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MoonDragon's Health & Wellness
Disorders

HYPERTHYROIDISM




BASIC INFORMATION


DESCRIPTION

Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone, resulting in an overactive metabolic state. All of the body's processes speed up with this disorder. Thyroid hormones regulate your metabolism - how your body burns calories to produce energy - and influence all of your body processes, including heart rate, digestion, muscle and bone strength, and cholesterol levels. The most common type of this disorder is Graves' disease, which affects about 2.5 million Americans. Hyperthyroidism is sometimes called thyrotoxicosis.




thyroid


CAUSES

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 secrets too much hormone, hyperthyroidism results; too little hormone results in hypothyroidism. Many cases of hypothyroidism and hyperthyroidism are believed to result from an abnormal immune response. 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 (thyroiditis) can cause temporary hyperthyroidism, as can certain prescription drugs.

Hyperthyroidism is not as common as hypothyroidism. Both of these thyroid disorders affect women more often than men. A malfunctioning thyroid can be the underlying cause of many recurring illnesses.

GRAVES' DISEASE

Graves' disease is the most common cause of hyperthyroidism. Graves' disease is an autoimmune disorder that affects the thyroid gland and eye muscles. The thyroid gland produces hormones that control many of the body's chemical functions, including how muscles relax and contract. Graves' disease causes the thyroid gland to produce too much thyroid hormone (hyperthyroidism). Signs and symptoms of this include diarrhea, rapid heart rate, inability to tolerate heat, and weight loss.

Graves' disease is the most common cause of hyperthyroidism. It tends to run in families, and it affects women more often than men. It can develop at any age but most commonly affects people between the ages of 30 and 50. Graves' disease may be triggered by severe emotional stress, such as the death of a loved one or being involved in an automobile accident.

Some people with Graves' disease may have only a single episode of hyperthyroidism that ends in a few months or lasts a few years. In other people, Graves' disease causes repeated flare-ups of hyperthyroidism. Experts don't know what causes Graves' disease to go into remission. Some people develop hypothyroidism (an underproduction of thyroid hormone) after Graves' disease goes away.

THYROID NODULES

There are two types of thyroid nodules can cause hyperthyroidism. Toxic multi-nodular goiter (two or more nodules) or toxic thyroid adenoma (a single nodule) can cause the thyroid gland to produce too much thyroid hormone. Toxic multi-nodular goiter is a common cause of hyperthyroidism in older people.

THYROIDITIS

Most cases of thyroiditis occur when the body produces antibodies that damage the thyroid gland. At first, thyroiditis can cause hyperthyroidism. Later, it can lead to hypothyroidism, an underproduction of thyroid hormones. Thyroiditis can also be caused by a viral or bacterial infection.

UNCOMMON CAUSES OF HYPERTHYROIDISM

Uncommon causes of hyperthyroidism include:

  • Taking too much replacement thyroid hormone (thyrotoxicosis factitia). This can happen to people who are taking thyroid hormone to treat thyroid cancer. It can also happen to people who take too much thyroid hormone in an attempt to lose weight.


  • Taking large amounts of substances or medications that contain iodine, such as iodized salt, kelp, cough syrups, multivitamins, or certain medications, such as amiodarone, lithium, and interferon alfa.


  • Oversecretion of thyroid hormones after pregnancy (postpartum thyroiditis).


  • A growth in the uterus (trophoblastic tumor) that releases hormones into a woman's body, triggering the thyroid to produce excessive amounts of thyroid hormone.


  • A rare tumor (struma ovarii) that grows on a woman's ovaries. The tumor contains thyroid tissue, which releases thyroid hormone into the body.


  • A rare tumor on the pituitary gland (located in the brain). This tumor causes the pituitary gland to produce excessive amounts of thyroid-stimulating hormone (TSH). TSH stimulates the thyroid gland to secrete more thyroid hormones.


  • The thyroid gland usually returns to normal after treatment. For example, once you quit taking substances that contain large amounts of iodine or a hormone-producing tumor is removed, the thyroid gland again functions normally.





    SIGNS & SYMPTOMS

    Symptoms of hyperthyroidism include:
    • Nervousness and mood changes.
    • Irritability.
    • A constant feeling of being hot.
    • Increased perspiration.
    • Insomnia and fatigue.
    • Increased frequency of bowel movements with soft stools.
    • Less frequent menstruation and decreased menstrual flow.
    • Weakness.
    • Hair loss and fine, soft hair.
    • Weight loss.
    • Change in skin thickness.
    • Separation of the nails from the nail bed.
    • Hand tremors.
    • Intolerance of heat.
    • Rapid, pounding, irregular heartbeat.
    • Shortness of breath, even when resting.
    • Goiter.
    • Protruding eyeballs (sometimes).

    Hyperthyroidism symptoms vary by age. For example, children may have rapid growth with faster-than-expected bone maturation, while older adults may have a decreased appetite, weight loss, and atrial fibrillation. The severity of symptoms may also vary, and depression and fatigue may occur (apathetic hyperthyroidism).

    GRAVES' DISEASE SYMPTOMS

    Graves' disease: People with Graves' disease often have additional symptoms, including:
    • Graves' ophthalmopathy, which causes bulging, reddened eyes, among other symptoms. It occurs in about 50% of people who have Graves' disease.
    • Goiter, an enlarged, painless, soft thyroid.
    • Thickened nails that lift off the nail beds.
    • Myxedema, a condition characterized by lumpy, reddish thickening of the skin on the front of the shins and sometimes on top of the feet.
    • Clubbing (fingers that widen at the tips instead of tapering).

    Graves' ophthalmopathy is a frequent complication of hyperthyroidism. It can develop before, after, or at the same time as your symptoms of hyperthyroidism. People with Graves' ophthalmopathy develop eye problems, including bulging, reddened eyes, sensitivity to light, and blurring or double vision. Some cases of Graves' ophthalmopathy temporarily worsen with radioactive iodine treatment or, conversely, improve with antithyroid medication treatment.

