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Thyroid Dysfunction: Overactive vs. Underactive

The most common thyroid problems involve abnormal production of thyroid hormones. Insufficient hormone production leads to hypothyroidism. Excessive thyroid hormone results in hyperthyroidism.
Although the various effects of thyroid dysfunction can be unpleasant or uncomfortable, most thyroid problems can be managed well if properly diagnosed and treated.

There are many tests that an Endocrinologist may use to identify and treat a thyroid problem. These tests include blood-work, imaging tests such as a Neck Ultrasound, nuclear medicine tests, and sometimes Fine Needle Aspiration (FNA) biopsies.

Hypothyroidism

Conversely, hypothyroidism results from an underproduction of thyroid hormones. Since your body's energy production requires certain levels of thyroid hormones, a drop in hormone production leads to lower energy levels. Causes of hypothyroidism include:

• Hashimoto's thyroiditis: This is an autoimmune disorder in which the body attacks thyroid tissue. The tissue eventually dies and stops producing hormones.
• Removal of the thyroid gland: The thyroid may have been surgically removed or chemically destroyed.
• Exposure to excessive amounts of iodide: Cold and sinus medicines, the heart medicine amiodarone, or certain contrast dyes given before some X-rays may expose you to too much iodine.
• Lithium: This drug has also been implicated as a cause of hypothyroidism.

Treatment of Hypothyroidism

If untreated for long periods of time, hypothyroidism can bring on a myxedema coma, a rare but potentially fatal condition that requires immediate hormone injections.

Fortunately, hypothyroidism can be easily treated using thyroid hormone medicine. The most effective and reliable thyroid replacement hormone, levothyroxine, is man-made (synthetic) such as Synthroid, Levoxyl, or Levothroid.

Treatment for hypothyroidism during pregnancy is especially important because it can harm the developing fetus. If you develop hypothyroidism during pregnancy, treatment should be started immediately.

If you have hypothyroidism prior to pregnancy, your thyroid hormone levels need to be checked to make sure that you have the correct dose of thyroid medicine, which may need to be increased.

You are likely to need treatment for hypothyroidism for the rest of your life. As a result, you need to take your medicine as directed. For some people, hypothyroidism worsens with age and the dosage of thyroid medicine may be increased gradually as the thyroid continues to slow down.

Hyperthyroidism

Having too much thyroid hormone can make many things in your body speed up. You may lose weight quickly, have a fast heartbeat, sweat a lot, or feel nervous and moody. Or you may have no symptoms at all.

All types of hyperthyroidism are due to an overproduction of thyroid hormones, but the condition can develop in several ways:

• Graves' disease.
• Toxic adenomas: Nodules develop in the thyroid gland and begin to secrete thyroid hormones, upsetting the body's chemical balance.
• Subacute thyroiditis: Inflammation of the thyroid that causes the gland to "leak" excess hormones, resulting in temporary hyperthyroidism that generally lasts a few weeks but may persist for months.
• Pituitary gland malfunctions or cancerous growths in the thyroid gland: While rare, hyperthyroidism may also develop from these causes.

Treatment for Hyperthyroidism

Hyperthyroidism is easily treated. With treatment, you can lead a healthy life. Without treatment, hyperthyroidism can lead to serious heart problems, bone problems, and a dangerous condition called thyroid storm.

Most often, radioactive iodine and anti-thyroid medicine are the treatments. The best treatment for you depends on a number of things, including your age.

Radioactive iodine is the most common treatment. Most people are cured after taking a single dose. While it destroys part of your thyroid gland, it does not harm any other parts of your body.

Anti-thyroid medicine works best if your symptoms are mild. These pills do not damage your thyroid gland. But they do not always work, and you have to take them at the same time every day. If they stop working, you may need to try radioactive iodine.

If you have any questions about your thyroid, or would like to schedule an appointment to discuss your individual case, please contact a thyroid specialist today.

Because appointments can be brief, and because there's often multiple issues, it is best to be well prepared for your appointment. Here's some information to help you prepare and get the most from your appointment.

 

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