Undiagnosed thyroid disorders cost U.S. businesses over $50 billion in lost productivity annually, but well-run employee wellness ideas turned into programs can help reduce this cost while improving public health return on investment.
While many employee wellness programs often focus on benefits like gym memberships and vacation days, silent productivity killers like thyroid health are frequently overlooked. The American Thyroid Association (ATA) states that over 20 million people in the U.S. have thyroid disorders, with a staggering 60% of them undiagnosed.
The considerable impact of thyroid health on employee productivity is often blamed on the one-size-fits-all approach that many physicians take, typically prescribing medication like Levothyroxine. Many people with thyroid disorders still battle symptoms like fatigue, brain fog, and weight fluctuations that impact their productivity after receiving treatment, as the medication does not address the root cause and thus often is part of a non-tailored treatment plan without an understanding of what exactly is being treated.
Nutrition-led strategies guided by experts like registered dietitian Vincci Tsui, founder of Weight Inclusive Dietitians in Canada (WIDIC), can help close the thyroid care gap created by doctors who wrongly believe medication is all it takes to address thyroid imbalances.
She’ll join forces with Marion Davis, founder of Medical Office Marketing, during their June 19 webinar, “Are You Consuming Too Much Iodine?” to unpack how smarter dietary policies and thyroid education can improve employee health and save employers billions of dollars.
Imagine your top sales rep only hitting 60% of their quota during a quarter while complaining about fatigue, forgetfulness, and mysterious weight gain. The loss in productivity is being caused by a thyroid disorder, but the employee doesn’t know it yet, and your organization’s bottom line pays for it.
Thyroid disorders cause symptoms like fatigue, depression, weight gain, and brain fog, increasing employee presenteeism (showing up but not being there) and absenteeism.
Organizations can minimize the impact of productivity killers like thyroid disorders by developing programs that ensure employees with thyroid disorders are funneled to the right healthcare providers who can provide personalized nutrition counseling and help determine root causes. Employees can then be referred to specialists who can address the root causes of thyroid disorders, like spinal leak care.
The economic costs of the mismanagement of thyroid disorders include:
The average employee with an undiagnosed thyroid disorder can rack up about $2,000 yearly in direct costs like lab tests, medications, and clinic visits. That adds up to a $20 to $40 billion annual national burden.
These costs aren’t guaranteed to bring the desired results, as Levothyroxine, the go-to prescription for patients with hypothyroidism, often fails due to factors like:
Employers often end up paying for solutions that only work a fraction of the time when patients with thyroid disorders aren’t guided to specialists who can provide thyroid-friendly personalized meal plans.
The financial costs of untreated thyroid disorders hit public coffers much harder. For instance, it:
Healthcare premiums for families cost about $23,000 per employee annually, up 47% in the past decade. Providing reactive care rather than proactive care for employees no longer cuts it when chronic conditions like hypertension, obesity, and depression account for two-thirds of most organizations’ medical spend.
Rising Healthcare Costs and Employer Burden
Every dollar an organization spends on employee clinic visits, prescription drugs, and specialist referrals is a dollar that’s not spent on growth, innovation, or talent development. A wellness program that addresses productivity killers like thyroid imbalances considerably reduces an employer’s medical spend.
Link Between Wellbeing and Productivity
Data from Gallup shows that highly engaged employees are 21% more productive and 37% less likely to call in sick. Fostering a health-conscious culture that normalizes movement breaks, mental health, and healthy nutritional options directly increases innovation and productivity. There is often much talk of employee happiness and burnout, but when an employee is fighting to hang on with a thyroid disorder, there is little energy left for high levels of employee engagement.
Research shows that many thyroid disorders could be improved with simple approaches, such as educating employees on avoiding excess iodine intake while still achieving individual nutrition goals. Considering this, the ROI is immense for organizations hiring iodine-specializing registered dietitians to create employee and community education materials.
Public Health Implications
Reducing the prevalence of chronic diseases, which often are simply being poorly treated and are reversible with like thyroid disorders and persistent spinal leaks, in your workforce contributes to broader community health gains, including lower hospitalization rates, fewer disability claims, and diminished pressure on public health insurance programs like Medicare and Medicaid. Your return on your investment in community wellness programs is present in improving public health by reducing the strain on public health insurance programs, support programs, and so on.
