Exam 3 - other endocrine disorders Flashcards
What is the most common cause of goiter?
iodine deficiency
what micronutrients are required for the production of TRH & TSH?
ZINC
What micronutrients are required for TPO to create T4 and T3 hormones?
- Requires tyrosine, iodine & iron
- selenium is also a cofactor
What are some 5-Deiodinase inhibitors? (T4 –> T3 conversion)
- selenium deficiency
- inadequate protein, excess CHO
- high insulin
- chronic illness
- stress (cortisol)
- heavy metal toxins (Cd, Hg, Pb)
- compromised liver or kidney function
people struggling w/ wt not consuming adeq amounts of selenium, protein
What foods contain higher amounts of selenium?
meat
poultry
dairy products
cereals and grains
bananas
nuts
seafood
Hypothyroidism
- underactive thyroid
- Symptoms may include fatigue, weight gain, sensitivity to cold, high cholesterol, constipation, thinning hair, muscle aches, depression, goiter
- Over 50% is caused by autoimmune Hashimoto’s Thyroiditis
- Treatment: hormone replacement therapy
risk factors for Hashimoto’s thyroiditis
women, middle age, having other autoimmune diseases, genetics, excessive radiation exposure
- women are 8x more likely than men to have Hashimoto’s (no production of T4 or T3)
What is the most common hormone replacement medication given for hypothyroidism?
Synthroid (synthetic T4)
- absorption affected by soy, fiber, iron, antacids, calcium supplements (must take at least four hours before including any of these)
* Reduces the effectiveness of Metformin
* should be taken in the morning before eating due to chelation concerns
MNT for Hypothyroidism
- avaluate micronutrient intake: iodine, iron, zinc, selenium, vitamin D
- if iodine deficient: goitrogens must be avoides, soy should be limited (causes inhibition of TPO)
- fasting and restrictive diets may substantially reduce thyroid activity
- anti-inflammatory diet recommended
- possible food sensitivities should be addressed (gluten and casein)
Why should goitrogens be avoided with Hypothroidism? And what foods contain them?
- Goitrogens contain thiocyanate ions that will compete with iodine for the uptake on the thyroid hormone
- Cabbage, cauliflower, broccoli, Brussel sprouts, turnips, radish, mustard seeds, bamboo shoots should be avoided or cooked properly to break the thiocyanate ions less bioavailable (avoid raw foods)
MNT for Hashimoto’s Thyroiditis
- is an immune response so don’t supplement with iodine - is a T4 substrate so will stimulate TPO and therefore TPO antibodies and can cause flare-up
- Supplement if low Vitamin D
- Anti-inflammatory diet rich in fruits and vegetables
- Rule out Celiac Disease
- also higher risk of grave’s disease
Hyperthyroidism
- Grave’s Disease (80% of cases) - most ppl with grave’s will have thyroid gland removed and will be on lifelong thyroid medication there after
- Symptoms: hypermetabolic effects (nervousness, sweating, heat intolerance), weight loss, puffy and bulging eyes, difficulty sleeping, goiter
- Treatment: surgical removal of thyroid gland, radioactive iodine, antithyroid drugs
Hypoparathyroidism
- check calcium and PTH
- treatment: calcium and vit D supplements, calcium rich diet, low phosphorus diet
MNT for PCOS
Weight management
Restrict refined CHOs
Increase fiber intake
Assess benefit of high- vs. low-CHO diet
Consider vitamin D and chromium
Cushings syndrome
- Too much cortisol (from steroids usually)
- Symptoms include weight gain, depression, bruising, muscle loss
- Treatment is weight management
