Thyroid throwing your weight around?

At some stage in their lives one person in twenty will experience a thyroid problem. Most of these will be women.

Weighing only about 20 grams, the thyroid gland is an extremely important organ that controls metabolism and is responsible for the normal functioning of every cell in the body. It does this by manufacturing the hormones thyroxine (T3) and triiodothyronine (T4) which are fed into the bloodstream.

In healthy people the amounts of T3 and T4 in the blood are kept at the right levels by another hormone known as thyrotrophin or thyroid stimulating hormone (TSH). TSH is secreted by the pituitary gland.

When thyroid disease causes thyroid hormone levels in the blood to fall, TSH secretion is increased. When thyroid hormone levels rise, TSH secretion is switched off.

Thyroid disease often runs in families. If you think you may have a thyroid problem, your best course of action is to visit your GP, who will probably initially recommend you have a blood test if your symptoms warrant this. Test results should be available within a few days.

Dr.Loubser from Infinity Health Clinic in Dubai adds “Not all thyroid disease is diagnosed by a simple blood test. Thyroid cancer for example requires examination and specialised radiological investigations.” Infinity Health Clinic www.ihcdubai.com offers thyroid testing and examinations as well as support, counselling and ongoing care for patients.

THE FOUR MAIN THYROID PROBLEMS

1. Underactive Thyroid / hypothyroidism

• Low levels of T3 and T4. High levels of TSH
• Hypothyroidism usually comes on slowly
• Symptoms may include: Weight gain of 5 to 10 Kg even if appetite is normal or less than normal, sensitivity to the cold, tiredness, slowing down intellectually, slower or slurred speech, husky voice, slow pulse (60 beats /min.), constipation, heavier periods (in women), flaky, lighter skin, swollen eyelids, swollen hands and feet, lemon tint to skin sometimes with purplish flush to cheeks, dry, brittle hair, outer parts of eyebrows disappear, deafness, trouble with balance, tingling fingers.

2. Overactive thyroid / hyperthyroidism

• indicated by high levels of T3 and T4 and low levels of TSH
• Typical symptoms may include: Sudden unexplained weight loss, or sometimes slight weight gain in cases where sufferers feel constantly hungry (some patients even have to get up in the middle of the night to eat), heat intolerance and sweating, irritability, heart palpitations, breathlessness, tremor / shaky hands, more frequent bowel movements, irregular, light or absent periods, skin itchy all over, thinning hair, brittle nails.
• 70% of hyperthyroidism caused by Graves’ disease (see below)

3. Abnormal growth or enlargement of the thyroid, also known as goitre or thyroid nodule

• 70% of all overactive thyroid cases are caused by an antibody found in the blood that stimulates the thyroid not only to secrete excessive amounts of thyroid hormones, but also to increase the size of the thyroid gland, producing goitre. This type of hyperthyroidism is known as Graves’ disease.
• Typical symptoms may include those in point 2. Also patients with Graves’ disease sometimes develop prominent eyes, possibly with bags underneath. Their eyes may also become scratchy, watering more than usual. A few also suffer from raised, red itchy areas of skin on the front of the lower legs or tops of the feet
• Although Graves’ disease can occur at any age, it mostly affects women in the 30 to 50 age group.

4. Thyroid cancer

• Although rare, thyroid cancer is not necessarily terminal if detected early and treated correctly. Thyroid cancer is suspected when there is an enlargement in an area of the thyroid gland. Appropriate investigations include blood investigations as well as ultrasound scan and possibly fine needle biopsy of the swelling. Early investigation and management of thyroid swellings can lead to very favourable outcomes, even if the swellings are found to be cancerous.

A WORD ABOUT DIET

You may have heard that Iodine has something to do with the thyroid gland and it does. Iodine is found in T3 and T4 molecules. A lack of iodine in ones diet may cause a goitre or even hypothyroidism. But this is usually only seen in remote mountainous areas far away from the sea. In today’s modern cities, people get enough iodine in their diet without taking supplements, although some use iodized salt to make absolutely sure.

Bibliography
Understanding Thyroid Disorders* by Dr. Anthony Toft, Consultant Physician and Endocrinologist at the Royal Infirmary of Edinburgh.
*Published 1995 by Family Doctor Publications Limited, in association with the British Medical Association