I have not been here in a while, I wanted to check in and let the lovely people of this forum know my research on the Nutritional management of thyroid disorders has been accepted at Middlesex University. It took a while to convince the PhD team at MDX my research had substance.
If anyone would like to participate in the research, please let me know. I did ask Lynn's permission if I could ask the four users if you would like to participate. If you are interested in participating please message me directly.
Thank you
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Lavender71
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Congratulations Lavender72 and you will be very excited to have your research on the Nutritional management of thyroid disorders accepted at Middlesex University
Introduction: Thyroid disorders are the most common endocrine disorders diagnosed in primary care, the role of dietary factors and nutritional support for the prevention and treatment of thyroid disorders is largely unknown with inadequate scientific evidence (Bashar, MD Abu. Begam, Nazia. 2020).
Currently studies and research undertaken in Europe in thyroid disorders are limited, further investigation shows the current limited research only encompasses diseases linked to thyroid disorders, for example Diabetes Mellitus (Singh R.P 2020).
Thyroid disorders encompass a wide variety of additional disorders including, inflammatory, autoimmune and nutritional pathologies (Bashar, MD Abu. Begam, Nazia. 2020)
Thyroid hormone synthesis depends on the normal iodide transport with the support of nutritional co-factors, tyrosine and selenium.
The thyroid also requires Vitamins B1, B3, B6, Folic acid, Zinc and Magnesium. These nutrients can be obtained from a healthy wholegrain diet, in low doses (Roe M. Pinchen H.2015)
There is usually a continuum of change within the thyroid spectrum ranging from a normal thyroid structurally and physiologically to the extremes of varying thyroid disorders (Peatfield B 2015). Hashimoto’s disease (HD) and Graves disease (GD) are the most common of autoimmune thyroid disease (AITD), antibodies to thyroid peroxidase (TPO), the enzyme that catalyses thyroid-hormone production and antibodies to the receptor for the thyroid stimulating hormone, are characteristic of HT and GD. It is presently accepted, however not well researched, that environmental factors including nutritional factors contribute to the development of AITD (Rayman M.P. 2019).
Literature review: Current literature for the role of nutritional support in the management of thyroid disorders is limited (Bashar, MD Abu. Begam, Nazia. 2020). The definitive role of Selenium and Iodine in the treatment of Hypothyroidism is discussed in the current literature, however the role of other dietary nutrients and nutrition as a whole is lacking (Bashar, MD Abu. Begam, Nazia. 2020). Nutritional interventions, for example gluten-free, sugar free and the use of probiotics for promoting thyroid health is discussed, however not researched
( Krysiak R, Szkróbka W, Okopień B 2018)
Objective: The aim of the research is to establish the importance of the role of nutritional support in the management of thyroid disorders in a clinical environment. (Nagarkar R, Roy S, 2015).
Clinical health conditions for example Diabetes, is traditionally treated with medication, yearly appointments with the diabetic nurse, nutritional support and workshops on managing diabetes with nutrition and lifestyle advice, offered when initially diagnosed. (O'Connor P. J.Sperl-Hillen J. A. M. 2019)
Currently clinical treatment for thyroid disorders does not expand further then prescribed medication, surgery which is dependent on the thyroid disorder and a yearly review of the prescribed medication (Münch C. Gottschall M. Voigt K. 2016).
Medical established thinking is convinced that thyroid supplementation Thyroxine and yearly blood tests is sufficient as far as clinical intervention is concerned, but it is not (Peatfield B, D. 2012). The thyroid produces five biologically active hormones, when the thyroid gland is already damaged, and one of the hormones are not converting to the active thyroid hormones, the medical assumption is the other three thyroid hormones are converting, due to a number of physiological and pathological factors, this does not seem to be the case. (Peatfield B, D 2015)
The methodology of the proposed search currently exists within the capacity of my role as a clinical Nutritional therapist. Within my role on the shop floor of my Health food store, I currently advise customers on nutrition, nutritional supplements and lifestyle, to help address any health issues. Recently I have been advising customers diagnosed with a thyroid disorder. Anecdotal reporting from customers who have been diagnosed with a thyroid disorder, demonstrates the quality of primary care offered to customers diagnosed with a thyroid disorder to be inadequate. When the customer asked GP/endocrinologist advice on Nutritional and lifestyle support to manage the thyroid, none was given or was told there was no evidence to suggest the right nutrition would help manage the symptoms of the thyroid disorder in question.
