7 Weight Loss Tips for Hypothyroidism

Start with these seven strategies to jump-start weight loss with hypothyroidism:

1. Consider going gluten-free.Tina Beaudoin, ND, president of the New Hampshire Association of Naturopathic Doctors and medical director of HealthStrong Integrative Medicine in Manchester, New Hampshire says going gluten-free can help people with hypothyroidism lose weight. Gluten is high in goitrogens, which interfere with iodine uptake and suppress thyroid function, she says. The association between gluten intolerance and thyroid disorders has long been noted, but she says she also see results in her practice when people with hypothyroidism cut gluten from their diets. “When people with hypothyroidism cut out gluten and add integrative support, their antibodies steadily decrease in the majority of cases,” she says.

2. Cut out simple carbs and sugars. Dr. Austin recommends a moderate- to low-carbohydrate diet that focuses on complex carbohydrates (think starchy vegetables and legumes) and avoiding simple sugars (pass on the candy and soda). According to Harvard Medical School, eating complex carbohydrates and avoiding simple carbs can help reduce the production of cytokines, which are tiny proteins that can influence inflammation in the body. But Austin stresses the importance of eating enough calories because "low calories can cause a stress response and result in decreased T3 production.”

3. Eat more anti-inflammatory foods. Anti-inflammatory foods can help ease joint aches and pains and depression, all of which can result from hypothyroidism, Austin says. And anti-inflammatory foods can help soothe the immune system, which is often in “overdrive” in people with hypothyroidism, Dr. Beaudoin says. “An anti-inflammatory diet can help calm the immune system and excessive inflammation,” she says. Leafy green vegetables, tomatoes, fatty fish, nuts, fruit, and olive oil are all good foods to battle inflammation.

4. Stick to small, frequent meals. Hypothyroidism slows digestive function, Beaudoin says. “Eating smaller, more frequent meals with balanced macronutrients — quality proteins, complex carbs, and healthy fats — supports balanced blood sugar and helps avoid the highs and lows of oversized, highly processed meals," she says.

5. Keep a food diary. Your daily caloric intake can quickly skyrocket unless you log everything you eat and drink, Corsino says. It can also help ensure that you’re eating a balanced diet. “Keeping a food journal is important for someone with hypothyroidism to track their macronutrient intake,” Austin says. “A diet high in healthy fats, moderate proteins, and moderate- to low-carbohydrates is best for thyroid function.”

6. Keep your body moving. Exercise is an important complement to a healthy diet in order to help burn calories, Dr. Corsino says. But consider the individual case, Austin says. “If a person is terribly fatigued, exercise can further suppress hypothyroidism," she says. "If a person has properly managed their hypothyroid and has the energy, exercise is encouraged.”

7. Take thyroid medication as directed.Thyroid hormone should be taken on an empty stomach first thing in the morning with plenty of water, Corsino says. Don’t take it with any other medications and wait at least 30 to 60 minutes before eating breakfast. If your thyroid levels still aren’t where they should be when you take your medication properly, it could be affecting your ability to lose weight. Talk with your doctor about treatment adjustments that might be right for you.

Chemo Brain is Real!

Breast cancer survivors report substantially more cognitive difficulties as much as 6 months after chemotherapy compared with age-matched controls, according to new research. The result, from a study of 581 breast cancer patients recruited from community practices across the United States, adds to evidence from other studies which show that cognitive difficulties after chemotherapy, colloquially known as chemofog or chemo brain, are a real problem for breast cancer survivors, the authors write. 

"One of the main goals of our study, which was the largest prospective, longitudinal study in the community to date, was to help us understand more about the cognitive complaints that patients often report during their cancer treatments and to better understand the trajectory of those cognitive problems," lead author Michelle C. Janelsins, PhD, from the James P. Wilmot Cancer Institute, University of Rochester Medical Center, New York, told Medscape Medical News. "We found that a significant percentage of our breast cancer patients, 45.2%, reported that they had clinically meaningful changes in their cognitive function from before treatment to after treatment, compared with only 10% of healthy controls," Dr Janelsins said. "That's a lot of people who are complaining of problems. And after 6 months, although there was some rebound, still 36.5% of breast cancer patients were complaining of problems with cognitive function, compared with 13.6% in the control group," she added.