    UNTREATED HYPERTHYROIDISM SYMPTOMS & PROBLEMS

    Untreated hyperthyroidism can affect many aspects of your health.
    • Weight loss is a common complication because the body's metabolism is faster.
    • Over time, excessive thyroid hormones can lead to complications such as rapid heart rate, atrial fibrillation, and heart failure.
    • Hyperthyroidism can also lead to osteoporosis, because calcium and other minerals are not sufficiently replaced in the normal process of bone cell turnover. This can happen early in the disease, before hyperthyroidism is diagnosed.

    In rare cases, hyperthyroidism can cause a life-threatening condition called thyroid storm, which develops when the thyroid gland releases large amounts of thyroid hormones in a short period of time. It usually is triggered by a stressful event or a serious illness, such as a major infection.

    THYROID STORM

    Thyroid storm: Thyroid storm (thyroid crisis) is a life-threatening condition that develops in a person with hyperthyroidism when the thyroid gland suddenly releases large amounts of thyroid hormone in a short period of time. Emergency medical treatment is always needed for people who develop thyroid storm.

    Thyroid storm is more likely to develop when a person has a serious health problem in addition to hyperthyroidism. Thyroid storm most often occurs in people with untreated or undertreated Graves' disease; it is rare in people who have multiple thyroid nodules (multi-nodular goiter). It is usually triggered by a stressful event or a serious illness, such as a major infection, but may also be triggered by surgery or by using iodine as a contrast material for a computed tomography (CT) or in radioactive iodine therapy.

    Symptoms of thyroid storm include:
    • Extreme irritability.
    • High systolic blood pressure, low diastolic blood pressure, and rapid heartbeat (tachycardia). Low blood pressure (hypotension) may follow if the condition progresses.
    • Nausea, vomiting, or diarrhea.
    • High fever.
    • Shock and delirium.
    • Confusion.
    • Sleepiness.
    • Symptoms of heart failure, such as shortness of breath and fatigue.

    Thyroid storm can lead to coma, heart failure, or death.





    RISK FACTORS

    Risk factors for hyperthyroidism include:
    • Female gender. Women are more likely to develop hyperthyroidism than men.
    • Family history. People who have close relatives with Graves' disease are more likely to develop this condition.
    • Having an autoimmune disease, such as Addison's disease or type 1 diabetes.
    • Cigarette smoking. People who smoke have about twice the risk for Graves' disease and 7 times the risk for Graves' ophthalmopathy as non-smokers.
    • People with Graves' disease often have a history of recent stressful life events, such as divorce and loss of job. Also, Graves' disease is more common in areas where iodine intake is high.





    PREVENTION

    Hyperthyroidism cannot be prevented.

    People who smoke are about twice as likely to have Graves' disease and about 7 times more likely to have Graves' ophthalmopathy than those who do not smoke.




    TREATMENT


    DIAGNOSIS & TESTS

    THYROID FUNCTION

    The amount of thyroid hormone manufactured by the thyroid gland is primarily governed by the pituitary gland, which produces TSH (Thyroid stimulating Hormone). The amount of TSH delivered to the thyroid gland tells the thyroid how much thyroid hormone to manufacture. T4 (Thyroxine) is the main thyroid hormone produced by the thyroid. A well-regulated process causes thyroxine to lose iodine, generating the much more potent thyroid hormone T3 (Triiodothyronine). The amount of T3 present in the brain must remain within optimal range to keep the body functioning properly and is crucial for maintaining physical and mental health. Thyroid peroxidase, TPO is an enzyme that aids the synthesis of thyroid hormone. in 90 percent of patients with Hashimoto's (autoimmune thyroiditis) there is the presence of high levels of these antibodies. Individuals with other autoimmune disorders often have high TPO levels, as do women with polycystic ovaries. Since early identification of antibodies can result in treatment to improve patient health and well-being, testing TPO in those with sub-clinical hypothyroidism can be beneficial. Thyroid imbalance not only effects body weight, but also mood, emotions, behavior, sex life, menstrual problems, infertility, depression and anxiety disorders. Because symptoms of thyroid imbalance can mimic other hormonal imbalances, as many as 1.3 million Americans may be undiagnosed and/or misdiagnosed. Thyroid disease may go undetected in women of menopausal age as symptoms of menopause and low thyroid are often intertwined.

    THYROID HORMONES AND TESTING

    More than 10 million Americans have been diagnosed with thyroid disease, and another 13 million people are estimated to have undiagnosed thyroid problems in the U.S. alone. A February, 2000 research study found that the estimated number of people with undiagnosed thyroid disease may be 10 percent - a level that is double to what was previously thought.

    Hypothyroidism, or low thyroid, is a very common condition. It is estimated that 3 to 5 percent of the population has some form of hypothyroidism. Women are at greatest risk, developing thyroid problems seven times more often than men. Low thyroid increases with age and in fact, hypothyroidism is most common in women during the menopausal years, approximately 26 percent of women in or near menopause are diagnosed with hypothyroidism.

    In a recent study among patients taking thyroid medication, only 60 percent were within the normal range for TSH. The fact that 40 percent of patients, a number that translates to millions of Americans, are already taking thyroid hormone and being treated by a health care provider but are still not within the expected normal TSH range is of great concern. Not only does this show the need for more frequent monitoring and adjustment of dosages - versus the standard recommendation of maximum yearly testing - but may in fact suggest that there are serious inadequacies in the current therapies, which primarily rely on synthetic thyroid hormone replacement known as levothyroxine (brandnames: Synthroid, Levoxyl, Levothyroid, Eltroxin). The inadequacy of the standard therapy in relieving symptoms is addressed in the February 11, 1999 - New England Journal of Medicine landmark T3 Thyroid Drug Study which found that the majority of patients studied felt better on a combination of two drugs, including levothyroxine (T4) and T3, and NOT solely levothyroxine/T4 (i.e., Synthroid or Levoxyl) alone. The addition of T3 was found to help relieve depression, brain fog, fatigue and other symptoms.

