Showing posts with label autoimmune thyroid disease. Show all posts
Showing posts with label autoimmune thyroid disease. Show all posts

Friday, June 12, 2009

What is the Thyroid?

In her book, All Your Health Questions Answered Naturally II Maureen Kennedy Salaman explains what the thyroid is. See her article below.

The thyroid gland sits at the base of the neck. If you wore a tie, it would be where the knot lies - two lobes on either side of the trachea. Considered a master gland, because of its importance to the body's metabolism, the thyroid's main functions are to create thyroid hormone that forms protein RNA and oxygenates cells. (1)

The gland regulates growth and metabolism, and it releases hormones that affect numerous bodily functions such as heartbeat, temperature, digestion, calorie burning and hair growth.

Thyroid hormones are made from iodine and the amino acid tyrosine. A thyroid hormone deficiency results from a lack of stimulation by the pituitary gland, the master gland located in the brain that secretes the thyroid stimulating hormone (TSH). (2)

Symptoms run the gamut. They include weight gain, depression, fatigue, cold hands and feet, mental disorders, infertility, miscarriage, poor sex drive, heavy or irregular menstruation, high cholesterol, hair loss, dry skin, pale skin, brittle hair, thin and grooved fingernails, muscle weakness, stiff joints, heart problems, constipation, goiters and kidney problems. Since metabolism breaks down with a thyroid problem, having many different ailments can signal a dysfunction. (3)

An article in the British Medical Journal addressed a study in which "six percent of children with Down's syndrome have thyroid disorders, a rate roughly 28 times that of the general population." (4)

Researchers at the Department of Medicine, National University Hospital, Singapore, backed this up when they found a significant link between Down's syndrome and autoimmune thyroid disease, usually hypothyroidism. (5)

Even sleep apnea, a situation where breathing stops during sleep, is shown in studies to be caused by hypothyroidism. When the hypothyroidism is treated, not only is sleep apnea alleviated, but overall sleep is improved. Bashir A. Chaudhary, M.D., of the Sleep Disorder Center, Medical College of Georgia in Augusta, suggests it is reasonable to evaluate thyroid function in all sleep apnea patients. (6)


References:
(1) Braverman, Eric, M.D., and Pfeiffer, Carl C., M.D., Ph.D., The Healing Nutrients Within, Keats Publishing, New Canaan, CT, 1987.
(2) Krampf, Leslie, "Natural Help for Hypothyroidism," Vegetarian Times, n. 207, p. 122, November 1994.
(3) Murray, Michael, M.D., and Pizzorno, Joseph, N.D., Encyclopedia of Natural Medicine, Prima Publishing, Rocklin, CA, p. 388-389, 1991.
(4) Thorpe-Beeston, J.G., et al, "Thyroid Function in Fetuses with Chromosomal Abnormalities," British Medical Journal, v. 302, n. 6777, p. 628, March 16, 1991.
(5) Tambyah P.A. and Cheah J.S., "Hyperthyroidism and Down Syndrome," Annual Academy of Medicine, v. 22, n. 4, p. 603-605, July 1993.
(6) Kittle, William M., M.D., and Chaudhary, Bashir, M.D., "Sleep Apnea and Hypothyroidism," Southern Medical Journal, v. 81, n. 11, p. 1421-1425, November 1988.
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Thursday, June 11, 2009

Hypothyroidism

Nathan Becker, M.D., F.A.C.E., F.A.C.P, assistant clinical professor of medicine at University of California at San Francisco, says this about hypothyroidism in Thyroid Power: Ten Steps to Total Health written by Richard L. Shames, M.D., and Karilee Halo Shames, R.N., Ph.D.:

Hypothyroidism is undoubtedly the most common disorder of thyroid function. It affects both sexes and all ages; it may be overt or subclinical; the spectrum of severity is broad. At one extreme are patients who have a few symptoms and signs. At the other extreme are patients in coma. Hypothyroidism can be subclinical for many years, particularly in patients with autoimmune Hashimoto's thyroiditis.

Although we are beginning to understand immune mechanisms, we do not yet fully understand autoimmune thyroid disease. Hashimoto's disease is primarily cell-mediated immune destruction of the thyroid gland. In the less common Graves' disease (also called thyrotoxicosis), a circulating antibody drives the thyroid to hyperfunction, out of the control of pituitary TSH feedback. Graves' disease and Hashimoto's disease frequently coexist in families. Although the tendency to develop these autommune disorders is almost certainly inherited, we do not yet know how the malady is inherited.

What frequently confuses the average clinician is that patients often experience other autoimmune endocrinopathies simultaneously. Addison's disease (adrenal insufficiency), type 1 diabetes (insulin dependent), autoimmune gonadal failure, hypoparathyroidism and pituitary failure are not rare partners. Several years ago, Phyllis Saifer, M.D., and I coined the term APICH Syndrome, which introduced associative non-endocrine maladies with the previously outlined endocrine disorders. While clinically important, these relationships tantalized more than informed us about the basic mechanisms of autoimmunity.

Thyroid disorders are coupled maladies: localized inflammation with generalized flu-like symptoms and resultant hormone excesses or deficiencies. It is no surprise that the patient, as well as the physician, is confused.

Admid this confusion, treatment with thyroid hormone -- to the point of TSH suppression -- is often diagnostic as well as therapeutic. These remarks would be considered heresy by academicians. Physicians and patients should, however, remember that academicians are often passionate, idealistic, eccentric, quarrelsome and self-serving. They often do research, publish, teach, but rarely see or care for thyroid sufferers.

Regarding actual patient care, a trial of thyroid hormone therapy was often used to good advantage in the past. Today, with sensitive laboratory studies, such as TSH assays, our presumed ability to diagnose thyroid disease has encouraged the physician to treat the laboratory data instead of the patient. Consequently, empiric treatment with thyroid hormones has fallen out of favor.

Nevertheless, sensible, cost-effective treatments of widespread thyroid disorders remain an important concern of the physician, not least because the patient often presents with vague complaints that easily can be misdiagnosed. Patients who present with fatigue, depression and subtle cognitive defects are frequently dismissed, discouraged and mistreated. I've spent many years treating these patients with thyroxine (T-4) and more recently with concomitant triiodothyronine (T-3) with much success.
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