What do changes in heart rate, unexplained changes in weight, anxiousness, and sensitivity to cold have in common?

These are all possible symptoms of thyroid dysfunction.

In the US, more than 20 million people have a condition related to their thyroid - that’s more than 1 in 10 Americans (1). Even though thyroid dysfunction is extremely common, it may take a long while and several different doctor visits for a person to get an accurate diagnosis.

As dietitians, we have expertise to offer because dietary changes can make a significant impact on how people with a thyroid condition can feel.

In this article, we’ll explore the most common thyroid disorders and meet some of the dietitians who are practicing in this niche. You’ll also discover some helpful resources for you if you’d like to get started working to improve your client’s thyroid function.

Let’s dive in!

What conditions are we talking about?

Did you know that women are five times more likely to develop a thyroid condition than men (2)? There are several different conditions that have to do with your thyroid (3). The most common of these include:

• Hypothyroidism - when your thyroid makes too little thyroid hormone
• Hyperthyroidism - when your thyroid makes too much thyroid hormone
• Hashimoto’s thyroiditis - an autoimmune condition where your body attacks your thyroid
• Thyroid cancer - a growth of cancerous cells in your thyroid gland

These conditions can be tricky to diagnose and treat! Taylor Stolt, RDN, LD, CLT, IFNCP, founder of Plate and Canvas, explains:

"Thyroid disease is never caused by one factor alone. It's critical to take a comprehensive approach and address nutrition, gut health, blood sugar stability, stress levels, liver function, sleep quality, and other foundational aspects of health in order to effectively improve thyroid function and get symptoms under control."

Alyssa Smolen, MS RDN CDN, registered dietitian, founder of ArugAlyssa, and thyroid cancer survivor, encourages dietitians to take a personalized approach for each client.

“Each person will have a different care plan and recovery journey. Some people may take longer to adjust to thyroid replacement therapy. It could take many trials to find the right dosage. It can be difficult to stay positive when learning how to move on after this diagnosis.

However, I would recommend staying positive and acknowledging that your body has been through a trauma. Remain strong and give yourself grace.”

Work settings

As a dietitian, you could explore different options for work settings to support clients with their thyroid function.

This could include:

• Private practice: it is getting easier to launch a private practice. We spoke with Adrien Paczosa, RD, LD, CEDRD-S, of the telehealth nutrition counseling company, about How to Be a Virtual Private Practice Dietitian Without Setting Up Your Own Business.
• Endocrinology Clinic: as an employee in a hormone-focused clinic, you could be a valuable member of the team to support your patients through thriving with their thyroid and other hormone-based conditions.
• Cookbook author: You could write a book for the public to better learn how to manage their specific thyroid condition, such as Lisa Andrews did with The Complete Thyroid Cookbook: Easy Recipes and Meal Plans for Hypothyroidism and Hashimoto's Relief or Emily Kyle MS RDN HCP did with The 30-Minute Thyroid Cookbook: 125 Healing Recipes for Hypothyroidism and Hashimoto's.
• Create digital goods: you can create valuable resources and sell them on your own website and/or offer them on WellResourced.

For those of you who are interested in private practice, several of our guest experts for this article recommended establishing a good relationship with your local endocrinology clinics and gynecologists. They’ll be glad to have a reliable RD to refer to!

Myths and facts

Megan Huff, RD, founder of Nutrition by Megan and someone who has both Hashimoto's and hypothyroidism, offers us two common myths she hears about thyroid health as well as the truth.

Myth 1: There is no treatment until TSH levels are high enough to prescribe medication.

This is false. You can have subclinical hypothyroidism, where TSH levels may be slightly elevated but not high enough to warrant standard treatment, and still experience symptoms that could benefit from medication like levothyroxine.

