Health> What exactly does a thyroid do?

Text by: Tanya Munshi

Not many are sure what the thyroid does in the human body.

Some associate it with a disease. Dr Caesar Sengupta, MD, Senior Manager Processing of Thyrocare Technologies (a thyroid testing laboratory) clarifies:"It is not a disease, but a gland, and an integral part of the body."

The thyroid is a small, butterfly-shaped gland located in the base of our neck, just below the Adam's apple. The two main hormones produced by it are iodine (containing hormones Thyroxine or T4) and Triiodothyronine (or T3) that circulate in the body through the bloodstream and work on every living tissue and cell. TSH, a thyroid-stimulating hormone, is produced by the pituitary that stimulates the thyroid gland. "These hormones are essential for life and have many effects on body metabolism, growth and development. For example, thyroid hormones make the heart beat faster and cause the body to burn up calories more quickly," says Dr Sengupta.

Thyroid levels
The normal or healthy range for T3, T4 and TSH will vary slightly from laboratory to laboratory, depending upon the kind of tests, brand of reagents and analysers used for the measurement of the hormones.
According to Thyrocare, the values are:
Triiodothyronine (T3): 60-200 ng/dL
Thyroxine (T4): 4.5-12 g/dL
Thyroid stimulating Hormone (TSH): 0.30-5.50 � IU/ml

When you get your medical reports, this is what you will see. Any amount below or above the given range needs medical advice. "But remember, no single laboratory test is 100 per cent accurate in diagnosing all types of thyroid disease. A combination of two or more tests can detect abnormality of thyroid function," adds Dr Sengupta. Treatment regimes for thyroid disorders are normally determined by regular blood tests and clinical observation.

When you get your medical reports, this is what you will see. Any amount below or above the given range needs medical advice. "But remember, no single laboratory test is 100 per cent accurate in diagnosing all types of thyroid disease. A combination of two or more tests can detect abnormality of thyroid function," adds Dr Sengupta. Treatment regimes for thyroid disorders are normally determined by regular blood tests and clinical observation.

Common thyroid conditions
"There are certain problems associated with thyroid, the most common among the general population being Hypothyroidism and Hyperthyroidism," adds Dr Sengupta. Hypothyroidism is a condition where the thyroid gland doesn't produce a sufficient amount of hormones (underactive thyroid), while it produces more (overactive thyroid) in the case of Hyperthyroidism.

Hypothyroidism
The most common cause of this is Hashimoto's thyroiditis, an autoimmune condition that destroys the thyroid gland. Hashimoto's thyroiditis is an auto-immune disease where the body's own anti-bodies attack the thyroid cells. Auto-immunity occurs when an organism or body fails to recognize its own constituent parts, thereby turning against its own cells and tissues. It is a state where immune cells in your body mistake your own organs, cells or glands as intruders and attack them. "Auto-immunity can work against any organ. It could be auto-immunity of the stomach or joints, and when it acts on the thyroid gland, we call it auto-immune thyroiditis," explains Dr. Sengupta.

Hypothyroidism is found more often in women than men and can be missed in its early stages because of its very insidious onset with symptoms, which can simulate many other diseases. In the beginning of development of clinical hypothyroidism, even before the TSH level is high enough to warrant treatment, the body's metabolism can slow down. This means fewer calories burned each day, and even those few calories start to add up.

Hypothyroidism brings in lethargy, which makes regular exercise even more troublesome and the vicious cycle sets in. It occurs when the body's metabolism is too slow due to an absence or deficiency of the thyroid hormone. The good news is, it can be easily treated, as it requires a replacement of hormones through medication and the regular monitoring of blood levels of the hormones.

Hyperthyroidism
This occurs when an excess in thyroid hormone produces symptoms of abnormally high metabolism, either due to an overactive thyroid gland or taking too much thyroid hormone replacements � like medicines. The most common cause of hyperthyroidism is Graves' disease -- an auto-immune disease where the body's own immune system mistakenly attacks its own thyroid gland, causing it to overproduce the Thyroxine hormone.

There are three options for treatment namely: medical, surgical and radioactivity.

"An experienced and trained physician would be the best judge to offer the appropriate form of treatment especially if the problem is further complicated with pregnancy. Some of the symptoms in pregnancy also mimic those manifested with thyroid dysfunction," adds Dr Sengupta.

Published in Rediff.com, on March 8, 2007
Link: http://in.rediff.com/getahead/2007/mar/08thyroid.htm

Health> Diet, execercise and thyroid trouble

Text by: Tanya Munshi
In the earlier story, we looked at what a thyroid does. Here's more of what you need to know.