The study was published in the February issue of the Journal of Clinical Oncology. For the study, 581 patients with breast cancer and 364 age-matched noncancer controls completed the Functional Assessment of Cancer Therapy — Cognitive Function (FACT-Cog) before and after chemotherapy, and again 6 months after the course of chemotherapy had ended. Controls were family members, friends of patients, or unrelated, and obtained from the National Cancer Institute Community Oncology Research Program (NCORP) research database, Dr Janelsins explained.

"The FACT-Cog is a validated measure of patient-reported outcomes that was developed specifically to assess cognitive challenges identified by patients with cancer," she noted. The mean age of study participants was 53 years, and 48% of breast cancer patients received anthracycline-based chemotherapy regimens. Before any chemotherapy, FACT-Cog scores were lower in patients with breast cancer compared with controls (P < .001). Older age (P = .009), black race (P = 0.34), lower reading ability, higher anxiety, and higher depressive symptoms (all P < .001) were predictive of lower FACT-Cog scores at baseline. Education, however, was not predictive (P = .809). Significantly greater cognitive complaints, as shown by declines in the FACT-Cog score as well as four subscales (perceived cognitive impairment [PCI], perceived cognitive abilities [PCA], and impact on quality of life [QOL]), were reported by breast cancer patients compared with controls before, immediately after, and 6 months after chemotherapy (P < .001) at all time points.

This study has several strengths, Patricia A. Ganz, MD, professor of medicine and public health at UCLA Schools of Medicine and Public Health, Los Angeles, California, told Medscape Medical News. In addition to its large sample size and control group, the use of self-reported perceptions of cognitive decline could also be considered a strength, commented Dr Ganz, who coauthored an accompanying editorial. "This is a large trial, where they also did neuropsychological testing, although those results were not reported in this paper," Dr Ganz said. "The issue is, how much does self-reported difficulty with cognition relate to test-associated changes? The tests, by and large, that are used in these settings are pretty crude in the sense that they are designed to pick up big changes, whereas these patients may have much more subtle changes, and as a result, self-report may actually be more sensitive at detecting these changes," she said.

"For instance, the neuropsychologist will tell you that you have to have more than a one or two standard deviation difference to say somebody is impaired, but I think what patients are really aware of is that they can perceive a difference. It's just not big enough in magnitude to be detected on these tests," Dr Ganz said. "The other thing that we find is that the norms for a lot of these tests are based on the general population who have an IQ of 100, whereas at least in the breast cancer patients we have tested, some have IQs of 110, 120, so they are brighter and may still appear in the normal range, but they are not perceiving their mental functioning as being normal," she said. Both Dr Janelsins and Dr Ganz agree that the findings from this and other studies should reassure breast cancer survivors who experience symptoms of cognitive impairment after chemotherapy that what they are experiencing is, indeed, real.

"This is one of the largest studies to be conducted to date in a nationwide setting and is really validating concerns that patients have — that this is a real problem and it needs respect. Patients should be aware this is a possible side effect of cancer treatment, and if they are having any concerns about their cognition they should bring them up with their provider and not just brush them off as an aging effect. These are real problems," Dr Janelsins emphasized. The study results reinforce the perception that something is going on with these women, Dr Ganz agreed.

"Women will come in and say 'I can't think straight,' or 'It's really hard for me to concentrate,' or 'I'm having trouble finding words. I used to be able to start to work at my computer and I'd know what I was doing, but now I forget within a few minutes why I am sitting there,'" she said. "Those are the kinds of things patients who have had cancer treatments often complain of. Many patients are able to go back to work, but continued to be troubled by these problems, but others are unable to. I remember one patient who was legal counsel for a big corporation. She just couldn't go back to work," Dr Ganz said.

New study suggests strategies for keeping off pounds

You've succeeded in losing weight. Now, what can you do to keep the pounds off? Most people seem to struggle with long-term weight loss. By some estimates, only about 20% of overweight individuals are successful in keeping off at least 10% of their initial body weight for a year or longer. A new study, however, suggests that using specific strategies -- such as weighing yourself regularly and planning for situations in which you might backslide -- could modestly slow the rate of weight regain in obese adults who have lost weight. In the study, employing such strategies in a maintenance program increased the proportion of adults who stayed at or lowered their weight, after initial weight loss, by 13.9 percentage points, said Corrine Voils, research career scientist at William S. Middleton Veterans Memorial Hospital in Madison, Wisconsin and lead author of the study.

