Hypothyroidism myths & realities
by David Dunaief
Jan 09, 2019 | 6534 views | 0 0 comments | 595 595 recommendations | email to a friend | print
Dr. David Dunaief is located in Downtown Brooklyn and focuses on the integration of medicine, nutrition, fitness and stress management.
Dr. David Dunaief is located in Downtown Brooklyn and focuses on the integration of medicine, nutrition, fitness and stress management.
Hypothyroidism indicates an under-active thyroid, a butterfly-shaped organ in the base of the neck responsible for maintaining metabolism, and results in slowing of the metabolism. Blood tests determine if a person has hypothyroidism.

There are two types of primary hypothyroidism: subclinical and overt. In the overt (more obvious) type, classic symptoms include weight gain, fatigue, thinning hair, cold intolerance, dry skin and depression, as well as the changes in all three thyroid hormones on blood tests mentioned above.

In the subclinical, there may be less obvious or vague symptoms and only changes in the TSH. The subclinical can progress to the overt stage rapidly in some cases. Subclinical is more common than overt.

Potential causes or risk factors for hypothyroidism are medications, including lithium; autoimmune diseases, whether personal or in the family history; pregnancy, though it tends to be transient; and treatments for hyperthyroidism (overactive thyroid), including surgery and radiation.

The most common type of hypothyroidism is Hashimoto’s thyroiditis, where antibodies attack thyroid gland tissues. Several blood tests help determine if a patient has Hashimoto’s.


Levothyroxine and Armour Thyroid are two main medications for hypothyroidism. One medication may be more appropriate than the other, depending on the circumstance.


A study tested 10 different thyroid support supplements; the results were downright disappointing, if not a bit scary.

Of the supplements tested, 90 percent contained actual medication, some to levels higher than those found in prescription medications. These supplements could cause toxic effects on the thyroid, thyrotoxicosis.

Supplements are not FDA-regulated, therefore, they are not held to the same standards as medications. There is a narrow therapeutic window for medication dosage when treating hypothyroidism, and it is sensitive.

Therefore, if you are going to consider supplements, check with your doctor and tread very lightly.

Soy impact

In a randomized controlled trial, the treatment group that received higher soy supplementation had a threefold greater risk of conversion from subclinical hypothyroidism to overt hypothyroidism than those who received considerably less supplementation.

According to this small, yet well-designed, study, soy has a negative impact on the thyroid. Therefore, those with hypothyroidism may want to minimize or avoid soy.

Weight loss

Wouldn’t it be nice if the silver lining of hypothyroidism is that, with medication to treat the disease, we were guaranteed to lose weight? In a retrospective study, results showed that only about half of those treated with medication for hypothyroidism lost weight. This was a small study, and we need a large randomized controlled trial to test it further.

The FDA has a black box warning on thyroid medications — they should never be used as weight loss drugs. They could put a patient in a hyperthyroid state or worse, having potentially catastrophic results.


Taking levothyroxine and coffee together may decrease the absorption of levothyroxine significantly, according to a study published in the journal Thyroid. It did not seem to matter whether they were taken together or an hour apart.

This was a very small study involving only eight patients. Still, I recommend avoiding coffee for several hours after taking the medication.

There are three take-home points, if you have hypothyroid issues: Try to avoid soy products, don’t think supplements that claim to be thyroid support and good for you are harmless because they are over the counter and “natural” and, for those on levothyroxine, space your coffee and your medication consumption.

For further information, visit medicalcompassmd.com or consult your personal physician.
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