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Ailmemts & Remedies

Hypercalcaemia

Definition:-

Calcium is a mineral that’s vital for the development of healthy bones and teeth – 99 per cent of the calcium in our bodies is found here. It’s also needed for muscle contraction, regulation of the heartbeat and formation of blood clots. A long-term shortage of calcium can lead to osteoporosis (brittle-bone disease).

The four pea-sized parathyroid glands (found at the front of the neck) are responsible for regulating the body’s calcium levels. These small glands, which are embedded in the tissue of the thyroid gland in the neck, detect fluctuations in the level of calcium in the blood.

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There are times when this delicate balance is upset and too much calcium enters the blood. If levels rise too much, the glands decrease the secretion of the parathyroid hormone (PTH) and calcium levels return to normal again.
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Hypercalcaemia  is an elevated calcium level in the blood. (Normal range: 9–10.5 mg/dL or 2.2–2.6 mmol/L). It can be an asymptomatic laboratory finding, but because an elevated calcium level is often indicative of other diseases, a diagnosis should be undertaken if it persists. It can be due to excessive skeletal calcium release, increased intestinal calcium absorption, or decreased renal calcium excretion.

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Symptoms:
There is a general mnemonic for remembering the effects of hypercalcaemia: “groans (constipation), moans (psychic moans (e.g., fatigue, lethargy, depression)), bones (bone pain, especially if PTH is elevated), stones (kidney stones), and psychiatric overtones (including depression and confusion).”

Other symptoms can include fatigue, anorexia, nausea,abdominal pain, weightloss,loss of appetite, vomiting,constipation, pancreatitis and increased urination.

Abnormal heart rhythms can result, and ECG findings of a short QT interval and a widened T wave suggest hypercalcaemia. Significant hypercalcaemia can cause ECG changes mimicking an acute myocardial infarction.

Peptic ulcers may also occur.

Symptoms are more common at high calcium blood values (12.0 mg/dL or 3 mmol/l). Severe hypercalcaemia (above 15–16 mg/dL or 3.75–4 mmol/l) is considered a medical emergency: at these levels, coma and cardiac arrest can result.

Causes:-
One of the commonest causes of hypercalcaemia is cancer. Up to 20% of people with cancer have high calcium levels, especially with cancers of the breast, lung, head and neck, and certain blood cancers.

Abnormal parathyroid gland function:
*primary hyperparathyroidism
*solitary parathyroid adenoma
*primary parathyroid hyperplasia
*parathyroid carcinoma
*multiple endocrine neoplasia (MEN)
*familial isolated hyperparathyroidism
*lithium use
*familial hypocalciuric hypercalcaemia/familial benign hypercalcaemia

Malignancy:
*solid tumour with metastasis (e.g. breast cancer or classically squamous cell carcinoma, which can be PTHrP-mediated)
*solid tumour with humoral mediation of hypercalcaemia (e.g. lung cancer [in turn, most commonly of the small cell lung cancer type] or kidney cancer, pheochromocytoma)
*haematologic malignancy (multiple myeloma, lymphoma, leukaemia)

Vitamin-D metabolic disordershyper:
*vitaminosis D (vitamin D intoxication)
*elevated 1,25(OH)2D (see calcitriol under Vitamin D) levels (e.g. sarcoidosis and other granulomatous diseases)
*idiopathic hypercalcaemia of infancy
*rebound hypercalcaemia after rhabdomyolysis

Disorders related to high bone-turnover rateshyperthyroidism:
*prolonged immobilization
*thiazide use
*vitamin A intoxication
*Paget’s disease of the bone
*multiple myeloma

Renal failure
*severe secondary hyperparathyroidism:
*aluminium intoxication
*milk-alkali syndrome

Risk Factors:
An overproduction of PTH may also responsible for hypercalcaemia; this is often caused by a tumour in one or more of the parathyroid glands. Excess production of PTH may occur to compensate for a malfunction in one of the body’s other calcium-balancing mechanisms; for example, when the kidneys aren’t working properly or when there’s a deficiency of vitamin D.

Women over the age of 50 are most likely to have hypercalcemia, usually due to primary hyperparathyroidism.

Diagnosis:
Hypercalcaemia is diagnosed by laboratory tests including: serum calcium, albumin, phosphate, alkaline phosphate, BUN, creatinine, electrolytes and PTH level. These investigations assist in diagnosing the cause of hypercalcaemia and give a baseline indication of renal function. Urinary calcium should be measured as hypercalciuria may be detected. Other investigations may include an ECG and radiology examinations such as x-ray or bone scans which may show bone metastases

Treatment:
The treatment of hypercalcaemia is determined by the underlying disease, the degree of the hypercalcaemia and the patient’s clinical presentation. The aim of treatment is directed at decreasing serum calcium levels by increasing urinary excretion of calcium and decreasing bone resorption of calcium. Immobilization should be avoided as inactivity will cause an increase in bone resorption of calcium. The level of activity will be appropriate for the patient’s physical condition and other measures such as pain control may need to be considered prior to undertaking any physical activities. A review of the patient’s medications will need to be considered. Drugs that inhibit urinary calcium excretion, such as thiazide diuretics, should be ceased. NSAID and H2-receptor drugs, such as Ranitidine which decrease renal blood flow, should also be avoided if possible. Any calcium, Vitamin A and D supplements should also be ceased. Dietary restrictions of calcium have not been proven to be of any benefit to patients that are hypercalcaemic, or at risk of hypercalcaemia. Currently there is no data to suggest that hypercalcaemia has been attributed to food. However, some dietary supplements can cause abnormally hight levels of calcium in the blood. Patients with chronic renal failure are at risk of becoming hypercalacemic due to calcium intake.

This is due to decreased urine production, in combination with high calcium intake). Intravenous fluids (0.9% sodium chloride) will be administered to rehydrate the patient, the volume of fluid given will depend on the extent of the patients dehydration and cardiovascular and renal functions. At least 4-6 litres of saline on day 1, and 3-4 litres for several days thereafter is usual. Diuretics such as frusemide may also be given. Repeat blood tests should be taken several hours after treatment and reassessed. Cardiac status and urinary output should also be assessed, thus a strict fluid balance chart should be maintained on the patient. Oral phosphates, which inhibit bone resorption, may be administered. Diarrhoea is a common side effect and may lead to non-compliance. Bisphosphonates, which are given intravenously, inhibit osteoclast activity that contributes to bone resorption may also be administered. The two most common drugs used are Pamidronate/Aredia (60-90mg IV over 2 hours) and Zoledronic Acid/Zometa (4mg IV over 15 minutes). Both of these agents are generally well tolerated with limited side effects such as mild fever and irritation at the infusion site.