However, more research is needed to determine which specific strategies offered the most benefit and which may have not had much of an impact. The study, which involved mostly men of various races and involved self-reports, was published in the journal Annals of Internal Medicine on Monday. "We went into this study unsure what to expect," said Voils, who is also a professor of surgery at the University of Wisconsin-Madison. "We knew that maintaining weight loss is hard and that previous maintenance studies have tended to focus on middle-aged white females. We were unsure if a mainly telephone-based program would work in a population that is primarily men and of mixed race," she said. "We were happy to see that our strategies reduced the rate of weight regain." More than one-third of American adults are considered to be obese, meaning their body mass index is 30 or higher, according to the Centers for Disease Control and Prevention. Obesity has been linked to numerous health problems, including heart disease, stroke, type 2 diabetes and several types of cancer.

'Obesity is now recognized as a chronic disease'

The new study involved 222 obese patients, of whom only 34 were women. All of the patients had lost at least 8.8 pounds in a 16-week weight loss program. They were randomly assigned to participate in either an intervention group that provided weight maintenance strategies for an additional 42 weeks or a group that received usual medical care, with no emphasis on weight maintenance. Those in the intervention group participated in three in-person group meetings and eight individual telephone calls, in which they were given a maintenance calorie budget and strategies on how to exercise, get support from their family and friends, and monitor their weight.

The phone calls also involved the patients reflecting on how their lives have improved as a result of weight loss, making a plan for situations when they might feel tempted to go back to old habits, and specifying how frequently they weigh themselves and revisit weight loss efforts if they have gained weight. All participants, in both groups, were scheduled for assessment appointments at the beginning of the study and then after 14, 26, 42 and 56 weeks. After 56 weeks, Voils said, 58.6% of patients in the intervention group either regained some weight or saw no change in weight, while 72.5% of patients in the other group regained or saw no change, a difference of 13.9 percentage points. The average weight regain in the intervention group was only about 1.6 pounds, compared with about 5.2 pounds in the other group, the researchers found.

"Although this may not seem like a lot of weight, given the low program costs and the high benefit of carrying less weight over the longer term, this is an important finding that adds to our understanding about how best to help patients with obesity," said Dr. Jennifer Kraschnewski, associate professor at the Penn State College of Medicine, who was not involved in the new study. "Obesity is now recognized as a chronic disease. However, we still don't treat it this way in the clinical setting. Clinically, we typically help patients engage in weight loss efforts, stand back and watch as they regain, and then try to re-engage them in additional weight loss efforts," she said. "We wouldn't treat someone's high blood pressure with a medication for only a year and then scratch our heads as to why their blood pressure is high again two years later. For obesity to be treated as a chronic disease, new approaches to management are critical." Yet, the new study had some limitations.

What might help weight control the most?

It remains unclear in the study whether regular weighing, planning for high-risk situations or obtaining outside support was most effective in weight loss management, Voils said. "Our study design did not allow us to say which component of our intervention was most effective," Voils said. "There is evidence that self-weighing and relapse prevention help people maintain weight loss. Our intervention incorporates those skills and adds having patients reflect on the benefits they experienced with weight loss and talking with a support person about what they can do to support weight maintenance efforts," she said.

 Though it remains difficult to establish which part of the intervention had the most impact on patients, having constant interaction with a supportive coach probably played a significant role in weight maintenance, said Dr. Samuel Grief, associate professor of clinical family medicine at the University of Illinois College of Medicine at Chicago, who was not involved in the study. "Group dynamics tend to be more helpful, or a team-based approach using care coordination," Grief said. "That would be my answer. Because strategies like food journaling or diaries or writing out what activities you do every day or emotions that you're feeling, all that is relevant, but there's not a lot of science behind those causing weight loss or mitigation of weight regain.

Otherwise, everybody would do it," he said. "Also, it would have been helpful to gauge their self-efficacy." Studies suggest that having self-efficacy, or believing that you will be successful in losing weight, has been linked to greater success in weight management, Grief said. Additionally, the researchers were unable to assess longer-term weight maintenance and relied on self-reports about dietary intake and physical activity. "Our population was primarily middle-aged men who were white or African-American, and results may not generalize to other populations," Voils said.

Tips for keeping the weight off

The National Weight Control Registry, which has tracked more than 10,000 individuals who have maintained significant weight losses, offers some recommendations on how to maintain weight control. Rena Wing, a professor at Brown University's Warren Alpert Medical School, and James Hill, director of the Center for Human Nutrition at the University of Colorado Health Sciences Center, established the registry in 1994. "To maintain weight loss, there must be continued adherence to a low-calorie diet and high physical activity," Wing said.

