Scenario 7

• A 72-year-old man has been diagnosed with hypothyroidism this past

year.
• He comes to your clinic with his medicine and traditional folk
remedies, including Synthroid, garlic, and chamomile.
• His diet history indicates daily use of chicken, rice, celery, dandelion,
green pepper, mango, and papaya.
• He states that he has been very tired lately, has little energy, and has
constipation.
• His hormone levels on his last medical report were
• thyroxine (T4): 1.7mcg/dl, triiodothyronine (T3): 75mg/dl, and
thyroid-stimulating hormone (TSH): 15, indicative that his
hypothyroidism is still not well controlled.
• Nutrition Care Questions
• PES statement?
• Normal ranges of thyroid hormones? Active form of thyroid hormone?
1. What other information do you need for a more thorough assessment?
2. What advice would you offer about his diet?
• Nutrient considerations
• Supplement considerations
• Role of fasting
• Time of food consumption
• Caloric requirements of the patient?
3. What foods and herbs conflict with Synthroid?
4. Because traditional folk remedies are commonly used, how do you plan to
discuss these issues with Patient?
5. Plan a diet for the patient.