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Transcript
Brought to you by
Harvard
Hypothyroidism (Underactive Thyroid)
Treating Graves’ Eye Disease
Symptoms
Graves’ eye disease develops in some people with hyperthyroidism. It results in swelling of tissues behind the eyes that
causes the eyes to bulge out. In addition to treatment for
the underlying thyroid problem, Graves’ eye disease may be
treated with medications or eye surgery.
Hypothyroidism can cause:
• Lack of energy
• Constipation
• Weight gain
• Abnormal sensitivity to cold temperatures
• Muscle cramps and stiffness
• Dry skin and hair
• Slowed heart rate
• Brittle fingernails
• Hoarseness or husky voice
• Enlarged thyroid gland
• Depression
• Hair loss
• Joint pain
Diagnosis
Your doctor will check the size and shape of your thyroid
gland. Common signs of hypothyroidism should be
checked. Knee and ankle reflexes will be checked to see
if they respond more slowly than expected. The levels of
thyroid hormones and TSH in your blood will be tested.
The result can help tell if your thyroid is underactive.
If you have an elevated TSH and low free T4, you are said
to have primary hypothyroidism. That means the problem
lies within the thyroid. This is by far the most common
type of hypothyroidism. If you have a low TSH and low
free T4 levels, you may have secondary hypothyroidism.
This is a normal thyroid gland, but the underactive
pituitary gland cannot make enough TSH.
Treatment
Treatment for hypothyroidism means taking synthetic
thyroid hormone to replace the hormone your body is
missing. Synthetic T4—thyroid hormone created in a
lab—works the same way your own thyroid hormone
would normally work.
An initial dose will be carefully selected, but some trial
and error may be necessary because your body needs a
very specific amount of thyroid hormone. With just one
dose per day, you can go on with your life and keep your
disease in check. A combination of synthetic drugs may
also be necessary.
Remember: Thyroid medication must be taken at the
same time every day.
Written by
Medical School
Living Well With Thyroid Disease
Thyroid
Disorders
With treatment, you can help get your thyroid hormone levels back to within a normal range. After this happens, you can
go on with life as usual. That said, you will need to continue
taking your medication and
following your doctor’s recommendations for follow-up
tests and monitoring. Doing
so will help you live well
with your thyroid
condition.
Brought to you by:
Patient Education Center
& Harvard Medical School
Patient Education Center
2127 Second Avenue North
Fort Dodge, IA 50501
[email protected]
About This Brochure: This brochure was written by practicing physicians
from Harvard Medical School. It is part of a series developed and distributed
by the Patient Education Center. All the information in this brochure and on
the associated Web site (www.patientedu.org) is intended for educational use
only; it is not intended to provide, or be a substitute for, professional medical
advice, diagnosis, or treatment. Only a physician or other qualified health care
professional can provide medical advice, diagnosis, or treatment. Always consult
your physician on all matters of your personal health. Harvard Medical School,
the Patient Education Center, and its affiliates do not endorse any products.
Consulting Physician: Anthony L. Komaroff, MD
Senior Director, Editorial Operations: Jonathan Nichol
Editorial Director: Keith D’Oria
www.patientedu.org
© Copyright Harvard Medical School.
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Read this brochure
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www.patientedu.org/thyroid
Y
our thyroid is a small, butterflyshaped gland that sits below
your voice box, with its “wings”
wrapped around the front of your windpipe. The thyroid gland influences the rate
at which every cell, tissue, and organ in
your body functions. This includes
your muscles, bones, and skin
as well as your digestive
tract, brain, and heart.
Your thyroid gland makes two thyroid hormones—
T4 and T3—that control how quickly and effectively
your cells turn nutrients into energy. Other kinds of
hormones activate your thyroid gland. The hypothalamus, a part of the brain, makes a hormone that sends
a signal to the pituitary gland, which is located at the
base of your brain. The pituitary gland makes thyroidstimulating hormone (TSH). TSH stimulates your
thyroid gland, telling it how much hormone to make.
Your thyroid gland makes two thyroid hormones that control
how quickly and effectively your cells turn nutrients into energy.
Hyperthyroidism (Overactive Thyroid)
Treatment
Symptoms
Treatment for hyperthyroidism works to stop your
thyroid from producing too much thyroid hormone.
There are three ways to do this:
When levels of thyroid hormones are unusually high, the
body burns energy faster, and many of your vital functions
speed up. Symptoms of hyperthyroidism include:
• Nervousness
• Insomnia
• Sweating
• Dramatic emotional swings
• Tremors
• Unexplained weight loss
• Increased heart rate
• Feeling warm or hot all the time
• Hair loss
• Shortness of breath and heart palpitations
• Frequent bowel movements
• Muscle weakness
• Protruding eyes
Diagnosis
Signs of hyperthyroidism will be examined by your doctor.
If hyperthyroidism is suspected, blood tests will be ordered
to check thyroid hormone levels. Tests for TSH, T4, and T3
levels may be necessary.
In some cases, your doctor will want to perform additional
tests that can show how well your thyroid gland is working
and whether your thyroid has any structural abnormalities.
What happens when the thyroid
gland doesn’t work properly?
Sometimes, the thyroid does not produce enough
hormones, which can then slow down all of your body’s
functions. This condition is known as hypothyroidism
or underactive thyroid. Other times, the thyroid can
produce too much hormone, sending your systems into
overdrive. This condition is known as hyperthyroidism, or
overactive thyroid. The symptoms of thyroid diseases are
wide-ranging. They may affect your mood, energy, body
temperature, weight, heart, and more.
Thyroid Blood Test Results
Condition
TSH level
Free T4 level
Free T3 level
0.8–2.0 ng/dL
Within normal range
Normal
0.45–4.12 mIU/L
Primary hyperthyroidism (common)
Low
High
High
Central (secondary) hyperthyroidism (rare) High
High
High
1
Radioactive iodine destroys a significant portion of
your thyroid in order to make your thyroid gland
produce normal levels of hormone. Your doctor
will estimate how much radioactive iodine will cure
your hyperthyroidism. It’s important to know, however,
that it’s nearly impossible to be exact. Most likely, the
treatment will make you somewhat hypothyroid, and you
will need to take a little thyroid hormone once each day
for life. This may not sound ideal, but it will keep your
thyroid hormone levels normal and leave you feeling well.
2
Anti-thyroid drugs block the thyroid gland’s ability
to make hormones. This reduces the amount of
thyroid hormone in your body. The advantage of
anti-thyroid drugs is that they do not leave your thyroid
permanently damaged. The downside is that they can
have serious side effects.
3
Surgery to remove all or part of the thyroid gland
is called thyroidectomy. Thyroid surgery is safe
and very effective. If your entire thyroid
gland is removed, you will require thyroid
hormone replacement for life.
Regardless of what treatment
is right for you, your
doctor may initially
prescribe a drug known
as a beta-blocker. This
will not cure your hyperthyroidism, but it will
relieve some of its symptoms, including increased
heart rate and tremor.