Prognosis:
The prognosis of hypercalcaemia depends upon the cause of increased calcium levels. When the underlying cause is treatable and the treatment is initiated promptly, hypercalcaemia can have a good prognosis. However, when associated with malignancy that has progressed into development of hypercalcemia, prognosis is poor. Hypercalcaemia is potentially fatal. Early diagnosis is important, as the cause of high blood calcium is usually identified and treated to avoid long-term complications. Signs and symptoms may be confused with those of end stage disease in terminal patients. In some patients, symptoms may be non-specific and have a slow onset.Some examples of these are:
•Anorexia
•Weakness
•Nausea
•Vomiting
•Constipation

In other cases, symptoms such as dehydration, renal failure and coma may develop very quickly resulting from very rapidly rising calcium levels. This may result in a life threatening situation. Symptoms do not always correlate with serum calcium levels. These must be closely compared with an in-depth patient history, examination and laboratory report. Signs and symptoms of hypercalcaemia can be numerous and nonspecific. They depend on the underlying cause and how quickly the calcium level rises. Mild hypercalcaemia may be asymptomatic but as the calcium levels rise, the symptoms begin to appear in all body systems. Some non-specific findings associated with hypercalcaemia include: decreased heart rate, hypertension, proximal muscle weakness (chronic hypercalcaemia), bony tenderness, increased tendon reflexes, unwanted tongue movements, dehydration and even coma.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/hypercalcaemia1.shtml
http://en.wikipedia.org/wiki/Hypercalcaemia
http://www.virtualmedicalcentre.com/symptoms.asp?sid=31&title=Hypercalcaemia#C3

http://erc.endocrinology-journals.org/content/12/3/549.full

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Ailmemts & Remedies

Graves’ disease

Alternative Names :Toxic diffuse goiter, thyrotoxicosis,diffuse thyrotoxic goiter

Definition:
Graves’ disease is the most common cause of hyperthyroidism . Hyperthyroidism is an autoimmune disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs.

The thyroid is a small, butterfly-shaped gland in the front of the neck below the larynx, or voice box. The thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels.


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Thyroid hormone production is regulated by another hormone called thyroid-stimulating hormone (TSH), which is made by the pituitary gland located in the brain.

Graves’ disease is an autoimmune disorder, meaning the body’s immune system acts against its own healthy cells and tissues. In Graves’ disease, the immune system makes antibodies called thyroid-stimulating immunoglobulin (TSI) that attach to thyroid cells. TSI mimics the action of TSH and stimulates the thyroid to make too much thyroid hormone. Sometimes the antibodies can instead block thyroid hormone production, leading to a confusing clinical picture. The diagnosis and treatment of Graves’ disease is often performed by an endocrinologist—a doctor who specializes in the body’s hormone-secreting glands.

Graves’ disease is rarely life-threatening. Although it may develop at any age and in either men or women, Graves’ disease is more common in women and usually begins after age 20.

Recent studies in England put the incidence of Graves’ disease at 1 to 2 cases per 1,000 population per year (in England). It occurs much more frequently in women than in men. The disease frequently presents itself during early adolescence or begins gradually in adult women, often after childbirth, and is progressive until treatment. It has a powerful hereditary component.

Graves’ disease tends to be more severe in men, even though it is rarer. It appears less likely to go into permanent remission and the eye disease tends to be more severe, but men are less likely to have large goitres. In a statistical study of symptoms and signs of 184 thyrotoxic patients (52 men, 132 women), the male patients were somewhat older than the females, and there were more severe cases among men than among women. Cardiac symptoms were more common in women, even though the men were older and more often had a severe form of the disease; palpitations and dyspnea were more common and severe in women.

Cigarette smoking, which is associated with many autoimmune diseases, raises the incidence of Graves’ ophthalmopathy 7.7-fold.

There’s no way to stop your immune system from attacking your thyroid gland, but treatments for Graves’ disease can ease symptoms and decrease the production of thyroxine.

Symptoms:
Graves’ disease symptoms may include:

*Anxiety

*Difficulty sleeping
*Fatigue
*A rapid or irregular heartbeat
*A fine tremor of your hands or fingers
*An increase in perspiration
*Sensitivity to heat
*Weight loss, despite normal food intake
*Brittle hair
*Enlargement of your thyroid gland (goiter)
*Change in menstrual cycles
*Frequent bowel movements
*Increased appetite
*Diarrhoea
*Tremor and shaking
*Irritability and emotional upsets
*Profuse sweating
*Dislike of hot weather
*Itching, reddening and thickening of the skin, typically over the shins

Graves’ ophthalmopathy
It’s also fairly common for your eyes to exhibit mild signs of a condition known as Graves’ ophthalmopathy. In Graves’ ophthalmopathy, your eyeballs bulge out past their protective orbit (exophthalmos). This occurs as tissues and muscles behind your eyes swell and cause your eyeballs to move forward. Because your eyes may be pushed so far forward, the front surface of your eyes can become dry. Cigarette smokers with Graves’ disease are five times more likely than nonsmokers to develop Graves’ ophthalmopathy. This is possibly because smoking inhibits the absorption of anti-thyroid medication that is used to treat Graves’ disease.

Graves’ ophthalmopathy may cause these mild signs and symptoms:

*Excess tearing and sensation of grit or sand in either or both eyes
*Reddened or inflamed eyes
*Widening of the space between your eyelids
*Swelling of the lids and tissues around the eyes
*Light sensitivity
.
Less often, Graves’ ophthalmopathy can produce these serious signs and symptoms:
*Ulcers on the cornea
*Double vision
*Limited eye movements
*Blurred or reduced vision

There may also be a goitre (or swelling of the thyroid gland in the neck) and swelling of the tissues over the front of the shins.

Cause:
The trigger for autoantibody production is unknown.

