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BROWN: All you need to know about the thyroid and its ills

The thyroid is a butterfly shape endocrine gland located in the lower front of the neck. According to the American Thyroid Association, the job of the thyroid is to make hormones, which flow into the blood stream and are then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscle and other organs working as they should. The thyroid helps the body’s metabolism function properly. If the thyroid is not working, then the body’s metabolism will either increase or decrease.

Hypothyroid indicates the body can’t make enough thyroid to keep the body running normally. Causes for hypothyroidism are autoimmune disease, surgical removal of thyroid and radiation treatment. Thyroiditis is an inflammation of the thyroid gland, usually caused by an autoimmune attack or viral infection affecting the thyroid. Rare reasons are congenital hypothyroidism that a few babies are born without a thyroid or a partly formed thyroid. The thyroid gland must have iodine to make thyroid hormone. The Thyroid Association says taking in too much Iodine can cause or worsen hypothyroidism. The pituitary gland, the master gland, tells the thyroid how much hormone to make. When the pituitary is damaged by a tumor, radiation, or sugary, it may no longer be able to give the thyroid instruction and the thyroid may stop making enough hormone.

The American Thyroid Association identifies two blood test used to diagnose hypothyroidism or hyperthyroidism are the TSH (thyroid-stimulating hormone) test. It measures how much of the thyroid hormone thyroxine (T4) the thyroid gland is asked to make. An abnormally high TSH means hypothyroidism: the thyroid gland is asked to make more T4 because there isn’t enough T4 in the blood. There is also the T4 test to determine how much free T4 is in the blood stream. The free T4 and the free T4 index are both simple blood tests that measure how much unattended T4 is in the blood and available to get into cells.

When thyroid levels are too low, the body’s cells can’t get enough thyroid hormone and the body’s processes start slowing down. As the body slows, you may notice that you feel colder, you tire more easily, your skin is getting drier, you’re becoming forgetful and depressed. Because the symptoms are so variable, the only way to know if it’s hypothyroidism is with a simple blood test for TSH.

There is no cure for hypothyroidism. Many patients with viral thyroiditis have their thyroid function return to normal over time. Hypothyroidism may become more or less severe and the dose of thyroxin may need to change over time. Taking the prescribed medication every day and working with the doctor to get and keep thyroxin dose right should keep the thyroid completely controlled throughout life. Symptoms should disappear and the serious effects of low thyroid hormone should stop getting worse. If seeing an endocrinologist, have results sent to a primary care manager.

TSH should be checked according to the doctors instructions. Tests may be required if pregnant or taking medicine that interferes with the body’s ability to use thyroxine. The goal of treatment is to get and keep the TSH in the normal range. Return to the doctor sooner if symptoms return or get worse. If someone takes more than the prescribed medicine, it’s possible for symptoms of hyperthyroidism, an overactive thyroid, to develop, according to the American Thyroid Association.

Hyperthyroidism is the overproduction of thyroid hormone. The most common symptoms of too much thyroid hormone are fatigue but inability to sleep, greater appetite, nervousness, shakiness, irritability, thinning skin, fine brittle hair, and trouble exercising because of weak muscles, shortness of breath, and a racing, skipping heart.

The American Thyroid Association says that Graves’ disease (named after the doctor who discovered the condition), which is the most common form of hyperthyroidism, may cause the eyes to look enlarged because the upper lids are elevated. Some patients have an enlarged thyroid (a goiter) on the front of the neck. Graves is caused by antibodies in the blood that attack the thyroid, which tends to run in families. Another type of hyperthyroidism may have one or more nodules or lumps in the thyroid. Also people may temporarily have symptoms of hyperthyroidism if they have thyroiditis.

A physical exam by the doctor usually detects an enlarged thyroid gland and a rapid pulse. The doctor will also look for tremors of the fingertips. Diagnosis is usually made by measuring the amounts of T4 and triiodothyronine (T3) and TSH in the blood. A high level of thyroid hormone in the blood plus a low level of TSH is common with an overactive thyroid. If the thyroid is overactive, the doctor may obtain a picture of the thyroid (a thyroid scan). The scan identifies if the entire thyroid gland is overactive or whether there is a toxic nodular goiter or thyroiditis. A test that looks at the ability of the gland to collect iodine (a thyroid uptake) may be given also.

The Thyroid Association says the appropriate treatment choice is influenced by age, type of hyperthyroidism, and any other medical conditions that may be affecting the person’s health. Drugs known as antithyroid agents may be used if the doctor chooses to treat hyperthyroidism by blocking the thyroid gland’s ability to make new thyroid hormone. Antithyroid agents work well, according to the Thyroid Association, to control the overactive thyroid and do not cause permanent damage to the thyroid gland. Radioactive iodine is selected with the goal of making the thyroid low so that the hyperthyroidism does not come back. Hyperthyroidism can be permanently cured by surgical removal of most of the thyroid gland. The American Thyroid Association adds Beta blockers can be helpful in slowing down the heart rate and reducing the symptoms of palpitations, shakes and nervousness until one of the other forms of treatment has a chance to take effect.

For more information related to the thyroid, visit the American Thyroid Association at www.thyroid.org.

Dairlyn Brown is a nurse in Warner Robins

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