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Thyroid
Diseases
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Thyroid gland is
of two lobes situated in the neck area. It is a spongy like
tissue storing iodine body requirements from various
nutritional sources. The gland produces thyroxin, which is an
important hormone because it controls body cells activities to
acquire necessary heat energy.
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The thyroid may
show various diseases. These are more common amongst women
than men especially after 40 years of age.
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Diseases include:
hyper or hypothyroidism, which means that the gland become
either hyperactive or hypoactive. Gland tissue infection.
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The most common
thyroid disorder is the hyperthyroidism or Goitre which leads
to the unusual enlargement of the gland and the bulging of the
eye lobe as a result of muscle swelling underneath the eyes.
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The test of the
gland include blood test to check on the activity of the
antibodies and their role in the body immunity. Besides that,
hormonal analyses are also carried out for THS, which is
secreted by the pituitary gland, and Thyroxin T3 and T4.
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Other common
disease is the hypothyroidism or Hashimoto. Symptoms of the
disorder include, Depression, tiredness, hair loss, feeling
cold, slow heart beat and susceptibility to infections.
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Lodine deficiency
in the foetus is a hereditary phenomena causing mental
retardation and abnormal growth of the children after birth.
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Thyroid activities
may suffer from a temporary reduction in pregnant women. It
usually go back to normal after birth.
Hypothyroidism
What is hypothyroidism?
Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormone. Too little hormone slows down all the chemical reactions in the body, causing mental as well as physical changes.
Hypothyroidism can occur in anyone. Middle-aged and elderly women are most commonly affected. There is a strong tendency for all kinds of thyroid disorders to run in families.
How does it occur?
The thyroid gland is a small gland that wraps around the windpipe below the Adam's apple. The thyroid takes iodine from the food you eat to make iodine-containing hormones called thyroxine (T4) and triiodothyronine (T3).
These hormones regulate the rate at which you burn calories for energy. Too little hormone, as in hypothyroidism, may cause you to gain weight. Also, if you don't have enough hormone, your heartbeat slows down and your body temperature decreases. In addition, the rate at which food moves through your intestines and the rate at which your muscles contract slow down.
Causes of hypothyroidism include:
Hashimoto's disease (thyroiditis): This condition is an inflammation of the thyroid gland. It is a disorder of your immune system. The immune system normally protects you from infection.
Radiation treatment for hyperthyroidism (an overactive thyroid gland): Radioactive iodine is commonly used to treat an overactive thyroid gland. Radioactivity can destroy the gland.
People who have received x-ray treatment for cancers of the head and neck may develop hypothyroidism, if their thyroid was exposed to radiation.
Viruses and bacteria: They can cause the thyroid to produce too little hormone. These infections can be treated and do not usually cause permanent hypothyroidism.
Problem with the pituitary gland (rare): The pituitary gland stimulates the thyroid to produce hormones. The pituitary may fail to stimulate the thyroid to make enough hormones to meet your body's needs.
Congenital hypothyroidism (rare): Some people are born without thyroid glands or with glands that cannot make thyroid hormone.
What are the symptoms?
The gradual slowing of all your body's processes caused by hypothyroidism can take months or even years, making it difficult for you to recognize the disease.
Symptoms of hypothyroidism include:
sleepiness and fatigue
muscle weakness
constipation
weight gain
intolerance to cold
heavy and prolonged menstrual periods
coarse, dry hair
premature graying of hair in young adults
thick, dry skin
swollen eyelids
deep, hoarse voice
thick tongue
thickened facial features
slowed heart rate
decreased sexual interest
loss of hearing
numb and tingling hands.
Untreated hypothyroidism may result in:
enlargement of the heart and heart failure (rare)
psychiatric disorders
difficulty breathing
loss of consciousness
slowing of mental processes
inability to maintain normal body temperatures.
The condition that develops after several years of untreated hypothyroidism is called myxedema. A person with myxedema becomes cold and drowsy and may lapse into a coma.
How is it diagnosed?
If the doctor thinks that you may have hypothyroidism, he or she will order blood tests to measure the levels of both thyroid hormone and your pituitary's thyroid-stimulating hormone (TSH).
How is it treated?
After your doctor has diagnosed hypothyroidism, he or she will prescribe synthetic thyroid hormone tablets. You will most likely need to take them every day for the rest of your life.
Most people need only small doses to replace their gland's normal output. After starting treatment, your doctor will repeat the original blood tests to be sure you are taking enough thyroid hormone.
If you have coronary artery disease or are at risk for it, your doctor will prescribe a smaller dose of hormone tablets in the beginning. Replacing the thyroid hormone too quickly can worsen coronary artery disease and, in some cases, can prompt a heart attack. Women prone to osteoporosis may have greater bone loss if they are treated with too much thyroid hormone. They, too, will be given a smaller dose.
Usually hypothyroidism improves within a week after the hormone therapy is begun. All symptoms disappear within a few months. In most cases, however, you must continue this treatment for the rest of your life.
How long will the effects last?
Mild hypothyroidism causes no symptoms. If the disease progresses, however, it can become disabling over a long time if it is not treated.
If not treated, long-lasting thyroiditis can cause goiter, a swelling of the thyroid gland. The thyroid gland may look or feel enlarged.
How can I take care of myself?
Many people with hypothyroidism, especially older adults, don't seek medical treatment because they don't know they have a problem. They may accept their symptoms of fatigue, muscle weakness, dry skin, depression, cold intolerance, and constipation as signs of aging. If you notice some of the symptoms of hypothyroidism, see your doctor.