    The thyroid gland produces 2 hormones: T4 (80 percent) and T3 (20 percent). Each thyroid hormone is made up of a tyrosine (protein) surrounded by four (T4) or (T3) iodines. T4 is the "inactive," while T3 is the "active" component. Thyroid hormones set metabolic activity and are thus responsible for the speed at which every enzyme action in the body takes place. When the thyroid gland produces T4, it is taken up by every cell in the body, and converted into T3 which produces activity within the cell. When thyroid hormones are transported in the blood they are "bound" to a protein, Thyroid Binding Globulin (TBG), that temporarily holds them inactive. This protein may be manipulated by many illnesses and medications. Therefore, the measurement of the unbound, "free" levels of T3 and T4 thyroid hormones as conducted in blood spot testing at ZRT Laboratory is the most accurate.

    Functional Thyroid Deficiency when free T3, free T4, and TSH are within normal range but symptoms (particularly a low basal temperature) are consistent with a hypothyroid state, a functional thyroid deficiency or "thyroid resistance" is often caused by autoimmune thyroiditis (Hashimoto's), which can be identified using Thyroid Peroxidase Antibody - TPO testing - available as part of the blood spot thyroid panel at ZRT Laboratory. Other causes of functional thyroid deficiency are estrogen dominance (excessive estrogens in the absence of adequate progesterone), low anabolic steroids (testosterone and DHEAS), and/or adrenal imbalance (low or high cortisol). If thyroid resistance is suspected (i.e., thyroid tests are normal and symptoms indicate hypothyroidism), saliva testing for estradiol, progesterone, testosterone, DHEAS and am/pm cortisol is strongly recommended. For more information see saliva test kits.

    Saliva Test Kits

    THYROID TEST PRODUCTS






    PHYSICAL EXAM & THYROID TESTS

    Hyperthyroidism is diagnosed through a medical history, a physical exam, and blood tests that check your levels of thyroid hormones.

    The most frequently used medical tests are:
    • Thyroid-stimulating hormone (TSH) test, which measures the levels of TSH in the blood stream. It is the most sensitive test to screen for hyperthyroidism.


    • Thyroid hormone tests, which are generally done at the same time as the TSH test. These tests help determine the cause of hyperthyroidism.

    If you are being treated for hyperthyroidism, your health professional will test your TSH and thyroid hormones several times each year to evaluate how well you are responding to treatment and to check for a worsening of the condition.

    Other Important Tests Include:
    • Antithyroid antibody test, which may help diagnose Graves' disease and autoimmune thyroiditis. An antibody test should be done during an initial examination (have a full thyroid panel with antibody testing performed). Other thyroid levels may appear relatively normal but the antibody test may find a hidden autoimmune thyroid condition if the test results come back with a high level of antibodies, which means the body is attacking the thyroid.


    • Radioactive thyroid scan and radioactive iodine uptake tests, which evaluate why the thyroid gland is overactive.

    If you have Graves' ophthalmopathy, a magnetic resonance imaging (MRI) and CT scan may be done to view the eye area.

    Early Detection: The American Thyroid Association recommends that adults, particularly women, be screened for thyroid dysfunction beginning at age 35 and every 5 years thereafter. Generally, a thyroid-stimulating hormone (TSH) test is adequate for this purpose. More frequent testing is recommended for people who have the symptoms of hyperthyroidism or risk factors - being female, a family history of Graves' disease, or an autoimmune disease such as Addison's disease or type 1 diabetes.





    CONVENTIONAL MEDICAL TREATMENT

    Treatment options for hyperthyroidism include antithyroid medication, radioactive iodine, and surgery to remove all or part of the thyroid gland. In most cases, one or more of these treatments reduce or eliminate symptoms. Because hyperthyroidism may return after successful treatment, it is important that your thyroid hormone levels be checked regularly. In rare cases, the condition is only monitored.

    Hyperthyroidism treatment for pregnant women and children:

    Pregnant women with hyperthyroidism are generally treated with antithyroid medications. These should be at the lowest possible dose, and as the pregnancy progresses, the dose often is decreased. The medications are often discontinued before delivery.

    Radioactive iodine cannot be used by women who are pregnant or breast-feeding. After radioactive iodine, a woman should not get pregnant for about 6 months.

    Hyperthyroidism may be severe in children and teens, and treatment is not always as effective as in adults.
    • Radioactive iodine generally is not used in children because of the potential for thyroid cancer, genetic damage, and an underproduction of thyroid hormone (hypothyroidism).


    • Antithyroid medication may not work as well in children as in adults.


    • Hyperthyroidism may return in children even after surgery.

    Left untreated, hyperthyroidism can lead to atrial fibrillation, osteoporosis, and a life-threatening condition called thyroid storm (see Signs & Symptoms).

    HYPERTHYROIDISM MEDICATION

    Antithyroid medication is often used for hyperthyroidism because it does not cause permanent thyroid damage and takes effect more quickly than radioactive iodine therapy, which destroys thyroid tissue. It is often used before radioactive iodine treatment or surgery for hyperthyroidism to bring the metabolism to normal. Doing so decreases the risk of complications.

    Antithyroid medications can control hyperthyroidism in most people, but as with all medications, there may be drawbacks.
    • It takes several weeks for symptoms to start to subside.


    • Treatment with antithyroid medications needs to continue for at least 1 year.


    • Symptoms may return after a few years, and antithyroid medication must be resumed or another treatment tried.


    • Side effects of antithyroid medications are rare but range in severity from a rash and itching to liver problems and lowered resistance to infection.


    • Additional medications may be prescribed to treat symptoms, such as rapid heartbeat and dry eyes, caused by hyperthyroidism. These medications are often used while waiting for antithyroid medication or radioactive iodine treatment to take effect.