Since Graves’ disease is an autoimmune disease which appears suddenly, often quite late in life, it is thought that a viral or bacterial infection may trigger antibodies which cross-react with the human TSH receptor (a phenomenon known as antigenic mimicry, also seen in some cases of type I diabetes)[citation needed]. One possible culprit is the bacterium Yersinia enterocolitica (not the same as Yersinia pestis, the agent of bubonic plague). However, although there is indirect evidence for the structural similarity between the bacterium and the human thyrotropin receptor, direct causative evidence is limited.  Yersinia seems not to be a major cause of this disease, although it may contribute to the development of thyroid autoimmunity arising for other reasons in genetically susceptible individuals.  It has also been suggested that Y. enterocolitica infection is not the cause of auto-immune thyroid disease, but rather is only an associated condition; with both having a shared inherited susceptibility. More recently the role for Y. enterocolitica has been disputed.

Some of the eye symptoms of hyperthyroidism are believed to result from heightened sensitivity of receptors to sympathetic nervous system activity, possibly mediated by increased alpha-adrenergic receptors in some tissues.

Like most auto-immune conditions, women seem to be far more susceptible. Graves is up to eight times more common in women than men.

Some people may have a genetic predisposition to develop TSH receptor autoantibodies. HLADR (especially DR3) appears to play a significant role.

Risk Factors:
It’s known there are links between autoimmune conditions, so Graves’ disease is linked to insulin-dependent diabetes and pernicious anaemia (which are classed as autoimmune conditions). So when a person has one of these, they or members of their family may be at increased risk of developing another.

There’s also a genetic influence contributing to Graves’ disease and it can run in families.

Diagnosis:-
The onset of Graves’ disease symptoms is often insidious: the intensity of symptoms can increase gradually for a long time before the patient is correctly diagnosed with Graves’ disease, which may take months or years. (Not only Graves’ disease, but most endocrinological diseases have an insidious, subclinical onset.) One study puts the average time for diagnosis at 2.9 years, having observed a range from 3 months to 20 years in their sample population. A 1996 study offers a partial explanation for this generally late diagnosis, suggesting that the psychiatric symptoms (due to the hyperthyroidism) appeared to result in delays in seeking treatment as well as delays in receiving appropriate diagnosis. Also, earlier symptoms of nervousness, hyperactivity, and a decline in school performance, may easily be attributed to other causes.[citation needed] Many symptoms may occasionally be noted, at times, in otherwise healthy individuals who do not have thyroid disease (e.g., everyone feels anxiety and tension to some degree), and many thyroid symptoms are similar to those of other diseases. Thus, clinical findings may be full blown and unmistakable or insidious and easily confused with other disorders. The results of overlooking the thyroid can however be very serious.  Also noteworthy and problematic, is that in a 1996 survey study respondents reported a significant decline in memory, attention, planning, and overall productivity from the period 2 years prior to Graves’ symptoms onset to the period when hyperthyroid.[28] Also, hypersensitivity of the central nervous system to low-grade hyperthyroidism can result in an anxiety disorder before other Graves’ disease symptoms emerge. E.g., panic disorder has been reported to precede Graves’ hyperthyroidism by 4 to 5 years in some cases, although it is not known how frequently this occurs.

English: Photograph showing a classic finding ...
English: Photograph showing a classic finding of Graves’ Disease, proptosis and lid retraction. (Photo credit: Wikipedia)

The resulting hyperthyroidism in Graves’ disease causes a wide variety of symptoms. The two signs that are truly ‘diagnostic’ of Graves’ disease (i.e., not seen in other hyperthyroid conditions) are exophthalmos (protuberance of one or both eyes) and pretibial myxedema, a rare skin disorder with an occurrence rate of 1-4%, that causes lumpy, reddish skin on the lower legs. Graves’ disease also causes goitre (an enlargement of the thyroid gland) that is of the diffuse type (i.e., spread throughout the gland). This phenomenon also occurs with other causes of hyperthyroidism, though Graves’ disease is the most common cause of diffuse goitre. A large goitre will be visible to the naked eye, but a smaller goitre (very mild enlargement of the gland) may be detectable only by physical exam. Occasionally, goitre is not clinically detectable but may be seen only with CT or ultrasound examination of the thyroid.

A highly suggestive symptom of hyperthyroidism, is a change in reaction to external temperature. A hyperthyroid person will usually develop a preference for cold weather, a desire for less clothing and less bed covering, and a decreased ability to tolerate hot weather. When thyroid disease runs in the family, the physician should be particularly wary: studies of twins suggest that the genetic factors account for 79% of the liability to the development of Graves’ disease (whereas environmental factors account presumably for the remainder).  Other nearly pathognomonic signs of hyperthyroidism are excessive sweating, high pulse during sleep, and a pattern of weight loss with increased appetite (although this may also occur in diabetes mellitus and malabsorption or intestinal parasitism).

Hyperthyroidism in Graves’ disease is confirmed, as with any other cause of hyperthyroidism, by a blood test. Elevated blood levels of the principal thyroid hormones (i.e. free T3 and T4), and a suppressed thyroid-stimulating hormone (low due to negative feedback from the elevated T3 and T4), point to hyperthyroidism

However, a 2007 study makes clear that diagnosis depends to a considerable extent on the position of the patient’s unique set point for T4 and T3 within the laboratory reference range (an important issue which is further elaborated below).

Differentiating Graves’ hyperthyroidism from the other causes of hyperthyroidism (thyroiditis, toxic multinodular goiter, toxic thyroid nodule, and excess thyroid hormone supplementation) is important to determine proper treatment. Thus, when hyperthyroidism is confirmed, or when blood results are inconclusive, thyroid antibodies should be measured. Measurement of thyroid stimulating immunoglobulin (TSI) is the most accurate measure of thyroid antibodies. They will be positive in 60 to 90% of children with Graves’ disease. If TSI is not elevated, then a radioactive iodine uptake should be performed; an elevated result with a diffuse pattern is typical of Graves’ disease. Biopsy to obtain histological testing is not normally required but may be obtained if thyroidectomy is performed.

Treatment :
Treatment aims to:
•Keep thyroid hormone levels in the normal range
•Prevent eye problems (which can result from exposure of the delicate eye tissues in Graves’ opthalmopathy) – this can be very difficult and eye symptoms may persist even when treatments work well to keep thyroid hormone levels within the normal range.

