Thyroid Problems More Than Just A Weight Issue Biology Essay

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When my mom was diagnosed with hyperthyroidism in mid-2002, she went through what one would probably describe as a "physical rollercoaster.  What used to be energy-packed days, which she would spend doing errands, were now wasted away at home, resting. Going up the short flight of stairs at home suddenly became a chore for her, and surprisingly, descending it also caused some strain.  She constantly felt hot, even when she was inside an air conditioned room or in front of an electric fan.  At 55, she initially thought these symptoms to be related to menopause.  But other physical indicators later manifested.  Gradually, she began losing a lot of weight despite maintaining her usual diet. Even if she took in more food, it would just be wasted because of the frequent bouts of diarrhea she experienced.  After a while, however, she regained her normal weight because of an increase in her appetite. But before long, she would shed off the weight again. It was a vicious cycle.

Less than a year later, just when everyone thought that her health was back to normal, my mom suffered a thyroid storm, a condition where metabolic processes go haywire because of increased thyroid hormone levels in the blood. She succumbed to it in less than 24 hours.  To be sure, everyone was devastated; even the doctors were shocked.  Despite the improving signs and the prescribed treatments, who would have known that hyperthyroidism would be such a thief in the night?  Just how can thyroid problems be treated effectively?


Increase vs. Decrease, Loss vs. Gain


The thyroid gland, located just below the Adam's apple, produces hormones responsible for regulating metabolism.  As such, when the gland's functions are amiss, problems in the management and regulation of energy, the body's use of other hormones and vitamins, and the growth of tissues may arise.  As a consequence of its role in regulating metabolism, a problem involving thyroid hormone secretion may manifest itself physically either by weight loss (as a result of excess hormone production) or weight gain (underproduction).


Excess and Deficiency


Two general conditions arise as a result of this hormone regulatory malfunction. Hyperthyroidism occurs when there is an overproduction of thyroid hormone in the blood, while hypothyroidism results in the production of too little of the hormone.  A problem in the production and secretion of thyroid hormones takes place when a gland in the brain, the pituitary gland, fails to detect the levels of hormone in the blood.  It is the job of the pituitary gland to send signals to the thyroid gland to increase or decrease the production and secretion of the thyroid hormones as necessary. 




A person with hyperthyroidism has an increased metabolic rate, and therefore, also has an increased risk of other health issues, such as cardiovascular disease, and bone loss.  Complications may also arise during pregnancy. The common causes of hyperthyroidism in adults may be:


-          Diffused Toxic Goiter or Grave's Disease - Antibodies in the blood stimulate the entire thyroid gland to grow, become overactive and produce too much hormone.


-          Toxic Adenoma (Hot Nodule) - Only a dominant part or nodule in the gland becomes overactive and secretes excess hormone.


-          Toxic Multinodular Goiter or Plummer's Disease - more than one lump becomes overactive.


-          Sub-acute Thyroiditis - A viral infection or post-partum inflammatory process causes the inflamed thyroid to release excess hormone in the bloodstream.


-          Drug-Induced Hyperthyroidism - Typical of the older population, it is a pre-existing non-toxic nodular goiter that is induced by iodine.


            Aside from the marked weight loss experienced by my mom, other symptoms can manifest depending on the age, amount of excess hormone, and the duration it has been present in the blood stream.  Patients with hyperthyroidism can experience, nervousness and irritability, palpitations, tremors, lower leg swelling, sudden paralysis and sleep disturbances.




Hypothyroidism, on the other hand, also increases the risk factors for other medical conditions, since it slows down the body's metabolism.   Hypothyroidism is more common in women than in men, and occurs as one ages.  Common causes include:


-          Iodine Deficiency - The most common cause of hypothyroidism in countries where iodized salt is not used.  Severe iodine deficiency results in low hormone levels and thyroid enlargement (goiter).

-          Autoimmune or Hashimoto's Thyroiditis -  A hereditary condition wherein the body's immune system attacks the thyroid gland.  This is the most common type of hypothyroidism in adults, which causes goiter and the progressive destruction of the gland.

-          Sub-acute Thyroiditis - After a period of infection-induced hyperthyroidism (see above), a hypothyroid phase follows.  Eventually, the thyroid function returns to normal.  The three types of this condition are granulomatous (painful), lymphocytic (painless), and postpartum thyroiditis.

-          Drug-Induced Hypothyroidism - Some prescription drugs, particularly those with lithium and amiodarone, can alter the function of the thyroid, causing it to produce less hormone.

-          Thyroid Surgery - Removal of thyroid nodules as part of previous thyroid treatment, and treatment of hyperthyroidism with radioactive iodine, result in the destruction of thyroid tissue and a decrease in hormone production.

-          Pituitary and Hypothalamic Diseases - Since both structures are responsible for the regulation of thyroid hormones, diseases to these can affect the amount of hormone production and secretion.

Excluding goiter, hypothyroidism symptoms are practically the opposite of their hyperthyroidism counterparts.  Some of these include intolerance to cold, constipation, weight gain or difficulty in losing weight, and poor appetite.  The skin may also become rough, the eyes and the face may swell, and the voice may become deeper as a result of the enlargement of the area which is in the proximity of the larynx or voice box.  Mental activity may slow down and blood cholesterol levels may go up as a result of slower metabolism.