It’s important to consider symptoms and do a comprehensive assessment that goes beyond just TSH levels. Testing T4 and T3 levels provides a fuller picture of thyroid function and how well the body is converting inactive thyroid hormone (T4) to its active form (T3). This deeper testing can help in making more informed decisions about treatment, especially if symptoms persist despite normal TSH levels.

Myth 2: You can't do anything to reduce TPO antibodies.

This is also false. Many diet and lifestyle changes can help lower TPO antibodies that drive Hashimoto's thyroiditis. For me, going gluten-free and supplementing with 1-2 Brazil nuts a day (a great source of selenium) helped lower my TPO antibodies by more than 500 points.

It's important to work with a healthcare provider to tailor these and other approaches to your individual needs.

Resources

There are many resources to support your growth of knowledge and confidence.

• The Dietitian Practice Groups of the Academy, including Oncology and Dietitians in Integrative and Functional Medicine.
• Thyroid Dietitian Group - a private Facebook community
• The Health Professional's Guide to Nutrition Management of Thyroid Disease includes the most current evidence-based guidelines from multiple professional organizations.
• Nutrition Management of Thyroid Disease: What RDNs Need to Know
• American Thyroid Association
• American Association of Clinical Endocrinology
• Understanding Thyroid Disease: An Integrative Approach to Optimizing Thyroid Health

Land the job

If you’re on the hunt for an employee position, keep in mind that not all jobs are listed as “registered dietitian.” Beyond the common misspelling of a dietitian as “dietician” with a “c,” job postings for practitioners working with thyroid patients and clients might be listed as:

• Women’s health dietitian
• Thyroid specialist dietitian
• Autoimmune dietitian
• Outpatient dietitian
• Oncology dietitian
• Functional medicine nutritionist
• Cancer dietitian

Be sure to search for roles and set up job alerts for different titles so that you are the first to know about a new posting that might be the perfect fit.

What about income?

Because things can vary so much from one work setting to another and from one state to another, it is tricky to draw firm conclusions at this point.

However, we do have a free anonymous database of salary trends that you’re welcome to check out! Simply make a free account here and then take a sneak peek at the thousands of listings in our database.

That’s a wrap

With more than 1 in 10 adults in the US having a thyroid condition at some point in their lifetime, dietitians have a lot of work to do to support their best health through personalized nutrition interventions.

Possible work settings can include private practice, functional medicine group clinics, inpatient or outpatient work with a hospital, and more, such as making digital goods or creating a course. The sky is the limit!

To feel prepared to land your next opportunity, check out our business skills courses. From optimizing your resume to polishing your LinkedIn profile, these assets can work hard to connect you with the perfect opportunity.

Check out our individual courses and course bundles here.

Next steps

Are you ready for a new dietitian job, or just want to browse job opportunities?

Start here on NutritionJobs.com for jobs, for those eligible to work in the US.

And if you want to get salary information for different job titles, participate in the anonymous dietitian salary survey at DietitianSalaries.com.

About the author

Stacey Dunn-Emke, MS, RDN, is the Founder Owner of NutritionJobs and DietitianSalaries.com and is an established dietetic career expert. She helps steer dietetic and nutrition professionals to a successful job search process with the top-ranked dietetic job board platform, NutritionJobs.com. Stacey is the author of The Dietetic Resume Guide and numerous dietetic career action-ables. She gives the tools to create a modern standout dietetic resume to land that job interview, help with job interview prep, and with creating Compelling LinkedIn profiles. Stacey has interviewed and hired many dietitians. Since running NutritionJobs in 2000, she has reviewed thousands of dietetic resumes. She works closely with dietetic hiring managers and recruiters to know the standout elements on a resume that land a job interview. Stacey speaks on successful compensation negotiation at professional conferences and frequently consults with the Academy of Nutrition and Dietetics at FNCE and co-created the webinar series, Dietetic Career Hack: The Complete Networking and Resume Guide and Dietetic Career Hack Part II: Interviewing Tips and Tricks. Her previous dietitian jobs have been in clinical, nutrition support, and research.