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Treatment for the raised hormone levels can include:
•Drugs for immediate and then long-term control
•Surgery to remove part of the thyroid gland
•Radioactive iodine treatment (RAI)

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In recent years, efforts have been made to find a dose of RAI that will give a good cure rate for thyrotoxicosis without leading to underactivity (known as hypothyroidism). However, this has proved difficult and hypothyroidism remains a side-effect of the treatment, affecting as many as 20 per cent of those treated within the first couple of years after treatment, and three to five per cent more each year after that.

Those affected may need lifelong supplements of thyroid hormones.

Treatment for the eye problems includes:
•Drug treatments and eye drops to reduce swelling and close lids
•Steroids, especially if the eye muscles are paralysed or the swelling is very bad
•Surgery to reduce swelling or closed lids
•Radiotherapy is sometimes used in difficult cases.

.

Neuropsychiatric symptoms:
A substantial proportion of patients have an altered mental state, even after successful treatment of hyperthyroidism. When psychiatric disorders remain after restoration of euthyroidism and after treatment with beta blockers, specific treatment for the psychiatric symptoms, especially psychotropic drugs, may be needed.[10] A literature study concluded in 2006, found that, after being diagnosed with Graves’ hyperthyroidism, approximately one-third of patients are prescribed psychotropic drugs. Sometimes these drugs are given to treat mental symptoms of hyperthyroidism, sometimes to treat mental symptoms remaining after amelioration of hyperthyroidism, and sometimes when the diagnosis of Graves’ hyperthyroidism has been missed and the patient is treated as having a primary psychiatric disorder. There are no systematic data on the general efficacy of psychotropic drugs in the treatment of mental symptoms in patients with hyperthyroidism, although many reports describe the use of individual agents.  De Groot mentions that a mild sedative or tranquilizer is often helpful.  German research of 2004 reported that 35 percent of treated Graves’ disease patients (with normal thyroid tests for at least six months after treatment), suffered from psychological distress, and had high levels of anxiety. Almost all these patients had clear-cut depression

General measurements:
Graves’ disease patients are nutritionally depleted in proportion to the duration and severity of their illness. Until metabolism is restored to normal, and for some time afterward, caloric and protein requirements may be well above normal. Specific deficiencies may exist, and multivitamin supplementation is indicated. The intake of calcium should be above normal. All in all, the physician should pay heed to the patient’s emotional needs, as well as to his or her requirements for rest, nutrition, and specific (anti)thyroid medication

Prognosis:
The disease typically begins gradually, and is progressive unless treated. If left untreated, more serious complications could result, including bone loss and fractures, inanition, birth defects in pregnancy, increased risk of a miscarriage. Graves disease is often accompanied by an increase in heart rate, which may lead to cardiovascular damage and further heart complications including loss of the normal heart rhythm (atrial fibrillation), which may lead to stroke. If the eyes are bulging severely enough that the lids do not close completely at night, severe dryness will occur with a very high risk of a secondary corneal infection which could lead to blindness. Pressure on the optic nerve behind the globe can lead to visual field defects and vision loss as well. In severe thyrotoxicosis, a condition frequently referred to as thyroid storm, the neurologic presentations are more fulminant, progressing if untreated through an agitated delirium to somnolence and ultimately to coma. All in all, untreated Graves’ disease can lead to significant morbidity, disability and even death. However, the long-term history also includes spontaneous remission in some cases and eventual spontaneous development of hypothyroidism if autoimmune thyroiditis coexists and destroys the thyroid gland.

When effective thyroid treatment is begun, the general response is quite favorable: physical symptoms resolve, vitality returns and the mental processes become efficient again. However, symptom relief is usually not immediate and is achieved over time as the treatments take effect and thyroid levels reach stability. In addition, not all symptoms may resolve at the same time. Prognosis also depends on the duration and severity of the disease before treatment. Swedish research of 2005 reports a lower quality of life for 14 to 21 years after treatment of Graves’ disease, with lower mood and lower vitality, regardless of the choice of treatment.

Remission and relapses:
A literature study in 2006 found that patients who have residual mental symptoms have a significantly higher chance of relapse of hyperthyroidism. Patients with recurrent Graves’ hyperthyroidism, compared with patients in remission and healthy subjects, had significantly higher scores on scales related to depression and anxiety, as well as less tolerance of stress.  According to a 2010 publication, a total thyroidectomy offers the best chance of preventing recurrent hyperthyroidism.

Mental impairment:
A literature review in 2006, whilst noting methodology issues in the consistency of Graves’ disease diagnostic criteria, found many reports about residual complaints in patients who were euthyroid after treatment with a high prevalence of anxiety disorders and bipolar disorder, as well as elevated scores on scales of anxiety, depression and psychological distress.  Bunevicius et al. point out that this “substantial mental disability” is more severe in patients with residual hyperthyroidism but is present even in euthyroid patients. Delay in therapy markedly worsens the prognosis for recovery, but complications can be prevented by early treatment.  In rare cases, patients will experience psychosis-like symptoms only after they have been treated for hypo- or hyperthyroidism, due to a rapid normalisation of thyroid hormone levels in a patient who has partly adapted to abnormal values.

Thyroid replacement treatment after thyroidectomy or radioiodine:
Several studies find a high frequency of TSH level abnormalities in patients who take thyroid hormone supplemenation for long periods of time, and stress the importance of periodic assessment of serum TSH.

Possible Complications:-
*Complications from surgery, including:
*Hoarseness from damage to the nerve leading to the voice box
*Low calcium levels from damage to the parathyroid glands (located near the thyroid gland)
*Scarring of the neck

*Eye problems (called Graves ophthalmopathy or exophthalmos)

•Heart-related complications, including:
*Rapid heart rate
*Congestive heart failure (especially in the elderly)
*Atrial fibrillation

*Thyroid crisis (thyrotoxic storm), a severe worsening of overactive thyroid gland symptoms
*Increased risk for osteoporosis, if hyperthyroidism is present for a long time

•Complications related to thyroid hormone replacement
*If too little hormone is given, fatigue, weight gain, high cholesterol, depression, physical sluggishness, and other symptoms of hypothyroidism can occur
*If too much hormone is given, symptoms of hyperthyroidism will return

Lifestyle and Home Remedies:
For Graves’ ophthalmopathy
These steps may make your eyes feel better if you have Graves’ ophthalmopathy:

*Apply cool compresses to your eyes. The added moisture may soothe your eyes.

*Wear sunglasses. When your eyes protrude, they’re more vulnerable to ultraviolet rays and more sensitive to bright light. Wearing sunglasses that wrap around the sides of your head will lessen the irritation of your eyes from the wind.

