It is shaped like a butterfly, is at the base of the neck, and regulates the metabolic processes and energy consumption of the organism. The thyroid gland is probably the best known endocrine gland, or at least the one you hear about most often. Not surprisingly, because the Italians affected by some thyroid disease: from hypothyroidism to hyperthyroidism (a gland that works too little or too much), to nodules (which affect more than 50% of women), from autoimmune thyroiditis to tumors, there are about 6 million: one in 10. And it is precisely because of the considerable diffusion of these diseases that correct information on this organ is necessary.
Treatable diseases
“Thyroid and health: I inform myself well” is in fact the claim of the World Thyroid Week 2022, scheduled from 25 to 31 May with the patronage in our country of the ISS, the Higher Institute of Health and promoted by the main scientific endocrinological medical and surgical. “Thyroid diseases are treatable: we have pharmacological and surgical treatments for all situations including cancers,” he says. Alfredo Pontecorvidirector of UOC of internal medicine, endocrinology and diabetology at the Agostino Gemelli-IRCCS University Polyclinic Foundation and full professor of Endocrinology at the Catholic University of the Sacred Heart.
The right diet for the thyroid
But “thyroid diseases can also be prevented – he adds – with a diet that ensures an adequate supply of iodine and selenium”. Which summarizing we could define a Mediterranean diet with the replacement of table salt with iodized salt, a product that since 2005 thanks to the iodoprophylaxis program (Law 21 March 2005, n ° 55) is compulsorily sold in every food point of sale and used in school and company canteens “We need moderation in the use of salt, but we should always use that fortified with iodine”, adds Pontecorvi.
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Iodine and thyroid hormones
Iodine is a microelement without which thyroid hormones – T3 and T4, i.e. triiodothyronine and thyroxine – could not be synthesized. T3 and T4 are small molecules both resulting from the fusion of two tyrosine amino acids and the addition of 3 iodine atoms in the case of T3 or 4 iodine atoms in the case of T4.
Iodine is taken through food (by the way, iodine cannot be breathed, it is eaten: the sea air has little to do with thyroid health), but for geological reasons, on the earth’s crust of our Peninsula, iodine there is very little of it. Instead, there is more of it in the waters of the sea and lakes.
Well, if we do not take enough iodine, due to the compensation mechanism typical of the endocrine glands, the level of another hormone, TSH, produced by the pituitary gland increases with the task of stimulating the thyroid to work, that is, to produce more hormones. A negative feedback phenomenon which, if exasperated and protracted over time, can cause the gland to increase in volume causing the onset of goiter (the enlargement of the thyroid gland in its entirety) and the formation of nodules.
“With the widespread and extensive use of ultrasound, thyroid nodules have become an epidemic because if a thyroid echo is performed in a group of women more than 50% show the presence of a nodule. 95% of the cases that nodule is benign. Preventing goiter and the formation of nodules passes through the adequate supply of iodine throughout life, indeed starting from intrauterine life “, adds Pontecorvi.
Fish, crustaceans, molluscs and algae
Once, when our diet was based on local products, we consumed iodine in very low quantities, today we consume food from areas of the world where there is no iodine deficiency so the problem has gradually diminished, it is the phenomenon of silent iodination of the population.
But in Italy we still have an iodine deficiency and therefore we need to supplement our diet. The foods that contain more iodine are sea fish (but also lake) and then crustaceans and molluscs. There is a lot of it in seaweed and blueberries, there is enough of it in eggs, milk and derivatives. “So yes to a varied diet and yes to the consumption of fish, at least 2-3 times a week. In addition to food – says the expert – some sweets for sore throats, disinfectants, toothpastes, iodized contrast agents, contain iodine. medicines for heart arrhythmias: this is called indirect iodination, and in some cases it can also be relevant “.
When Iodine per day?
To keep the thyroid healthy, adults need to take 150 micrograms of iodine per day. But during pregnancy and breastfeeding the levels rise. The iodized salt contains 30 micrograms per gram. Therefore, consuming the recommended 5 g of salt daily, in the form of iodized salt, guarantees the right daily intake of iodine. Iodized salt is not a medicine, it is a food and can be taken by anyone, even those who take drugs for the thyroid gland and iodine can harm health only when you exceed 600 micrograms per day “a situation that we really do not risk . In Italy, according to the latest ISS data, over 70% of the population is well supplemented with iodine “, says the specialist.
