Expert Advice
Acella Pharmaceuticals, LLC., is partnering with Lindy Ford, RD, LDN, to bring greater awareness to the importance of thyroid care and education. This post is sponsored by Acella Pharmaceuticals and should not be construed as medical advice. Please talk to your doctor about your individual medical situation
Disclaimer: The information provided is for educational purposes only and does not substitute professional medical advice. Consult a medical professional or healthcare provider before beginning any exercise, fitness, diet, or nutrition routine.
Hypothyroidism has profound effects on the heart. It can impact blood pressure, heart rhythm, blood flow, and cardiac pump performance
When a person presents with hypothyroidism, they have low output of thyroid hormones resulting in elevated levels of thyroid stimulating hormone (TSH). The reduced level of thyroid hormone causes the heart muscle to pump less vigorously. This can eventually lead to the heart being weakened.1
Hypothyroidism can even contribute to increased arterial stiffness that leads to high blood pressure.
Lipid alterations can also be seen with hypothyroidism, including low-density lipoprotein (LDL)cholesterol and apolipoprotein B. Perhaps more important are the elevations of both C-reactive protein and homocysteine. Both of these inflammatory markers are associated with heart disease.
We have known for a long time that insulin resistance and heart disease are interrelated. Insulin resistance raises blood sugar levels, which in turn leads to inflammation that can damage the lining inside the arteries.2 Hypothyroidism increases insulin resistance due to down-regulation of glucose transporters and negative effects on insulin secretion and clearance.3
Those are just a few ways hypothyroidism contributes to heart disease (there are more). Below are some ways we can support thyroid health, and at the same time, fight heart disease
1. Get Thyroid Hormones to Healthy Levels.
This includes free T3, free T4, and TSH. I like these numbers to be even better than the standard ranges. Yes, nutrition is important, but prescription thyroid medication is the place to start. I take NP Thyroid® because I present with Hashimoto's thyroiditis, a type of hypothyroidism where the body makes too many antibodies against the thyroid gland. This is the most common cause of hypothyroidism
NP Thyroid® keeps my thyroid hormones at healthy levels. Remember, when there is low output of thyroid hormones, and TSH rises, the heart’s ability to pump efficiently is weakened, which causes arterial stiffness and inflammation
2. Strive for a Lower Carb Diet
How low? The amount of carbohydrates depends on how insulin-resistant the person is. I put my patients on various low-carb diets depending on a diabetic marker called A1C. I'm finding that even if my patients don’t present with pre-diabetes or diabetes, a moderately low carb, nutrient-dense diet still helps their thyroid
Lower carb diets are shown to reduce anti-thyroid antibodies in Hashimoto’s thyroiditis patients as well as body fat.4 A reduction of body fat will most definitely decrease the risk of heart disease, as waist circumference (waist-to-height ratio) is a key contributor. Many carbohydrates contain gluten, which is also detrimental to thyroid health
Lowering blood sugar levels and insulin can reduce inflammation, which helps to keep arteries healthy. The carbs in low-glycemic vegetables should never be counted in a carb count because of the therapeutic reasons that I list below
3. Cut Out Inflammatory Cooking Oils
Corn, vegetable, canola, soybean oils, and the like certainly do have good press agents. These toxic omega-6 polyunsaturated oils are inexpensive, and that is why they are so widely used. They are marketed as "heart healthy," but nothing could be further from the truth
They contribute to inflammation in the body and overshadow heart-healthy omega-3 fats. According to a study in cardiology journal Open Heart, “Dietary linoleic acid, especially when consumed from refined omega-6 vegetable oils, gets incorporated into all blood lipoproteins (such as LDL, VLDL, and HDL) increasing the susceptibility of all lipoproteins to oxidize and hence increases cardiovascular risk.”5
Be a diligent label reader. So many products contain these oils, and we end up consuming massive amounts of them. They also contribute to thyroid dysfunction because of their inflammatory properties
Heart healthy cooking fats include avocado oil, coconut oil, and grass-fed butter.
4. Strive for a Nutrient-Dense Diet
The first place to start with this is low-glycemic vegetables. Fruits are fine in moderation, but they don’t have the same heart protective qualities as vegetables. The concerted action of nutrients, bioactive compounds, fiber, polyphenols, and antioxidants found in vegetables leads to a favorable cardiovascular outcome.6
Vegetables also promote gut health, which contributes to a healthy thyroid and a healthy heart
Nuts are also nutrient-dense and heart-healthy, and so are foods high in omega-3 fatty acids, such as oily fish. All of these nutrient-dense foods support the thyroid. Many of the nutrients in these foods make it possible for T4 to be converted into T3 and used actively in the body
After starting with a thyroid replacement pharmaceutical like NP Thyroid®, consuming a lower carb, nutrient-dense diet with minimal processed omega-6 cooking oils will lead to a happier thyroid and heart. When we support one, we support the other.
