Thyroid Treatment

A Small but Powerful Gland

 

 

Thyroid hormones help regulate body temperature, heart rate, brain and body growth in children, mood, and nervous system activity that is responsible for attention and reflexes.

Thyroid disease

Thyroid disease effects more than 20 million people in the United States, and it is estimated that over 10 million people are unaware that they have a problem. At Partners in Healthcare, Naturally, we want to provide Prescott residents with comprehensive treatment for thyroid health. Thyroid conditions are more common in women and as we age and thyroid treatment can become necessary for quality of life. The thyroid gland is in the throat area behind the “Adam’s Apple” and is a part of the endocrine system because it releases thyroid hormones.

The hypothalamus, located in the brain, releases thyrotropin-releasing hormone, which in turn stimulates thyroid-stimulating hormone (TSH) from the pituitary gland. The thyroid gland produces tetraiodothyronine or thyroxine (T4) and triiodothyronine (T3), both active thyroid hormones.

Thyroid hormones help regulate body temperature, heart rate, brain and body growth in children, mood, and nervous system activity that is responsible for attention and reflexes.

Another thyroid hormone, reverse-triiodothyronine (rT3) is also produced, which counteracts the actions of T3 during periods of stress or when too much T3 is produced, such as in hyperthyroidism. TSH is the most common lab test to evaluate the status of thyroid function; however, whenever someone is taking hormones or I highly suspect a thyroid condition, I always check free T4, free T3, TSH, and when appropriate, rT3.

Thyroid Conditions

In general, most thyroid diseases are autoimmune in nature. When hypothyroidism (low thyroid hormones) is related to an autoimmune cause it is called “Hashimoto’s Thyroiditis,” but most physicians just call it “Hypothyroidism.” When hyperthyroidism (high thyroid hormones) is caused by autoimmunity it is called “Grave’s Disease.”

Thyroid Tests

The type of thyroid tests varies depending on what the physician is looking to diagnose, and not all physicians agree on which tests are ordered. Some physicians will not run antibody tests because the treatment may be the same if the patient has or does not have an autoimmune condition. I disagree with this approach, because having one autoimmune condition may increase the likelihood of another condition. Thyroid hormones are either bound to proteins to carry them through the bloodstream, or free so they can act directly on cell receptors.

  • Total Thyroxine (TT4): total bound and non-bound T4 in the blood
  • Free Thyroxine (FT4): total non-bound T4 in the blood
  • Free Triiodothyronine (FT3): total non-bound T3 in the blood
  • Reverse-Triiodothyronine (rT3): The rT3 level tends to follow the T4 level: low in hypothyroidism and high in hyperthyroidism. However, increased levels of rT3 have been seen in stress, starvation, anorexia nervosa, severe trauma, liver dysfunction, following surgery, severe infection, and in burn patients. If patients are not responding to typical doses of thyroid hormones, especially when using non-synthetic hormones, I will order this test. It is very important to run this test along with TSH, FT4 and FT3, otherwise the test results will not make sense.
  • Thyroid-Stimulating Hormone (TSH): individuals with hypothyroidism will have elevated levels; those with hyperthyroidism will have low levels of TSH; and some people will have elevated levels of TSH but normal amounts of thyroid hormones (called subclinical hypothyroidism).
  • Thyroid peroxidase (TPO) Antibodies: These antibodies attack the thyroid gland and cause inflammation and impaired function of the thyroid. These can be found in both Hashimoto’s and Grave’s disease.
  • Thyroglobulin antibody (TgAb): These antibodies are present with an autoimmune cause of the thyroid disease but are not positive as often as the TPO antibodies are in Hashimoto’s disease.
  • Thyroid-stimulating immunoglobulins (TSI): this test is usually run to help diagnose and follow patients with Grave’s disease, which will elevate levels of this lab test.

Hypothyroidism Diagnosis

Hypothyroidism is when your thyroid hormones are low and usually need to be supplemented with hormone therapy. Because the thyroid hormones are low, your brain will try to stimulate more hormones to be produced, thus the TSH will be elevated to create more hormones. When the condition is caused by the autoimmune condition Hashimoto’s thyroiditis, the thyroid gland becomes inflamed and thus called “thyroiditis” or inflammation of the thyroid gland. This is the most common cause of hypothyroidism in humans. Symptoms of hypothyroidism include the following but vary person to person.

  • Fatigue
  • Feeling cold
  • Constipation
  • Dry skin
  • Weight gain
  • Puffy face
  • Hoarseness
  • Muscle weakness
  • Elevated blood cholesterol level
  • Muscle aches, tenderness and stiffness
  • Pain, stiffness or swelling in your joints
  • Irregular menstrual periods
  • Thinning hair
  • Slowed heart rate
  • Depression
  • Impaired memory
  • Insomnia

Hyperthyroidism Diagnosis

Hyperthyroidism is when your thyroid hormones are high and need to be lowered. Because the thyroid hormones are high, your brain will try and suppress or stop the production of thyroid hormones, thus the TSH will be very low. When the condition is caused by the autoimmune condition called Grave’s disease, the thyroid gland becomes inflamed and is thus called “thyroiditis” or inflammation of the thyroid gland. This is the most common cause of hyperthyroidism in humans. Symptoms of hyperthyroidism include the following but vary person to person. Inflammation behind the eyes can also cause the eyes to bulge out.

  • Sudden weight loss, despite increased appetite that comes with hyperthyroidism
  • Rapid heartbeat or feeling your heart beat (palpitations)
  • Nervousness, anxiety and irritability
  • Tremor, usually shakiness in hands
  • Sweating
  • Changes in menstrual patterns
  • Feeling hot
  • More frequent bowel movements
  • An enlarged thyroid gland (goiter)
  • Fatigue, muscle weakness
  • Difficulty sleeping
  • Skin thinning
  • Fine, brittle hair

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