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Hyperthyroidism: (The Overactive Thyroid)

Hyperthyroidism is an over functioning of the thyroid gland. This over functioning results in the production of too much thyroid hormone. Because the thyroid hormone controls many bodily functions, this increase in the thyroid hormone level causes these bodily functions, such as heart rate, or in some cases blood pressure, to increase, sometimes to very dangerous levels

Causes

Hyperthyroidism can be caused by:

• Graves' disease, which is an autoimmune disease

• Toxic nodules or goiters on the thyroid

• Excessive thyroid medication given to hypothyroid sufferers

• Iodine excess

• Thyroiditis (an inflammation of the thyroid)

Symptoms

It is easier to recognize. The person is jittery, suffers anxiety, has sweaty palms and feet, feels tired and sleepy, experiences continued weight loss, there is tremor of the outstretched hands. the pulse is inexplicably fast, the eyes become prominent due to inflammation of the tissues behind the eyeball (the medical term is exophthalmos), blurred or diminished vision, red or inflamed eyes, double vision, and a fall in efficiency levels. In short, the system is in overdrive. 

If left untreated, hyperthyroidism may cause the bones to become softer and women past menopause may suffer osteoporosis. Younger women may also suffer repeated miscarriages and even infertility.

Other symptoms:

• Fatigue

• Sweaty palms

• Weight loss

• Fine brittle hair

• Restlessness

• Depression

• Increased appetite

• Changes in sex drive

• Muscle weakness, especially in the upper arms and thighs

• Shortened attention span

• Heat intolerance

• Increased sweating

• Nervousness and irritability

• Restless sleep or insomnia

• Erratic behavior

• For women, irregular menstrual cycle and reduced menstrual flow

• Infertility, recurrent miscarriage

• Increased frequency of bowel movements

How can a doctor diagnosis one of the variations of hyperthyroidism?

Initial diagnosis usually simply requires a physical examination for the following:

• Enlarged thyroid gland

• Rapid heart beat (tachycardia) or heart palpitations

• Smooth, velvety skin

• Tremor of the fingertips

• For Graves' disease, Check eyes and skin for more click here.

Hyperthyroidism/Graves' Disease and Pregnancy

Hyperthyroidism � or having an overactive thyroid gland � can pose special concerns during pregnancy. When the body delivers too much thyroid hormone, both the mother and the baby can suffer. Miscarriages, premature births, and intrauterine growth retardation can occur when the disorder goes undiagnosed or untreated. Pregnant women with hyperthyroidism can also develop high blood pressure, and are at greater risk of heart conditions.

Many doctors will advise a woman with hyperthyroidism to get a permanent treatment -- such as radioactive iodine (RAI) or surgery -- before even trying to get pregnant. The best way to ensure a positive outcome is to find a well-trained obstetrician and endocrinologist familiar with the issues that might occur in a hyperthyroid pregnancy, take the appropriate medication, and closely monitor your thyroid levels in a timely manner. Think of your successful pregnancy as a team effort between all your health care providers, and most importantly, you.

Treatment

Drugs:
 The first course of action - when the disease is mild, is a course of anti-thyroid drugs, such as propylthiouracil (PTU) and methimazole (Tapazole ). These drugs make it more difficult for your thyroid to use the iodine it needs to make the thyroid hormone, resulting in a decrease in thyroid hormone production. Although both drugs can be used during pregnancy, PTU is preferable. There are two medications which are typically used for controlling hyperthyroidism in pregnancy: methimazole (Tapazole) and propylthiouracil (PTU). Usually PTU is the drug of choice, since it's considered safer during pregnancy and causes less risk of crossing the placenta or harming your baby's developing thyroid gland. Some antithyroid drugs are never used during pregnancy, like Tapazole, which can be associated with some birth defects. Radioactive iodine (RAI) treatment is not done during pregnancy, because it can harm the baby's thyroid gland.

Radioactive Iodine:
 Another course of treated is with radioactive iodine, otherwise known as RAI. This RAI is administered by mouth, by means of a capsule or a liquid. What happens then is that the RAI goes from the stomach into the bloodstream and eventually into the thyroid gland. The RAI lodges there because the thyroid gland needs iodine to produce the thyroid hormone and therefore the thyroid gland will readily pick up the iodine from the bloodstream. In the thyroid gland, the radiation destroys some of the thyroid cells, thereby reducing production of the thyroid hormone.