REFERENCES: 1. Maja Udovcic, M.D., Raul Herrera Pena, M.D., Bhargavi Patham, M.D., Ph.D., Laila Tabatabai, M.D., and Abhishek Kansara, M.D., M.P.H. “Hypothyroidism and the Heart,” Methodist Debakey Cardiovasc J. 2017 Apr-Jun; 13(2): 55–59. doi: 10.14797/mdcj-13-2-55. 2. Gerald Reaven, “Insulin Resistance and Coronary Heart Disease in Nondiabetic Individuals” Arteriosclerosis, Thrombosis, and Vascular Biology Originally published 1 Aug 2012 https://doi.org/10.1161/ATVBAHA.111.241885; 2012;32:1754–1759. 3. Pearce SH, Brabant G, Duntas L, et al. 2013 ETA Guideline: Management of Subclinical Hypothyroidism. Eur Thyroid J . 2013. December; 2 4: 215– 28. 4. Teresa Esposito , Jean Marc Lobaccaro , Maria Grazia Esposito, Vincenzo Monda, Antonietta Messina, Giuseppe Paolisso, Bruno Varriale, Marcellino Monda, Giovanni Messina. “Effects of low-carbohydrate diet therapy in overweight subjects with autoimmune thyroiditis: possible synergism with ChREBP” Drug Des Devel Ther, 2016 Sep 14;10:2939-2946. 5. James J DiNicolantonio and James H O’Keefe. “Omega-6 vegetable oils as a driver of coronary heart disease: the oxidized linoleic acid hypothesis” Open Heart BMJ J http://dx.doi.org/10.1136/openhrt-2018-000898. 6. Yuni Choi, Nicole Larson, Lyn M. Steffen, Pamela J. Schreiner, Daniel D. Gallaher, Daniel A. Duprez, James M. Shikany, Jamal S. Rana. “Plant ‐ Centered Diet and Risk of Incident Cardiovascular Disease During Young to Middle Adulthood.” Journal of the American Heart Association 4 Aug 2021 https://doi.org/10.1161/JAHA.120.020718
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INDICATIONS & IMPORTANT RISK INFORMATION INCLUDING BLACK BOX
WARNING
Important Risk Information
Drugs with thyroid hormone activity, alone or together with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.
- NP Thyroid® is contraindicated in patients with uncorrected adrenal insufficiency, untreated thyrotoxicosis, and hypersensitivity to any component of the product.
- In the elderly and in patients with cardiovascular disease, NP Thyroid® should be used with greater caution than younger patients or those without cardiovascular disease.
- Use of NP Thyroid® in patients with diabetes mellitus or adrenal cortical insufficiency may worsen the intensity of their symptoms.
- The therapy of myxedema coma requires simultaneous administration of glucocorticoids.
- Concomitant use of NP Thyroid® with oral anticoagulants alters the sensitivity of oral anticoagulants. Prothrombin time should be closely monitored in thyroid-treated patients on oral anticoagulants.
- In infants, excessive doses of NP Thyroid® may produce craniosynostosis.
- Partial loss of hair may be experienced by children in the first few months of therapy but is usually transient.
- Adverse reactions associated with NP Thyroid® therapy are primarily those of hyperthyroidism due to therapeutic overdosage.
- Many drugs and some laboratory tests may alter the therapeutic response to NP Thyroid®. In addition, thyroid hormones and thyroid status have varied effects on the pharmacokinetics and actions of other drugs. Administer at least 4 hours before or after drugs that are known to interfere with absorption. Evaluate the need for dose adjustments when regularly administering within one hour of certain foods that may affect absorption.
- NP Thyroid® should not be discontinued during pregnancy, and hypothyroidism diagnosed during pregnancy should be promptly treated.
Indication
NP Thyroid® (thyroid tablets, USP) is a prescription medicine that is used to treat a condition called hypothyroidism from any cause, except for cases of temporary hypothyroidism, which is usually associated with an inflammation of the thyroid (thyroiditis). It is meant to replace or supplement a hormone that is usually made by your thyroid gland.
NP Thyroid® is also used in the treatment and prevention of normal functioning thyroid goiters, such as thyroid nodules, Hashimoto’s thyroiditis, multinodular goiter, and in the management of thyroid cancer.