Previously, we have discussed on the topic hyperthyroidism. This time, we will touch on hypothyroidism, another disease of the thyroid. Thyroid is a butterfly-shaped gland located in the front of the neck. It produces hormones responsible for metabolism and the control of body functions such as the heart rate, temperature, digestion, and moods. Hypothyroidism is a condition whereby the thyroid gland does not produce enough hormones, causing these body functions to decelerate.
之前，我们讨论过甲亢这个话题。这一次，我们将谈谈另一种甲状腺疾病–甲状腺功能减退症。甲状腺是位于颈部前方的蝴蝶状腺体。它产生负责新陈代谢和控制身体功能（例如心率、温度、消化和情绪）的激素。甲状腺功能减退症是甲状腺不能产生足够的激素，导致这些身体的功能减慢的一种情况。
There are many causes of hypothyroidism, which include Hashimoto’s disease (autoimmune disorder), thyroiditis, congenital hypothyroidism, radiation treatment or surgical removal of the thyroid gland, and some medication. In rare cases, this condition can be caused by pituitary disease or iodine deficiency in the diet. Hypothyroidism can occur without any symptoms, but patients might experience fatigue or tiredness, unintentional weight gain, depression, cold intolerance, dry skin, dry and thinning hair, join and muscle aches, abnormal menstrual periods or fertility problems, and low heart rate. Hypothyroidism can be treated through hormone replacement medicine called levothyroxine.
甲状腺功能减退症的病因很多，包括桥本病（自身免疫性疾病）、甲状腺炎、先天性甲状腺功能减退症、放射性治疗或手术切除甲状腺，以及一些药物治疗。在极少数情况下，这种情况可能是由垂体疾病或饮食中的碘缺乏所引起的。甲状腺功能减退症可以在没有任何症状的情况下发生，但患者可能会感到疲劳或疲倦、体重意外增加、抑郁、不耐寒、皮肤干燥、头发干燥和稀疏、关节和肌肉疼痛、月经不正常或生育问题以及低心率。甲状腺功能减退症可以通过称为左旋甲状腺素的激素替代药物来治疗。
Hypothyroidism can contribute to high cholesterol level. Severe untreated hypothyroidism, though rare, can lead to myxoedema coma, where the body functions slow down to a life-threatening point. In pregnant women, this disease can cause complications such as preterm birth, preeclampsia, miscarriage and can affect the growth and development of the baby.
甲状腺功能减退症可导致高胆固醇水平。未经治疗的严重甲状腺功能减退症虽然罕见，但会导致粘液性水肿昏迷，身体机能减慢到危及生命的程度。在孕妇中，这种疾病会导致早产、先兆子痫、流产等并发症，并会影响婴儿的生长发育。
To treat hypothyroidism, patients may be prescribed with levothyroxine which is a synthetic thyroid hormone. This hormone can interact with food and caffein, therefore it is best to take it with a gap of at least 30 minutes before consuming anything else.
为了治疗甲状腺功能减退症，患者可能会服用一种称为左旋甲状腺素的合成甲状腺激素。这种激素可以与食物和咖啡因相互作用，因此最好间隔至少30分钟再服用其他任何东西。
Currently, there is no specific diet proven to treat hypothyroidism. However, people with hypothyroidism may benefit from these dietary changes:
目前，没有特定的饮食被证明可以治疗甲状腺功能减退症。然而，甲状腺功能减退症患者可能会从这些饮食改变中受益：
- Consume balanced meal / 均衡膳食
Like any other body functions, thyroid hormone production relies on the adequacy of nutrients consumed. The main nutrients associated with thyroid function is iodine. Adequate iodine intake is needed in the production of thyroid hormones by the thyroid follicular cells. However, is it advisable to increase intake of iodine to possibly reverse hypothyroidism? In some cases, whereby iodine deficiency is the cause of hypothyroidism, consumption of adequate (not excessive) iodine from food and supplement may restore the thyroid function. However, in cases of autoimmune thyroid disorders, excessive iodine intake can further aggravate hypothyroidism. Individuals with restricted diets such as vegetarians are at higher risk of having iodine inadequacy as vegetables are not iodine-rich food source.
与任何其他身体功能一样，甲状腺激素的产生依赖于消耗的营养是否充足。与甲状腺功能相关的主要营养素是碘。甲状腺滤泡细胞产生甲状腺激素需要摄入足够的碘。然而，是否建议增加碘的摄入量来逆转甲状腺功能减退症？在某些情况下，缺乏碘是甲状腺功能减退症的原因，从食物和补充剂中摄入足够（而不是过量）的碘可以恢复甲状腺功能。然而，在自身免疫性甲状腺疾病的情况下，过量摄入碘会进一步加重甲状腺功能减退症。由于蔬菜不是富含碘的食物来源，因此饮食受到限制的个人（例如素食者）发生碘不足的风险较高。
Aside from iodine, various other micronutrients are also important for thyroid function, such as selenium, iron, zinc, magnesium, Vitamin B and D. With balanced meal that emphasizes on vegetables, fruits, beans, seeds, whole grains, nuts; and includes fish, lean meat, low or non-fat dairy and non-tropical plant oil, individuals can get a proper amount of aforementioned nutrients. This balanced diet will also provide individuals with antioxidants, polyphenols and omega-3; all of which have anti-inflammatory properties helpful in preventing inflammation, which is one of the primary causes of hypothyroidism.