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The role of selenium
This element is also essential for thyroid health. Selenium does not participate in the synthesis of thyroid hormones but it is however necessary to make the deiodases work, the enzymes which, by cutting off an iodine atom, transform T4 into T3. This is an essential reaction, since the thyroid produces above all T4, and only a small amount of T3 “but T3 is the true thyroid hormone, about 10 times biologically more powerful than T4 – explains Pontecorvi – which in fact can be considered a pre-hormone. “.
What to eat
Brazil nuts are the best sources of selenium, which is also found in meat, dairy products, brown rice, legumes, some potatoes, eggs and mushrooms, and fish: 85 grams yellowfin tuna, for example, they contain about 90 micrograms of selenium. “Iodine and selenium are the two most important microelements for a correct thyroid dysfunction even if a selenium deficiency does not seem to be registered in our diet”, says the endocrinologist. He adds: “We hear and read about many ad hoc diets for the thyroid, but the scientific evidence to date tells us that only iodine and selenium are essential for the health of this gland and for the correct functioning of its hormones”.
The question of weight
“I’m fattening too much, will it be a matter of thyroid?” words that you hear very frequently. But is this really the case? Or is it a bit of a myth that the thyroid is to blame for our weight gains? “The thyroid regulates the metabolism and energy production of all cells. A hypothyroid, a person whose thyroid functions less, tends to use less energy, reducing its basal metabolic rate. But in most cases, hypothyroidisms are mild,” to have an evident effect on weight it takes a prolonged period of inactivity of the gland “, continues Pontecorvi. He adds: “That thyroid hormones can affect body weight is clearly demonstrated by the forms of severe hyperthyroidism, that is, excessive production of T3 and T4, which can lead to losing up to 5-7 kilos in a month. a harmful weight loss because it also affects lean mass “.
“The hyperthyroid patient in fact develops a hyperthyroid myopathy that sometimes does not allow him to climb the stairs of the house, which is why using thyroid hormones in slimming cocktails, as was used some time ago, is a mistake: thyroid hormones make light less kilos on the balance, but to the detriment of the muscle. As soon as you stop taking them, you find yourself with less muscle mass, a place where you burn the heat, and you gain weight “.
Pregnancy and children
Thyroid disease is also common in children, starting withcongenital hypothyroidism, which affects one child every 2500-3000. It is the most common thyroid disease in children but fortunately all children at birth have been screened for years.
Another common pathology in the developmental age is the Hashimoto’s thyroiditis, a common autoimmune disorder among teenage girls. “Central hypothyroidism caused by genetic diseases or malformations of the central nervous system are rarer, with a frequency of one case in 25,000 children,” he says. Mohamad Maghnie director of the Pediatric Clinic of the Gaslini Institute, University of Genoa. A meeting on the topic of iodine nutrition in pregnancy and pediatric age is scheduled at the Gaslini pediatric hospital on May 25th at 5.00pm, and on May 31st from 2.00pm to 5.30pm an Open Day to perform, free and without reservation, endocrinological specialist visits to children and adolescents with suspected or confirmed thyroid disease (info: [email protected])
Risk for children
“When a pregnant woman does not know she has a thyroid disease or takes little iodine – continues Maghnie – for the child who will be born there is a risk of experiencing cognitive problems around the age of 8-10, as we demonstrated last year. publishing a study on the Journal of Clinical Endocrinology and Metabolismthis is because the thyroid is involved in the development of the nervous system, “adds the pediatrician.
Here but now let’s move on from diseases to prevention, that is to diet for a healthy thyroid, both for pregnant women and children. “Until puberty the recommended amount of iodine is between 40 micrograms (the newborn) and 120. After development, the recommended requirement is 150 micrograms, as for adults – says the pediatrician – Pregnant women should take 250 micrograms of iodine: the fetus in the first trimester does not produce thyroid hormones on its own, in this phase it completely depends on the maternal ones to develop properly. The nursing woman needs 250-300 micrograms of iodine. To reach these levels, two things are important: eating in correct way, which means for pregnant and breastfeeding women and for weaned children especially fish, 2 or 3 times a week, and in particular blue fish, sardines, salmon, tuna … and then – Maghnie keeps saying – integrate iodine through iodized salt. Diet alone, although very rich in foods with a high iodine content, may not be sufficient to reach the necessary requirements of this m icroelement which is essential for thyroid gland health “. A final indication: when preparing meals, do not add iodized salt during cooking: boiling, frying or grilling cause the salt to lose 20-30% of iodine.