    ANTITHYROID MEDICATIONS

    Antithyroid Medication Choices: Methimazole and propylthiouracil are both considered to be highly effective antithyroid medications. In some cases, one medication works better than the other.
    • Methimazole (Tapazole): Methimazole is chosen most often because it can be given once a day, has fewer side effects, and is less expensive.


    • Propylthiouracil (Propyl-Thyracil or PTU): Propylthiouracil is the preferred medication for pregnant women because it is less likely to enter the bloodstream of the fetus. It also is commonly used to treat people who have severe hyperthyroidism, because it prohibits one type of thyroid hormone from converting into a more active form.

    MEDICATION SIDE EFFECTS

    Side Effects Include:
    • Rash and itching. Although other antithyroid medications have similar side effects, switching from one antithyroid medication to another may stop the rash.


    • Joint aches (arthralgias).


    • Liver problems (hepatitis).


    • Severely low white blood cell count (agranulocytosis), which can interfere with your body's ability to fight infection. This is a rare side effect and is more common in people over age 40. The white blood cell count will probably return to normal once the medication is stopped. If you develop a sore throat, fever, or malaise (a general feeling of illness), contact your health professional.

    All of these side effects tend to go away when the medication is stopped.

    Antithyroid medications taken in large amounts for long periods of time can result in an underproduction of thyroid hormone (hypothyroidism).

    Tell your health care provider about any sore throat, fever, or rash, which can indicate that your white blood cell count is low.

    Antithyroid medications need to be taken at the same time every day.

    Your health care provider will check your thyroid hormone levels frequently and adjust your medications accordingly. Your health care provider may prescribe low doses of thyroid medication along with antithyroid medication to keep thyroid hormone levels from falling too low.

    During pregnancy, antithyroid medications should be given in the lowest dose possible to prevent hypothyroidism in the fetus. Medication dosages may be adjusted throughout the pregnancy. Antithyroid medications can pass through the placenta to the fetus and have also been found in a nursing mother's breast milk. However, these medications have not been found to cause serious harm to the fetus or newborn.

    Children may be difficult to treat with antithyroid medication because their bodies are constantly changing.

    ADDITIONAL MEDICATIONS

    Additional medications that may be used to treat the symptoms of hyperthyroidism include:
    • Beta-blocker medications, such as propranolol (Inderal), atenolol (Tenormin), or metoprolol (Lopressor), to control rapid heartbeat, tremors, sweating, and nervousness. These medications are often used while waiting for antithyroid medication or radioactive iodine treatment to take effect. They are not as effective in people with mild hyperthyroidism as in those with a severe case. Large amounts of the medication are often needed initially, but the dose is reduced as symptoms improve.


    • Medicated eyedrops, to treat eye irritation.


    • Iodine (which blocks the release of thyroid hormone in the blood) together with an antithyroid medication, to bring thyroid hormone levels back to normal before thyroid surgery. It may also be given for thyroid storm.


    • Radiocontrast agents, such as ipodate sodium, to reduce the amount of thyroid hormone circulating in the blood.


    • Glucocorticoid medications, to reduce the amount of thyroid hormone in people with Graves' disease. In addition, they may control pain and swelling of thyroid gland inflammation.

    MEDICATION CONSIDERATIONS

    Results are mixed when using antithyroid medication for hyperthyroidism caused by Graves' disease. Remission rates vary and relapses are frequent; remission rates from 30% to 70% have been reported. You need to take the medication for 1 to 2 years.

    Antithyroid medication is most effective for mild hyperthyroidism, for an initial episode of Graves' disease in people younger than 50 years of age, and for slight enlargement of the thyroid gland (small goiter). It is not used for thyroiditis.

    Antithyroid medication is often used to treat pregnant women. Radioactive iodine cannot be used by pregnant or breast-feeding women or by women who are trying to become pregnant.

    Children may be difficult to treat with antithyroid medication because their bodies are constantly changing. However, antithyroid medication is the preferred treatment because of the possibility of long-term risks related to radioactive iodine use in children.

    Often, low doses of thyroid hormone medication are taken along with antithyroid medication to prevent thyroid hormone levels from falling below normal.





    TREATMENT CONSIDERATIONS

    Your Treatment Choices Are:
    • Try radioactive iodine, which destroys cells in the thyroid gland that make thyroid hormones.
    • Try antithyroid medication, which interferes with how the thyroid gland makes thyroid hormones.
    • Surgery to remove part or all of the thyroid gland (thyroidectomy) is rarely used for hyperthyroidism.

    The decision whether to use antithyroid medication or radioactive iodine takes into account your personal feelings and the medical facts.

    Be wary of treatment with radioactive sodium iodine (iodine 131, or I-131), which is often recommended for this condition. Severe side effects have been known to accompany the use of I-131.


    Treatment Reasons To Use Treatment Reasons Not To Use Treatment
    Antithyroid Medications
  • Remission rates up to 70% have been reported.
  • You have mild hyperthyroidism.
  • This is your first episode of hyperthyroidism.
  • You are under 50 years of age.
  • Antithyroid medication does not cause permanent thyroid damage.
  • If the medication is not successful, you can use radioactive iodine.
  • It takes 1 to 8 weeks for symptoms to lessen.
  • It may reduce the risk of developing Graves' opthalmopathy.
  • You need to take the medication at the same time every day.
  • You need to take the medication for 1 to 2 years, and the hyperthyroidism may return.
  • You have already used antithyroid medication, and your hyperthyroidism has returned.
  • Remission rates vary, and relapses are frequent. Remission rates from 30% to 70% have been reported.
  • There is no reliable way to determine who will have remission.
  • Side effects include a decreased ability to fight infection (due to a severely low white blood cell count), drowsiness, headache, nausea, vomiting, itching, and rash.
  • Radioactive Iodine
  • One dose of radioactive iodine treatment cures hyperthyroidism 80% or more of the time.
  • Long-term antithyroid drug therapy has not worked.
  • You usually only need one treatment.
  • You cannot use antithyroid medications because of side effects.
  • Side effects include an inflamed thyroid gland.
  • Hypothyroidism develops in 20% of those who had radioactive iodine therapy within the first few years. After 5 years, the incidence is 30%, and at 10 years 40%, although an incidence as high as 70% has been reported.
  • You may need to take more than one treatment.
  • You are under 20 years old.
  • It takes 8 to 24 weeks for symptoms to lessen.
  • It may temporarily worsen Graves' ophthalmopathy.
  • You cannot use it if you are pregnant, want to get pregnant within 6 months of treatment, or breast-feeding.