Surgery:
 Besides drug & radiation, a surgery to remove all or part of the thyroid gland (known as a thyroidectomy) will permanently cure hyperthyroidism. The goal of the surgery is to remove just enough of the gland so that thyroid production is back to normal. A number of factors will needed to be considered before opting for surgery like age, state of health etc.

Other Treatment:
 A class of drugs known as the beta adrenergic blocking agents block the action of thyroid hormone on your body, and usually make you feel better within hours, even though they do not change the high levels of thyroid hormone in your blood. Propranolol (Inderal�) was the first of these drugs to be developed. Related but longer-acting beta- blocking drugs such as atenolol (Tenormin�), metoprolol (Lopressor�) and nadolol (Corgard�), and Inderal-LA� are now preferred by some physicians because of their more convenient once- or twice-a-day dosage. Except for hyperthyroidism caused by thyroiditis, these drugs are not the only form of therapy, but are used in combination with other treatments that are specifically directed towards the thyroid gland

Hypothyroidism: (The Underactive Thyroid)

 Hypothyroidism, also known as myxedema, is an underproduction of the hormone thyroxine by the thyroid gland in the front of the neck. This underproduction affects metabolism and energy efficiency and is associated with fatigue, general sluggishness, depression, and weight gain

In hypothyroidism, the system slows down. Movements become slower, hair and eyes become dull, face and feet swell, the person is constipated, feels cold, gains weight, gets fatigued easily and has trouble concentrating.

Untreated hypothyroidism can affect the brain, causing memory loss, hearing defects, depression and even psychotic disorders. It may also push up cholesterol levels, leading to heart disease.

Causes

Hypothyroidism can be caused by

• An autoimmune disorder, 

• Surgical or radiation treatments to correct hyperthyroidism, or

• Hashimoto�s disease. Hashimoto�s disease is the most common cause of hypothyroidism and is when the body becomes allergic to its own thyroid hormones, which is also a common cause of goiter. 

It can also occur at any age, right from birth. In children, though, hypothyroidism is dominant . It is manifested in retarded growth, short stature, poor scholastic performance. However, unlike as in adults, early diagnosis is paramount especially in a newborn. Since the gland controls development, if undetected the child may suffer mental and physical retardation.Thyroid disorder can be hereditary, especially if the mother suffers from it.

Symptoms

The thyroid is the body�s internal thermostat which regulates temperature by secreting hormones that control how fast calories are burned and how the body uses energy. A person with hypothyroidism may experience symptoms of 

• Fatigue

• Loss of appetite

• Intolerability to cold

• Slow heart rate

• Weight gain

• Hair loss

• Dull looking hair

• Recurrent infections

• Constipation

• Depression

• Painful premenstrual periods

• Milky discharge from breasts

• Fertility problems 

• Muscle weakness

• Muscle cramps

• Dry and scaly skin

• Yellow-orange coloration of the skin, especially on the palm of the hands

• Difficulty concentrating

• Slow speech

• Goiter

• Drooping, swollen eyes

• Bloated face, and 

• Decrease in energy 

Treatment

Hypothyroidism is easily controlled, but incurable. If untreated it can lead to death. Thyroid hormone replacement comes in pill form and must be taken each day at the same time. Names of thyroid hormone pills are Armour, Cytomel, Eltroxin, Euthroid, Levothroid, Levoxine, Proloid, Synthroid, Thyrar, Thyrocine, and Thyrolar. Because these pills affect the endocrine system, they can affect other hormonal medications. There are some lifestyle modifications that need to be incorporated for better management of hypothyroidism:

Medicine Interactions:
 Birth control pills, Cholestyramine, and Colestipol all decrease the affect of the thyroid medication, and should therefore be taken at a different time of day. For example, take thyroid medication first thing in the morning, and take all other medications at lunch or at bedtime. It is also important for a person with hypothyroidism to take extra calcium because levothyroxine, a drug in Synthroid and other thyroid medicines, was shown to cause a loss of up to 13% bone mass in a study by the University of Massachusetts School of Medicine. 19 million people in the U.S. are on this medication for hypothyroidism and other thyroid disorders. 

