Wednesday, 20 January 2016

Thyroid diseases

Thyroid diseases
There are 2 types of thyroid disease ie. hyperthyroidisms and hypothyroidisms.

Hyperthyroidism is a condition where there is over-production of thyroid hormone by thyroid glands. It is quite a common disease in Malaysia.

Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone. Since the main purpose of thyroid hormone is to drive the body's metabolism, it is understandable that people with this condition will have symptoms associated with a slow metabolism.

What are the Symptoms of hyperthyroidisms & hypothyroidism?

Hyperthyroidisms treatments:
1. Anti-thyroid medicines 
  • Carbimazole (Camazol 5mg) - Carbimazole is used to treat hyperthyroidism. Carbimazole is a pro-drug as after absorption it is converted to the active form, Methimazole. 
  • Propylthiouracil 50mg - Now used only for women in the first trimester of pregnancy. 
  • Methimazole (Timazol 5mg) - Methimazole prevents thyroid peroxidase enzyme from coupling and iodinating the tyrosine residues on thyroglobulin, hence reducing the production of the thyroid hormones T3 and T4.
It is important to monitor any symptoms of fever or sore throat while taking Carbimazole and Methimazole; this could indicate the development of agranulocytosis, an uncommon but severe side effect resulting from a drop in the white blood cell count.

2. Beta Blockers (Propanolol 10mg)
Beta Blockers are used to reduce the heart rate and subsequently prevent palpitations as well as hand tremors.
However, it will cause side-effects like fatigue, headache, stomach upset, constipation, diarrhea, and dizziness.

3. Surgery (thyroidectomy)
This surgery is usually carried out in pregnant women by removing the thyroid.
However, lifelong treatment with levothyroxine and calcium is required post-surgery.

Hypothyroidisms treatments:

Hypothyroidism can be easily treated using thyroid hormone medicine. The most effective and reliable thyroid replacement hormone is Levothyroxine and Thyroxine. After starting treatment, you will have to follow-up with your doctor regularly to make sure you have the correct dose of medicine. Take your medicine as directed. You will have another blood test 6 to 8 weeks later to make sure the dose is right for you.

If you are under dose, you will experience symptoms of hypothyroidism, such as constipation, feeling cold or sluggish, and gaining weight. Overdose can cause nervousness, problems sleeping, and tremors.

If you have heart disease, too much medicine can cause irregular heartbeats and chest pain. People who also have heart disease often start on a low dose of levothyroxine, which is increased gradually.

Sometimes symptoms of hypothyroidism continue, such as sluggishness, constipation, confusion, and feeling cold. This may occur if you are not taking enough thyroid hormone or if your medicine is not absorbed from your gastrointestinal tract. Having a bowel disease or taking certain other medicines may block thyroid hormone. If needed, your doctor will increase your dose.

If your dose of thyroid hormone is too high, you may develop complications such as irregular heartbeats and, over time, osteoporosis. If you have heart disease, too much medicine can cause pain (angina) and irregular heartbeats. Your doctor will watch your thyroid levels using a thyroid-stimulating hormone (TSH) test. If needed, your doctor will lower your dose.

9 Food to avoid in hypothyroidism:

1. Soy

The hormone estrogen can interfere with your body's ability to use thyroid hormone.

2. Cruciferous Vegetables

Cruciferous vegetables, such as broccoli and cabbage, can interfere with the production of thyroid hormone, particularly people who have an iodine deficiency. Digesting these vegetables can block the thyroid's ability to absorb iodine, which is essential for normal thyroid function. People with hypothyroidism may want to limit their intake of broccoli, Brussels sprouts, cabbage, cauliflower, kale, turnips, and bok choy. Cooking the vegetables can reduce the effect that cruciferous vegetables have on the thyroid gland.

3. Gluten

People with hypothyroidism may want to consider minimizing their intake of gluten, a protein found in foods processed from wheat, barley, rye, and other grains. Gluten can irritate the small intestine and may hamper absorption of thyroid hormone replacement medication.
However, if you do choose to eat gluten, be sure to choose whole-grains varieties of bread, pasta, and rice, which are high in fiber and other nutrients and can help improve bowel irregularity, a common symptom of hypothyroidism. Also be sure to take your hypothyroidism medication several hours before or after eating high-fiber foods to prevent them from interfering with the absorption of your synthetic thyroid hormone.

4. Fatty Foods

Fats have been found to disrupt the body's ability to absorb thyroid hormone replacement medicines. Fats may also interfere with the thyroid's ability to produce hormone as well. Some health care professionals recommend that you cut out all fried foods and reduce your intake of fats from sources such as butter, mayonnaise, margarine, and fatty cuts of meat.

5. Sugary Foods

Hypothyroidism can cause the body's metabolism to slow down. Sugary food can worsen your body's metabolism.

