Hyperthyroidism
When thyroid levels are too high, it is called hyperthyroidism. Hyperthyroidism occurs in approximately 1% Americans and affects women up to 10 times more often than men. Mild forms may cause not symptoms but more often than not symptoms are uncomfortable, disabling or even life threatening.
Signs and Symptoms
Thyroid hormone excess, especially T3, can produce a variety of symptoms
- Anxiety, irritability
- Fatigue
- Depression
- Mood swings
- Sleep disturbances, including insomnia
- Diarrhea or loose, frequent bowel movements
- Cardiac arrhythmias
- Heart palpitations and tachycardia
- High blood pressure
- Weight loss
- Heat intolerance
- Sweating
- Decreased menstrual flow
- Impaired fertility
- Muscle weakness, especially of the upper arms and thighs
- Thinning scalp hair
- Smooth skin
- Fine tremor
- Changes in vision, photophobia, eye irritation. diplopia, or exophthalmus
- Pretibial myxedema (in patient’s with Grave’s disease)
- Tendency of fingernails to separate from the nail bed
- Rapid bone growth, specifically around the eyes, and protruding eyes. Suppressing TSH may elevate parathyroid levels, resulting in osteoporosis (less likely to occur in women receiving HRT and plenty of vitamin D3; vitamin D3 suppresses elevation of parathyroid hormone levels)
Exogenous hyperthyroidism (due to excess thyroid replacement) may not exhibit the same risks as those associated with endogenous hyperthyroidism.
Causes of Hyperthyroidism
- Grave’s Disease
- Toxic Multinodular Goiter – more often diagnosed in patients over the age of 50 and more likely to cause irregular heart rhythm
- Toxic Nodule
- Subacute Thyroiditis – may follow a viral infection and is characterized by a painful thyroid gland enlargement and inflammation. Usually resolves spontaneously
- Postpartum Thyroiditis
- Silent Thyroiditis – transient and temporary
- Excessive Iodine Ingestion
- Overmedication with Thyroid Hormone
Diagnosis
- Thyroid Studies
- TSH: Low TSH is the most accurate indicator of hyperthyroidism
- Usually find elevated Free T3 and T 4, although some patients may have increased values only for free T3
- Other Tests
- Thyroid autoantibodies, including TSH receptor antibodies (TRAb) or thyroid-stimulating immunoglbulins (TSI)
- Radioactive Iodine Uptake (RAIU)
- Thyroid scan, to help determine the cause of the hyperthyroidism
Treatment and Management
The treatment and management of hyperthyroidism is not the focus of this section. The categories of treatment for hyperthyroidism include:
- Surgical intervention
- Antithyroid drugs
- Radioactive iodine – the treatment of choice for Grave’s disease
Hypothyroidism
Hypothyroidism occurs when the thyroid gland produces less thant the normal amount of thyroid hormone. The result is the “slowing down” of many bodily functions. With age, thyroid levels decrease, conversion of T4 to T3 diminishes, and thyroid receptor sights become more resistant. It has been estimated that 15-40% of the population suffers from an underactive thyroid. Hypothyroidism is more widespread in women and the elderly. The most common cause is cellular hypofunction or thyroid hormone resistance.
Common Signs and Symptoms of Hypothyroidism
- Fatigue and morning grogginess
- Lower than normal resting (basal) body temperature – feeling chilly at normal temperature
- Coarseness or loss of hair
- Yellow skin
- Cold extremities
- Constipation
- Sensitivity to cold temperature
- Allergies
- Breathing difficulties
- Greater susceptibility to colds and other viruses
- Depression and mood swings
- Weight gain
- Dry skin and dry brittle hair or nails
- Headaches
- Hyperlipidemia (mainly due to low T3)
- Menstrual irregularities and anovulatory cycles
- Infertility
- Hoarseness
- Goiter (enlarged thyroid gland)
- Swallowing difficulty
- Ataxia
- Reflex delay, relaxation phase
- Memory and mental impairment
- Bradycardia
- Congestive heart failure – Low thyroid may cause heart contractility dysfunction
Causes of Hypothyroidism
- Autoimmune Thyroiditis
- Also known as Hashimoto’s thyroiditis, this is the most common thyroid disease in the United States. It is 7 times more common in women than in men. It is characterized by the production of immune cells and autoantibodies by the body’s immune system, which can damage thyroid cells. The thyroid gland may also enlarge, forming a goiter
- May not cause symptoms for many years
- First sign may be painless swelling in the lower front of the neck and difficulty swallowing.
- Symptoms are listed above, but may also include
- Puffy fact
- Sore muscles
- Heavy menstrual flow
- Increased sensitivity to many medications
- Radioactive Iodine Treatment
- Thyroid Operation
- Medications – e.g., Lithium, high doses of iodine, and amiodarone
- Subacute Thyroiditis
- Postpartum Thyroiditis
- Silent Thyroiditis
- Congenital Condition
- Pituitary Hypothyroidism
- Iodine deficiencies
- Rare in the U.S.
- Supplements high in iodine: kelp, seaweed, iodine tablets
- Toxicity/heavy metals
- Determined by hair analysis
- Selenium supplementation can help remove heavy metals by working in conjunction with glutathione peroxidase, found in asparagus, garlic, and mushrooms
- Candida
- Detected using stool testing for overgrowth of yeast and yeast antibodies
- Eliminate yeast, sugar (including honey, and fruits initially), and wheat to starve the Candida
- Supplements: fiber, biotin, acidophil us
- Environmental radiation
- Radiation can cause free-radical damage to the thyroid
- Turn off cell-phones
- Unplug bedside electronic and electrical devices (including telephone) at night
- Eat organic food
- The following foods can suppress thyroid function, and, in some instances, may need to be limited to consumption less than four times a week:
- Brussels sprouts
- Mustard greens
- Spinach
- Cabbage
- Kale