  • HOME TREATMENT

    See your health professional on a regular basis so that your hyperthyroidism can be closely monitored and your treatment adjusted, if necessary. It is important to take antithyroid medication each day at the same time. Talk with your health professional if you have developed side effects from the medications.

    People with hyperthyroidism who have Graves' ophthalmopathy may need to use artificial tears to moisten eyes, medicated eyedrops as prescribed, and glasses for protection from wind and sun.

    Steps you can take to relieve or reduce the symptoms of hyperthyroidism include:
    • Reducing stress. This helps relieve anxiety and nervousness that are often symptoms of hyperthyroidism, particularly Graves' disease. For more information, see the topic Stress Management.


    • Avoiding caffeine and other stimulants. These can worsen symptoms of hyperthyroidism, such as rapid heartbeat, nervousness, and difficulty concentrating.


    • Giving up smoking. Cigarette smoking increases the risk for developing both Graves' disease and Graves' ophthalmopathy.

    Children with hyperthyroidism, particularly children who take antithyroid medication, need close monitoring because the amount of thyroid hormone they need changes as they grow.

    As soon as you think your child is old enough to share the responsibility for his or her own health care (usually around age 9 or 10), teach him or her about hyperthyroidism, the importance of taking medication correctly, and why regular health checkups are important.





    thyroid and iodine


    COMPLEMENTARY & ALTERNATIVE THERAPIES

    Alternative medicine has the same goal. Holistic methods also aim to reduce the amount of thyroid hormone produced by the gland. However, alternative methods also target the immune system which is the underlying source of the problem. Many Graves' disease patients have gone into remission using alternative means alone, while others have used a combination of antithyroid drugs and alternative medicine. Still others have used antithyroid drugs until their thyroid levels fell into the normal range, and weaned themselves off these drugs while using alternative medicine.

    STRESS MANAGEMENT & DIET

    Most Graves' patients may have a good idea of what precipitated their disorder. In most instances, stress was mentioned and many patients are diagnosed with Grave' disease after the death of a close relative. The second cause has been dietary supplements with numerous patients admitting to taking diet pills or natural products including multi-vitamins with high iodine content. When the cause is clearly known, the first step in the road to wellness is dealing with it, either by eliminating the offending item or by stress reduction methods.

    Stress reduction and dietary changes are the first steps in any healing plan. Stress reduction methods include biofeedback, meditation, tai chi, yoga and prayer therapy. Stress directly reduces the number of immune system cells which would curb auto-antibody production, and stress is a well known trigger of autoimmune disease.

    Dietary changes involve an emphasis on goitrogens, foods which naturally block thyroid hormone synthesis and the avoidance of certain foods, particularly those high in iodine content. Goitrogens include broccoli, cauliflower, Brussels sprouts, cabbage, kohlrabi, sweet potatoes, almonds, peaches and peanuts. Soy is also known to interfere with iodine absorption in the gut, reducing thyroid hormone synthesis.

    Eat plenty of the following foods that suppress thyroid hormone production:
    • Broccoli.
    • Brussels sprouts.
    • Cabbage.
    • Kale.
    • Mustard greens.
    • Peaches.
    • Pears.
    • Rutabagas.
    • Soybeans.
    • Spinach.
    • Turnips.

    Foods to avoid include wheat, dairy products, sugar, saturated fats, caffeine, and artificial sweeteners. An ideal diet would have adequate, but not excess protein, fresh fruit, brown rice, millet and lightly steamed vegetables. It's also important to avoid any food allergens as allergic reactions heighten the autoimmune response.

    HOMEOPATHIC & NUTRITIONAL SUPPLEMENTS

    Herbs (See Herbs Below).

    A number of homeopathic preparations have been successfully used in Graves' disease. Again, they must be used under the guidance of a naturopathic or homeopathic practitioner. Homeopathic preparations used in the treatment of hyperthyroidism include Kelpsan, Coffea, Pulsatilla, Thyroidinum, and Natrum Muriaticum.



    Aurum homeopathic for extreme restlessness, high blood pressure with heart palpitations and cold hands and feet, especially when thyroid disease is accompanied by depression or aggravated by cold.



    Iodum homeopathic for inner restlessness, compulsion to move, tremors and weight loss despite great hunger.

    One of the earliest substances used in the treatment of Graves' disease is strong solution of iodine (Lugol's solution, saturated solution of potassium iodide or SSKI). For years it was the only method available. Although iodine exacerbates symptoms of hyperthyroidism, at extremely high doses it inhibits thyroid hormone production and thyroid hormone's release from the thyroid gland. However, the major effects tend to wane after several weeks and a careful dosage plan must be used. Many naturopaths still use strong iodine and many patients have used and are still using strong iodine successfully, some on an as needed basis.



    Ayurvedic medicine, craniosacral therapy and acupuncture have also been used successfully.

    Immunomodulators: Plant sterols and sterolins that strengthen, not stimulate, the immune system.

    Sufficient rest to help promote health and healing.

    Laughter, every time you laugh or smile, your immune system cells show changes that are beneficial to immune system health. Dr. Norman Cousins reversed his own autoimmune disorder with a combination of humor and biofeedback.

    Allow your pets to heal you and give you pleasure.





    CONSIDERATIONS

  • Along with other bodily processes, digestion speeds up with this disorder. Malabsorption occurs, so a proper diet is important.