Levothyroxine—the “Band-Aid” of thyroid care—might add synthetic T4 to a patient’s system who has low natural T4 levels, but it doesn’t address the root causes of imbalances. A third of patients on Levothyroxine still battle symptoms like fatigue, weight gain, and mood swings because medications can’t reduce iodine overload or nutritional gaps due to food avoidance because of sensitivities without guidance on what else to eat or how to navigate for the present to a future with more tolerances.
Think of the thyroid gland like an engine. Levothyroxine provides fuel in the form of the T4 hormone, but if the body is potentially already trying to stifle output from fuel due to being overwhelmed by too much iodine, this is what is called the Wolff-Chaikoff Effect. At times, if the body cannot stifle the overproduction of T4 from being given too much fuel, the body can flip into hyperthyroidism in the Jod-Basedow Effect, or escape from Wolff-Chaikoff, which is dangerous as the body flips into hyperthyroidism. Subclinical hypothyroidism without any concern for myxedema is not ideal but much less damaging to the body than severe hyperthyroidism.
The recommended daily allowance (RDA) of iodine is 150 mcg/day, but this comes from population studies where the RDA was made with the goal of slightly overestimating rather than underestimating needs to prevent birth defects.
Considering that 150 mcg/day could already be above what many people need, especially if they have an underlying issue causing iodine sensitivity, the average American consumes somewhere between 200 to 300 mcg daily thanks to sneaky sources of iodine like dairy, iodized salt, and especially in many healthy snack trends. Even small excesses of iodine in your diet can trigger flare-ups in patients with autoimmune thyroiditis or other underlying issues causing sensitivity.
Iodine is good for the thyroid, but in the right doses, since it's vital for thyroid hormone production. Not consuming enough iodine (less than 50 mcg/day for some people although some people may need less and some people may need more–especially if pregnant) can lead to the development of a goiter, an enlargement of the thyroid gland that is sometimes caused by the body’s attempt to compensate for not getting enough iodine. Iodine deficiency is not the only cause of a goiter, however, and goiters themselves have been shown to cause iodine sensitivity in some cases.
This is why care must be approached individually in every patient, treating the whole human and not the lab numbers–asking questions about what the patient is eating and why, when did certain dietary habits start, why did the patient start avoiding certain foods or adding certain foods if true. All of these give clues.
Some case studies demonstrate just how poorly endocrinologists are managing patients in the US, such as in one case study where a man in his 20s was avoiding iodine-rich foods due to dietary sensitivities and ended up with iodine deficiency, hypothyroidism, and a grade II goiter. The endocrinologists started him on a 150 mcg/day iodine supplement rather than slowly titrating iodine up and waited three months to follow up. At follow-up, they declared him to be euthyroid (normal, balanced thyroid) despite the fact that one of his thyroid hormone numbers was now at the low end of normal range, showing a risk factor for going into hyperthyroidism. Recovering from hyperthyroidism and hypothyroidism is like setting off a pendulum swing; just because the pendulum swung once through normal range doesn’t mean the body is good to go. Careful monitoring is needed as the pendulum loses momentum to vary significantly in either direction and instead deviates less and less from normal range. In the case study, as the man’s goiter had decreased in size and his TSH lowered, he was able to tolerate more iodine-rich foods without discomfort. The researchers noted that he then added high amounts of egg and fish to his diet while continuing the 150 mcg/day iodine supplement. The endocrinologists as researchers did not note any concerns here about sudden iodine introduction in large quantities from food and a supplement now (basically the pendulum was hit hard again with a shock to the system) and seemed to assume the patient would be fine until he reappeared with palpitations and in significant discomfort. Sure enough, he had entered into iodine-induced hyperthyroidism. The endocrinologist-researchers simply reduced his iodine supplement rather than asking how much iodine was in his daily diet as well.
Too much iodine can trigger an autoimmune destruction of thyroid cells or overstimulate hormone production. For patients with health disorders causing iodine sensitivity, even moderate excesses in either direction can lead to debilitating symptoms.
