Endocrine Health - Hypothyroidism Flashcards
Q: List some common symptoms of hypothyroidism.
A: Common symptoms include fatigue, weight gain, dry skin, hair loss, depression, and intolerance to cold.
Q: What cardiovascular symptom is often associated with hypothyroidism?
A: Bradycardia (slow heart rate) is commonly associated with hypothyroidism.
Q: What distinguishes subclinical hypothyroidism from overt hypothyroidism?
A: In subclinical hypothyroidism, TSH is elevated while T4 levels remain within the normal range.
Q: What risks are associated with untreated subclinical hypothyroidism?
A: Risks include increased heart disease, cognitive impairment, and infertility.
Q: What is Hashimoto’s thyroiditis?
A: Hashimoto’s thyroiditis is an autoimmune disease in which antibodies attack thyroid tissue, leading to reduced thyroid hormone production.
Q: What infections are associated with an increased risk of developing Hashimoto’s?
A: Epstein-Barr virus (EBV) and Helicobacter pylori infections are associated with an increased risk.
Q: What is the primary allopathic treatment for hypothyroidism?
A: Levothyroxine (synthetic T4) is the primary treatment for hypothyroidism.
Q: What can interfere with the absorption of levothyroxine?
A: Absorption can be affected by food, coffee, and certain medications, so it’s recommended to take it on an empty stomach.
Q: Name two lifestyle changes that support hypothyroidism in a naturopathic approach.
A: Optimizing digestion and supporting stress management through the HPA axis are key naturopathic approaches.
Q: What dietary modification can help reduce inflammation in hypothyroid patients?
A: Optimizing omega-3:6 ratios and avoiding trans fats and high-sugar foods can help reduce inflammation.
Q: Why is selenium important for thyroid health?
A: Selenium supports the conversion of T4 to T3 and reduces inflammation in autoimmune thyroid conditions.
Q: Which vitamin helps modulate thyroid receptor function and reduce TSH?
A: Vitamin A plays a role in modulating thyroid receptor function and can help lower TSH levels.
Q: What is primary hypothyroidism, and what causes it?
A: Primary hypothyroidism involves pathological processes within the thyroid gland, leading to high TSH and low T4/T3. Causes include iodine deficiency, autoimmune disease, viral infections, drug-induced issues, and postpartum conditions.
Q: What is secondary hypothyroidism?
A: Secondary hypothyroidism occurs due to issues in the pituitary gland, leading to inadequate TSH release and subsequent low thyroid hormone levels (T4 and T3).
Q: How does tertiary hypothyroidism differ from primary and secondary types?
A: Tertiary hypothyroidism is due to inadequate release of TRH from the hypothalamus, which reduces TSH stimulation of the thyroid gland.
Q: What is subclinical hypothyroidism, and how is it detected?
A: Subclinical hypothyroidism involves slightly elevated TSH with normal T4 levels. It may involve T4 to T3 conversion issues or thyroid cell receptor resistance.
Q: List common symptoms of hypothyroidism.
A: Common symptoms include fatigue, weight gain, cold intolerance, joint pain, dry skin, hair loss, brain fog, depression, constipation, low libido, and heavy or irregular menstrual periods.
Q: What cardiovascular symptoms are associated with hypothyroidism?
A: Bradycardia (slow heart rate) and high cholesterol, especially elevated LDL levels, are common cardiovascular symptoms.
Q: How might hypothyroidism affect reproductive health?
A: Hypothyroidism can cause fertility issues, low libido, increased miscarriage risk, and heavy or irregular menstrual periods.
Q: What distinguishes subclinical hypothyroidism from overt hypothyroidism?
A: In subclinical hypothyroidism, TSH is elevated, but T4 levels are within the normal range.
Q: What are the risks associated with untreated subclinical hypothyroidism?
A: Risks include heart failure, coronary artery disease, infertility, cognitive impairment, fatigue, and altered mood.
Q: At what TSH level is subclinical hypothyroidism more likely to progress to overt hypothyroidism?
A: Higher TSH levels above 10 mU/L, along with thyroid autoantibodies, increase the likelihood of progression to overt hypothyroidism.
Q: Why is hypothyroidism more common in women?
A: Women have increased rates of autoimmune thyroid disorders, especially postpartum or during menopause.
Q: How does iodine intake influence hypothyroidism risk?
A: Both iodine deficiency and excess iodine intake can lead to hypothyroidism, especially in those with autoimmune predispositions.
Q: What environmental factors are linked to hypothyroidism?
A: BPA, pesticides, fluoride, heavy metals, and smoking are environmental factors that disrupt thyroid function and increase hypothyroidism risk.
Q: What is Hashimoto’s thyroiditis, and what are its characteristics?
A: Hashimoto’s thyroiditis is an autoimmune disease where the immune system attacks thyroid tissue, leading to increased TSH, low FT4, and the presence of TPO and anti-thyroglobulin antibodies.
Q: What infections are associated with Hashimoto’s thyroiditis?
