Osteoporosis.. Hypothyroidism.

. Anemia - not just a woman’s

diseasePresented by

Prema KodicalWeight Management

Consultant

More common in women•Hypothyroidism

•Anemia•Osteoporosis•Rheumatoid Arthritis•Gallbladder Stones

Thyroid - most ignored gland in the body

 

Thyroid hormones

control • metabolism• brain function• proper sexual development• normal growth of bones

Hormones released:• T4 – 80%• T3 – 20%

Thyroid gland functioning is affected:

• Hypothyroid - more common - 6 to 8 %

Hypothyroidism is an underactive thyroid gland. Hypothyroidism means that the thyroid gland can’t make enough thyroid hormone to keep the body running normally.

 

• Hyperthyroid – 1%

Signs of Hypothyroidism

Signs of hypo• Slow reflexes and movement• Low body temp• Slow heartbeat• BP irregularities• Dry skin• Dull facial expression• Hoarseness of voice• Swelling in the neck

Symptoms of Hypothyroidism• Obesity/weight gain/inability to lose weight• Constipation• Muscle and joint pain and aches• Low body temp, feeling cold• Fatigue and weakness• Slow pulse, low BP..at times, high BP• Delayed sexual development, delayed menstruation,

heavy flow leading to anemia, problem conceiving a baby

• Puffiness and swelling• Low husky and hoarse voice• Imbalance in prolactin hormone – lactation in a

woman who is not breastfeeding • Mood, depression• Low sex drive

Hypo Causes:• Too much or too little iodine – dietary

intake – 150 mcg/day• Autoimmune disease – TPO antibodies

(Thyroid Peroxidase AB): these are antibodies that attack the thyroid instead of bacteria and viruses, they are a marker for autoimmune thyroid disease, which is the main underlying cause of hypothyroidism and hyperthyroidism

•Thyroiditis - autoimmune attack orby a viral infection•Surgical removal of part or all of thethyroid gland – in thyroid cancer or hyperthyroidism•Radiation treatment - in thyroid canceror hyperthyroidism•Congenital hypothyroidism – babiesborn without or partly formed thyroid gland

•Medication – Lithium – to treat depression

•Damage to the pituitary gland – tumor,radiation or surgery – have Low T4 and normal or low TSH

Obesity and hypothyroidism:

•Childhood weight gain and obesity areassociated with adult hypothyroidism and autoimmune thyroid disease in women•But childhood obesity at 14 associated with occurrence of adult hypothyroidismin both sexes

Obese Adults• Obesity associated with increased levels of TSH into the hypothyroid range

• Obese adults are more likely to have positive TPO antibodies than do normal weight adults.

Hyperthyroidism – Grave’s disease - autoimmune disease - thyroid goes into uncontrolled hormone overproduction 

Planning pregnancy

• Thyroid disease during pregnancy - miscarriage, pre-term delivery, brain abnormalities in the baby and postpartum thyroid inflammation in the mother

• Women with a history of thyroid disease, thyroid autoimmunity or a family history of thyroid disease – evaluate their thyroid health d before planning pregnancy and again after getting pregnant

• Those on thyroid hormone replacement - 30-50% increase in their dose when pregnant

• Fetal development dependent on adequate maternal T4 levels

ConsequencesHypothyroid woman • inadequate treatment – child of low IQ

• Untreated – high BP, ruptured placenta, anemia

Hypothyroid woman • uncontrolled– premature delivery/fetal malformation/hyperthyroid baby

Iodine intakeIodine for increased thyroid hormone

and Iodine• Foetus takes Iodine from maternal blood in the first 3 weeks

• Foetus requires Iodine to make its own thyroid hormone

Optimal iodine nutrition important during pregnancy and lactation - Total daily iodine intake 220 mcg/day for pregnant women and 290 mcg/day for lactating women

No cure, Only control

Hypothyroidism can’t be cured. But in almost every patient, hypothyroidism can be completely controlled.

DietBoost Your Thyroid Function• Eat more of these great sources of iodine to enhance thyroid function

Low fat cheese & yogurt, Cow’s milk, Eggs, Saltwater fish, Shellfish

• Eat selenium-rich foods  Mushrooms, garlic, onions, eggs, beef, liver, shellfish, wheat germ, sunflower seeds,sesame seeds

Eat less of these foods

They slow down your thyroid - block your thyroid hormone and your medication from producing thyroid hormone properly

• Almonds,Cauliflower,Millet,Pears,Corn,Mustard & Mustard Greens,Pinenuts,Cabbage,Peach,Peanuts,Spinach,Flaxseeds,Lima Beans,Sweet Potato,Citrus fruits,Parsley,Onions,Wheat Sprouts,Red wine,Beer

