My last column discussed the thyroid gland and what happens when it is under-active, a disorder called hypothyroidism. This week’s offering will explore the opposite ailment, hyperthyroidism, a condition in which the thyroid gland is over-active and produces too much of the thyroid hormones. The thyroid gland is a butterfly-shaped gland which is located at the base of the neck just below the Adam’s apple. In healthy individuals it produces just the right amounts of hormones which regulate the rate of metabolism in the body. Since the body’s metabolism sets the tone for every action in most organ systems, it is essential that it not get out of balance.
Hyperthyroidism causes an increase in the metabolic rate, so people who are affected by it often feel hotter than usual. People who suffer from this disorder might also experience gradual weight loss even in the presence of an increased appetite. The body burns calories much faster than normal if too much thyroid hormone is being produced. At the end of the day a person with hyperthyroidism feels fatigued but finds it very difficult to fall asleep. Sufferers might also develop trembling hands, heart palpitations, and shortness of breath. Some people have reported warm, moist skin, hair loss, weak muscles, and a blank staring gaze. Most often the symptoms of hyperthyroidism have a gradual onset and people tend to brush them off as symptoms of something else until they become severe. This is one danger of this disorder since people can be sick for weeks or even months before they realize it. Another danger of hyperthyroidism is malnourishment. Many nutrients, especially minerals, become more quickly depleted in the presence of a hyper-metabolic state such as that caused by the presence of excess thyroid hormones. This is an often overlooked problem, and can set a person up for other disorders which might result from improper nutrition.
There are several causes of hyperthyroidism, but the most common one by far is Graves’ disease. It is named for the Irish physician who first described the disorder. Graves’ disease is an autoimmune disorder, or one in which the body’s antibodies are working against it instead of for it and they attack the thyroid gland. These antibodies attach to the thyroid gland and cause it to make too much thyroid hormone. The thyroid gland becomes enlarged (produces a goiter) in response to the overproduction of thyroid hormones. About one out of twenty patients with Graves’ disease will develop an eye condition in which the eyes bulge. Otherwise, in addition to hyperthyroidism, people with Graves’ disease suffer from inflammation of the soft tissue around the eyes which might cause swelling, irritation, and thickening of the skin over the lower portions of the legs. Graves’ disease is most common in women, and for some unknown reason it tends to be inherited. Other less common causes of hyperthyroidism include inflammation of the thyroid gland which might cause the gland to overproduce the thyroid hormones, non-cancerous nodules inside the gland, and overdosing on any of the several pharmaceutical thyroid hormone replacements.
Treatment for those with hyperthyroidism is fairly simple once the diagnosis is confirmed by a blood test. Anti-thyroid medications work to suppress the function of the thyroid gland, surgical removal of the gland itself certainly curtails its function, and radioactive iodine treatment specifically targets thyroid gland cells to destroy them. The latter is the most widely recommended treatment since the only cells in the body which absorb iodine are those in the thyroid gland, and radioactive iodine is not shown to affect any other part of the body. Surgical removal poses a small risk of damage to the nerve to the voice box, the recurrent laryngeal nerve, and can result in leaving one unable to speak. (This actually happened to a friend of mine who was an English professor, and she was forced to retire.) Some of the treatments for hyperthyroidism can (and often do) cause hypothyroidism, and result in the need for permanent use of levothyroxine to replace thyroid hormones in the body. There are some dietary considerations and natural treatments for hyperthyroidism, but the balance in the body is so delicate that sometimes treatment without knowing the extent of the problem with the thyroid gland can be dangerous.
Pay attention to your body, and if you have been experiencing any of the symptoms of hyperthyroidism, ask your doctor to run a simple blood test to check the levels of your thyroid hormones. Since the symptoms appear gradually, you can spend a long time chasing them. A simple blood test can easily confirm hyperthyroidism and allow you to begin treatment right away or eliminate it completely from the list of possible causes of your trouble. Treat your body well.