Sunday 13 July 2014

Hyperthyroidism Overview

A condition in which there is speeding up of all the metabolic processes in the body, hyperthyroidism, results from excess thyroid hormones circulating in blood. Thyroid hormones are basically substances secreted by the thyroid gland and these are responsible for controlling growth, development and energy usage of the body. When these hormones are secreted in excess of their requirement, the body throws symptoms such as excess hunger, weight loss, fatigue, hyperactivity, tremors, intolerance to heat, etc.
Hyperthyroidism affects females more commonly as compared to males and it can occur at any age though it’s common for it to show up during 20 to 40 years of age. Conventional treatment includes drugs that give symptomatic relief and antithyroid drugs to reduce the production of thyroid hormones. However, these drugs are not without side-effects some of which can be serious in nature.
Natural medicine provides effective treatment for hyperthyroidism in a natural and safe way without disturbing the existing balance of the body. The remedies target the root cause of hyperthyroidism thereby giving results that are more lasting in nature. At Hashmi Dawakhana, we have the experience of treating cases of hyperthyroidism for more than 40 years. Many patients have benefitted from the treatment experiencing good control of their problem and reduced dependence on conventional medicines, if any. It is suggested that for best results, patients must opt for natural treatment of hyperthyroidism during the early stages itself.

What is Hyperthyroidism?
About the Thyroid gland
The thyroid gland is a small butterfly-shaped gland located in the neck region and it weighs about 20 to 25 grams in an adult. The thyroid gland takes up the iodine from the foods we eat and converts it into hormones namely Thyroxine (T4), Tri-iodothyronine (T3) Calcitonin. The levels of thyroid hormones are in turn controlled by TSH (Thyroid Stimulating Hormone/ Thyrotropin) that is secreted by another gland called Pituitary which is situated in the brain.
Thyroid hormones are instrumental in growth and development of the body and also control the way body utilizes energy. Besides these, thyroid hormones also affect the functioning of brain, nervous system and heart; regulate body temperature, skin hydration, muscle strength, body weight, menstrual cycles, etc.
What happens in Hyperthyroidism?
When the thyroid gland starts producing more than the required quantities of thyroid hormones, the patient ends up having 'too much of thyroid hormones' circulating in the blood. This condition is called hyperthyroidism and can be caused due to various factors ranging from excess iodine intake to infection of the thyroid gland to excess stimulation by the pituitary gland.
Normal hormone levels:
T3 (Tri-iodothyronine): 80-220 nanograms/dl
T4 (Thyroxine): 4.5 to 12.5 micrograms/dl
TSH (Thyroid Stimulating Hormone): 0.5-6 micro International units/ml
Hyperthyroidism can have widespread consequences on the body since the excess hormones speed up the normal body metabolism resulting in numerous symptoms like excess hunger yet losing weight, intolerance to heat, tremors, hyperexcitability, anxiety, fatigue, etc.
Hyperthyroidism can occur at any age though it tends to have a peak incidence during 20 to 40 years of age. It’s almost 5 to 10 times more common in women as compared to men. The overall incidence of this condition is between 0.05 to 1 %.
A large number of cases are diagnosed with subclinical hyperthyroidism wherein the patient has no apparent symptoms of hyperthyroidism but abnormal levels of thyroid hormones are detected in laboratory tests.
A sudden worsening of hyperthyroid state may lead to a crisis condition called Thyrotoxicosis (also known as Thyroid storm). Thyrotoxicosis is not very common but can be life threatening and requires immediate medical attention whenever it does occur.