She said the registry suggests that the following strategies may help someone who is trying to maintain their weight loss:

• Maintain high levels of physical activity, in which the recommended goal is 250 minutes per week of moderate-intensity activity, such as brisk walking. 
• Monitor your weight by weighing yourself frequently. 
• Monitor and keep track of your diet and activity. 
• Take immediate action in the face of small weight regains.

Will I Go Bald? Genetic Study Shows Complex Answer

Researchers searching for the genetic roots of hair loss say they've found more than 280 different genes are involved. And they've come up with a formula that can predict a man's risk of losing his hair, although it's too soon to say there could be a blood test to forecast whether and when a man would start losing his hair. It turns out that hair loss is very complicated genetically, the British team reports in the Public Library of Science journal PLoS Genetics.

"In this large genome-wide association study study of male pattern baldness, we identified 287 independent genetic signals that were linked to differences in the trait," Riccardo Marioni and colleagues at the University of Edinburgh wrote. "The results of this study might help identify those at greatest risk of hair loss, and also potential genetic targets for intervention." The team studied the DNA from more than 52,000 mostly middle-aged men taking part in a gigantic British genetic experiment called BioBank. "We identified hundreds of new genetic signals," said Saskia Hagenaars, a student who worked on the study.

Although hair loss runs strongly in families, men cannot always look at their fathers and predict their own fates, hair-wise. Some can blame their mothers, the researchers found. The trawl though all of the mens' genes found 40 linked with baldness on the X chromosome. The rest were scattered across the genome. "It was interesting to find that many of the genetic signals for male pattern baldness came from the X chromosome, which men inherit from their mothers," Hagenaars said in a statement. Of the men in the study, 16,700 had no hair loss.

Another 12,000 had slight hair loss; 14,000 had moderate hair loss and 9,800 had severe hair loss. "We identified hundreds of new genetic signals," said Saskia Hagenaars, a student who worked on the study. Although hair loss runs strongly in families, men cannot always look at their fathers and predict their own fates, hair-wise. Some can blame their mothers, the researchers found. The trawl though all of the mens' genes found 40 linked with baldness on the X chromosome. The rest were scattered across the genome. "It was interesting to find that many of the genetic signals for male pattern baldness came from the X chromosome, which men inherit from their mothers," Hagenaars said in a statement. Of the men in the study, 16,700 had no hair loss. Another 12,000 had slight hair loss; 14,000 had moderate hair loss and 9,800 had severe hair loss.

However, it's possible to predict whether a man will lose hair with pretty good certainty. Most are fated to at least have their hair thin out. "Male pattern baldness affects around 80 percent of men by the age of 80 years," the researchers wrote. "We are still a long way from making an accurate prediction for an individual's hair loss pattern," Marioni said in a statement. "However, these results take us one step closer. The findings pave the way for an improved understanding of the genetic causes of hair loss."

Cooling Cap May Limit Chemo Hair Loss In Women With Breast Cancer

It's no surprise that most women with breast cancer consider hair loss one of the most traumatic aspects of chemotherapy. That has led to a big market for cooling caps, which are purported to limit hair loss. But cooling caps haven't been extensively studied in the U.S., and womens' experiences with the caps have been hit or miss. And just one cooling cap, the DigniCap, is approved by the Food and Drug Administration.

Two studies released Tuesday show that at least half the women who used either the DigniCap or another scalp cooling system, the Paxman, lost less than 50 percent of their hair. "These findings appear to represent a major step forward in improving the quality of life of individuals with cancer," says Dr. Dawn Hershman, who studies the effects of cancer treatments at the Columbia University School of Medicine in New York. She wrote an editorial accompanying the studies in JAMA, the journal of the American Medical Association.

But Hershman cautions that more study is needed to determine whether there is psychological benefit in using the caps to prevent hair loss. And the cost and who will pay for the treatment are also issues, she says. The average cost is $1,500 to $3,000, depending on the number of chemotherapy cycles. In the DigniCap study, 67 of 106 women (66.3 percent) lost less than half their hair after four rounds of taxane chemotherapy. The women had either stage I or II breast cancer. In contrast, all of the 16 women who did not use the cap lost all of their hair during chemotherapy. The DigniCap system uses a double cap fitted to the scalp 30 minutes before an infusion, which keeps the scalp at 37 degrees Fahrenheit, plus or minus 2 degrees, during the session.