  • Researchers in England studied 10 people who were being treated for Parkinson's disease and found that all of them also had hyperthyroidism. Once the thyroid condition was treated, the Parkinson's disease improved dramatically.


  • If a goiter affects breathing or swallowing, surgery may be needed to remove part or all of the thyroid. It may be necessary to make thyroid pills after surgery.


  • The pituitary gland, parathyroid glands, and sex glands all work together and are influenced by thyroid function. If there is a problem in one place, they all may be affected.


  • The parathyroid glands, small endocrine glands that are positioned near or within the rear surface of the thyroid secrete parathyroid hormone (PTH), which aids in controlling calcium levels. Hyperparathyroidism is a rare disorder in which these apple-seed-sized organs become enlarged and overactive. When too much PTH is released, excess calcium leaches out of the bones and into the blood. Routine blood tests may reveal excess calcium in the blood. If left untreated, it can lead to other problems such as bone pain and kidney stones. The standard treatment for this disorder is surgery. Permanent hoarseness is a possible side effect, if the nerves supplying the voice box are injured.


  • An undiagnosed thyroid condition can be mistaken for menopausal symptoms. Symptoms such as fatigue, mood swings, and depression are often present in both circumstances. If you are experiencing menopausal symptoms, you should have your thyroid function tested.





  • seaweed and kelp - iodine from the sea
    IODINE FROM THE SEA


    The thyroid gland needs dietary iodine to produce the hormones required to keep the body functioning well. Too much iodine can make hyperthyroidism more severe, while too little iodine can worsen hypothyroidism. If you like seafood and have trouble with your thyroid, you should know that crustaceans and fish have a relatively high iodine content. The same is true of the salty-flavored kelp and other seaweeds.



    DIETARY RECOMMENDATIONS

    DIET FOR HYPERTHYROIDISM

  • Eat plenty of the following foods: broccoli, Brussels sprouts, cabbage, cauliflower, kale, mustard greens, peaches, pears, rutabagas, soybeans, spinach, and turnips. These help to suppress thyroid hormone production. Crucifer-family vegetables may be consumed regularly.


  • Avoid dairy products for at least 3 months. Also avoid stimulants, coffee, cola, tea, nicotine, and soft drinks. Stimulating beverages and foods can worsen heart palpitations, insomnia, and nervousness.


  • Avoid all foods and medications that contain iodine to keep from stimulating the thyroid even more. If iodine is required, it should be carefully managed to maintain the proper balance. Iodine supplements should be used under the supervision of a health care provider. Be wary of treatment with radioactive sodium iodine (iodine 131, or I-131), which is often recommended for this condition. Severe side effects have been known to accompany the use of I-131. Also, do not rush into surgery. Try improving your diet first.


  • MoonDragon's Health & Wellness: Hypothyroidism





    HERBS

  • Bayberry bark

  • Blue flag

  • Red Clover

  • Black Cohosh

  • Kelp

  • White Oak bark

  • Skullcap

  • Watercress


  • Herbs, under the guidance of a herbalist or naturopath, are also known to reduce thyroid hormone synthesis. They are usually prescribed as tonics including one or more of the following ingredients: Lycopus virginicus (bugleweed), Melissa (lemon balm), Leonurus cardica (motherwort) and Lithospermum. The World Authority on Herbs, The German Commission E, reports that Bugleweed, Motherwort, and Lemon Balm are safe and efficacious for treating hyperthyroidism. Caution: Like anti-thyroid drugs, herbs cannot be withdrawn abruptly. When remission is achieved, they should be slowly tapered.

  • Bugleweed (Lycopus europaeus/virginicus): Bugleweed is a specific for over-active thyroid glands, especially where the symptoms include tightness of breathing, palpitation and shaking. It may safely be used where palpitations occur that are of nervous origin. This herb decreases excessive thyroid activity by influencing pituitary regulation. Bugleweed will aid the weak heart where there is associated build-up of water in the body. As a sedative cough reliever it will ease irritating coughs, especially when they are of nervous origin.

    Infusion: Pour a cup of boiling water onto 1 teaspoonful of the dried herb and let infuse for 10-15 minutes. This should be drunk one to three times a day.
    Tincture: Take 1-2 ml of the tincture three times a day.
    Combinations: Bugleweed may be used with nervines such as Skullcap or Valerian.

  • Lemon Balm (Melissa officinalis): Lemon balm is used in herbal teas, both for its flavor and its mild sedative properties. Melissa had been used for centuries. References are found in Roman writings. The Arabs relied on it to treat depression and anxiety.
    Use 2 tablespoons chopped herb or leaves to 1 cup boiling water. Drink warm as required.
    For a cold extract use 2 tablespoon per cup of cold water, let stand 8 hours.
    If you are using powder, take 10 to 40 grains at a time.

  • Motherwort (Leonurus cardiaca): Motherwort is used for menstrual and uterine conditions as well as in heart and circulation treatments. It is valuable in the stimulation of delayed or suppressed menstruation, especially where there is anxiety or tension involved. The leaves of this mint-family plant contain bitter glycosides which reduce hyperactivity of the thyroid. The botanical species name of the plant, cardica, was earned because its ability to reduce abnormal rhythms and heart palpitations, which are symptoms of hyperthyroidism. It is a good relaxing tonic for aiding in menopausal changes. Eases false labor pains. An excellent tonic for the heart, strengthening without straining. It is considered to be a specific in cases of tachycardia (heart palpitations), especially when brought about by anxiety and other such causes. It may be used in all heart conditions that are associated with anxiety and tension. Chinese research referred to in Potters Cyclopedia found that it both reduced blood platelet aggregation and decreased levels of blood lipids.
    Infusion: pour a cup of boiling water onto 1-2 teaspoonfuls of the dried herb and leave to infuse for 10-15 minutes. This should be drunk three times a day.
    Tincture: take 1-4 ml of the tincture three times a day.

