Thyroid Disorders by Nathan Kiskila, M.D.

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The thyroid is a small, highly vascular, butterfly-shaped gland at the front of the neck. It is stimulated by TSH (Thyroid Stimulating Hormone) to produce thyroid hormones: T4 and T3, which in turn, influence body metabolism, growth, and development. Many people, especially women ages between 20-40 years old, suffer from thyroid dysfunctions. Symptoms can vary from very mild to severe, and if not treated they may became a life-threatening emergency.

The most common thyroid problems result from abnormal levels of circulating thyroid hormones. Hyperthyroidism occurs when patient has excessive thyroid hormones circulating throughout her/his body. It is detected by a simple blood test and presents with decreased TSH and elevated T4. The most common symptoms are: heart palpitations, elevated BP, weight loss, agitation, heat intolerance, nausea, bulging eyes, and enlarged goiter. People with hyperthyroidism, who are not on any medications to correct it, are at risk for thyroid storm, a potentially fatal acute episode of thyroid activity. Thyroid storm can be triggered by stress, illness, infection, or medication overdose. Hyperthyroidism may be also caused by Graves’ disease, an autoimmune disorder in which a patient develops antibodies to the TSH receptor, which attach to the receptor and stimulate gland to release more thyroid hormones than necessary. Treatment of hyperthyroidism is based on bringing circulating thyroid hormone levels back to normal. Patients are usually put on beta-blockers like Propranolol to control heart arrhythmias, along with antithyroid medications like PTU (Propylthiuracil). These medications inhibit the synthesis of thyroid hormones or iodine to decrease vascularity of the gland and decrease the release of thyroid hormones into circulation. A patient with hyperthyroidism should be on high calorie diet, 4,000-5,000 kcal/day to satisfy hunger and prevent tissue breakdown.

Hypothyroidism, on the other hand, results from inadequate thyroid hormone secretion, and requires lifelong thyroid hormone replacement. Patients are usually prescribed Levothyroxine to correct thyroid deficiency and Cytomel to replace the T3 hormone. Hypothyroidism may be caused by the following: destruction of thyroid tissue which is an autoimmune disorder called Hashimoto’s thyroiditis, pituitary disease, iodine deficiency, discontinuation of thyroid supplement, and amiodarone or lithium intake. Patients who suffer from hypothyroidism show symptoms of fatigue, weight gain, increased triglycerides and lipids, hypotension, constipation, cold intolerance, and activity intolerance. Untreated hypothyroidism may lead to mixedema coma, a life-threatening condition manifested by severe hypotension, hypothermia, hypoglycemia, and eventually coma.

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The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

 

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