The system was approved by the FDA in 2015 and is available at infusion centers in 17 states. The other study found similar results using the Paxman system. It was led by oncologist Julie Nangia of the Baylor College of Medicine in Houston. Half of the 95 women (50.5 percent) using the Paxman system lost less than half their hair after four rounds of anthracycline and taxane chemotherapy, including five women who had no significant hair loss, as judged by independent observers from photographs. Among the 47 who did not use the cooling system, all lost all of their hair. The Paxman study was stopped earlier than planned, after four cycles of chemotherapy, because findings showed the cooling cap was highly effective at preventing hair loss. That cooling system is not yet available commercially in the U.S. and is under review at the FDA. "It's nice now to have two good studies focusing on the quality of life to make the cancer journey easier for women," Nangia tells NPR. There were no serious side effects related to either cooler.

A few people reported headaches, and some stopped using the device because they got too cold. Nangia says most patients described the device as "reasonably comfortable." The studies were funded and designed, in part, by their respective manufacturers, with varying levels of company input to the university investigators. In both cases, the researchers were free to publish results they deemed appropriate. Researchers don't know exactly how the cooling caps work. One theory is that cooling constricts the blood vessels in the scalp, slowing the circulation and thereby reducing the amount of toxins to which hair follicles are exposed. Or it may be that cold slows the growth of hair follicles, making them less susceptible to damage from chemotherapy, which targets rapidly dividing cells.

Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, says it could be that "by slowing down those cells whatever mechanism it may be — either starving their blood flow or slowing them down straightforwardly — the net effect is beneficial, causing hair not to fall out." While chilling the scalp may seem to carry few risks, Lichtenfeld says there is a theoretical risk that inhibiting the effect of chemotherapy in the scalp could allow metastases to take hold there. "These techniques are relatively new," he says, and "breast cancer is a disease that can take a long time before it comes back and if one is to be 100 percent certain then you need a long period of time to answer the question." So far, cancer recurrence on the scalp has not been seen in the U.S. studies, but authors of both JAMA papers say longer follow-up is needed to be sure that this is not a risk.

Wishing you a Happy Valentine's Day!

Winter hair fall: Is seasonal hair loss a myth or fact?

Hair fall is a natural phenomenon where old hair falls off, giving space for the new hair to grow. But in the cooler months, we notice that there are too many strands on our hairbrush and too little on our scalp.

While winter is great for bonfire parties, hot beverages and fried food, it is not exactly a party for your scalp. There seems to be a spike in the amount of hair we lose during these months, apart from the constant itchiness and flakiness. Is winter to be blamed for our ordeal? To find out, we spoke to trichologist Dr Priya Mohod to understand why we lose so much hair during the winter months.

Is it true that you have more hair loss during winter? “It is definitely not a myth. Hair fall does happen a lot in the winter months,” states the doctor. Being mammals, we undergo hair fall during the onset of winter [1].However, certain other seasonal changes in winter also contribute towards hair loss. What happens to your scalp during winters? Winter months are particularly rough on the scalp. Dryness and flakiness tend to make the hair roots weak, which causes the hair to fall off according to Dr Mohod. Winter is also the time when fungal infections thrive, giving rise to a host of scalp problems. The doctor adds, “These microbes can cause dandruff which leads to more hair fall.” Does seasonal hair fall affect women more than men? According to the doctor, no gender is immune from the seasonal problem. “When it comes to hair fall, the season affects both men and women in a similar manner. So both experience hair fall during the winters,” says the doctor.

How to reduce hair fall during winters?

• Hygiene is an important factor: Wash your hair more often to keep your scalp clean. The doctor advises against using store bought shampoos. “They have higher levels of sulphate. Opt for a medicated one instead,” says Dr Mohod.

• Avoid stepping out with oil in your hair: The doctor adds, “If you step out with oily hair, dust, pollution and dirt may stick to it, which can worsen the condition.” Oil should be kept on the scalp only for 10-15 minutes or overnight before washing it off thoroughly.

• Cover your hair: Draping a shawl or a dupatta around your hair will keep it safe from direct sunlight and other irritants that may affect the scalp. These small tips can help your hair tide over the harsh winter months effectively.