    HERBAL BOOKS:
    HERBAL LINKS:

    Chinese Herbs Treatment on Hyperthyroidism
    HerbChina200.com: Herbal Therapies - Hyperthyroidism
    Treatment for Thyroid Diseases with Chinese Herbal Medicine
    Sparteine for Graves' disease





    NUTRITIONAL SUPPLEMENT RECOMMENDATIONS

    The following nutrients are important for healing once appropriate local treatment has been administered. Unless otherwise specified, the following recommended doses are for those over the age of 18. For a child between 12 and 17 years old, reduce the dose to 3/4 the recommended amount. For a child between 6 and 12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended amount.

    NUTRIENTS
    Supplement Suggested Dosage Comments
    Very Important
    Multi-Vitamin & Multi-Mineral Complex As directed on label. All nutrients are needed in balance. Increased amounts of vitamins and minerals are needed for this "hyper" metabolic condition. Use a super-high potency formula.
    Super Multi-Vitamin & Multi-Mineral, Pure Vital Earth, 32 fl. oz. (98% Bio-Available for Absorption), Damage Control Master Formula, High Potency, Multi-Vitamin & Mineral, 60 Packets (30 Day Supply)
    Vitamin B Complex 50 mg of each B vitamin daily, with meals 3 times daily (amounts of individual vitamins in a complex will vary). B vitamins work best when taken together. Needed for thyroid function. Injections (under a health care provider's supervision) may be necessary.
    Ultimate B (Vitamin B Complex), Nature's Secret, 60 Tabs,
    Vitamin B-100 Complex, w/ Coenzyme B-2, Nature's Way, 631 mg, 100 Caps
    Plus Extra
    Vitamin B-1 (Thiamine)
    50 mg twice daily. B vitamins work best when taken together. Needed for blood formation and energy levels.
    Vitamin B-1 / Thiamine HCl (Hydrochloric Acid), 100% Natural, Nature's Way, 100 mg, 100 Caps
    And
    Vitamin B-2 (Riboflavin)
    50 mg twice daily. Required for normal functioning of all cells, glands, and organs in the body.
    Vitamin B-2 / Riboflavin, 100% Natural, Nature's Way, 100 mg, 100 Caps
    And
    Vitamin B-6 (Pyridoxine)
    50 mg twice daily. Activates many enzymes and is needed for immune function and antibody production.
    Vitamin B-6 / Pyridoxine, Nature's Way, 100 mg, 100 Caps
    Helpful
    Brewer's Yeast 1 to 3 tablespoons daily and up. Rich in many basic nutrients, especially the B vitamins. A natural source of the B vitamins.
    Brewer's Yeast, NOW Foods, 650 mg, 200 Tabs,
    Brewer's Yeast, Debittered, NOW Foods, 1 lb.
    Essential Fatty Acids
    (Flaxseed Oil, Black Currant Seed Oil, MaxEPA, Primrose Oil, and Salmon Oil are all good sources.)
    As directed on label. Needed for correct glandular function.
    Ultimate Oil, Essential Fatty Acids Supplement, Nature's Secret, 90 SoftGels,
    Barlean's Flax Oil, 100% Highest Lignan Content, Organic, Pesticide & Herbicide Free, 16 fl. oz.,
    Barlean's Flax Oil, Highest Lignan, 1000 mg, 250 Caps,
    Black Currant Oil, 500 mg, NOW Foods, 100 SoftGels,
    Barlean's Primrose Oil, With Gamma Linolenic Acid (GLA), 1300 mg, 120 SoftGels,
    Wild Salmon Oil, 2000 mg, 120 EPA/ 80 DHA, NOW Foods, 250 SoftGels
    Kyolic EPA As directed on label. Needed for correct glandular function.
    Lecithin Granules
    Or
    Capsules
    1 tablespoon 3 times daily, before meals.

    1,200 mg 3 times daily, with meals.
    Aids in digestion of fats and protects the lining of all cells and organs.
    Lecithin Vegetarian Granules, NOW Foods, 97% Phosphatides, Identity Preserved Non-GE, 1 lb,
    Lecithin Liquid, NOW Foods, Vegetarian, 16 fl. oz.,
    Lecithin Concentrate, Nature's Way, 400 mg, 100 SoftGels
    Vitamin C With Bioflavonoids 3,000-5,000 mg daily and up, in divided doses. Extremely important in this stressful condition.
    Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz.,
    Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs,
    Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps,
    The Right C, Nature's Way, 1000 mg, 120 Tabs
    Vitamin E 200 IU daily or 400 IU every other day. Do not exceed 400 IU daily. An antioxidant and necessary nutrient. However, excessive amounts may stimulate the thyroid gland. Use d-alpha-tocopherol form.
    Ester E Natural Vitamin E, California Natural, 400 IU, 60 Softgels,
    Vitamin E, 400 IU, 100% Natural, NOW Foods, 100 Gels,
    Vitamin E-1000, NOW Foods, 1000 IU, 100 Gels,
    Vitamin E, d-alpha-tocopherol, 400 IU, 100 Softgels





    HYPERTHYROID SUPPLEMENTS & PRODUCTS

    Information, supplements and products for hyperthyroidism, a disorder that occurs when the thyroid gland produces too much thyroid hormone.

    Agar Agar Seaweed Extract Tincture, Kelp Supplement, 100% Organic, 2 fl. oz.

    Agar Agar, kelp supplement, is a gelatinous substance obtained from several varieties of seaweed and used as a bulk laxative and as a treatment for hyperthyroidism.
    Bladderwrack, Nature's Way, 580 mg, 100 VCaps

    Bladderwrack is a natural source of minerals and is guaranteed to contain 0.06% iodine.
    Energy Ephedra Free, NOW Foods, 90 Caps

    NOW Foods Energy, Ephedra Free, combines a comprehensive array of nutrients and dietary ingredients that provide your body with a natural source of energy.
    Iodine Dietary Supplement, WaterOz, 16 fl. oz.