*Use lubricating eyedrops. Eyedrops may relieve the dry, scratchy sensation on the surface of your eyes. At night, a paraffin-based gel such as Lacri-Lube can be applied.

*Elevate the head of your bed. Keeping your head higher than the rest of your body lessens fluid accumulation in the head and may relieve the pressure on your eyes.

For Graves’ dermopathy
If the disease affects your skin (Graves’ dermopathy), use over-the-counter creams or ointments containing hydrocortisone to relieve swelling and reddening. In addition, using compression wraps on your legs may help.

Coping and support:
If you have Graves’ disease, make your mental and physical well-being a priority. Eating well and exercising can enhance the improvement in some symptoms while being treated and help you feel better in general. For example, because your thyroid controls your metabolism, you may have a tendency to gain weight when the hyperthyroidism corrects. Brittle bones can also occur with Graves’ disease and weight-bearing exercises can help maintain bone density.

Try to ease stress as much as you can, as stress possibly contributes to the development of Graves’ disease. Listening to music, taking a warm bath or walking can help relax you and put you in a better frame of mind. Partner with your doctor to construct a plan that incorporates good nutrition, exercise and relaxation into your daily routine.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/gravesdisease.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/000358.htm
http://en.wikipedia.org/wiki/Graves’_disease
http://www.mayoclinic.com/health/graves-disease/DS00181

http://www.nlm.nih.gov/medlineplus/ency/imagepages/17067.htm

http://endocrine.niddk.nih.gov/pubs/graves/#symptoms

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Featured

Eyes are Unique Window to Predict Diseases

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Looking people straight in the eye may or may not reveal their honesty — but the eyes *can* tell you about cholesterol, liver disease, or diabetes, if you know what to look for.

Click to see the picture

Your eyes are a unique window into health. Yahoo Health has assembled a list of 14 things your eyes can tell you about your entire body.
Some of them are mentioned below:-

*Disappearing eyebrows : When the outer third of your eyebrow starts to disappear on its own, this is a common sign of thyroid disease.

*A stye that won’t go away : If it doesn’t clear up in three months, or keeps recurring in the same location, it could be a rare cancer called sebaceous gland carcinoma.

*Burning eyes, blurry vision while using a computer : This is the result of “computer vision syndrome” (CVS). The eyestrain is partly caused by the lack of contrast on a computer screen, and the extra work involved in focusing on pixels.

*A small blind spot in your vision, with shimmering lights or a wavy line : A migraine aura produces this disturbed vision. It may or may not be accompanied by a headache.

*Whites of the eye turned yellowish : This is known as jaundice. It appears in either newborns with immature liver function, or adults with problems of the liver, gallbladder, or bile ducts.

*Eyes that seem to bulge : The most common cause of protruding eyes is hyperthyroidism, which is overactivity of the thyroid gland.

*Sudden double vision, dim vision, or loss of vision : These are the visual warning signs of stroke.

*Blurred vision in a diabetic : Diabetics are at increased risk for several eye problems, but the most common is diabetic retinopathy, in which diabetes affects the circulatory system of the eye. It’s the leading cause of blindness in American adults.

For the rest of the list, click on the link below.

Sources: Yahoo Health February 3, 2011

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Health Quaries

Some Health Quaries & Answers

No saccharin, please :
___________________
Q: I am diabetic and use a branded sugar substitute in coffee, milk and juices. I am breast feeding and want to know if it is safe for my baby.

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A:
Any medication or chemicals that you consume crosses over into the breast milk and reaches the baby. Common artificial sweeteners such as saccharin and aspartame are classified by the US Food and Drug Administration as class “C”. This means they should not be used during pregnancy or lactation unless they are absolutely essential to the health and survival of the mother. This is not the case with artificial sweeteners. Human beings are very adaptable. You may try unsweetened coffee, tea and juice. That is healthier for you as well as the baby.

Thyroid pill
:-
____________
Q: I was not conceiving and then was diagnosed as having hypothyroidism. Once I started taking Eltroxin, I became pregnant. Do I need to continue the medicine?

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A: Eltroxin needs to be continued all your life as your thyroid gland is not producing enough eltroxin for your own needs. The blood hormonal levels need to be monitored during pregnancy. Eltroxin can cross the placenta to the baby. Too little will affect you adversely and too much will be harmful to the baby. Your baby needs to have a thyroid test soon after birth. The eltroxin you are taking will not affect the baby’s test results.

My feet burn :-
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Q: The soles of my feet burn every night. I leave them uncovered but that does not help much. My sleep is disturbed and I am left feeling irritable all day.

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A: Diabetes can cause burning feet. So can a disease in the blood vessels, kidney or liver failure, vitamin deficiency or alcoholism. Remove your shoes and socks as soon as you return from work and soak your feet in tepid water. Take calcium and vitamin supplements. If there is no improvement in a week, consult a physician.

Hearing loss

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Q: I feel that my son is becoming deaf. He does not respond when he is called. He seems to live in a world of his own. The problem started after we bought him a new mobile phone.

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A: The new mobile phone may have an MP3 player which might be the reason your son is glued to it. If he has been using “in-ear” earphones at a high volume for long periods of time, it is possible he has developed some hearing loss. The condition can be evaluated.

Your son may become socially withdrawn as he has his music and SMS friends. This is now an international social problem. Encourage him to be more physically active. Also, you can consider spending more time talking to him and listening to what he has to say.

Obstetric care :-
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Q: My wife is pregnant with our first child and I am at a loss as to how to deal with things. I want a good hospital so that the mother and child are safe.

A: Before choosing a hospital (and an obstetrician) you need to scout a few places to see where you are likely to receive the best care. Preferably, there should be several duty doctors following a “shift” system. A single doctor, however good, cannot be “on call” night and day. If he or she is tired or busy, you might wind up with an unnecessary Caesarian section. Also check if the hospital has a paediatrician.

Ear block
:-
___________

Q: My left ear gets blocked whenever I swim. I have had the ear checked and there is no wax blocking it.

A: After getting out of the pool, tilt your head to the left and hop on the left leg a few times. This usually does the trick. If that doesn’t work, hold your nose, close your mouth and breathe out through the nose.

Fractured collar bone:-

___________________
Q: My four-year-old grandson fell down a couple of stairs and fractured his collar bone. The doctor says it will heal and gave him just a cloth sling. Is this enough?

