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The leading cause of hyperthyroidism (also known as thyrotoxicosis or 'overactive thyroid') is Graves' disease. Graves' disease represents a basic defect in the immune system, causing production of immunoglobulins (antibodies) which stimulate and attack the thyroid gland, causing growth of the gland and overproduction of thyroid hormone. Similar antibodies may also attack the tissues in the eye muscles and in the skin on the front of the lower leg.
Some facts: - Graves' disease occurs in less that 1/4 of 1% of the population, but as many as 3% to 4% of asymptomatic populations have been found to have suppressed TSH levels suggestive of subclinical Graves' disease.
- Graves' disease is more prevalent among females than males.
- Graves' disease usually occurs in middle age, but also occurs in children and adolescents.
- Graves' disease is not curable, but it is a very treatable disease.
The thyroid gland is shaped like the letter "U." The larger side parts are tucked in behind neck muscles next to the trachea (windpipe) while the middle connecting part is closer to the skin, just below the larynx (Adam's apple). It is like two walnuts connected at the bottom by an almond. The normal gland is barely palpable by a physician's hand, and then it is only the connecting part that can be felt. Enlargement of the gland occurs with most thyroid ailments and is either generalized (a goiter), nodular (bumpy) or both.
The sole function of the thyroid gland is to make thyroid hormone. The production process involves uptake of iodine from the bloodstream and attachment of this mineral to a protein produced within the gland. Production and release of thyroid hormone by the thyroid gland are controlled by another gland - the pituitary. Living at the base of the brain, the pituitary gland senses the body’s need for thyroid hormone and then triggers the thyroid gland by releasing a chemical named thyroid stimulating hormone, or TSH. As you might guess, disease of the pituitary can affect function of the thyroid gland.
Thyroid hormone is the body's "governor." It controls the rate of metabolism - the speed of physiologic processes and functions. Normally everything is fine-tuned. The thyroid and its pituitary controller keep the body’s machinery running at the most effective and efficient rate. But a host of environmental and genetic factors can foul the system.
The most common disease of the thyroid gland is hypothyroidism, or under function. With too little thyroid hormone, the machinery slows and the person slows. Fatigue, somnolence, mental sluggishness, and a desire for high room temperature are common symptoms. In advanced states the victim has thickened and boggy facial skin, a slow raspy voice, baggy eyes and a dull appearance. Thinking is slowed, and the person may appear depressed or even confused. Because an underactive thyroid gland develops slowly, the problem often goes unrecognized by the patient, the family and even the physician. Too often the trouble is attributed to old age. Diagnosis is easy if a blood test is obtained. And treatment with a daily thyroid hormone tablet is also easy.
Over function of the thyroid gland is less common than under function, but is not uncommon in the elderly.
Incidence; Causes & Development
Although Graves' disease most frequently occurs in women in their middle decades (8 times more than men), it also occurs in children and in the elderly.
There are several elements contributing to the development of Graves' disease. There is a genetic predisposition to autoimmune disorders and infections and stress play a part. Graves' disease may have its onset after an external stressor In other instances, it may follow a viral infection or pregnancy. Many times the exact cause of Graves' disease is simply not known. It is not contagious, although it has been known to occur coincidentally between husbands and wives.
Signs & Symptoms
Hyperthyroidism may manifest as an enlarged thyroid (goitre), hair changes, erratic behavior, heart rate irregularities, tremor, sweating, palpitations, nervousness and increased activity and eye abnormalities.
The metabolic speed-up associated with hyperthyroidism is easily diagnosed in younger patients who present with symptoms of weight loss, excess appetite, sweating, rapid pulse and tremor. In older adults these characteristic symptoms may not exist. The elderly often present with depressed mood, confusion, heart failure, irregular pulse rate and a myriad of symptoms that do not readily suggest an acceleration of metabolism.
Diagnosis & Tests
Advances in laboratory technology now allow both underactive and overactive thyroid conditions to be diagnosed quickly and accurately with simple blood tests. Geriatricians routinely examine a patient’s thyroid gland and order periodic blood checks - they believe it is best to detect and treat thyroid problems before significant symptoms arise. It is another reason why regular medical checkups are important for older adults.
Treatment & Prevention
Once diagnosed, treatment of hyperthyroidism in an older person is safely accomplished by administration of radioactive iodine. The zapped iodine molecules are taken up by the thyroid gland and tame the overactive factory.