Methodology: The methodology is quantitative, designing a survey to measure the dietary intake of participants undergoing treatment for thyroid disorders. The survey will include questions regarding dietary intake and symptoms experienced when eating certain foods.
Once the data from the surveys has been collected and analysed, a food plan with recepies to support thyroid health will be provided. The participants will be asked to follow the food plan for 24 weeks, changing the food plan every 4 weeks. The changes are for the purpose of inclusion of a variety of different foods, which support thyroid health.
The period of 24 weeks is to allow the function of the thyroid to adjust to foods that may help with the process of efficient thyroid hormone production.
Post 24 weeks, the participants will be asked to fill in another survey, designed to measure symptoms and signs experienced when eating foods from the meal plan provided. The survey will establish if nutritional intervention can improve the signs and symptoms of their particular thyroid disorder.
For the sake of contrast and differential markings in the thyroid blood tests undertaken every year with the Gp, the participants will be asked to provide previous thyroid blood test results, and blood test results taken in the subsequent years. Thyroid blood tests are undertaken on a yearly basis, to assess if the medication is at the correct dosage.
The previous and subsequent blood test results will be assessed for any significant difference, previous to participating in the study and subsequent to participating in the study.
The thyroid blood test results will establish if the change in diet and the addition of essential nutrients benefited the participant.
Ethics
Participants will be provided with a letter designed by the researcher, informing their family GP and Endocrinologist they will be participating in the research. The letter will confirm the participants will be receiving dietary advice from a fully qualified nutritional therapist, the letter will also confirm food supplements will form part of the dietary intervention. The food supplements will be provided by the researcher.
Copies of previous blood test results taken in a yearly review in primary care, will form part of the results for the study. The thyroid blood test measures TSH and T4, T3, FT3 FT4 are not measured, these thyroid hormones form part of the five important thyroid hormones, highlighted in the objective of the study (Tuchendler D, Bolanowski M 2014)
Conclusion
Current studies in thyroid disorders show the importance of iodine, Selenium and Tyrosine in the manufacture of the thyroid gland, however there are very limited studies on the importance of nutrition in supporting the management of symptoms in thyroid disorders.
The symptoms of the thyroid disorders vary significantly from extreme weight loss to weight gain, hair loss, dry skin, sub-optimal fertility, digestive disorders, cardiovascular and central nervous system disorders. The role of Nutrition is essential in managing the many symptoms experienced in Thyroid disorders.
I hope my study will establish the importance of Nutrition in the management of thyroid disorders.
Bibliography
Bashar, MD Abu. Begam, Nazia. 2020. Role of dietary factors in thyroid disorders: Current evidences and way forwards. Journal, Thyroid research and practice 17: 104-9
Rayman M 2019. Multiple nutritional factors and thyroid disease, with particular reference to autoimmune thyroid disease. Faculty of health and medical sciences. University of Surrey.
Krysiak R, Szkróbka W, Okopień B. The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto's Thyroiditis: A Pilot Study. Exp Clin Endocrinol Diabetes. 2019 Jul;127(7):417-422.
Voigt, K., Gottschall, M., Köberlein-Neu, J. et al. 2016. Why do family doctors prescribe potentially inappropriate medication to elderly patients?. BMC Fam Pract 17, 93
Nagarkar R, Roy S, 2015. Incidence of Thyroid Disorders in India: An Institutional Retrospective Analysis. Journal of dentistry and medical speciality. Vol 2
O Connor PJ, Sperl-Hillen JAM. 2019 Current status and future directions for electronic point of Care clinical decision support to improve diabetes management in primary care. Diabetes Technol ther. 21(S2); 22-26, S2-34
Durrant-Peatfield, B. (2010) 2nd Edition. Your Thyroid and how to keep it healthy p7-39
Roe M Pinchen H. 2015. McCance and Widdowson’s The composition of food. British Nutrition society, updated summary. Nutrition Bulletin 40: 1 36-9
Singh R.P 2019 Can decreased heart rate variability be a marker of autonomic dysfunction, metabolic syndrome and diabetes. Journal of Diabetology 10:2 48-56
Tuchendler D, Bolanowski M. 2014 The influence of thyroid dysfunction on bone metabolism. Thyroid Res. ;7(1):12. Published 2014 Dec 20. doi:10.1186/s13044-014-0012-0
Hi to Everyone who responded to my post, thank you. I will continue to post updates here, as the PhD continues. The research element or the trial part of the study will commence in 2022. Thank you again.
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