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Mayo Clinic Q and A: food's effect on hypothroidism; endometrial cancer

Published Oct. 27, 2016

THE EFFECTS OF FOOD ON HYPOTHYROIDISM

I have hypothyroidism and take medication for it. I read that I should avoid kale and spinach.

In general there are no specific foods you must avoid if you have hypothyroidism. Eating a healthy, balanced diet and taking your medication as prescribed will go a long way toward managing hypothyroidism.

Your thyroid is a small, butterfly-shaped gland at the base of the front of your neck. Hypothyroidism, sometimes called underactive thyroid, is a condition in which your thyroid gland doesn't produce enough of certain important hormones.

The hormones that the thyroid gland makes — triiodothyronine, or T3, and thyroxine, or T4 — have a large impact on your health, affecting all aspects of your metabolism. They maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate and help regulate the production of proteins.

When your thyroid doesn't make enough T3 and T4, the result is hypothyroidism. In most cases, hypothyroidism can be treated safely and effectively with the synthetic thyroid hormone levothyroxine.

Concern surrounding the impact of spinach, kale and other similar vegetables, including broccoli and cauliflower, on thyroid health is due to the effect they can have on the thyroid's ability to absorb iodine. Having enough iodine in your diet is crucial because your thyroid gland needs iodine to make T3 and T4.

Eating a lot of these vegetables could limit your thyroid's uptake of iodine, but the amount you would need to eat is very large.

In addition, the effect of these vegetables is on the thyroid gland itself. That means for someone like you whose thyroid gland isn't working properly, and who is taking medication, even if you ate these vegetables in large amounts, there wouldn't be any impact on the amount of thyroid hormone in your body.

It is worth noting, though, that some foods, dietary supplements and medications may interfere with your body's ability to process thyroid hormone replacement. For example, it can be hard for your body to absorb the medication if you take your tablets with meals high in fiber.

Also, to avoid problems with absorption, don't take your medication with foods that contain walnuts, soybean flour or cottonseed meal. Don't take it at the same time as you take an iron supplement or a multivitamin that contains iron. It's also important to avoid taking it with calcium supplements or antacids that contain aluminum or magnesium. Some ulcer medications and cholesterol-lowering drugs also can interfere.

John Morris III, M.D., Endocrinology, Mayo Clinic, Rochester, Minn.

ENDOMETRIAL CANCER: IS IT HEREDITARY?

My sister, 56, was diagnosed with early-stage endometrial cancer. Does it run in families? Are there screening tests?

An increased risk for endometrial cancer can run in families, but it's rare. More commonly, it is linked to risk factors such as obesity, age and underlying medical conditions. At this time, no screening test is available.

Endometrial cancer begins in the uterus, within the layer of cells that form the uterine lining, called the endometrium.

Endometrial cancer often is found early. That's because the most common symptom, abnormal vaginal bleeding, usually prompts a woman to see a doctor. If found early, removing the uterus typically offers a cure.

Endometrial cancer on its own is not a disease you inherit. However, a genetic disorder known as Lynch syndrome that is passed down through families has been shown to increase the risk of developing endometrial cancer, as well as other cancers of the colon, stomach, kidney, small intestine, liver and sweat glands.

In most cases, factors other than family history play a larger role in raising a person's risk. Some of the most significant include medical conditions that change the balance of the hormones estrogen and progesterone in your body. Having high blood pressure or high cholesterol can raise your risk, too.

Women who have never been pregnant, those who started menstruation at an early age or who go through menopause at a later age, and women who have had hormone therapy for the treatment of breast cancer all are at an increased risk. Age is a factor, as well. Endometrial cancer most often affects women after menopause.

Jamie Bakkum-Gamez, M.D., Gynecologic Surgery, Mayo Clinic, Rochester, Minn.

Mayo Clinic Q & A is an educational resource and doesn't replace regular medical care. Email a question to MayoClinicQ&A@mayo.edu. For more information, visit mayoclinic.org. © 2016 Mayo Foundation for Medical Education and Research. Distributed by Tribune Content Agency LLC. All rights reserved.

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