    It is one of the most vital of the biochemical elements and has one of the highest vibratory frequency rates of all the elements.
    Kelp Seaweed (Norwegian) Tincture, 100% Organic, 2 fl. oz.

    Due to overwhelming research results, Kelp has become an effective treatment for hyperthyroidism.
    Kelp Supplement, Nature's Way, Certified, 650 mg, 100 Caps

    A kelp supplement is used as an effective treatment for hyperthyroidism. Nature's Way collects their kelp from pristine environments so that coastal pollutants are not introduced into their products.
    L-Tyrosine Powder, Vegetarian, NOW Foods, Free Form, 4 oz.

    NOW L-Tyrosine is an essential amino acid and a precursor of the neurotransmitters dopamine, norepinephrine, epinephrine (adrenaline) and the thyroid hormones.
    L-Tyrosine, Pharmaceutical Grade, Free Form, NOW Foods, 500 mg, 120 Caps

    L-Tyrosine is used to treat insomnia, improve muscle tone, improve skin and hair pigment and depression and anxiety. L-Tyrosine should not to be used while taking prescription antidepressants or MAO inhibitors.
    L-Tyrosine, High Potency, NOW Foods, 750 mg, 90 Caps

    L-Tyrosine is a non-essential amino acid that plays an important role in the production of the neurotransmitters dopamine and norepinephrine. In addition, because L-Tyrosine is necessary for the synthesis of thyroid hormone and epinephrine (adrenaline), L-Tyrosine supports healthy glandular function and stress response.
    Multi-Vitamin Without Iron, Nature's Way, 100 Caps

    The vitamins and minerals in this Multi Vitamin without Iron play many important roles in the body: antioxidants to protect fats, cells and DNA, coenzyme precursors for energy production and metabolism, and cofactors for hormones and enzymes which regulate body processes.
    Organic Coconut Oil, Virgin, Unrefined Premium Nutritional Edible Oil, Vegetarian, NOW Foods, 12 oz.

    NOW Organic Coconut Oil is a high grade, virgin unrefined premium nutritional edible oil obtained from the first cold pressing of organic coconut (Cocos nucifera) kernels.
    Potassium Plus Iodine (Potassium Iodide), NOW Foods, 180 Tabs

    Potassium Iodide (KI) is a compound that contains Iodine, a nutrient necessary for normal thyroid function. Iodine in the form of Iodide is an integral part of thyroid hormones, which regulate cellular metabolism and energy production.
    Pure Virgin Coconut Oil Cream, Cosmetic Cream, NOW Foods, 7 oz.

    NOW Foods Pure Virgin Coconut Oil Cream can be used in recipes as it is food grade, but also as an excellent hair and skin treatment.
    Stomach Peace TCM Formula (Ganweishu), 100% Natural, 400 mg, 60 Caps

    In China this product is extensively used for gastritis, peptic ulcer, abdominal pain, hepatitis, cholecystitis, costal neuralgia, kidney stone, cystitis, epilepsy, neurasthenia, anti-shock, anti-arrhythmia, mastitis, otitis media, costal chondritis, obstruction of Fallopian tube, chronic annexitis, hyperthyroidism and impotence.
    The Complete Thyroid Book, By Kenneth Ain M.D. & M. Sara Rosenthal, Ph.D, Paperback

    The Complete Thyroid Book, is the ultimate resource for the growing number of thyroid disease sufferers covering both state-of-the-art and standard-of-care treatments for every thyroid condition imaginable.
    The Thyroid Guide, By Beth Ditkoff, M.D. & Paul Gerfo, M.D.

    This comprehensive guide to thyroid problems covers hyperthyroidism and hypothyroidism, Grave's disease and thyroid cancer.
    Thyroid Energy Natural Thyroid Supplement, NOW Foods, 90 VCaps

    Unique, Synergistic Thyroid Support Formula is a custom combination of vitamins, amino acids, trace minerals and standardized herbal extracts formulated to support healthy thyroid gland function.
    Thyroid / Pituitary Formula Tincture, 100% Organic, 2 fl. oz.

    The Thyroid Pituitary Formula helps restore balance for both the underactive and overactive thyroid.
    Thyroid Support Wellness Oil, 2 fl. oz.

    Whether your thyroid is high or low, this Thyroid Support Wellness Oil will help to balance out this important gland.


    Herbal Remedies: Hyperthyroidism Information

    Herbal Remedies: Hyperthyroidism Supplements, Information & Products

    Herbal Remedies: Hypothyroidism Supplements, Information & Products

    HYPERTHYROID PRODUCTS FROM AMAZON.COM





    NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...

    Although uncommon, thyroid storm can be life-threatening and requires emergency treatment. It usually is triggered by a stressful event or a major illness.

    Call 9-1-1 or other emergency services immediately if you have signs of shock or delirium, which are severe symptoms of thyroid storm.

    Call your health professional immediately if you have been diagnosed with hyperthyroidism and you develop any other signs of thyroid storm, including:
    • Extreme irritability or agitation.
    • Abnormally high or low blood pressure.
    • Nausea, vomiting, and/or diarrhea.
    • Rapid heartbeat (tachycardia).
    • Vomiting.
    • High fever.
    • Confusion.
    • Sleepiness.
    • Symptoms of heart failure, such as shortness of breath or fatigue.

    Call your health professional if you develop symptoms of Graves' ophthalmopathy, such as bulging, reddened eyes, or one of more of the following symptoms:
    • Fatigue.
    • Weight loss.
    • Increased discomfort in warm temperatures.
    • Muscle weakness.
    • More frequent bowel movements.
    • Increased swelling on one or both sides of the throat, or difficulty or discomfort swallowing.
    • Rapid, pounding heartbeat.

    Watchful waiting is a period of time during which you and your health professional observe your symptoms or condition without using medical treatment. If you think you have symptoms of hyperthyroidism, watchful waiting is not appropriate. Talk with your health professional; he or she will determine the cause of your symptoms and decide whether you need treatment.

    MoonDragon's Health & Wellness: Hypothyroidism





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