Thyroid for Dummies (4 page)

Measuring your waist size ................................................................176

Losing excess weight ........................................................................177

Selecting a variety of foods ...............................................................177

Choosing your fats wisely .................................................................182

Checking out your cholesterol .........................................................182

Moderating your sugar intake ..........................................................184

Sifting the salt .....................................................................................184

Drinking alcohol in moderation........................................................185

Going Organic ....................................................................................186

Thinking about food safety ...............................................................186

Clarifying the Thyroid–Weight Connection ..............................................187

Does my metabolism slow when I lose weight? .............................187

If I’m treated for hyperthyroidism, am I doomed

to gain weight? ................................................................................187

Considering Iodine in Your Diet .................................................................189

Getting enough iodine in a vegetarian diet .....................................189

Exercising for Your Thyroid........................................................................190

Recognising the natural consequences of ageing ..........................190

Working out with hypothyroidism ...................................................191

Exercising with hyperthyroidism .....................................................192

Meeting your minimal exercise needs .............................................193

Introducing Leptin: The New Hormone on the Block..............................194

Understanding the functions of leptin.............................................194

Interacting with thyroid hormone....................................................195

Chapter 16: Helping Yourself: Herbs and Homeopathy . . . . . . . . . . . .197

Finding a Reputable Practitioner ...............................................................198

Digging into Medicinal Herbs .....................................................................199

Bladderwrack......................................................................................199

Bugleweed ..........................................................................................200

Korean ginseng ..................................................................................200

Motherwort .........................................................................................200

Oats .....................................................................................................201

Siberian ginseng ................................................................................201

Turmeric .............................................................................................201

Valerian ................................................................................................201

Understanding Homeopathy ......................................................................202

Discovering homeopathic remedies ................................................202

Taking a remedy .................................................................................203

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Arsenicum album ...............................................................................203

Iodum ..................................................................................................204

Belladonna ..........................................................................................204

Natrum Mur.........................................................................................204

Part IV: Special Considerations in Thyroid Health ........205

Chapter 17: Examining the Genetic Link to Thyroid Disease . . . . . .207

Genetics for Beginners ................................................................................207

A monk and his pea plants ................................................................208

Talk the talk.........................................................................................209

The great divide..................................................................................209

Genes, chromosomes, and the traits they create ..........................210

The secret lives of genes ...................................................................211

Shall I form a liver or a brain?...........................................................213

The Origins of Genetic Thyroid Diseases..................................................214

Inheriting a disease through a single gene......................................214

Inheriting a disease through multiple genes...................................216

Inheriting a chromosome abnormality ............................................217

The Future of Managing Hereditary Thyroid Disease .............................218

Genetic engineering ...........................................................................218

The ethics of germline gene therapy ...............................................219

Chapter 18: Controlling Thyroid Disease during Pregnancy . . . . . . .221

Looking at Normal Thyroid during Pregnancy.........................................222

Pregnancy and Hypothyroidism.................................................................223

Decreased fertility ..............................................................................223

Iodine deficiency ................................................................................224

Autoimmune hypothyroidism...........................................................224

Hyperthyroidism in Pregnancy ..................................................................225

Postpartum Graves’ disease .............................................................229

Gestational transient thyrotoxicosis ...............................................229

Hydatidiform mole and choriocarcinoma .......................................231

Finding New Thyroid Nodules during Pregnancy ....................................231

Chapter 19: Developing Thyroid Conditions in Childhood . . . . . . . . .233

Understanding the Onset of Thyroid Function ........................................233

Screening the Newborn ...............................................................................235

Coping with Hypothyroidism in Children .................................................236

Transient congenital hypothyroidism .............................................237

Congenital hypothyroidism ..............................................................237

Acquired hypothyroidism .................................................................239

Dealing with Hyperthyroidism in Children ...............................................241

Signs and symptoms ..........................................................................241

Laboratory confirmation ...................................................................243

Treatment ............................................................................................243

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Diagnosing Goitres in Children...................................................................245

