Does obesity cause thyroid problems in an individual

Introduction

It has been assumed since a long time that thyroid disorders leads to weight gain. However, it is obesity that leads to thyroid dysfunction. Relation between obesity and thyroid has been described in the present article

Statistics

According to the World Health organization the number of individuals with obesity has doubled since 1980. Approximately 1.4 billion adults are overweight, and over 500 million of them are obese. Thyroid dysfunction is found in 33% of the obese individuals.

Etiopathogenesis

Numerous theories have been proposed linking the association between obesity and thyroid disorders

1. One theory suggests an increased deiodinase activity in obese individuals leading to a high conversion rate of thyroid hormones (T4 to T3). This is a defense mechanism in obese subjects to counteract fat accumulation by increasing energy expenditure.

2. Another probable mechanism is the compensatory increase in secretion of thyroid hormones to overcome decreased tissue response to circulating thyroid hormones in adipocytes of obese subjects.

3. Increased levels of Leptin found in obese subjects are another potential cause

Clinical features

Obesity doesn’t have any specific sign and symptoms. Associated problems observed in obese individuals include difficulty breathing, increased sweating, tiredness and inability to manage physical activities. There is growing evidence on the relationship between hypothyroidism and weight gain. Hypothyroidism along with obesity causes a cold feeling.

Complications

An individual with obesity and thyroid gland dysfunction has an increased risk of thyroid cancer.

Diagnosis

Body mass index (BMI) is frequently used to determine if an individual is overweight/obese. An adult with BMI around 25-29.9 is considered to be overweight, while BMI of 30 or high is considered to be obese.

Other methods of fat estimation and its distribution include

  • Skinfold thickness

  • Waist circumference

  • Analyzing the waist to hip ratios

Hypothyroidism

Diagnosis of hypothyroidism is based on the clinical features and blood tests measuring the level of thyroid hormones. A low level of thyroxine and high levels of thyroid stimulating hormone indicates hypothyroidism.

Treatment of Obese Patients with thyroid dysfunction

The adequate treatment of obese patients with hypothyroidism depends on the adequate administration of thyroid hormone. The thyroid hormone commonly employed in these individuals is levothyroxine. Obese individuals usually need a higher dose of levothyroxine. These individuals should concomitantly aim for weight loss by

  • Limiting processed foods

  • Exercising regularly

  • Intake of high fiber foods

  • Limiting goitrogenic foods (kale, mushroom, broccoli)

Prevention

There are numerous factors which can lead to obesity. The major predisposing factors include excess dietary fat intake and sedentary lifestyle. Additional factors that can predispose to obesity include chronic stress, menopause, and certain medications. Healthy eating, avoiding stress and increased physical activity can prevent obesity consequently the associated thyroid dysfunction

  • Healthy eating (low fat, fiber dense foods)

  • Avoiding stress (yoga)

  • Physical activity (walking, cycling, swimming, jogging)

References

1. Sanyal D, Raychaudhuri M. Hypothyroidism and obesity: An intriguing link. Indian journal of endocrinology and metabolism. 2016 Jul;20(4):554.

2. Longhi S, Radetti G. Thyroid function and obesity. Journal of clinical research in pediatric endocrinology. 2013 Mar;5(Suppl 1):40.

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