Blocks Iodine uptake• Soya

Exercise• Hypothyroid – fatigue• Hyperthyroid – fatigue. cannot increase workload. Heart and skeletal muscles require more energy

Anemia

Reduced Haemoglobin in blood

Reasons:

• Nutritional Deficiency – Iron, Vitamin B12, Folic Acid deficiency 

Most common of the three• Iron Deficiency Anemia - serum iron is low

DAILY REQUIREMENT

Iron requirements/day:

• Adult men and non-menstruating women - about 8 mg iron/day • Menstruating women - 18 mg/day • Pregnant women - increased need

Iron Deficiency Anemia

Reasons • Amount of iron in diet inadequate

• Malabsorption • Excessive iron loss like in bleeding - colon cancer, stomach ulcers, piles, parasites like hookworms, drugs like aspirin

IRON SOURCES

• LIVER• MEATS• EGG YOLK• DARK GREEN VEGETABLES• LEGUMES• NUTS

Other causes of Anemia

• Folic Acid deficiency - Megaloblastic Anemia (10 mg/day)• Vitamin B12 deficiency - Pernicious Anemia (2 mcg/day)• Hemolytic Anemia - RBC destruction• Cancers of the bone marrow

FOLIC ACID DEFICIENCYFolic Acid deficiency – • Dangerous in pregnant women• Rich sources of Folic Acid: LIver, Broccoli, Bananas, Lima Beans, Green Leafy Vegetables, Legumes, Yeast

Note:Folic Acid with B12 boosts production of RBCs

•  

OsteoporosisOsteoporosis is a condition of the skeletal system, common in middle aged and older individuals, mainly caused by the body’s attempt to correct an unhealthy biochemical imbalance by utilizing the calcium that should normally remain in the bones, causing bone density loss. However, unless certain abnormal endocrine and/or gastrointestinal conditions are present, the biochemical imbalance may be corrected by diet and lifestyle changes

Risk Factors• Hyperparathyroidism (excessive parathyroid hormone

production causes too much calcium to be removed from the bone)

• Hyperthyroidism • Long-term use of certain medications - heparin (a blood

thinner), antiseizure medications • Thin and small body frames• Family history of osteoporosis• Cigarette smoking• Excessive alcohol consumption - inhibits Ca absorption

and bone formation• Lack of exercise• Poor nutrition and poor general health• Too much salt –increases urinary excretion of Ca• Too much animal protein –increases Ca loss from bones• Malabsorption• Low estrogen levels• Immobility

Acidic FoodSerum Ca levels - 8.5 to 10.2

mg/dL (deciliter)

• Bone loss occurs when there is excessive accumulation of acid waste

• Body pH 7.35 and 7.45 • If Serum Ca level falls, it takes it from

the bones

(With age, a slight decrease in bone density is natural )

DEXA

T-score• Normal: > -1 • Osteopenia: between -1 to -2.5 • Osteoporosis: < -2.5

Supplements to build strong

bonesMinerals• Calcium: 1,200 - 1500 mg; Dairy products. • Phosphorus 700 mg; Meat, Dairy products• Magnesium: 200-400 mg – helps Calcium get into bones and

converts vitamin D into its active form. Wheatgerm, nuts, seafood, dairy products, green leafy veg

• Boron: 3 mg daily – plugs the Ca leak. May reduce urinary excretion of Ca and Mg. Fruits and veg

• Zinc: 8 mg for women and 11 mg for men; eggs, milk, seafood, meat, wholegrains.

• Copper: 0.9 mg; liver, wholegrains, legumes, nuts• Manganese: (Deficiency found in woemn with osteoporosis) 1.8 mg for women and 2.3 mg for men; fruits, wholegrains,

legumes, nuts, vegetables, soya

Note: Mn deficiency found in women with osteoporosis

Some more supplementsNote: Zn, Cu, Mn work together for stronger bones

Vitamins: • Vitamin D: 400 IU up to age 70, and 600 IU for those older than 70. Ability of the skin to synthesize it decreases with age; fish oils, fatty fish, and to a lesser extent in beef liver, cheese, egg yolks

• • Vitamin K: 70 mg for women and 80 mg for men. Enables proteins in bones to hold on to Calcium. Osteoporotic women have low vitamin K levels; fruits, leafy greens, dairy products, seeds, root vegetables

• Vitamin C: 500 mg – building collagen;dark leafy vegetables, potatoes citrus fruits, cabbage

Some more supplements

• Estrogen, Testosterone, Vitamin D increase Calcium absorption

•Antioxidants•Exercise

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