Linking Nodules and Cancer in Children...................................................245

Chapter 20: Maturing: Thyroid Disease in Later Life . . . . . . . . . . . . . .247

Assessing the Extent of the Problem .........................................................248

Understanding Sources of Confusion in Diagnosis ..................................249

Acknowledging other diseases .........................................................249

Taking medications ............................................................................250

Discovering Hypothyroidism in Older People..........................................250

Deciphering signs and symptoms ....................................................251

Getting laboratory confirmation ......................................................252

Trying thyroid hormone for subclinical patients...........................252

Taking treatment slowly ....................................................................253

Managing Hyperthyroidism in Older People ............................................253

Sorting through confusing signs and symptoms............................254

Securing a diagnosis ..........................................................................255

Checking Out Thyroid Nodules in Older People ......................................256

Part V: The Part of Tens .............................................257

Chapter 21: Ten Myths about Thyroid Health . . . . . . . . . . . . . . . . . . . .259

I’m Hypothyroid, So I Can’t Lose Weight...................................................259

I’m Hyperthyroid, So I Can’t Gain Weight..................................................260

Breastfeeding and Antithyroid Pills Don’t Mix .........................................261

Brand Name Thyroid Hormone Pills Are Best..........................................261

I Have to Take Thyroid Medication for Life ..............................................262

Natural Thyroid Hormones Are Better Than Synthetic Hormones .......263

Thyroid Disease Is Catching .......................................................................264

Iodine Deficiency Is a Medical Problem ....................................................264

The Higher My Autoantibody Levels, the Worse My Thyroid Disease .......................................................................................................265

Clinical Symptoms Are More Reliable Than Blood Tests........................266

Chapter 22: Ten Ways to Maximise Thyroid Health . . . . . . . . . . . . . .269

Screening at Appropriate Intervals............................................................270

Checking Thyroid Function As Your Body Changes ................................270

Performing a ‘Neck Check’ ..........................................................................271

Getting Enough Iodine to Satisfy Your Thyroid........................................272

Stopping Thyroid Medication, If Possible.................................................272

Using Both Types of Thyroid Hormone.....................................................272

Preventing the Regrowth of Thyroid Cancer ............................................273

Anticipating Drug Interactions ...................................................................274

Protecting Your Thyroid from Radiation...................................................275

Keeping Up-to-Date with Thyroid Discoveries .........................................275

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Part VI: Appendixes...................................................277

Appendix A: Glossary of Key Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . .279

Appendix B: Sources of More Information . . . . . . . . . . . . . . . . . . . . . .283

Index........................................................................285

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Introduction

As part of my medical training, I (Sarah) was taught by an enlightened physician, Dr David Rubenstein of Addenbrooke’s Hospital, Cambridge.

He encouraged me to do three things when evaluating a patient with puzzling symptoms: Think Drugs (so as not to miss unsuspected side effects), Think Dirty (to exclude syphilis, a disease that mimics so many other conditions) and Think Thyroid – because under and overactive thyroid problems are so often missed, especially in older people.

I went on to make a career out of thinking drugs and thinking thyroid (thinking dirty is no longer as necessary as it was just a generation ago).

For hundreds of years, people understood that a connection exists between a strange looking growth in the neck and certain diseases. Until about 60 years ago, confusion reigned as people with similar growths in their necks often have opposite symptoms. One group shows excessive excitement, nervousness, and shakiness, while the other has depression, sleepiness, and general loss of interest. What the two groups have in common is that they are mostly all women.

As recently as 60 years ago, scientists started to measure the chemicals coming from these growths (enlarged thyroid glands), and suddenly the whole picture began making sense. Now, many of the secrets of the thyroid gland and the hormones it makes are known, although it undoubtedly still has a few surprises up its sleeve.

This book explains that, with very rare exceptions, thyroid diseases, including thyroid cancer, are some of the most easily treated of all disorders. This fact is why many thyroid specialists say, ‘If I have to have cancer, let’s hope it’s a thyroid cancer.’