Disease of the thyroid gland is a common cause of vague ill health, weight loss or weight gain.

 

Causes of Thyroid Problems

If there is one switch that controls the body’s activity it is the thyroid gland. This shield-shaped gland lies in the neck on either side of the windpipe. Thyroid hormone regulates the level of metabolic activity of the cells of the body: too much and they go into overdrive (hyperthyroidism); too little and there is a sluggish underactivity (hypothyroidism).

Thyroid disease is usually the result of an auto-immune condition, where the body treats its own tissues as a foreign invader. It sends in white cells and other immune factors which destroy the thyroid gland. This holds both for over- and underactive glands. Underactive glands can also result from treatment of a previous overactive gland. Iodine is essential to the formation of thyroid hormone and iodine deficiency leads to underactivity of the gland.

Symptoms of Thyroid Problems

Both under- and overactivity of the thyroid begin in a slow way and are often overlooked by family, friends and doctors.

Overactivity

The body’s rate of activity is speeded up. People feel on edge and notice a fine tremor of their hands. They sweat, feel hot and seem in a rush. The heart rate is raised well above the normal 60-90 beats per minute and they feel palpitations. Weight loss is common as the body bums energy at a rapid rate; the appetite is good to ravenous. In Graves’ disease a
staring eye appearance is due to abnormal tissue deposited behind the eyes. Left untreated, hyperthyroidism (thyrotoxicosis) ends in exhaustion and, ultimately, heart failure. It is most common in women between 20 and 50.

Underactivity

The picture is in reverse: people feel sluggish and tired and might gain weight despite a normal appetite. Their skin feels cool and rough and their features look coarse and puffy. The heart rate is below 60. There is sometimes constipation and depression. Hypothyroidism can lead to severe hypothermia (very low body temperature), apathy, self-neglect and heart failure. It is common in middle age and very common in the elderly. Underactivity is rare in children. It is detectable by a blood test which is done routinely in many countries at birth.

Treatment of Thyroid Problems

The diagnosis is confirmed by blood tests of the exact level of thyroid hormone. These tests can also monitor treatment.

Overactivity

Two drugs are used to bring the gland under control: carbimazole and propylthiouracil. Both take several weeks to work, during which time a beta-blocker helps relieve the sense of agitation and palpitations. Treatment continues for several months. Many cases settle like this. If the illness recurs the options are to remove part of the gland (a thyroidectomy) or destroy it with a radioactive, but harmless, form of iodine.

Underactivity

Replacement hormone is given as a daily tablet of thyroxine. It is initially used as a very low dose – as the hypothyroid heart is very sensitive to it – and guided by blood tests as to the right dose. Once stable, the patient remains on thyroxine for life, requiring regular blood tests to check control.

Complementary Treatment of Thyroid Problems

Complementary approaches should not replace conventional treatment. Autogenic training allows mind and body to rebalance themselves; hormone levels may rise and fall according to the system’s needs. Nutritional deficiencies may be implicated in some thyroid problems, for example zinc, vitamin A, selenium and iron – a nutritional therapist will be able to advise on supplementation. Other therapies to try: cymatics; yoga; tai chi/chi kung; reflexology.

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