Diet and Supplement Dangers for Thyroid Patients

Prepared to take my nutritional supplements
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The dangers of hypothyroidism are real.  There are risks in failing to treat hypothyroidism, and not treating it properly. At the same time, there are also unregulated or dangerous supplements that some hypothyroid patients make take in an effort to lose weight, or feel better.

It is important to know what you are taking, and why, especially with supplements.

Ephedra

One substance to steer clear of as a thyroid patient is ephedra.

The stimulant ephedra, an herbal component may still be found in some imported diet, weight loss and energy supplements and teas, poses too great a risk to warrant its use.

Ephedra was contained in many popular products and caused problems like hypertension (high blood pressure,) followed by palpitations, rapid heartbeat (known as tachycardia), stroke, seizures, and death - and these effects can occur in people who are young and otherwise healthy. According to experts, at least 54 known deaths and about 1,000 reports of various complications were been associated with the use of ephedra since the mid-1990s.

In 2004, the U.S. Food and Drug Administration (FDA) prohibited the sale of dietary supplements containing ephedra, but some imported supplements available in the US continue to contain ephedra.

Implications for Thyroid Patients

Speaking to Reuter's Health, Dr. Neal L. Benowitz of the University of California, San Francisco said he believes that anyone with heart disease, high blood pressure, a previous stroke, psychiatric problems, an overactive thyroid or kidney disease should steer clear of any products that contain ephedra and caffeine.



These products, including ephedra supplements and drugs containing the synthetic version pseudoephedrine (i.e., Sudafed), carry warnings for thyroid patients. The main concern was assumed to be for those who are hyperthyroid, as some stimulant drugs can have an exaggerated response in people with hyperthyroidism, and cause tachycardia in hearts already overstimulated by hyperthyroidism.



But there are also potential concerns for people with hypothyroidism. There are anecdotal reports of people with thyroid disease becoming extra-sensitive to stimulants, and in particular, to the norepinephrine that is released by exposure to ephedra. It's always a good idea to choose cold medicines that don't include pseudoephedrine.

Orlistat/Alli

Some thyroid patients who want to lose weight turn to over-the-counter products like Alli, a lower-dose version of the drug Orlist (brand name Xenical)  Although you may be frustrated with weight gain that often accompanies hypothyroidism, Orlistat could have serious side effects for those who suffer thyroid, diabetes, heart and other chronic conditions.

Taking thyroid medications at the same time as Orlistat can reduce the blood levels of your medication. Talk to your doctor about more frequent thyroid function monitoring if taking Orlistat.

Over-the-Counter Thyroid Supplements

If you are tempted to reach for an over-the-counter thyroid supplement, or "thyroid support" remedy, think again. Research shows that many of them contain actual thyroid hormone. If you are hypothyroid and taking thyroid hormone replacement medication, this puts you at risk of being overmedicated with too much thyroid hormone.

If you are hyperthyroidism, these drugs can also worsen your hyperthyroidism.

Interactions

It's also important for you to be aware that if you are taking thyroid hormone replacement medication, you should not take supplements that contain calcium or iron within three to four hours of taking your thyroid drugs. Calcium and iron can interfere with your body's ability to absorb your thyroid medication, resulting in sub-optimal treatment. 

A Word From Verywell 

The reality is that some over-the-counter diet drugs and supplements are not suitable for thyroid patients, and are even a concern for those without thyroid conditions as well.

If you are interested in taking diet or thyroid supplements, you'll need to talk to a trained herbalist or naturopath about other options for weight loss support that might be helpful, or consult your doctor about the prescription options available.

Sources:

Braverman, L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL/Wolters Kluwer; 2012.

Garber, J. et. al. "Clinical Practice Guidelines for Hypothyroidism," Endocrine Practice, Nov/Dec 2012.

Hainer V, et al. "Are the thyroid hormones and thyrotropin associated with cardiometabolic risks and insulin resistance even in euthyroid subjects?" Vnitr Lek. 2016 Fall;62(Suppl 3):63-67. Czech.

Iacobellis, G., Cristina Ribaudo, M., Zappaterreno, A., et al. Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euthyroid obese women. Clinical endocrinology, 2005. 62(4), 487-491.

Müller MJ, Enderle J, Bosy-Westphal A. Changes in Energy Expenditure with Weight Gain and Weight Loss in Humans. Curr Obes Rep. 2016 Dec;5(4):413-423.

Laurberg, P. et al. "Thyroid Function and Obesity." Eur Thyroid J. 2012 Oct; 1(3): 159–167. Published online 2012 Sep 22. doi: 10.1159/000342994.

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