A: Collar bone fractures are common in babies, children and adolescents. The only treatment is rest, a figure-of-eight bandage, a sling and analgesics for the pain. Healing usually takes around 12 weeks but a painless bump may persist for many months.

Active brain :-
_____________
Q: Is there any way I can keep my brain active? I am scared of dementia.

A: Several studies show that memory games, memorising poetry and regularly doing Sudoku puzzles keep the mind active and prevent deterioration of the grey matter. Most newspapers regularly feature puzzles. You can also access them on the Internet.

Source: The Telegraph (Kolkata, India)

Categories
Health Alert

Many Symptoms Suggest Sluggish Thyroid — Check if You Have Any

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Most people realize that their thyroid is important for controlling their metabolism and body weight.

CLICK & SEE THE PICTURES

But did you know that depression, heart disease, chronic fatigue, fibromyalgia, PMS (premenstrual syndrome), menopausal symptoms, muscle and joint pains, irritable bowel syndrome, or autoimmune disease could actually indicate a problem with your thyroid?

The classic signs of a sluggish thyroid gland include weight gain, lethargy, poor quality hair and nails, hair loss, dry skin, fatigue, cold hands and feet, and constipation — and these symptoms are relatively well known.

However, some of the conditions you might not associate with your thyroid include:

•High cholesterol
•Irregular menstruation
•Low libido
•Infertility
•Gum disease
•Fluid retention
•Skin conditions such as acne and exzema
•Memory problems
•Poor stamina
And there are, in fact, many more conditions that can be associated with poor thyroid function. Your thyroid plays a part in nearly every physiological process. When it is out of balance, so are you. This is why it is so important to understand how your thyroid gland works and what can cause it to run amok.

The sad fact is, half of all people with hypothyroidism are never diagnosed. And of those who are diagnosed, many are inadequately treated, resulting in partial recovery at best.

Hypothyroidism: The Hidden Epidemic

Hypothyroidism simply means you have a sluggish or underactive thyroid, which is producing less than adequate amounts of thyroid hormone.

“Subclinical” hypothyroidism means you have no obvious symptoms and only slightly abnormal lab tests. I will be discussing these tests much more as we go on since they are a source of great confusion for patients, as well as for many health practitioners.

Thyroid problems have unfortunately become quite common.

The same lifestyle factors contributing to high rates of obesity, cancer and diabetes are wreaking havoc on your thyroid… sugar, processed foods, stress, environmental toxins, and lack of exercise are heavy contributors.

More than 10 percent of the general population in the United States, and 20 percent of women over the age of 60, have subclinical hypothyroidism. But only a small percentage of these people are being treated.

Why is that?

Much of it has to do with misinterpretation and misunderstanding of lab tests, particularly TSH (thyroid stimulating hormone). Most physicians believe that if your TSH value is within the range of “normal,” your thyroid is fine. But more and more physicians are discovering that the TSH value is grossly unreliable for diagnosing hypothyroidism.

And the TSH range for “normal” keeps changing!

In an effort to improve diagnosis of thyroid disease, in 2003 the American Association of Clinical Endocrinologists (AACE) revised the “normal” TSH range as 0.3 to 3.04. The previous range was defined as 0.5 and 5.0, which red-flagged only the most glaring hypothyroidism cases.

However, the new range is still not wholly reliable as the sole indicator of a sulky thyroid gland. You simply cannot identify one TSH value that is “normal” for every person, regardless of age, health, or other factors.

Having said that though most physicians who carefully follow this condition recognize that any TSH value greater than 1.5 could be a strong indication that an underactive thyroid is present.

Your TSH value is only part of the story, and your symptoms, physical findings, genetics, lifestyle and health history are also important considerations. Only when physicians learn to treat the patient and not the lab test will they begin to make headway against thyroid disease.

Understanding How Your Thyroid Works is Step One:-

The thyroid gland is in the front of your neck and is part of your endocrine, or hormonal, system. It produces the master metabolism hormones that control every function in your body[3]. Thyroid hormones interact with all your other hormones including insulin, cortisol, and sex hormones like estrogen, progesterone, and testosterone.

The fact that these hormones are all tied together and in constant communication explains why an unhappy thyroid is associated with so many widespread symptoms and diseases.

This small gland produces two major thyroid hormones: T4 and T3. About 90 percent of the hormone produced by the gland is in the form of T4, the inactive form. Your liver converts this T4 into T3, the active form, with the help of an enzyme.

Your thyroid also produces T2, yet another hormone, which currently is the least understood component of thyroid function and the subject of much ongoing study.

Thyroid hormones work in a feedback loop with your brain — particularly your pituitary and hypothalamus — in regulating the release of thyroid hormone. Your pituitary makes TRH (thyroid releasing hormone), and your hypothalamus makes TSH. If everything is working properly, you will make what you need and you’ll have the proper amounts of T3 and T4.

Those two hormones — T3 and T4 — are what control the metabolism of every cell in your body. But their delicate balance can be disrupted by nutritional imbalances, toxins, allergens, infections and stress.

If your T3 is inadequate, either by insufficient production or not converting properly from T4, your whole system suffers.

You see, T3 is critically important because it tells the nucleus of your cells to send messages to your DNA to crank up your metabolism by burning fat. That is why T3 lowers cholesterol levels, regrows hair, and helps keep you lean.

How to Know if You are Hypothyroid:-

Identifying hypothyroidism and its cause is tricky business. Many of the symptoms overlap with other disorders, and many are vague. Physicians often miss a thyroid problem since they rely on just a few traditional tests, so other clues to the problem go undetected.

But you can provide the missing clues!

The more vigilant you can be in assessing your own symptoms and risk factors and presenting the complete picture to your physician in an organized way, the easier it will be for your physician to help you.

Sometimes people with hypothyroidism have significant fatigue or sluggishness, especially in the morning. You may have hoarseness for no apparent reason. Often hypothyroid people are slow to warm up, even in a sauna, and don’t sweat with mild exercise. Low mood and depression are common.

Sluggish bowels and constipation are major clues, especially if you already get adequate water and fiber.

Are the upper outer third of your eyebrows thin or missing? This is sometimes an indication of low thyroid. Chronic recurrent infections are also seen because thyroid function is important for your immune system.