Disease Diagnosis


Aside from taking note of symptoms, both thyroid problems need to be further assessed and confirmed using laboratory tools and analyses.  A blood test which measures the level of thyroid stimulating hormone (TSH) is most commonly used.  TSH will yield low for hyperthyroidism, and high for hypothyroidism.  A test for the detection of free T4 and T3 thyroid hormone levels in the blood is also used; these hormones will be low in persons with hypothyroidism and high in those with hyperthyroidism. 


Target-specific assays are also used to determine the cause of the thyroid problem. In people with suspected hypothyroidism, autoantibodies are used to determine if autoimmune thyroiditis is the cause of the condition.  If hyperthyroidism is suspected, a patient is asked to ingest radioactive iodine so an image of how much iodine is taken up by the thyroid can be taken, and from there, further diagnosis can be made and treatment can be prescribed.


Thyroid and Food


In general, the onset of thyroid conditions may be difficult to prevent.  However, one's diet as a youngster may play an important role in reducing the risk of developing such conditions. For people with hyperthyroidism, particularly Grave's disease, it is best to stay away from the following food:


-          Iodine-Rich Food - Iodine intake should be limited to the daily requirement.  Iodine is an important component in the synthesis of thyroid hormones, and is abundant in seafood, seaweeds, etc. 


-          Animal Thyroid - Meat from a slaughtered animal's neck, where the thyroid gland may still be attached, may be ground and included in mixes for hamburgers, meatballs, sausages, etc. Ingestion of orally active thyroid hormones found in this meat is said to cause thyrotoxicosis, the clinical condition wherein excessive amounts of thyroid hormone are present in the blood, and eventually cause problems in metabolism and other bodily processes.


-          Other regular food items that may increase the severity or frequency of the symptoms of hyperthyroidism. These may include coffee, soda, chocolate, alcohol, nuts, etc.


Meanwhile, patients suffering from hypothyroidism should avoid food items that are too high in dietary fiber.  Fiber may prevent the absorption of oral thyroid drugs that the doctor may prescribe.  These may include, but not limited to, oatmeal, psyllium husk, walnuts, soybean flour, calcium and iron supplements, antacids, etc.  If taking these cannot be avoided, one should make sure that food consumption and drug intake are effectively spaced.


Medical Treatment and Management


Unfortunately, treating the two general thyroid conditions is not as simple as keeping the weight off or trying to maintain it.  Thyroid conditions should not be taken lightly, and should not be treated solely by addressing the weight issues associated with them. 


An endocrinologist is the best specialist to see for thyroid problems.  But since the condition may increase the risk of developing other ailments, other specialists, like a cardiologist, may be asked to help in the treatment.

There are two possible approaches in treating hyperthyroidism.  One is to decrease excess hormone production, while the other is to treat the effects of the excess hormone already present in the body.  The most common treatment employed by doctors to bring down hormone levels to normal is by radioactive iodine ablation, or the destruction of thyroid cells that produce the excess hormone.  This is especially effective for toxic multi-nodular goiter and Grave's disease.  Pregnant and breastfeeding mothers, however, should not undergo this treatment for complications it may cause on the infant.


Other modes of reducing hormone levels include oral chemotherapy and surgery.  Several anti-thyroid medications to help normalize hormone levels are usually prescribed by doctors as a "first line of defense," perhaps to avoid the side effects associated with radioactive iodine treatment or surgery.  Meanwhile, surgery is used when there is an urgent need to bring down the level of thyroid hormone, such as during pregnancy.  In both surgery and radioactive iodine therapy, the patient becomes hypothyroid and will usually require hormone replacement therapy afterwards.


On the other hand, a specific class of drugs can be prescribed to block the action of the thyroid hormone in the body and decrease the symptoms caused by its overproduction.  Although the high level of the hormone remains, the hormone itself is rendered inactive to affect or spike metabolic processes.  It is, however, important for a cardiologist to monitor the use of such drugs as they slow down the heart rate.


Unfortunately, people with hypothyroidism have to undergo life-long therapy for their condition.  Synthetic forms of the T4 thyroid hormone are used in majority of patients to augment insufficient hormone levels.  A patient needs to see his or her doctor regularly to monitor the levels of the hormone in the blood.


The Extreme Scenario


Of course, nobody wants to experience what my mom had to go through 7 years ago. A thyroid storm, or thyrotoxic crisis, is a state when the metabolism is pumped up by an excessive release of thyroid hormones. Symptoms include fever, hypertension, tachycardia, gastrointestinal and neurological abnormalities.  It is fatal if left untreated and rapid diagnosis and treatment are therefore critical.


In patients with hyperthyroidism, thyroid storm may be induced by an infection of the blood, surgery, drugs, excessive thyroid hormone ingestion, the failure or withdrawal of anti-thyroid medications prescribed to treat hyperthyroidism, etc.  This clinical condition is mostly associated with Grave's disease.


But as with any medical condition, extreme cases, such as a thyroid storm, may be prevented, with drugs and treatments that will inhibit the effects of excess thyroid hormones.  Seeing the doctor regularly and following a healthy and balanced diet are also key to managing thyroid conditions and their possible disruption of the body's metabolic processes. ####