What can be done to help prevent hypothyroidism?
Hypothyroidism is no longer caused by not getting enough iodine in the diet in the United States.
There is no way to prevent hypothyroidism. However, treatment is simple and inexpensive.
Colonoscopy
Favored for Colorectal Cancer Screening
By PEGGY PECK, UPI Science News
WASHINGTON, July 20 (UPI) -- Two new studies released Thursday make
a
persuasive case for widespread use of a more expensive, high tech
method
called a colonoscopy to detect colon cancer, the second leading
cause of
death in America, but it is still unknown if most insurers will pay
for use
of this test..
The studies in Thursday's issue of The New England Journal of
Medicine
suggest that colon cancer can only be prevented by looking at the
entire
length of the colon. To do that doctors need to use a small flexible
tube,
called a colonoscope, that is threaded through the colon, a
procedure that
costs about $1,000 and requires that patients be sedated.
Researchers compared that to use of a flexible sigmoidoscope, which
examines only a short segment of the colon and is usually performed
in a
doctor's office without anesthesia.
Analysis of findings from a series of 1994 healthy persons aged 50
or
older who underwent colonoscopy as part of an employer-paid health
plan
found that a growth near the rectum-the area that is easily examined
using
the flexible sigmoidoscope- was often an indication that more
serious
growths were located higher up in the colon, said Dr. Thomas
Imperiale, an
associate professor of medicine, Indiana University School of
Medicine,
Indianapolis. That, however, is less than half the story, he said.
More than
half of these more distant growths were found in patients who had no
precancerous growths near the rectum, he said. That's a significant
finding,
he said, because some colon cancer experts say that colonoscopy
should be
limited to only those patients who have growths, called polyps,
detected
using the flexible sigmoidoscope.
"If you rely only on the distal findings from flexible
sigmoidoscopy, you
will miss nearly half of the advanced lesions on the right
side," Imperiale
said.
An author of the second study, Dr. David A. Lieberman, said his
study of
colonoscopy screening in healthy males found "10% of this
asymptomatic
population had serious growths inside the colon."
Lieberman recruited 3121 male volunteers through the VA medical
system.
All of the men were age 55 or older and none of them had symptoms of
colon
disease such as bleeding, weight loss, constipation or diarrhea. He
said the
growths detected by colonoscopy in these men "would not have
been detected
with a flexible sigmoidoscope."
Lieberman, professor of medicine and chief of the division of
gastroenterology at the Oregon Health Science University in
Portland, said
colorectal cancer screening offers a unique public health
opportunity
"because most lesions begin as precancerous growths that we can
detect and
remove and thus prevent cancer."
Lieberman and his co-authors conclude that "the use of
colonoscopy to
screen asymptomatic men for colorectal cancer is feasible and that
such
screening can identify patients with [abnormal tissue or growths]
who may
benefit from the detection and removal of the lesions."
Imperiale, however, said it is too soon to recommend across the
board
use of colonoscopy.
"My take is that there should be a more balanced approach. I do
think we
need to be more liberal in the use of colonoscopy but our long term
goals
should be to find ways to estimate risk more accurately,"
Imperiale said. He
said that abandoning flexible sigmoidoscopy in favor of colonoscopy
is
"going to the other extreme...remember the vast majority of
patients in our
study and other studies had no polyps."
Imperiale said he differs from many of his gastroenterology
colleagues in
that he takes a conservative approach to colonoscopy. "We don't
have high
enough numbers to say with great confidence who does and who doesn't
need
colonoscopy."
One person who takes a different tack is Imperiale's medical
partner,
Douglas Rex, a professor of medicine at Indiana University. Rex is
also a
trustee of the American College of Gastroenterology and one of the
authors
of the ACG colorectal cancer screening guidelines published last
April in
the American Journal of Gastroenterology. Those guidelines recommend
baseline colonoscopy at age 50 for all average risk adults and a
follow-up
colonoscopy every 10 years thereafter. Rex said that making a case
for
colonoscopy at 50 isn't that difficult. He said there is a
significant jump
in colon cancer "beginning at age 50 and continuing through age
60, and then
it levels off with age...the full colon has a higher yield at 50
than at any
other time."
As a lower cost alternative to colonoscopy the ACG suggests that
flexible
sigmoidoscopy could be performed at 5-year intervals beginning at
age 50,
along with annual fecal occult blood tests, a test of blood in the
stools,
a marker for colon cancer.
Joining Rex and Lieberman in their advocacy for colonoscopy is Dr.
David A. Johnson, a professor of medicine at Eastern Virginia
Medical School
as well as an ACG trustee. Johnson, who joined Lieberman and Rex as
a
co-author of the ACG guidelines, said he thinks both papers make a
compelling case for the use of colonoscopy. He said,
"colonoscopy is the
best evolving screening modality that we have and it should be
utilized
without waiting for symptoms."
But while Lieberman favors the ACG recommendations for baseline
colonoscopy at age 50, he said there is a clear need for more risk
stratification. He said the VA study has collected data on risk
factors and
will be publishing that later this year.
Imperiale said until that data is available, each person should be
evaluated individually. For example, he said that a 60-year-old
African-American man who smokes and who is overweight and has never
had any
type of colorectal cancer screening is probably a good candidate for
colonoscopy screening.
"But a healthy white woman age 50, who doesn't smoke, and isn't
overweight
can probably be screened using flexible sigmoidoscopy," he
said.
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Copyright 2000 by United Press International.
All rights reserved.
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