Get to know your Thyroid

The function of the hormones is to regulate numerous metabolic processes throughout the body. The production of these hormones is regulated by a feedback mechanism involving the brain.

When thyroid hormone levels are low, the hypothalamus in the brain produces a hormone known as thyrotropin, releasing hormone TRH that causes the pituitary gland, located at the base of the brain, to release the thyroid stimulating hormone TSH.

TSH stimulates the thyroid gland to release more T4. Since the thyroid gland is controlled by the pituitary gland and hypothalamus, disorders of these tissues can also affect thyroid function and cause thyroid problems.

The most common thyroid problems involve abnormal production of thyroid hormones. Too much thyroid hormone results in a condition known as hyperthyroidism. Insufficient hormone production leads to hypothyroidism.

Thyroid disorders can range from a small, harmless goitre (enlarged gland), that needs no treatment, to life-threatening cancer. Although the effects can be unpleasant or uncomfortable, most thyroid problems can be managed well if properly diagnosed and treated.

Hyperthyroidism, particularly Graves’ disease, tends to run in families and is more common in women than in men.

Causes of Thyroid problems

• Hyperthyroidism: All types of hyperthyroidism are due to an overproduction of thyroid hormones, but the condition can occur in several ways.
• Graves’ disease: The production of too much thyroid hormone by the gland.
• Toxic adenomas: Nodules develop in the thyroid gland and begin to secrete thyroid hormones, upsetting the body’s chemical balance; some goitres may contain several of these nodules.
• Subacute thyroiditis: Inflammation of the thyroid that causes the gland to produce excess hormones, resulting in temporary hyperthyroidism that generally lasts a few weeks but may persist for months.
• Pituitary gland malfunctions or cancerous growths in the thyroid gland: Although rare, hyperthyroidism can also develop from these causes. Hypothyroidism happens because of an underproduction of thyroid hormones. Since your body’s energy production requires certain amounts of thyroid hormones, a drop in hormone production leads to lower energy levels.

Causes of hypothyroidism include: 

• Hashimoto’s thyroiditis: This is an autoimmune disorder where the body attacks its own thyroid tissue. The thyroid tissue eventually dies and stops producing hormones.
• Removal of the thyroid gland: The thyroid may have been surgically removed or chemically destroyed.
• Exposure to excessive amounts of iodine: This can happen from exposure to cold and sinus medication, the heart medicine amiodarone, or certain contrast dyes given before some X-rays may expose you to too much iodine.
• Lithium: This drug used to treat mental illness has also been implicated as a cause of hypothyroidism.

A defective thyroid gland or lack of it entirely, seen in infants and newborns. Hypothyroidism is especially a danger to newborns and infants.

A lack of thyroid hormones in the system at an early age can lead to the development of cretinism (mental retardation) and dwarfism (stunted growth). Most infants now have their thyroid levels checked routinely soon after birth. If they are hypothyroid, treatment begins immediately.

A hypothyroid infant is unusually inactive and quiet, has a poor appetite, and sleeps for excessively long periods of time. Cancer of the thyroid gland is quite rare and occurs in about 5% of thyroid nodules. You might have one or more thyroid nodules.

For several years before nodules are determined be cancerous, people who have received radiation treatment to the head and neck earlier in life, possibly as a remedy for acne, tend to have a higher-than-normal risk of developing thyroid cancer.

Signs and symptoms

For several years before nodules are determined be cancerous, people who have received radiation treatment to the head and neck earlier in life, possibly as a remedy for acne, tend to have a higher-than-normal risk of developing thyroid cancer.

Hyperthyroidism

The body metabolism speeds up and cause symptoms that are common to hyperthyroidism when there’s a high level of thyroid hormone in the bloodstream. Symptoms include:

• Anxiety
• Irritability
• Fatigue
• Hand tremors
• Increased or irregular heartbeat
• Excessive sweating
• Difficulty sleeping
• Diarrhoea or frequent bowel movements
• Altered menstrual cycle
• Enlarged thyroid (goitre) seen as swelling in the front of the neck
• Breathing or swallowing difficulties
• Bulging eyes and vision problems
• Increased appetite with weight loss

Hypothyroidism

It is now understandable that people with this condition will have symptoms associated with a slow metabolism which include: v Fatigue v Weakness v Weight gain or increased difficulty losing weight

• Coarse, dry hair
• Dry, rough pale skin
• Hair loss
• Cold intolerance (you can’t tolerate cold temperatures like those around you)
• Muscle cramps and frequent muscle aches
• Constipation v Depression
• Irritability
• Memory loss
• Abnormal menstrual cycles
• Decreased libido

Each individual patient may have any number of these symptoms, and they will vary with the severity of the thyroid hormone deficiency or excess and the length of time the body has been having the condition.

