Thyroid dysfunction.
Subject: Hyperthyroidism (Risk factors)
Hyperthyroidism (Diagnosis)
Hyperthyroidism (Drug therapy)
Hyperthyroidism (Prognosis)
Thyroxine (Dosage and administration)
Thyroxine (Research)
Author: Cowper, Anne
Pub Date: 03/22/2007
Publication: Name: Australian Journal of Medical Herbalism Publisher: National Herbalists Association of Australia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2007 National Herbalists Association of Australia ISSN: 1033-8330
Issue: Date: Spring, 2007 Source Volume: 19 Source Issue: 1
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 174818468
Full Text: McCormack AI, Learoyd DE, 2006. A guide to thyroid dysfunction. MedToday 7:5;28-35.

Hyperthyroidism occurs in approximately 2% of the community and hypothyroidism in 5-10%. There is a female to male predominance of 5:1. A family history of the thyroid dysfunction is common in affected patients.

Hyperthyroidism

The most common cause of hyperthyroidism is Graves' disease; a diffuse goiter with a bruit is commonly found. A nodular goiter may suggest either a toxic multinodular goiter or toxic adenoma. Subacute thyroiditis is associated with a tender asymmetrically enlarged thyroid, and patients are typically systemically unwell with fever and neck pain.

Eye lid lag and lid retraction can occur in any thyrotoxic state, but proptosis (bulging eye) is specific for Graves' disease.

Treatment of hyperthyroidism usually involves antithyroid drugs, radioactive iodine or total thyroidectomy.

Hypothyroidism

Common symptoms include weight gain, fatigue, cold intolerance, depression, constipation, dry skin, muscle and joint aches and slowed mental processing. There may be bradycardia, periorbital edema, thinning of the outer third of the eyebrows, hoarse voice or goitre. Hypothyroidism is suggested if several of these features occur in combination or with recent onset.

Causes of hypothyroidism include autoimmune disease (Hashimoto's thyroiditis), congential hypothyroidism, thyroid or head and neck surgery, previous irradiation, drug treatment (e.g. lithium, interferon), pituitary or hypothalamic disease.

Primary hypothyroidism is confirmed by an elevated TSH and decreased free T4 level. Patients with autoimmune thyroid disease should have their vitamin [B.sub.12] levels measured.

Treatment of hypothyroidism involves thyroxine therapy (Eutroxsig, Oroxine). Most patients require maintenance doses of 100 to 150 [micro]g daily. Women taking thyroxine and planning pregnancy may need to increase the dose by 30% during pregnancy.

Thyroid function tests should be considered in any patient with symptoms or signs suggestive of thyroid disease and in any patient at risk of developing thyroid dysfunction.

Anne Cowper

PO Box 45, Concord West NSW 2138

Email ajmh@nhaa.org.au
Gale Copyright: Copyright 2007 Gale, Cengage Learning. All rights reserved.


 
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