Another telltale sign of hypothyroidism is a low basal body temperature (BBT), less than 97.6 degrees F averaged over a minimum of 3 days. It is best to obtain a BBT thermometer to assess this.

How about your family history? Do you have close relatives with thyroid issues?

Some of the family history that suggests you could have a higher risk for hypothyroidism includes:

•High or low thyroid function
•Goiter
•Prematurely gray hair
•Left-handedness
•Diabetes
•Autoimmune diseases (rheumatoid arthritis, lupus, sarcoidosis, Sjogren’s, etc.)
•Crohn’s disease or ulcerative colitis
•Multiple sclerosis (MS)
•Elevated cholesterol levels
It might be useful to take an online thyroid assessment quiz, as a way to get started. Mary Shomon has a good one. Some of the classic symptoms are mentioned above, but there are many more — too many to list here.

If you suspect you might be hypothyroid, you should see a healthcare provider who can evaluate this, including ordering the basic lab tests for thyroid function.

Laboratory Testing:-

Even though lab tests are not the end-all, be-all for diagnosing a thyroid problem, they are a valuable part of the overall diagnostic process. The key is to look at the whole picture.

New studies suggest a very high incidence of borderline hypothyroidism in Westerners. Many cases are subclinical, and even “sublaboratory,” not showing up at all in standard laboratory measurements.

Coexistent subclinical hypothyroidism often triggers or worsens other chronic diseases, such as the autoimmune diseases, so the thyroid should be addressed with any chronic disease.

Many physicians will order only one test — a TSH level. This is a grossly inadequate and relatively meaningless test by itself, as well as a waste of your money. It would be like saying you know your water is pure because it tastes fine.

Dr. Mercola recommends the following panel of laboratory tests if you want to get the best picture of what your thyroid is doing:

•TSH — the high-sensitivity version. This is the BEST test. But beware most all of the “normal” ranges are simply dead wrong. The ideal level for TSH is between 1 and 1.5 mIU/L (milli-international units per liter)
•Free T4 and Free T3. The normal level of free T4 is between 0.9 and 1.8 ng/dl (nanograms per deciliter). T3 should be between 240 and 450 pg/dl (picograms per deciliter).
•Thyroid antibodies, including thyroid peroxidase antibodies and anti-thyroglobulin antibodies. This measure helps determine if your body is attacking your thyroid, overreacting to its own tissues (ie, autoimmune reactions). Physicians nearly always leave this test out.
•For more difficult cases TRH can be measured (thyroid releasing hormone) using the TRH stimulation test. TRH helps identify hypothyroidism that’s caused by inadequacy of the pituitary gland.
Other tests that might be indicated for more complex cases are a thyroid scan, fine-needle aspiration, and thyroid ultrasound. But these are specialized tests that your physician will use only in a small number of cases, in special situations.

Even if all your lab tests are “normal,” if you have multiple thyroid symptoms, you still could have subclinical hypothyroidism.

Keeping Your Thyroid Healthy in a Toxic World:-

Now that you have some understanding of the importance of your thyroid and how it works, let’s take a look at the factors that can readily cause problems with your thyroid gland.

Diet:-

Your lifestyle choices dictate, to a great degree, how well your thyroid will function.

If you follow my plan to eat for your nutritional type[5], and my nutritional plan your metabolism will be more efficient, and your thyroid will have an easier time keeping everything in check. Eating for your type will normalize your blood sugar and lipid levels and enhance your immune system, so that your thyroid will have fewer obstacles to overcome.

Eliminate junk food, processed food, artificial sweeteners, trans fats, and anything with chemical ingredients. Eat whole, unprocessed foods, and choose as many organics as possible.

Gluten and Other Food Sensitivities:-

Gluten and food sensitivities   are among the most common causes of thyroid dysfunction because they cause inflammation.

Gluten causes autoimmune responses in many people and can be responsible for Hashimoto’s thyroiditis, a common autoimmune thyroid condition. Approximately 30 percent of the people with Hashimoto’s thyroiditis have an autoimmune reaction to gluten, and it usually goes unrecognized.

How this works is, gluten can cause your gastrointestinal system to malfunction, so foods you eat aren’t completely digested (aka Leaky Gut Syndrome ). These food particles can then be absorbed into your bloodstream where your body misidentifies them as antigens — substances that shouldn’t be there — our body then produces antibodies against them.

These antigens are similar to molecules in your thyroid gland. So your body accidentally attacks your thyroid. This is known as an autoimmune reaction or one in which your body actually attacks itself.

Testing can be done for gluten and other food sensitivities, which involves measuring your IgG and IgA antibodies.

Soy :-

Another food that is bad for your thyroid is soy[9]. Soy is NOT the health food the agricultural and food companies would have you believe.

Soy is high in isoflavones (or goitrogens), which are damaging to your thyroid gland. Thousands of studies now link soy foods to malnutrition, digestive stress, immune system weakness, cognitive decline, reproductive disorders, infertility and a host of other problems — in addition to damaging your thyroid.

Properly fermented organic soy products such as natto, miso, and tempeh are fine — it’s the unfermented soy products that you should stay away from.

Coconut Oil:-

Coconut oil is one of the best foods you can eat for your thyroid. Coconut oil is a saturated fat comprised of medium chain triglycerides (MCTs), which are known to increase metabolism and promote weight loss.

Coconut oil is very stable (shelf life of 3 to 5 years at room temperature), so your body is much less burdened with oxidative stress than it is from many other vegetable oils. And coconut oil does not interfere with T4 to T3 conversion the way other oils can.

Iodine:-

Iodine is a key component of thyroid hormone. In fact, the names of the different forms of thyroid hormone reflect the number of iodine molecules attached — T4 has four attached iodine molecules, and T3 has three — showing what an important part iodine plays in thyroid biochemistry.

If you aren’t getting enough iodine in your diet (and most Americans don’t), no matter how healthy your thyroid gland is, it won’t have the raw materials to make enough thyroid hormone.

Chlorine, fluorine and bromine are also culprits in thyroid function, and since they are halides like iodine, they compete for your iodine receptors.

If you are exposed to a lot of bromine, you will not hold on to the iodine you need. Bromine is present in many places in your everyday world — plastics, pesticides, hot tub treatments, fire retardants, some flours and bakery goods, and even some soft drinks. I have written a special article about bromine and its influence on your thyroid gland and I encourage you to read it.