6. Processed Foods

Processed foods tend to have a lot of sodium, and people with hypothyroidism should avoid sodium. Having an underactive thyroid increases a person's risk for high blood pressure, and too much sodium further increases this risk. Read the Nutrition Facts label on the packaging of processed foods to find options lowest in sodium. People with an increased risk for high blood pressure should restrict their sodium intake to 1,500 milligrams a day

7. Excess Fiber

Getting enough fiber is good for you, but too much can complicating your hypothyroidism treatment. Guidelines currently recommend that older adults take in 20 to 35 grams of fiber a day. Amounts of dietary fiber from whole grains, vegetables, fruits, beans, and legumes that go above that level affect your digestive system and can interfere with absorption of thyroid hormone replacement drugs. If you're on a high-fiber diet, ask your doctor if you need a higher dose of thyroid medication. Your maintenance dose may need to be increased if you aren't absorbing enough medication.

8. Coffee

Caffeine has been found to block absorption of thyroid hormone replacement. People who were taking their thyroid medication with their morning coffee had uncontrollable thyroid levels. Patients are advised to only take their medication with water. Patient should gap at least 30 minutes after taking your medication before having a cup of coffee.

9. Alcohol

Alcohol consumption can wreak havoc on both thyroid hormone levels in the body and the ability of the thyroid to produce hormone. Alcohol appears to have a toxic effect on the thyroid gland and suppresses the ability of the body to use thyroid hormone. Ideally, people with hypothyroidism should cut out alcohol completely or drink in careful moderation.

4 Foods to ease symptoms of hyperthyroidism:

1. Berries

Strawberries, blueberries & raspberries—the choice is yours. Berries pack a powerful punch because they’re bursting with antioxidants, which keep your immune system strong. Eat a serving of berries every day.

2. Vitamin D and Omega-3s for Thyroid Health

Salmon contains vitamin D—an essential nutrient that works with calcium to prevent bone loss. Salmon also carries a mega dose of omega-3 fatty acids that keep you healthy. Your body doesn’t naturally produce these fatty acids, so you have to get them from food. If you’re not into fish, get your vitamin D from eggs and mushrooms and your omega-3s from walnuts, olive oil, and flaxseed oil.

3. Protein
Weight loss is a common hyperthyroidism symptom. Protein is important because your body needs protein for energy and to build and maintain muscle.

4. Calcium

Untreated hyperthyroidism can eventually weaken your bones and may lead to osteoporosis. To prevent this, get 3 servings a day of calcium from yogurt or other dairy foods, such as cheese and milk.

7 Hypothyroidism-friendly foods:
1. Fish
Fatty fish such as wild salmon, trout, tuna, or sardines offer great source of omega-3 fatty acids. Unmanaged hypothyroidism can increase the risk for heart disease as a result of higher levels of low-density lipoprotein (LDL). Omega-3s are known to decrease inflammation, help with immunity, and lower the risk for heart disease. Fish is also a good source of Selenium, which is the most concentrated in the thyroid. Selenium also helps decrease inflammation.

2. Nuts
Nuts are also another great source of selenium. Brazil nuts, macadamia nuts, and hazelnuts are all particularly high in selenium, which helps the thyroid function properly. With Brazil nuts, you only need to eat one or two; with other nuts, a small handful is enough to get your daily nutrients. Do keep an eye on portion size, as nuts are very high fat.

3. Whole Grains
Constipation is a common symptom of hypothyroidism. Whole-grain foods such as cereal, bread, pasta, and rice are high in nutrients in addition to fiber, which can help with bowel regularity. However, fiber can interfere with synthetic thyroid hormones. Some people with hypothyroidism choose to avoid whole-grains altogether, but if you do choose to eat them, take your thyroid medication several hours before or after eating foods rich in dietary fiber.

4. Fresh Fruits and Vegetables
An early symptom of hypothyroidism is weight gain. Low-calorie, high-density foods such as fresh produce are the cornerstone of every successful weight loss program. Include either fresh fruits or veggies at each meal, if possible. Specific foods such as blueberries, cherries, sweet potatoes, and green peppers are also rich in antioxidants, nutrients that are known to lower risk for heart disease.

However, people with hypothyroidism may want to limit their intake of cruciferous vegetables, such as broccoli and cabbage, to 5 ounces a day, as they can block the thyroid's ability to absorb iodine, which is essential for normal thyroid function

5. Seaweed
Iodine is the precursor for the production of thyroid hormone. Seaweed has a high concentration of iodine, an essential nutrient for thyroid function. Seaweed can be used in sushi, soups, and salads. In addition to that, seaweed offers other nutritional benefits like fiber, calcium, and vitamins A, B, C, E, and K.

It is possible to have too much iodine, which can worsen thyroid disease. However, according to the American Thyroid Association the likelihood of this is greater if you're taking supplements that contain iodine. Please discuss with your doctor before increasing your iodine intake.

6. Dairy
There is an association between vitamin D deficiency and Hashimoto's disease, the most common cause of hypothyroidism. Fortified milk not only has added vitamin D, but also has significant amounts of calcium, protein, and iodine.

7. Beans
Beans are a great source for sustained energy; it contains protein, antioxidants, complex carbohydrates, and loads of vitamins and minerals. They are also high in fiber, which can be beneficial if you suffer from constipation, a common side effect of hypothyroidism. Guidelines recommend that adult get 20 to 35 grams of fiber each day, so, do not overdose youself with fiber. Excess fiber can interfere with your hypothyroidism treatment.

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