A: Epstein-Barr virus (EBV) and Helicobacter pylori (H. pylori) infections are associated with increased Hashimoto’s risk.
Q: How does Hashimoto’s typically progress?
A: Symptoms may initially present with normal or hyperthyroid test results due to intermittent thyroid cell destruction, often progressing to late-stage hypothyroidism.
Q: Why can excess iodine trigger Hashimoto’s thyroiditis?
A: Excess iodine increases the immunogenicity of highly iodinated thyroglobulin, triggering autoimmune responses in susceptible individuals.
Q: Which genetic polymorphisms are linked to Hashimoto’s thyroiditis?
A: VDR and MTHFR polymorphisms are associated with increased autoimmune thyroid disease (AITD) risk.
Q: How might personal care products impact Hashimoto’s risk?
A: Triclosan, found in some personal care products, resembles thyroid hormones in structure and can disrupt thyroid function.
Q: What is the primary medication used to treat hypothyroidism, including Hashimoto’s?
A: Levothyroxine, a synthetic form of T4, is commonly prescribed to treat hypothyroidism.
Q: What factors can reduce the absorption of levothyroxine?
A: Coeliac disease, atrophic gastritis, coffee, and certain medications (like PPIs) can reduce levothyroxine absorption.
Q: Why should levothyroxine be taken on an empty stomach?
A: Levothyroxine should be taken on an empty stomach to maximize absorption, as food and other substances can interfere with its uptake.
Q: What are common triggers or mediators in the development of thyroid disorders?
A: Triggers include medications, radiation, surgery, pathogens, increased intestinal permeability, environmental toxins, micronutrient insufficiencies, inflammation, iodine imbalance, and blood glucose dysregulation.
Q: Why is supporting the HPA axis important in hypothyroidism management?
A: The HPA axis impacts the HPT axis; stress and HPA imbalance can disrupt thyroid function and exacerbate hypothyroidism.
Q: What are the four steps in the naturopathic approach to hypothyroidism?
A: The four steps are: 1) Address triggers and mediators, 2) Reduce inflammation and insulin resistance, 3) Reduce goitrogenic compounds, and 4) Balance T-cell functioning.
Q: How can cooking methods reduce goitrogens in food?
A: Pre-soaking, steaming, or boiling foods reduces goitrogens by activating myrosinase, an enzyme that deactivates goitrogenic glucosinolates.
Q: How can naturopathic treatments help balance T-cell functioning in hypothyroidism?
A: By addressing intestinal permeability, increasing glutamine intake, and supporting SCFA-producers, such as probiotics and fiber-rich foods, to maintain immune tolerance.
Q: What is the recommended dosage of selenium for thyroid support?
A: The recommended dosage of selenium is 150–200 mcg of selenomethionine per day.
Q: How does selenium benefit thyroid function?
A: Selenium supports antioxidant activity, reduces inflammation, and aids in the conversion of T4 to T3.
Q: What can excessive selenium intake cause?
A: Excessive selenium may enhance iodine deficiency effects but, with proper dosing, it can help alleviate iodine excess.
Q: Why is zinc important for thyroid function?
A: Zinc acts as a co-factor for deiodinase enzymes and aids in TRH synthesis, supporting overall thyroid health.
Q: How does zinc deficiency affect thyroid hormone levels?
A: Zinc deficiency can increase hepatic D1 expression, raising RT3 and inactivating thyroid hormones.
Q: What is the recommended daily dose of zinc for thyroid health?
A: A daily dose of 15–30 mg of zinc is recommended for thyroid support.
Q: Why is iron critical for thyroid hormone production?
A: Iron is a component of thyroid peroxidase (TPO), which catalyzes the iodination of tyrosine to produce T3 and T4.
Q: How does iron deficiency impact thyroid hormone levels?
A: Iron deficiency decreases T4 and T3 levels, reduces T4 to T3 conversion, and can blunt the effects of iodine supplementation.
Q: What is the recommended iron dosage for those with thyroid issues?
A: Approximately 10 mg/day for maintenance or up to 30 mg/day if deficient.
Q: What is the recommended dosage of iodine for general thyroid support?
A: 150–400 mcg daily, although it is not advised for those with AITD, hyperthyroidism, or on thyroxine therapy.
Q: How does iodine affect TSH response?
A: Iodine can decrease thyroid sensitivity to TSH; however, high doses can inhibit thyroid hormone secretion.
Q: Why should Lugol’s iodine be used cautiously?
A: Lugol’s iodine should not be taken orally as a supplement due to variable absorption and additive effects with other iodine sources.
Q: How does vitamin A influence thyroid function?
A: Vitamin A helps modulate thyroid hormone receptor function, supports iodine uptake, and can reduce TSH when levels are optimal.
Q: What is the suggested daily dose of vitamin A for thyroid support?
A: 2000 IU per day.
Q: How does vitamin A deficiency affect the thyroid?
A: Deficiency in vitamin A can lead to higher TSH levels and reduced iodine uptake by the thyroid.