Causes of Hyperthyroidism

Hyperthyroidism can result due to multiple reasons some of which include the following:
Graves' Disease: Graves’ disease is also known as ‘Toxic Diffuse Goiter’ and it is the most common cause of hyperthyroidism in the United States. Graves’ disease is an auto immune disease in which the body’s immune system starts producing an antibody called as the ‘thyroid stimulating immunoglobulin’ or TSI. These antibodies mimic the action of Thyroid Stimulating Hormone (TSH) and cause the thyroid to produce too much of thyroid hormones.
Graves' disease is hereditary in nature and it is up to five times more common in women as compared to men. Some other common factors that can trigger Graves’ disease are stress, smoking, and radiation to the neck region.
Thyroid Nodules: Thyroid nodules are also known as adenomas or functioning adenomas or even referred to as ‘Hot Nodules’. These are basically lumps in the thyroid gland which are usually noncancerous. When these lumps become overactive, they start producing too much of thyroid hormones leading to the state of hyperthyroidism. When multiple such lumps are overactive in a given person, the state is called Toxic Multinodular Goiter (TMNG).
Thyroiditis: Inflammation of the thyroid gland may occur after a viral illness and this is commonly known as subacute Thyroiditis. Another variant of Thyroiditis which is seen after pregnancy is called Lymphocytic Thyroiditis and this can occur in up to 8% of women after delivery.
In either case, inflammation of the gland leads to excess production of the hormone thus giving rise to hyperthyroidism.
Over-dosage of thyroid hormones: Excessive intake of thyroid hormones (prescribed for treatment of hypothyroidism) can lead to a hyperthyroid state. This especially happens if patients don’t follow up regularly with their physicians and continue to take the prescribed dose for hypothyroidism without keeping a check on the hormone levels.
Excessive iodine: Intake of excess iodine may also lead to a hyperthyroid state in people who have an abnormal thyroid gland.
High level of TSH: An abnormally high level of Thyroid Stimulating Hormone (TSH) can lead to excess stimulation of the thyroid gland resulting in high level of thyroid hormones. This can occur due to a tumor of the pituitary gland and is relatively rare.
Drugs: Iodine-containing drugs such as amiodarone or certain other medications like interferon-alpha, lithium, etc. may lead to a hyperthyroid state.

Symptoms
Hyperthyroidism may have vague symptoms especially at the onset and this is one of the commonest reasons for the diagnosis being missed. However, if these symptoms persist over a period of time, a physician must be consulted and the condition evaluated with laboratory tests.
Subclinical hyperthyroidism, on the other hand, is a state in which the person does not present with any symptoms of hyperthyroidism but laboratory tests indicate abnormal thyroid hormone levels.
Here is a list of some of the common presenting symptoms of hyperthyroidism:
•    Excess appetite
•    Weight loss in spite of eating well
•    Goiter (enlarged thyroid gland)
•    Tremors
•    Muscle weakness
•    Fatigue
•    Palpitations
•    Nervousness
•    Intolerance to heat
•    Sleeplessness
•    Breathlessness
•    Increased frequency of stools
•    Hair loss
•    Excessive perspiration and warm moist skin
•    Rapid heart rate
•    Abnormalities of menses – irregular cycles, scanty flow
•    Staring gaze
•    Reduced concentration
•    Brittle nails
•    Decreased libido
•    Exophthalmos (swelling of the tissue behind the eyeballs leading to protrusion of the eyeball)
•    Double vision
All these symptoms may not be present at the same time in the same person and the combination of symptoms varies from person to person.
Thyroid storm or Thyrotoxicosis is a life-threatening complication of hyperthyroidism and it may present as a state of high fever, vomiting, extreme irritability, delirium and coma. It is usually triggered by a stressful event and typically has a sudden onset. Patient is generally found to have a high blood pressure and rapid heart rate. If left untreated, Thyrotoxicosis can be fatal.