The selection of treatment will include factors such as age, degree of illness, and personal preferences. Generally speaking, from least invasive to most invasive, the treatments include: - Anti-thyroid drugs that inhibit production or conversion of the active thyroid hormone (20-30% effective, often used to control mild cases)
- Radioactive iodine (I-131), which destroys part or all of the thyroid gland and renders it incapable of overproducing thyroid hormone
- Surgery, in which most of the thyroid gland is removed, renders it incapable of overproducing thyroid hormone.
The latter two treatments result in a 90-95% remission rate of the disease. In a few cases the treatments must be repeated. In all cases lifetime follow-up laboratory studies must be done, and in almost all cases lifetime replacement thyroid hormone must be taken.
Prognosis; Complications
Grave's disease usually responds to treatment and, after the initial period of hyperthyroidism, is relatively easy to treat and manage.
Another common disorder of the thyroid gland is a nodule, or lump. A physician’s main concern is whether the growth is caused by cancer. Fortunately, the vast majority of nodules discovered in the elderly are harmless. "Wait and watch" is usually the best advice. If cancer of the gland is discovered, the prognosis with treatment is usually good.
The more serious complications of prolonged, untreated, or improperly treated Grave's disease include weakened heart muscle leading to heart failure, osteoporosis, or possible severe emotional disorders.
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Signs, symptoms & indicators of Hyperthyroidism:
Conditions that suggest Hyperthyroidism:
Risk factors for Hyperthyroidism: | | | | | Addictions |  Cigarette Smoke Damage | A study of 132 pairs of twins (264 subjects) showed that smoking can have negative effects on the endocrine system, causing a 3- to 5-fold increase in the risk of all types of thyroid disease. The association was most pronounced in autoimmune disorders (Graves' disease and autoimmune thyroiditis), although there was still a strong association for non-autoimmune thyroid disorders. |
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Family History |
Hyperthyroidism in family members |
Nutrients |
 Copper Deficiency| | Although supportive data is limited, a report from a study group of hyperthyroid women suggests that copper status should at least be investigated in women with hyperthyroidism.
"Thyroid and immune system health are crucially dependent upon copper. As far as I can see now, copper deficiency is the most important factor in the development of hyperthyroidism. Virtually all hypers in the hyperthyroidism group have found that copper supplementation reduced their symptoms, usually within hours or a few days at most. Most have reported that within three to six months of beginning copper supplementation, they have been able to significantly reduce their intake of antithyroid drugs. While copper is the big story in hyperthyroidism, it is not the whole story. If it were, it would have been discovered years ago. Proper copper metabolism interrelates with and depends upon many other nutrients." [John Johnson, iThyroid.com] |
Iodine Requirement| | Hyperthyroidism may occur, particularly in elderly people, due to long term slight iodine deficiency as this may result in additional nodules on the thyroid. |
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Symptoms - Food - Intake |
High iodine consumption |
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Hyperthyroidism suggests the following may be present: | | | | | Addictions | Cigarette Smoke Damage| | A study of 132 pairs of twins (264 subjects) showed that smoking can have negative effects on the endocrine system, causing a 3- to 5-fold increase in the risk of all types of thyroid disease. The association was most pronounced in autoimmune disorders (Graves' disease and autoimmune thyroiditis), although there was still a strong association for non-autoimmune thyroid disorders. |
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Hyperthyroidism can lead to:
Recommendations and treatments for Hyperthyroidism: | | | | | Diet |  Gluten-free Diet
Dairy Products Avoidance| | One doctor reports that taking calcium without magnesium is one of the worst things you can do if you have hyperthyroidism because this increases any magnesium deficiency and increases the heart rate and likelihood of arrhythmia. This is one of the reasons why dairy products, which are high in calcium and low in magnesium, need to be restricted until magnesium levels are replenished. |
 Therapeutic Fasting |
Digestion |
Hydrochloric Acid (Trial) |
Lab Tests/Rule-Outs |
 Test Thyroid Function
Test for DHEA| | Some doctors report finding that a high percentage of patients with autoimmune disorders, such as Graves' disease, are also deficient in DHEA, and should be tested. |
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Mineral |
Iodine| | Very high doses of Iodine for short periods (about thirty drops daily of SSKI for three weeks) have sometimes produced favorable results in Graves' disease. Because of the possibility of causing a 'thyroid storm' (an acute hyperthyroid state), this therapy should only be attempted under close supervision by a doctor experienced in its use: Excessive iodine ingestion can cause either hypothyroidism or hyperthyroidism and should be avoided. |
Selenium| | On June 22, 2001 Dr. Barbara Gasnier reported the findings at the 83rd Annual Meeting of the Endocrine Society in Denver, Colorado that selenium supplementation may prevent progression of autoimmune thyroid disease, especially during the onset of the disease.
