INTRODUCTION TO THE THYROID GLAND:
All of us have a small gland in our necks called the Thyroid gland. Normally it is not visible and we cannot feel its presence inside us. It sits comfortably in its bed and does a lot of good to us through its excretions (hormone) which are synthesized by Iodine. These hormones are essential for the function of every cell in the body. They help regulate growth and the rate of chemical reactions (metabolism), and are involved in the circadian rhythms that govern sleep, among other essential functions. Optimum human health is not possible without adequate supply of Thyroid hormones. So this small gland which is not seen by others and is not felt by ourselves is critical to our health. That is why the over production of these hormones causes a disease called Hyperthyroidism which is our topic in this blog.
IODINE AND THYROID HORMONES:
The two most important thyroid hormones are thyroxine (T4) and triiodothyronine (T3), and Thyroid stimulating hormone (TSH), which is produced by the pituitary gland in the brain. The thyroid also makes the hormone Calcitonin, which is involved in calcium metabolization and stimulating bone cells to add calcium to bone. It is the same Iodine which is presentin Sea weed, Fish (Cod, Shrimp and Tuna etc), milk, Corn, Prunes, Banana, Cheese, Cereal, Apple juice, and some vegetables. If the level of Iodine drops in our blood and remains low for prolonged period of time we can have enlargement of thyroid gland (also called as Goiter) or a disease Hypothyroidism (we will talk about it in another blog). Remember it is the lack of Iodine in the diet which causes the Thyroid gland to swell.
The Goiter shown in this picture is pretty large and usually represents very long standing Iodine deficiency. But sizes even greater than this are a pretty common site in some areas of the world where the Iodine content of the water is below normal. Use of table salt containing Iodine is therefore advised in such areas. Please remember that some young females have what is called as Physiological Goiter. That is small, diffuse enlargement of thyroid gland in menstruation and pregnancy. This condition is mostly self limiting and is mainly due to hormonal changes in the body.You can have hyperthyroidism with or without thyroid gland swelling.
RISK FACTORS IN THE PRODUCTION OF HYPERTHYROIDISM:
The risk factors for development of hyperthyroidism or Graves’ disease include personal or family history of thyroid or autoimmune disease, recent pregnancy, and exposure to Iodine, among other factors. Women are affected by this illness 8 times more than men.
So it can be said that this is predominantly a disease of women. The riskiest age for developing Graves’ disease and hyperthyroidism is between 20 and 40. Pregnancy and the year after childbirth are both times of greater risk for this disease. There is an increased risk of Graves’ disease in smokers. Smokers with this disease tend to have more severe symptoms like thyroid Opthalmopathy feature (the prominent eye problems or the protrusion of eye balls) that are more resistant to treatment. Some treatments and medications can trigger Graves’ disease and/or thyrotoxicosis in some people, including: Interferon Beta-1b and Interleukin-4, immunosuppressant therapy for Hepatitis, antiretroviral treatment for AIDS, and lithium, widely used to treat Depression and Manic Depressive illness. There are two particular treatments that are known triggers hyperthyroidism: a third of patients receiving monoclonal antibody (Campath-1H) therapy for multiple sclerosis (MS) develop Graves’ disease within six months, and receiving a donated organ or bone marrow transplant from someone with Graves’ disease can also cause the disease in the recipient. Talking of risk factors in the production of hyperthyroidism it may be kept in mind that Stress is a factor that appears to trigger the onset of Graves’ disease in some patients. There is a definite connection between major life stressors – i.e., death of a spouse or close family relative/ friend, divorce or separation, loss of a job, major accident/personal injury, moving, marriage – and the onset of this disease.
SYMPTOMS OF HYPERTHYROIDISM and its treatment (What you should be experiencing if you are suffering from it):
As the thyroid gland acts upon our body through its hormones in numerous number of ways, it is often difficult for the doctor to correctly diagnose this condition on the symptoms alone. Most of the symptoms are vague and are present in so many other conditions also. At such times the laboratory comes to the help and decides the onset of this disease as the levels of hormones are disturbed. Most frequent symptoms are:
* Sudden weight loss, even when your appetite and diet remain normal or even increase,
* Rapid heartbeat — commonly more than 100 beats a minute; irregular heartbeat (arrhythmia) or pounding of your heart (palpitations),
* Nervousness, and anxiety,
* Tremor — usually a fine trembling in your hands and fingers,
* Excessive sweating,
* Changes in menstruation patterns,
* Increased sensitivity to heat, or heat intolerance,
* Changes in bowel patterns, especially more frequent bowel movements, or loose motions,
* An enlarged thyroid gland (goiter), which may appear as a swelling at the base of your neck,
* Fatigue, muscle weakness, feeling of not being well,
* Difficulty in falling sleep.
* Staring eyes (Hyperthyroid Opthalmopathy).
Older adults are more likely to have either no signs or symptoms or some very subtle ones, such as an increased heart rate, heat intolerance and a tendency to become tired easily. Medications called beta blockers, which are used to treat high blood pressure and other conditions, can mask many of the signs of hyperthyroidism. So never use any medication unless your doctor has prescribed it after careful evaluation of your symptoms and with the help of available laboratory tests.
Prompt diagnosis and treatment of hyperthyroidism can lead to a good prognosis or a cure in some cases. With regular medical care and compliance with treatment plans, most of the people with the disease live active, normal lives. It may be emphasized that patients with hyperthyroidism may need Radio active Iodine treatment (also called as medical thyroidectomy), surgery (removal of the whole or part of the thyroid gland), and various drugs to be taken for considerable periods of time. At the end of which, you should be sure, that even if it is not completely cured, your life will be as near normal as possible and you will enjoy all the activities of a normal healthy being.
CAN IT BE SERIOUS:
Hyperthyroidism can lead to serious, potentially life-threatening symptoms and complications, such as cardiac arrhythmias and heart failure. Seek immediate medical care if you, or someone you are with, have symptoms such as unexplained weight loss, hair loss, frequent bowel movements, excessive sweating, weakness, joint and body pains and aches, tachycardia (palpitations), heat intolerance, irritability, anxiety, irregular periods / excessive bleeding (in women only), loss of hair, loss of sleep, chest pain, or shortness of breath.
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