Also make sure the water you drink is filtered. Fluoride is particularly damaging to your thyroid gland[14]. Not all water filters  remove fluoride, so make sure the one you have does.

Stress and Adrenal Function:-

Stress is one of the worst thyroid offenders. Your thyroid function is intimately tied to your adrenal function, which is intimately affected by how you handle stress.

Many of us are under chronic stress, which results in increased adrenalin and cortisol levels, and elevated cortisol has a negative impact on thyroid function. Thyroid hormone levels drop during stress, while you actually need more thyroid hormones during stressful times.

When stress becomes chronic, the flood of stress chemicals (adrenalin and cortisol) produced by your adrenal glands interferes with thyroid hormones and can contribute to obesity, high blood pressure, high cholesterol, unstable blood sugar, and more.

A prolonged stress response can lead to adrenal exhaustion (also known as adrenal fatigue), which is often found alongside thyroid disease.

Environmental toxins place additional stress on your body. Pollutants such as petrochemicals, organochlorines, pesticides and chemical food additives negatively affect thyroid function.

One of the best destressors is exercise, which is why it is so beneficial for your thyroid.

Exercise directly stimulates your thyroid gland to secrete more thyroid hormone. Exercise also increases the sensitivity of all your tissues to thyroid hormone. It is even thought that many of the health benefits of exercise stem directly from improved thyroid function.

Even something as simple as a 30-minute walk is a great form of exercise, and all you need is a good pair of walking shoes. Don’t forget to add strength training to your exercise routine, because increasing your muscle mass helps raise your metabolic rate.

Also make sure you are getting enough sleep. Inadequate sleep contributes to stress and prevents your body from regenerating fully.

Finally, one excellent way to reduce stress is with an energy psychology tool such as the Meridian Tapping Technique (MTT). More and more people are practicing MTT and experiencing amazing results.

Treatment Options for a Sluggish Thyroid:-

Here are some suggestions that can be used for general support of your thyroid, as well as treating an underperforming one:

•Eat plenty of sea vegetables such as seaweed, which are rich in minerals and iodine (hijiki, wakame, arame, dulse, nori, and kombu). This is probably the most ideal form of iodine supplementation as it is also loaded with many other beneficial nutrients.
•Eat Brazil nuts, which are rich in selenium.
•Get plenty of sunlight to optimize your vitamin D levels; if you live where sunlight is limited, use vitamin D3 supplementation.
•Eat foods rich in vitamin A, such as dandelion greens, carrots, spinach, kale, Swiss chard, collard greens, and sweet potatoes.
•Make sure you are eating enough omega-3 fatty acids.
•Use pure, organic coconut oil in your cooking — it’s great for stir fries and sautéing many different meats and vegetables.
•Filter your drinking water and your bathing water.
•Filter your air, since it is one of the ways you take in environmental pollutants.
•Use an infrared sauna to help your body combat infections and detoxify from petrochemicals, metals, PCBs, pesticides and mercury.
•Taking chlorella is another excellent detoxification aid.
•Take active steps to minimize your stress … relaxation, meditation, hot soaks, EFT, whatever works for you.
•Exercise, exercise, exercise!
Thyroid Hormone Replacement
If you know your thyroid function is poor, despite making the supportive lifestyle changes already discussed, then it might be time to look at thyroid supplementation.

Taking thyroid hormone should be done only after you have ruled out other conditions that could be causing the thyroid dysfunction such as adrenal fatigue, gluten or other food allergies, hormonal imbalance, etc. It is always best to get your thyroid working again by treating the underlying cause, as opposed to taking an external source of thyroid hormone.

But sometimes supplementation is necessary.

Conventional pharmaceutical treatment usually consists of replacing only T4 in the form of Synthroid, Levoxyl, Levothyroid, Unithroid, and levothyroxine, leaving your body to convert this to T3.

However, research has shown that a combination of T4 and T3 is often more effective than T4 alone. The conversion to T3 can be hampered by nutritional deficiencies such as low selenium, inadequate omega-3 fatty acids, low zinc, chemicals from the environment, or by stress.

Oftentimes, taking T4 alone will result in only partial improvement.

Taking T3 alone is usually too stimulating. The drug Cytomel is a very short-acting form of T3 that can cause palpitations, anxiety, irritability and insomnia. I never recommend this drug.

By far, the better approach is combined T4 and T3 therapy.

Natural thyroid products, like ArmourThyroid are a combination of T4, T3 and T2 made from desiccated, or dried, porcine thyroid. Armour Thyroid has gotten a bad rap over the years, perceived by physicians to be unstable and unreliable in terms of dosage. However, many improvements have been made in the product, making it a safe and effective option for treating hypothyroidism today.

In fact, a study done ten years ago clearly demonstrated that patients with hypothyroidsim showed greater improvements in mood and brain function if they received treatment with Armour Thyroid than if they received Synthroid.

The optimal dose for Armour Thyroid ranges from 15 to 180 milligrams, depending on the individual. You will need a prescription.

Once on thyroid replacement, you will not necessarily need to take it for the rest of your life, which is a common misconception. Once all the factors that have led to your thyroid dysfunction have been corrected, you may be able to reduce or discontinue the thyroid hormone replacement.

Once on thyroid hormone replacement, I recommend you monitor your progress by paying attention to how you feel, in addition to regular lab studies.

You can also routinely check your basal body temperature. If you are on the correct dose, your BBT should be about 98.6 degrees F.

If you begin to feel symptoms such as anxiety, palpitations, diarrhea, high blood pressure, or a resting pulse of more than 80 beats per minute, your dose is likely too high as these are symptoms of hyperthyroidism, and you should let your physician know immediately.

Final Thoughts
A thyroid problem is no different than any other chronic illness — you must address the underlying issues if you hope to correct the problem. The path to wellness may involve a variety of twists and turns before you find what works for you.

But hang in there.

If you approach it from a comprehensive, wholistic perspective, you will find in time that all of the little steps you take will ultimately result in your feeling much better than you could have ever imagined.

Related Links:
What is Thyroid-Related Fatigue?
Signs, Symptoms, and Solutions for Poor Thyroid Function
Fatigue, Dry Skin, Gaining Weight? See Why You’d Better Check Your Thyroid!

Source:
http://articles.mercola.com/sites/articles/archive/2010/01/02/Many-Symptoms-Suggest-Sluggish-Thyroid.aspx

 

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