Conditions

Hyperthyroidism

This disorder occurs when the thyroid gland produces too much thyroid hormone, resulting in an overactive metabolic state.

Signs and Symptoms:

• Nervousness
• Irritability
• Constant feeling of being hot
• Increased perspiration
• Insomnia and fatigue
• Increased frequency of bowel movements
• Frequent menstruation and decreased menstrual flow
• Weakness
• Hair and weight loss
• Change in skin thickness
• Separation of the nails from the nail bed
• Hand tremors
• Heat intolerance
• Rapid heartbeat
• Goiter
• Protruding eyeballs
• Swelling at the base of the neck
• Sensitivity of eyes to light

Diagnosis:
The diagnosis of hyperthyroidism is usually straightforward and depends on a detailed clinical history and physical examination, a high index of suspicion, and routine thyroid hormone function tests. A serum TSH is the best first test, because TSH is always suppressed in hyperthyroid patients except when the etiology is a TSH-secreting pituitary tumor or pituitary resistance to thyroid hormone. Free T4 should then be measured, and if normal, serum T3 should be measured.

Treatment Options:
Treatment options allow doctors to lower thyroid hormone production in most cases, either by pharmaceuticals or surgery.

Traditional Treatments:

• Propylthiouracil and methimazole (Tapazole) are drugs that lower the output of thyroid hormone. These are often the first types of treatment used for hyperthyroidism. Once the levels of thyroid hormone have been reduced to within the normal range with these drugs, the dosage is usually reduced until an appropriate maintenance regimen is present. It is possible for the production of thyroid hormone to be reduced too much.
• If drugs are ineffective or cause intolerable side effects, your doctor may recommend a procedure to destroy overactive thyroid tissue. This is accomplished by taking radioactive iodine, or I-131. Since the thyroid takes up most of the iodine that enters the body, the effect of the radiation is focused there, and some of the gland's cells are destroyed. The idea is to destroy only enough cells to bring the production of thyroid hormone down to a normal level, but very often too much is destroyed and permanent hypothyroidism results, necessitating oral treatment with thyroid hormone for the rest of one's life.
• Iopanoic acid (Telepaque), a drug used to aid in visualizing organs in radiologic examinations, has been found to block thyroid hormones, but the body responds less and less to it over several months' time.
• Surgery to remove a portion of the thyroid tissue was once a common approach to treating hyperthyroidism, but it is used more rarely today. Possible problems with this technique include accidental removal of the parathyroid glands, which are located at the back of the thyroid gland and control the body's used of calcium and phosphorous, and damage to the nerve to the vocal cords.
• A type of drug called a beta-blocker, which blocks the transmission of certain nerve impulses, can control symptoms of hyperthyroidism. The drug most often used for this purpose is propranolol (Inderal). It handles almost all of the symptoms of the condition, even though it has no effect whatsoever on the actual output of thyroid hormone. If hyperthyroidism goes away on its own after a short time, this may be the only treatment necessary, but often more aggressive types of treatment, such as those mentioned before, are necessary.
• Treatment of a thyroid storm is much the same as for ordinary hyperthyroidism but is undertaken more aggressively.
• Propylthiouracil or methimazole is used to lower the output of thyroid hormone, and propranolol is prescribed to lower the heart rate and the stress on that organ. Hydrocortisone, a steroid, is used initially to reduce symptoms (the dose is then lowered as quickly as possible to avoid damage to the adrenal glands).
• For a thyroid storm that occurs during pregnancy, the lowest possible doses of propylthiouracil are used and thryoid function is left somewhat elevated, if possible, until after delivery. This drug appears in lower concentrations in breast milk than methimazole, so it is preferred over that drug.
• If hyperthyroidism is due to a tumor elsewhere in the body, treatment consists of surgical removal of the tumor.

Complementary and Alternative Therapies:
May minimize symptoms of mild thyroid dysfunction. Moderate to severe cases may need concurrent treatment with conventional therapies.

Nutritional Supplementation:

• Multivitamins and mineral complexes are needed for this "hyper" metabolic condition.
• Calcium and magnesium help calm the nervous system. Take 400mg of calcium and 200 to 300mg of magnesium three times daily.
• The essential fatty acids found in black currant seed oil, borage oil, evening primrose oil, and flaxseed oil assist in the regulation of the immune response. They also help to stimulate steroid production and aid in the transmission of nerve impulses. If you suffer from fatigue, dry skin, dry hair, constipation, depression, and/or frequent colds and flu, you may want to consider taking 500 to 1,000mg of any of these oils twice daily.
• Gamma-aminobutyric acid (GABA) is an amino acid that acts as a claming neurotransmitter. It can be helpful if nervousness is overwhelming or if you have been diagnosed with hyperthyroidism and are perimenopausal. Take 500mg two to three times daily for one week. Stop for one week, then repeat.
• A green-foods supplement that contains iodine, such as spirulina or chlorella, can help to improve and regulate metabolic and endocrine gland function. Take a dose that supplies the equivalent of 150mg of iodine daily.
• The B vitamins help to support and regenerate the nervous system. Take a B-complex vitamin supplement supplying 25mg of each of the major B vitamins twice a day. Or talk with your doctor about B vitamin injections.

Alternative Therapies:

• Bupleurum and dong quai, also known as Hsiao Yao Wan, is a Chinese patent medicine that helps to regulate the endocrine system. Take 500mg three times daily for tow months. Stop for one month, then repeat.
• Dandelion root is noted for its ability to regulate liver function, which in turn benefits the thyroid gland. Take 500mg or one cup of dandelion-root tea twice a day for six weeks. Stop for one month, then repeat.
• Iceland moss, Irish moss, and kelp are natural sources of the iodine the thyroid gland requires. Take a dose supplying the equivalent of 150mcg of iodine daily.
• Valerian is a noted calmative that is a proven aid to sleep. Choose a standardized extract containing 0.5 percent isovalerenic acids and take 200 to 300mg one-half hour before bedtime.
• The homeopathic remedy, Iodium, is good if you have dark hair and brown eyes, often feel very warm, tend to be obsessive about details and are usually very much in a rush. Take one dose of Iodium 200x or 30c twice daily for three consecutive days. Stop for one week, then repeat.
• The homeopathic remedy, Natrum muriaticum, is the remedy to choose if you have heart palpitations, constipation, and, possibly, a craving for salt. Take one dose of Natrum muriaticum 200x or 30c twice daily for three consecutive days. Stop for one week, then repeat.
• A homeopathic practitioner can prescribe a constitutional remedy formulated especially for you.
• The combination of lavender and rosemary oil is soothing to the nerves. Use them as an inhalant or diffuse them into the air in your home. Or add a few drops to a relaxing bath or massage oil.

General Recommendations:

• Get some type of exercise daily.
• Consult a licensed acupuncturist. Acupuncture is very helpful for endocrine disorders because it works to restore balance in the body.
• Craniosacral therapy, which involves gentle, subtle manipulation of bones in the head, face, and vertebral column, can also be beneficial.
• Eat plenty of the following foods: broccoli, Brussels sprouts, cabbage, cauliflower, kale, mustard greens, peaches, pears, rutabagas, soybeans, spinach, and turnips. These help to suppress thyroid hormone production.
• Avoid dairy products for at least three months. Also avoid stimulants, coffee, tea, nicotine, and soft drinks.

Warnings:
Be wary of treatment with radioactive sodium iodine (iodine 131, or I-131), that is often recommended for this condition. Severe side effects have been known to accompany the use of I-131.
Also, do not rush into surgery. Try improving your diet first.