Employers should partner with registered dietitians (RDs) and physicians specializing in this area to assess iodine intake, test for micronutrient deficiencies, create personalized nutrition plans, and teach employees how to manage their iodine intake.
Let’s explore some of the ways employers unknowingly contribute to the thyroid crises:
The average break room is an iodine trap because many popular snacks contain it. Some of the worst offenders include:
Even “healthy” office snacks aren’t so great for the thyroid gland:
Some of the ways organizations can safeguard the thyroid health of their employees include:
Employers can save $7 in productivity and healthcare costs for every dollar invested in thyroid education. Here’s the math behind the 7:1 ROI formula:
Here are some ideas to help you get started on your organization’s wellness programs:
Promoting movement at work is a fundamental part of employee wellness since most spend the majority of their time sitting in front of a desk. You can promote movement by offering on-site fitness classes like yoga, high-intensity interval training (HIIT), or pilates, and pair them with virtual workout subscriptions for remote employees. Empower employees to choose what fitness approach works best for them to boost engagement.
You can also create walking challenges where teams compete on step counts with wearable trackers, creating friendly competitions incentivized with gifts for winning teams.
Organizations can also create ergonomic assessment programs coupled with stipends for standing desks, which helps mitigate musculoskeletal disorders, which cost U.S. employers an estimated $20 billion in workers' compensation claims annually, according to the Bureau of Labor Statistics (BLS).
Stress and burnout reduce productivity, but employers can minimize their effects by providing stress-management tools to employees, such as on-demand coping tools and confidential counseling through employee benefit programs.
Designate quiet rooms where employees can go to recharge away from stressors on the work floor.
The foods and beverages employees consume affect their energy levels, cognitive function, and long-term health. Start by overhauling your cafeteria menu to ensure it offers healthier, nutrient-dense food options like lean proteins, whole grains, and fresh produce. Install smart snack stations that rotate seasonal fruits, raw nuts, and low-sugar snacks instead of the candy and chips typically found.
Employers can also provide virtual cooking demonstrations hosted by registered dietitians. These live sessions foster engagement and empower staff to make informed food choices at home and on the road.
Complement demos with downloadable meal-planning guides that break down micronutrient content like sodium, iodine, or selenium, so employees learn how to read between the lines of nutrition labels.
Prevention is the foundation of any impactful wellness strategy. Host on-site health-screening events where employees can get free blood pressure, cholesterol, glucose, and body mass index (BMI) checks.
Partner with local or mobile clinics to offer services like flu shots, vaccination drives, and biometric screenings that feed data directly into anonymous health-risk assessments. These assessments let you flag potential issues, like a spike in prediabetes risk, so you can customize follow-up programs like diabetes education workshops or nutrition counseling. Personalized risk reports also serve as powerful motivators. Employees are more likely to take action when they see concrete data about their health.
Employers should reinforce that preventative care isn’t a one-and-done affair by scheduling quarterly checkups, sending friendly reminders, and celebrating milestones. Creating a wellness culture that prioritizes preventative care fosters a shared responsibility for health while reducing your organization’s medical spend. You also get to boost public health as a return on your investment.
Some of the steps employers should take to launch wellness programs that focus on thyroid health include:
Any wellness program falls flat without engagement. Some ways to keep participation high include:
Invest in platforms like Wellable to manage the logistics of wellness programs, track participation, and display real-time progress. These tools allow employees to set goals, join challenges, and access resources from their phones or laptops.
Sync wellness programs with existing HR software or benefits platforms so enrollment and usage feel seamless. Use analytics to calculate the return on investment of your employee wellness programs idea and public health.
Levothyroxine isn’t a cure-all solution for thyroid disorders. A shift to a nutrition-first care guided by dietitians like Vincci Tsui could save employers billions of dollars and transform public health outcomes.
Join Vincci Tsui, an RD and founder of Weight-Inclusive Dietitians in Canada (WIDIC), and Marion Davis, a spinal CSF leak patient experience consultant and founder of Medical Office Marketing, at our June 19 webinar on “Are You Consuming Too Much Iodine? Excess Intake & Thyroid Disorders” to explore:
…And much more!
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