Diagnosis of Hyperthyroidism
The features of hyperthyroidism are characteristic of the condition; however, certain laboratory tests help to firmly establish the diagnosis and also to determine the cause hyperthyroidism.
Some of the tests required for diagnosis are:
•    Thyroid hormone T3 and T4 levels: These will be higher than normal in cases of hyperthyroidism. T4 levels are high in the early stages whereas T3 levels rise in the later stages of the disease.
•    Thyroid Stimulating Hormone (TSH) level: This will be lower than normal in case of Hyperthyroidism since high levels of T3 and T4 in the blood provide a negative feedback to the pituitary thereby reducing the release of TSH.
•    Thyroid Scan with radioactive iodine: This shows whether the excess thyroid hormones are being secreted by the entire gland or one or more nodules (Hot Nodules) in the gland.
•    Iodine Uptake Scan: This test measures the amount of iodine that is taken up by the Thyroid gland. Patients with hyperthyroidism take up too much of iodine.
•    Thyroid Ultrasound: An ultrasound of the thyroid gland determines the presence of thyroid nodules and also whether they are solid or cystic (fluid-filled) in nature.
•    Thyroid stimulating immunoglobulin or TSI – the presence of thyroid stimulating antibodies indicates Graves’ disease. In such cases, these immunoglobulins stimulate the thyroid to produce excess amounts of hormones resulting in a hyperthyroid state.

Natural Treatment
Natural treatment has good scope in the treatment of hyperthyroidism. The condition needs an in-depth analysis of the patient’s history in order to prescribe the constitutional remedy which will target the root cause of the ailment thus offering relief to the patient.
A detailed history includes not only the particulars of symptoms of hyperthyroidism but also information about other complaints of the patients, their likes and dislikes, general functions, mental attributes, history of diseases in past as well as in family, etc. At Hashmi Dawakhana, each of these are studied in detail for every case of hyperthyroidism and this is what gives us good results in most cases.
Natural treatment primarily helps in controlling the symptoms of the hyperthyroidism while restoring the thyroid hormone levels back to normal. The treatment also helps in reducing the dosage of conventional medication in the long run.
If the patient is already on conventional treatment, it may not be possible to stop the same immediately after starting natural treatment. The patient may need to take both treatments together initially and the dosage of the drugs can be tapered down with time depending on the patient’s progress with natural approach.
Patients on natural treatment for hyperthyroidism do report a significant improvement in their general well-being after commencing natural treatment. This can be attributed to the medication working at the level of the immunity to restore the imbalance therein, back to normal. It is suggested that the patients must opt for natural treatment in the early stages itself for best results.

Living with Hyperthyroidism
Hyperthyroidism may initially throw your life out of gear but it is not an impossible task to get things back on track. In fact, with proper medication and certain diet and lifestyle changes, it may well be possible to get the symptoms under control so that you may lead a healthier and more fulfilling life.
Here are certain things that have helped a lot many of our patients to cope better with their hyperthyroidism:
•    For people who have lost a lot of weight or have wasting of muscles, a diet high in calories and proteins is suggested. However, this must be properly planned with a professional dietician so as to get the best results.
•    The dietician will also suggest a diet that is rich in calcium (e.g. milk, yogurt, cheese, okra, spinach, tofu, etc.) since hyperthyroidism causes thinning down of the bone tissue and this too needs to be addressed properly.
•    It is very important to be educated about the disease in detail as well about the foods that can help to keep the problem under check. It must be noted that these may not reverse your hyperthyroidism completely but can surely be useful in controlling your problem:
•    Broccoli
•    Cabbage
•    Cauliflower
•    Kale
•    Brussels sprouts
•    Turnips
•    Soybeans
•    Peanuts
•    Linseed
•    Pine nuts
•    Millet
•    Cassava
•    Mustard greens
•    It is also advisable to limit the intake of refined foods like white bread, pastas and sugar; red meat, processed meat, etc.
•    The diet should be rich in antioxidant foods especially fruits (like blueberries, cherries, tomatoes, etc.) and vegetables (like squash, bell pepper, etc.)
•    Incorporating stress reduction techniques can be very helpful especially yoga, meditation, breathing exercises, progressive muscle relaxation, acupuncture, etc.
•    In cases where the eyes have been affected, warm and cold compresses should be used to alleviate the pain and swelling. Also minimize salt intake to prevent edema around eyes.
•    Eye drops may be used in cases of dry eyes
•    Use of a good conditioner can help in preventing dryness of hair and thereby minimize hair loss due to breakage. This is especially useful for people who experience excessive hair loss due to hyperthyroidism.

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