Some of the symptoms appear in both hypothyroidism and hyperthyroidism. One may have one of these symptoms as the main complaint, while another will not have that problem at all and will be suffering from an entirely different symptom.

Most people will have a combination of these symptoms. Occasionally, some patients have no symptoms at all, or they are just so subtle that they go unnoticed. If you have any of these symptoms, you need to discuss them with your doctor.

In practice, for example, we have seen people struggling to lose weight for a while even on proper diets and exercise, then on further investigation you find out the patient actually has hypothyroidism.

Lifestyle changes if you have Hyperthyroidism

• Diet supplements: If you’ve lost a great deal of weight or experienced muscle wasting, you may benefit from adding extra calories and protein to your diet. Your doctor or a dietitian can help you with meal planning. Treatment for hyperthyroidism can also eventually contribute to excessive weight gain, so please combine with exercise. It is important to learn how to get as much nutrition as possible from your food without eating a lot of extra calories. In addition, eating the correct amount of sodium and calcium are important dietary considerations for people with hyperthyroidism.
• Get enough calcium and vitamin D: Because hyperthyroidism may contribute to thinning bones, it’s important to get enough calcium every day to help prevent osteoporosis. Talk to your doctor about dietary guidelines for you. v
• Eye problems: Apply cool compresses to your eyes. The extra moisture may provide relief. Wear sunglasses. When your eyes protrude, they’re more vulnerable to ultraviolet rays and more sensitive to sunlight. Wearing sunglasses helps protect them from both sun and wind. Use lubricating eyedrops. Eyedrops may help relieve dryness and scratchiness. Be sure to use eyedrops that don’t contain redness removers. Because your eyelids may not cover the entire eye when sleeping, a lubricating gel can be used before bed to prevent drying out. Elevate the head of your bed. This may reduce swelling and relieve pressure on your eyes.
• Skin problems: Try over-the-counter creams for swollen skin. Over-the-counter creams containing hydrocortisone may help relieve red, swollen skin on your shins and feet. For help finding these creams, talk to your pharmacist.

And for Hyperthyroidism

There is no substitute for getting a proper diagnosis and starting hormone replacement treatment if you have hypothyroidism, but leading a healthier lifestyle will help you feel better faster. Try these five easy tips to implement lifestyle changes:

• Eat a Healthy Diet: Eating well improves your energy levels, which is important in the face of daytime sleepiness and hypothyroid-related fatigue. Eat small, nutrient dense meals throughout the day to keep your engine revved. Hypothyroidism is linked to weight gain and can make it harder to lose weight. Eating a healthy diet that is low in carbohydrates will help you lose weight and/or maintain your weight. There’s no single diet or magical nutrient that will improve your thyroid function. Talk to your doctor or a nutritionist about the best way to eat.
• Shape Up: Exercising is likely the last thing you feel like doing when your thyroid is sluggish, but getting regular physical activity will boost your energy, help with weight loss efforts, and lower your stress levels. Aim for 150 minutes of moderate-intensity aerobic activity a week such as brisk walking and include some toning exercises that target key muscle groups including legs, hips, back, abdomen, chest, shoulders, and arms.
• De-stress: Stress can make hypothyroidism worse, but taking steps to change how you cope with it can make a big difference in how you feel. Yoga, meditation, deep breathing, or just chilling out to some relaxing music can all help reduce stress and anxiety. Find a stress-reducing technique that works for you.
• Sleep More Soundly: Even though you are dragging through the day, it can be hard to fall and stay asleep at night if you have hypothyroidism. Getting enough good quality sleep will improve your daytime fatigue. Set and stick to a regular wake and bedtime, keep your bedroom cool, cold and cave-like, and avoid caffeine after 2pm.

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