Thyroid Eye Disease (TED)
Many people with autoimmune thyroid diseases such as Graves or, in a few cases, Hashimoto's, develop TED. It is an autoimmune disease of the orbit (eye socket) and eye muscles, characterised by inflammation, swelling and possible scarring (rare/ occasional), with swollen eyelids and 'poppy' eyes. The treatment for TED may involve two parts � first treating the thyroid disorder, then possible eye surgery.

Thyroid nodules
These are lumps or abnormal growths on the thyroid gland, that are either benign (non-cancerous) or malignant (cancerous). They are generally asymptomatic (i.e. have no symptoms), although some people experience tenderness and pain in their thyroid. Treatment for such patients will vary on a case-to-case basis, depending on the doctor's advice and therapy.

Goitre
This is an enlarged thyroid gland that causes a large swelling in the neck. All people suffering from thyroid disorders can develop goitre.Treatment depends on the case, a doctor's advice and therapy.

Thyroid cancer
There are different types of thyroid cancer (papillary, follicular, anaplastic, medullary, and lymphoma), the vast majority of which are readily treatable. Treatment for patients suffering from any kind of thyroid abnormalities will depend on individual cases, a doctor's advice and therapy. However, in all cases of thyroid abnormalities, it is imperative to control goitrogen food items in one's daily diet.

Causes of thyroid disease
These can be due either to an abnormal thyroid gland, inadequate levels of thyroid hormone replacement (the treatment for hypothyroidism), iodine deficiency disorder (IDD -- remedied by the use of iodised salt), not enough hormones released by the pituitary gland to the thyroid, or the treatment for hyperthyroidism, thyroid nodules or thyroid cancer.

Some individuals are more likely than others to have a thyroid problem. These include those with high cholesterol, those who have lost or gained more than 2 kilos in 2-3 months, those who feel exhausted, those suffering from infertility, and those with a family history of thyroid disease. It affects 1.5 per cent of the population and its incidence is higher in women than men (4:1). Also, women in their reproductive age are more vulnerable. The menstrual cycle, pregnancy, delivery and related hormonal, immunological and other stresses make women more prone to these problems.Thyroid related diseases can also be hereditary. Hashimoto's thyroiditis and Grave's disease may run in families.

Symptoms of thyroid disease
The signs and symptoms of thyroid problems can be wide ranging from person to person. Some that make doctors suspect thyroid problems are:
~ weight loss/ weight gain
~ hair loss, coarse/ dry hair
~ excessive dryness/ moist skin
~ anaemia, fatigue/ weakness
~ palpitations, tremors, extreme heat or cold intolerance
~ muscle cramps and aches
~ anorexia/ increased appetite
~ constipation/ increased bowel movements
~ abnormal menstrual cycles
~ decreased libido, infertility/ miscarriages,
~ exophthalmic eyes or a starting gaze (protrusion of the eyes in Grave's Disease)~ hoarse voice, deafness
~ high cholesterol levels
~ memory loss, poor concentration, depression, insomnia, irritability, restlessness and
~ family history/ thyroid problems
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Diet for thyroid patients
Goitrogens are naturally-occurring substances in food that can interfere with the functioning of the thyroid gland. There are two general categories of foods that have been associated with disrupted thyroid hormone production in humans: soybean-related foods and cruciferous vegetables like broccoli, cabbage, cauliflower, turnips, mustard etc. Other foods not included in these categories -- such as peaches, strawberries, peach, peanuts, radish, tofu, spinach and millet -- also contain goitrogens. Patients with hypothyroidism should avoid the intake of iodine containing foods such as red food dyes, iodine in multivitamins and metabolic boosters, dairy products, shellfish, and processed foods that can block iodine absorption.

Exercise for patients
Regular exercise is very important. Early diagnosis and subsequent weight loss programmes are also important for overweight hypothyroid patients. The longer it takes to diagnose hypothyroidism, the more weight an individual may gain. There are also lifestyle changes a patient may have to make.

For instance, toxins in cigarette and alcohol directly injure thyroid cells during their passage through the body. Immune system cells within the thyroid gland react to these compounds by producing thyroid antibodies or inflammation. People with Graves' disease who smoke are 7.7 times more likely to develop TED. By avoiding cigarettes and chemical additives, we can help restore immune function and thyroid health.

Published in Rediff.com, on March 9, 2007
Link: D:\Tanya Munshi\Rediff_Published_Articles_Mumbai\Diet, exercise and thyroid trouble.htm