除碘外，其他各种微量营养素对甲状腺功能也很重要，如硒、铁、锌、镁、维生素B和D。均衡膳食，着重于蔬菜、水果、豆类、种子、全谷物、坚果；包括鱼、瘦肉、低脂或脱脂乳制品和非热带植物油，个人可以获取适量的上述营养素。这种均衡饮食还将为个人提供抗氧化剂、多酚和omega-3；所有这些都具有抗炎特性，有助于预防炎症，而炎症是甲状腺功能减退的主要原因之一。
- Avoid excessive consumption of goitrogenic food / 避免过量食用会导致甲状腺肿大的食物
Goitrogen, – derived from the word ‘goitre’ which means the enlargement of thyroid -, is a compound that can interfere with the production of thyroid hormone, mostly through competing with iodine uptake by thyrocytes causing reduced iodine utilization or by impairing the enzyme activities essential for thyroid hormone production. However, there is no specific guidelines on how much goitrogens can be consumed until they significantly affect the thyroid function. Goitrogens typically shows their effect after prolonged use and/or when consumed in large amount and are of greater impact when paired with low iodine intake.
甲状腺肿素源自“goitre”一词，意思是甲状腺肿大，是一种可以干扰产生甲状腺激素的化合物，主要是通过与甲状腺细胞竞争碘的摄取，导致碘利用率降低或损害用于产生甲状腺激素的活性酶。然而，对于甲状腺肿素在显著影响甲状腺功能之前可以摄入多少，并没有具体的指导方针。甲状腺肿素通常在长期使用和/或大量食用后显示出其作用，并且在与低碘摄入量搭配使用时会产生更大的影响。
Goitrogen is a cause of concern in countries where goitrogenic foods, such as cassava, maize, bamboo shoots, sweet potato, pearl millet and lima beans, are staple. Otherwise, they are safe to consume if consumption is not in excess. Hypothyroid patients can avoid consumption of raw cruciferous vegetables such as broccoli, cabbage, kale, cauliflower, mustard leaves, and turnip. Instead, these vegetables should be cooked as the cooking can denature the goitrogens. Soy products are also goitrogenic, but there is no conclusive evidence on the effect of soy to the thyroid function. Thus, they are safe to consume in moderate amount.
甲状腺肿素在以木薯、玉米、竹笋、红薯、珍珠小米和利马豆等致甲状腺肿食物为主的国家，是一个令人担忧的问题。否则，只要消费不过量，食用它们是安全的。甲状腺功能减退症患者可以避免食用生的十字花科蔬菜，如西兰花、卷心菜、羽衣甘蓝、花椰菜、芥菜叶和萝卜。相反，这些蔬菜应该煮熟，因为烹饪会使甲状腺肿素变质。豆制品也具有致甲状腺肿的作用，但没有确凿的证据证实大豆对甲状腺功能有影响。因此，适量食用是安全的。
- Avoid pro-inflammatory food / 避免食用促炎的食物
As mentioned previously, one of the main causes of hypothyroidism is inflammation (such as in autoimmune diseases). Thus, it is crucial for individuals with hypothyroid to avoid pro-inflammatory food. Pro-inflammatory food can affect the key pathways to inflammation which includes sympathetic activities, oxidative stress, and activation of pro-inflammatory cytokines (signaling proteins that control inflammation).
如前所述，甲状腺功能减退的主要原因之一是炎症（例如自身免疫性疾病）。因此，对于甲状腺功能减退症患者来说，避免促炎食物至关重要。促炎食物可以影响炎症的关键途径，包括交感神经活动、氧化应激和促炎细胞因子（控制炎症的信号蛋白）的激活。
Among the foods that contributes to inflammation are processed meats (such as patty and sausage), processed food (such as fast food, chips, and instant noodles), food with added sugar and salt, sweetened beverages (carbonated drinks, 3 in 1 drinks et cetera), refined grains (white rice, white bread et cetera), saturated and trans-fat.
引起炎症的食物包括加工肉类（如肉饼和香肠）、加工食品（如快餐、薯片和方便面）、添加糖和盐的食物、含糖饮料（碳酸饮料、三合一饮料等）、精制谷物（白米、白面包等）、饱和脂肪和反式脂肪。
In conclusion, there is no specific dietary guidelines in preventing or treating hypothyroidism. However, some changes can help in improving the disease. It is best to consult your healthcare provider before making changes on your dietary intake.
总之，目前尚无预防或治疗甲状腺功能减退症的具体饮食指南。然而，一些改变可以帮助改善这种疾病。在改变饮食摄入量之前最好咨询您的医疗保健提供者。
