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| Thyroid (Photo credit: Wikipedia) |
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Updated 03:45 PM May 12, 2009
Question by Jun Jie
I am 23. I have been diagnosed with hyperthyroidism since 2001. I was on carbimazole treatment for 18 months, but when the treatment was stopped in 2003, I had a relapse. I also suffered from hand tremors, rapid heartbeat and leg muscle weakness.
Because of this, I was put on carbimazole again. I have been on the medication since, but have had further relapses.
I weigh 77kg and am 1.78m tall. Since maintaining a healthy body mass index has been a problem for me, I have started exercising more and watching my diet. But this causes my blood test results to goes out of range again. Could this be caused by my increase in strenuous activities?
I have been advised to consider radioiodine treatment, but am not keen to try it. Is it realistic for me to continue with carbimazole treatment?
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Reply from Dr Stanley Liew, Specialist for Endocrinology, Raffles Hospital
Hyperthyroidism is due to an overactive thyroid gland, which results in the gland making and releasing too much thyroid hormone. The thyroid is located in front of the neck, and it makes hormones that control metabolism, the pace of the body's processes.
Some of the symptoms of hyperthyroidism are nervousness, increased sensitivity to heat and sweatiness, rapid heartbeats, hand tremors, difficulty sleeping, and weight loss.
In the majority of cases, hyperthyroidism is caused by an autoimmune disorder called Graves' disease. Normally, antibodies produced by the immune system help to protect the body against viruses and bacteria. In Graves' disease, antibodies produced by the immune system inadvertently stimulate the thyroid, making it release too much thyroid hormone.
There are a few options of treatment for hyperthyroidism. They are anti-thyroid medication, radioactive iodine and surgical removal of the thyroid. In general, anti-thyroid medication is very effective in blocking the production of thyroid hormone.
Hyperthyroidism is due to an overactive thyroid gland, which results in the gland making and releasing too much thyroid hormone. The thyroid is located in front of the neck, and it makes hormones that control metabolism, the pace of the body's processes.
Some of the symptoms of hyperthyroidism are nervousness, increased sensitivity to heat and sweatiness, rapid heartbeats, hand tremors, difficulty sleeping, and weight loss.
In the majority of cases, hyperthyroidism is caused by an autoimmune disorder called Graves' disease. Normally, antibodies produced by the immune system help to protect the body against viruses and bacteria. In Graves' disease, antibodies produced by the immune system inadvertently stimulate the thyroid, making it release too much thyroid hormone.
There are a few options of treatment for hyperthyroidism. They are anti-thyroid medication, radioactive iodine and surgical removal of the thyroid. In general, anti-thyroid medication is very effective in blocking the production of thyroid hormone.
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However, in some patients who have relapse or the return of hyperthyroidism after stopping anti-thyroid medication, radioiodine should be considered. Radioactive iodine is concentrated in thyroid glands. The quantity of radioiodine used to treat hyperthyroidism is safe and not enough to injure any other body tissue except the thyroid, which slowly shrinks over a matter of months.
In some countries, such as the United States, radioiodine is often viewed as the definitive treatment of choice. In recent years, surgery is less commonly used.
Your doctor will choose an appropriate treatment based on your particular circumstances. Based on your revelations, your thyroid seems rather active as it has relapsed a few times even when you are on anti-thyroid medication.
Therefore, radioiodine treatment would be a good choice. If you monitor your thyroid status regularly and it is well controlled and not over treated, you should not have the tendency to gain weight. Exercise is unlikely to be the cause of your abnormal thyroid status. Frequent review by your doctor and appropriate adjustment of anti-thyroid medication would usually get your thyroid better controlled.
There is no one answer for everyone suffering from hypothyroidism. However, there are different natural alternatives available, including porcine thyroid supplements which may decrease the need for a high dosage of hormone replacement therapy.
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