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Nora Saul, MS, RD, LDN, CDE

Manager, Nutrition Services
Joslin Diabetes Center
Boston, MA

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Thyroid Management

Ask the Expert


Are there specific strategies for keeping your thyroid in check?


The short answer to your question is no. However, many thyroid diseases, such as Graves' disease (hyperthyroidism) and Hashimoto's thyroiditis (hypothyroidism) have a genetic component, and research into the whys and hows of thyroid disease is ongoing.

The thyroid gland is a small double-lobed gland located at the base of the neck. Despite its small size, the thyroid gland is the powerhouse of metabolism. The two hormones the gland produces-tetraiodothyronine (T4) and triiodothyronine (T3)-help regulate temperature control, growth and metabolism. The body controls how much thyroid hormone is released by a feedback mechanism involving two other glands: the pituitary and the hypothalamus. When circulating thyroid hormone is low, the hypothalamus releases thyroid releasing hormone (TRH), which causes the pituitary to release thyroid stimulating hormone (TSH). TSH acts on the thyroid gland to increase production of T3 and T4.

In order for T3 and T4 to function properly, the body must have an adequate supply of iodine. In some areas, such as parts of the United States, parts of Canada and the Swiss Alps, the soil and water do not contain adequate amounts of iodine to prevent goiter (enlargement of the thyroid), so foods such as salt are fortified with iodine. If the supply of iodine is inadequate, the TSH causes the thyroid gland to swell in size to better capture more iodine.

Currently, the best method for keeping your thyroid in check is to recognize the symptoms of both hypothyroidism and hyperthyroidism and see your doctor if you notice such symptoms. Avoiding excess amounts of iodine is important if you have an autoimmune thyroid condition, such as Graves'.

Symptoms of hypothyroidism:

  • weak, slow heart beat
  • muscular weakness and constant fatigue
  • sensitivity to cold
  • thick, puffy skin
  • slowed mental processes and poor memory
  • constipation
  • goiter

Symptoms of hyperthyroidism:

  • rapid, forceful heartbeat
  • tremor
  • muscular weakness
  • restlessness, anxiety and sleeplessness
  • profuse sweating and heat intolerance
  • diarrhea
  • eye changes
  • goiter
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