking the right diet and science-based supplements (avoiding guesswork and random selection) is the best natural remedy for cancer and treatment-related side effects.


90,000 May 25 – World Thyroid Day

World Thyroid Day is celebrated annually on May 25. It was founded in 2008 at the initiative of the European Thyroid Association (ETA), which studies issues related to the thyroid gland and its diseases.

The idea received wide support in the professional community and spread in many countries. On this day, in different countries of the world, events are held, the purpose of which is to raise the level of awareness of the population about diseases of the thyroid gland (thyroid gland), methods of their treatment and prevention. The best doctors are awarded with certificates of honor, diplomas for success in the treatment of thyroid diseases. Educational lectures, conferences, seminars are being arranged. Participants make reports on topical problems of endocrine diseases.Charitable foundations raise funds to help those in need. Experts give advice on how to stay healthy. Documentary tapes tell about the discoveries of scientists.

Thyroid diseases are very common!

So, a decrease in thyroid function develops in 2% of people and 8% of people over 60 years old, thyroid nodules are detected by modern methods in almost 30% of adults, goiter is an increase in the size of the thyroid gland in regions of iodine deficiency, which, unfortunately, includes the whole Russia, found in 10 – 30% of the population.A similar situation is developing in most countries of the world and the number of patients with thyroid diseases is measured in tens of millions. At least 1/3 of the world’s population suffers from various diseases of the thyroid gland.

World Thyroid Day has five main goals:
1. Raising public awareness of thyroid problems and their medico-social significance.
2. Raising awareness of the prevalence of thyroid diseases and methods of their early detection.
3. Promotion of prevention programs and educational programs in the field of thyroid pathology.
4. Promotion of modern methods of treating thyroid diseases.
5. Increasing the availability of medical care in the field of thyroid diseases.

First of all, World Thyroid Day belongs not to doctors, but to patients with thyroid diseases.

Today the overwhelming majority of thyroid diseases are curable, and in some cases – preventable!

The latter concerns diseases associated with iodine deficiency in the diet.Iodine deficiency, contrary to popular beliefs, leads not only to an increase in the size of the thyroid gland, but, acting, for example, on the body of a pregnant woman, can lead to irreversible changes in the nervous system of the fetus, the extreme manifestation of which is cretinism, accompanied by severe mental retardation. Thanks to the programs of universal iodization of table salt, iodine deficiency has been eliminated in many countries, but remains in the Russian Federation.
The widespread awareness of the population about the thyroid gland partly rendered it a “disservice”, as it led to the widespread use of dietary supplements “for the thyroid gland” and handicraft, which have no analogues in world medical practice, methods of “treatment” of its diseases.

A little about the thyroid gland

The thyroid gland is considered one of the largest organs of the endocrine system. It produces hormones that regulate the body’s metabolism, affecting the growth and development of the body. Thyroid hormones help regulate oxygen consumption by the body’s tissues, they are responsible for the normal functioning of the immune system: they stimulate its cells, with the help of which the body has to fight infections. Thus, the thyroid gland affects all aspects of a person’s life, including even his mood and appearance.

The thyroid gland is fully formed by the 8th-9th month of fetal development. And hormones in it begin to be produced even earlier – in the fifth week of fetal development. By the end of the first year of a person’s life, the mass of the gland doubles, and it grows especially intensively during puberty and by the age of 18-20 its mass increases 20 times! The mass of the thyroid gland is 30-40 grams, while the mass and volume of the gland in women is greater than in men. Iodine is required for the production of some thyroid hormones.

Diseases of the thyroid gland are dangerous because disturbances in its work are often disguised as symptoms of diseases of other organs. Therefore, an unsuspecting person does not go to an endocrinologist for help, but to other specialists.

Decreased production of thyroid hormones manifests itself in weight gain and increased cholesterol content, weakness, drowsiness, increased fatigue, edema of the face and extremities, depression, sleep disorders, menstrual cycle, decreased potency (men).Dry skin, brittle nails and hair, constipation, weak throbbing, impairment of memory and attention can be signs of thyroid dysfunction.

With increased production of thyroid hormones , complaints of general weakness, malaise, insomnia and irritability arise. There is an increase in blood pressure, tremors in the limbs or the whole body, weight loss even with adequate nutrition, menstrual irregularities (women) and decreased potency (men).In addition, there is increased sweating, heat intolerance, loose stools, disturbances in the work of the heart, tachycardia. Visual impairment is possible, manifested in unpleasant sensations in the eyes, double vision, protrusion of the eyeballs.

If such symptoms appear, an urgent consultation with an endocrinologist is required!

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