DISORDERS

Description: The thyroid is a small, somewhat butterfly-shaped structure located at the base of the neck. The hormone it produces, thyroxine (also known as T4) is converted in the liver into another hormone, triodothyronine (T3), which regulates metabolism. The thyroid gland is the body’s internal thermostat. It regulates the temperature by secreting two hormones that control how quickly the body burns calories and uses energy. If the thyroid secretes too much hormone, hyperthyroidism results. Too little hormone results in hypothyroidism. There are different types of hyperthyroidism. One of the most common is Graves’ disease. This is believed to be an autoimmune disorder in which the immune system produces antibodies that stimulate the thyroid to produce excessive amounts of thyroxine. Another type of hyperthyroidism is toxic multinodular goiter, or Plummer’s disease. For reasons unknown, some of the nodules in the thyroid fail to respond to the normal chemical messages that govern thyroid function, and begin producing excessive amounts of thyroid function. Thyroid storm is an uncommon but very serious form of hyperthyroidism that comes on suddenly and causes severe symptoms, including fever, wild mood swings, muscle-wasting with marked muscle weakness, anxiety, confusion, and even overt psychosis or coma. There may also be liver enlargement and jaundice. This disorder must be treated as an emergency.

Symptoms: Symptoms can range from mild to severe.

One of the primary symptoms of hyperthyroidism is a disturbance in appetite. You may find you have little interest in food, or you may be much hungrier than normal. No matter how much you eat, however, you will likely experience noticeable weight loss. Other symptoms of hyperthyroidism include fine tremors of the hands and fingers; warm, moist palms; fatigue; irritability; nervousness; rapid heartbeat; heart palpitations; elevated blood pressure; sleep disturbances; bulging eyes; breathlessness; frequent bowel movements; stomach and intestinal spasms; muscle weakness; intolerance to heat; profuse perspiration; hair loss; and light, infrequent menstrual periods. As the disease progresses, a swollen thyroid gland may become apparent; this is known as a goiter. It usually occurs in people who are deficient in iodine, which the thyroid needs in order to function.

A deficiency of thyroid hormones, or hypothyroidism, causes fatigue, followed by apathy and lethargy. Unexplained weight gain is common. Other symptoms include loss of appetite; inability to tolerate cold; a slow heart rate; painful premenstrual periods; a milky discharge from the breasts; fertility problems; muscle weakness; muscle cramps; dry and scaly skin; a yellow-orange coloration in the skin (particularly on the palms of the hands); yellow bumps on the eyelids; hair loss (including the eyebrows); recurrent infections; constipation; depression; difficulty concentrating; slow speech; goiter; and drooping, swollen eyes. The most common symptoms are fatigue and intolerance to cold. If you consistently feel cold while others around you are hot, you may be suffering from reduced thyroid function. Hypothyroidism, sometimes also called myxedema often progresses so slowly that the affected person may not be aware of the problem, and early symptoms like forgetfulness, slowed reaction, tiredness, and weight gain may be attributed to other causes.

Incidence: Hyperthyroidism is not as common as hypothyroidism. Both of these thyroid disorders affect women more than men. Hyperthyroidism affects about one percent of the population, occurs most often between the ages of twenty and forty, and often arises after an infection or following physical or emotional stress.

Causes: The exact cause is not understood, but the immune system can produce antibodies that invade and attack the thyroid, disrupting hormone production. Hyperthyroidism can also be caused by lumps or tumors that form on the thyroid and disrupt hormone production. Infection or inflammation of the thyroid can cause temporary hyperthyroidism, as can certain prescription drugs. Most cases of hypothyroidism are a result of Hashimoto’s thyroiditis, an autoimmune disorder in which the body mistakenly develops antibodies that attack the thyroid gland, resulting in inflammation and, ultimately, destruction of thyroid tissue.

Treatments: Both hyperthyroidism and hypothyroidism are diagnosed by measuring the levels of thyroid hormones present in the blood. Synthetic copies of the hormone thyroxine (T4), the hormone produced by the thyroid gland, is the drug of choice in treatment of hypothyroidism. In most cases, hormone therapy must be continued throughout life. The blood levels of thyroid hormone must be checked regularly, as hormone requirements can fluctuate, which affects the dosage. Hypothyroidism is a chronic disorder that cannot be cured, but that can be managed successfully.

Hyperthyroidism is usually first treated with drugs that lower the output of thyroid hormone. If these drugs are ineffective or cause intolerable side affects, your doctor may recommend a procedure to destroy overactive thyroid tissue. This is done by taking radioactive iodine, or I-131, which destroys enough of the gland’s cells to bring the production of thyroid hormone down to a normal level. Treatment may also include beta-blocker type drugs to control they symptoms of hyperthyroidism.

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