Diet Modification:
 In addition to taking thyroid hormone replacement, dietary changes can also help control hypothyroidism and its symptoms. An increased consumption of iodine (found in great abundance in kelp and algae) can improve the functioning of the thyroid. Because low plasma levels have been associated with hypothyroidism, L-Tyrosine is also an important supplement. Certain foods further suppress the thyroid and should therefore be avoided. These include; brussel sprouts, cruciferous vegetables (cabbage, broccoli, etc.), peaches, pears, spinach, turnips, and processed and refined sugars and foods. In addition, it is important to avoid fluoride (found in toothpaste and tap water) and chlorine (also found in tap water). Chlorine, Fluoride, and Iodine are chemically related and chlorine and fluoride block iodine receptors in the thyroid, resulting in reduced iodine-containing hormone production. B-vitamins and essential fatty acids also play an important role in proper thyroid function. 

Eat a low fat, low carbohydrate, protein sufficient diet. This means that in addition to the usual restrictions of a low-fat diet, you also need to seriously limit intake of sugar and starches, cutting back on pasta, rice, potatoes, white flour breads, cereal, corn, peas, sweet potatoes, desserts, dairy products, meats, and fruit with a high sugar content. Shifting to a diet of chicken, turkey, fish, non-starchy vegetables, legumes, and certain grains is an answer. And for those who are insulin resistant, once you start eating this way, you'll find it easier, as your carbohydrate cravings will subside dramatically.

Magnesium is typically deficient in hypothyroidism, and the safest way to get it is by using orange juice and meats, and by using epsom salts baths; magnesium carbonate can be helpful, if the person doesn't experience side effects such as headaches or hemorrhoids

Exercise/Fitness:
 The best way to kick-start your metabolism and reduce insulin levels is to get into a regular exercise program. For only 40 minutes, 3 times a week, the Ultimate Thyroid Exercise Program doesn't even require any extra equipment, just sneakers and a watch, and a willingness to get moving to lose weight and get healthy.

You can approach aerobic exercise followed through an "Interval" training approach that allows you to start at any level of fitness you are capable of, and builds in an improvement in your fitness over time. You should strive to do this at least 3 times a week.

Typically one hour per day, each and every day is required, until ideal weight is achieved. The one-hour can be split into two or three sessions and the exercise needs to be relatively intense. I explain to patients it should be just below the threshold where they lose the ability to talk comfortably to someone standing next to them. If they can talk easily they are not working out hard enough. Of course one needs to gradually build up to this level and have clearance from their physician if they have heart disease.

Besides, Yoga is an excellent alternative form of healing that is very suited to the needs of thyroid patients. For beginners, yoga's gentle stretching and emphasis on breathing can be done by almost anyone, and reap immediate rewards in terms of energy, reduction of stress levels, flexibility and reduction of muscle and joint stiffness, and much much more in terms of peace of mind and general harmony.

Hypothyroidism and Pregnancy

 The key in dealing with your thyroid condition during pregnancy is close monitoring of your TSH and T3 and T4 levels and compliance with your treatment regimen. Many guidelines say that a pregnant woman with hypothyroidism should have her thyroid function checked during each trimester. In particular, it's known that the thyroid hormone dosage requirement can increase in the early part of pregnancy due to the increased estrogen levels of early pregnancy. Remember, you are your baby's only source of thyroid hormones at this point - your baby's thyroid gland isn't fully functional until after 12 weeks of pregnancy. If you don't have sufficient thyroid hormones, you are at an increased risk of miscarriage, and your baby is at increased risk of developmental problems. Consult with a cutting-edge endocrinologist or thyroid expert who is willing to monitor not only your TSH but your FT4 levels throughout your pregnancy. The best things you can do to ensure a healthy outcome is comply with your treatment, make sure your endocrinologist and/or ob-gyn truly understand hypothyroidism and pregnancy, ask questions of your doctor, and finally, relax.

Hypothyroidism is easy to diagnose and easy to treat, but can have serious consequences if not treated properly. Symptoms of this condition will progress into very serious medical problems if the thyroid hormones that your body does not produce on its own are not replaced synthetically. Treatment may not make symptoms completely vanish, but it will stop them from progressing further. If you have hypothyroidism, your doctor should check your blood levels every six months at the beginning of treatment, and every 12 months after your hormone levels are back in balance.