According to the researchers, selenium deficiency appears to contribute to the development and maintenance of autoimmune thyroiditis because of its effect on the function of selenium-dependent enzymes, which can modulate the immune system.
Selenium supplementation with 200mcg of sodium selenite may improve the inflammatory activity seen in patients with autoimmune thyroiditis, but whether this effect is specific for autoimmune thyroiditis or may also be effective in other organ-specific autoimmune diseases remains to be investigated. Selenium supplementation may lower free radical activity, which contributes to inflammation.
It appears that taking selenium without iodine will result in a decrease in production of Thyroxine (T4), although there may be an initial transient increase in T4 to T3 conversion and hence higher T3 and seemingly worse hyperthyroidism. |
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Surgery/Invasive |
Neural Therapy| | Neural Therapy to the thyroid gland may help normalize its function and stabilize or shrink nodules. |
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KEY | | Weak or unproven link | | | Strong or generally accepted link |  | | Proven definite or direct link |  | | Weakly counter-indicative |  | | Strongly counter-indicative |  | | Very strongly or absolutely counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Allergy (Allergies)
Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.
Antibody (Antibodies)
A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.
Arrhythmia (Arrhythmias)
A condition caused by variation in the regular rhythm of the heartbeat. Arrhythmias may cause serious conditions such as shock and congestive heart failure, or even death.
Asymptomatic
Not showing symptoms.
Autoimmune Disease (Autoimmune, Autoimmunity)
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. The body also needs calcium to carry nerve signals, keep the heart functioning, contract muscles, clot blood and maintain healthy skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Checkup (Check-up, Checkups, Check-ups)
A thorough physical examination that includes a variety of tests depending on the age, sex and health of the person.
Cobalamin (B12, B-12, Cobalamine, Vitamin B12)
Essential for normal growth and functioning of all body cells, especially those of bone marrow (red blood cell formation), gastrointestinal tract and nervous system, it prevents pernicious anemia and plays a crucial part in the reproduction of every cell of the body i.e. synthesis of genetic material (DNA).
Copper
An essential mineral that is a component of several important enzymes in the body and is essential to good health. Copper is found in all body tissues. Copper deficiency leads to a variety of abnormalities, including anemia, skeletal defects, degeneration of the nervous system, reproductive failure, pronounced cardiovascular lesions, elevated blood cholesterol, impaired immunity and defects in the pigmentation and structure of hair. Copper is involved in iron incorporation into hemoglobin. It is also involved with vitamin C in the formation of collagen and the proper functioning in central nervous system. More than a dozen enzymes have been found to contain copper. The best studied are superoxide dismutase (SOD), cytochrome C oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase, lecithinase and other monoamine and diamine oxidases.
DHEA (DHEA-S)
Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. DHEA may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEA-S. One form is converted into the other as needed.
Enzymes (Enzyme)
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Free Radical (Free Radicals)
A free radical is an atom or group of atoms that has at least one unpaired electron. Because another element can easily pick up this free electron and cause a chemical reaction, these free radicals can effect dramatic and destructive changes in the body. Free radicals are activated in heated and rancid oils and by radiation in the atmosphere, among other things.
Gland (Glands)
The glandular system is one of the most important and complicated systems of the body. Gland tissue can be either an organ or general tissue that secretes chemicals and there are two types of gland: exocrine and endocrine. Those glands which secrete chemicals through tubules or ducts are called exocrine and include sweat, tear and salivary glands. Ductless glands - part of the endocrine system - secrete special chemicals (hormones) directly into the blood.
Goiter (Goitre)
A chronic enlargement of the thyroid gland (visible between the Adam's apple and the collarbone at the front of the neck) produced by the body in an attempt to increase hormone production from limited amount of iodine. It is not due to cancerous growth.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Hyperthyroidism (Hyperthyroid)
An abnormal condition of the thyroid gland resulting in excessive secretion of thyroid hormones characterized by an increased metabolism and weight loss.
Hypochlorhydria (Hypochlorhydric)
The condition of having low hydrochloric acid levels in the stomach, often the cause of digestive disorders.
Hypothyroidism (Hypothyroid)
Diminished production of thyroid hormone, leading to low metabolic rate, tendency to gain weight, and sleepiness.
Immune System (Immune Response, Immunity)
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation. The process may involve acquired immunity (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).
Iodine
A essential mineral that is an integral part of the thyroid hormones, thyroxin and triiodothyronine which have important metabolic roles and govern basal metabolism. The best known iodine deficiency symptom is goiter. Other iodine deficiency problems are reduced vitality, hypothyroidism, inability to think clearly, low resistance to infection, loss of control of the muscles of the mouth resulting in mouth contortion and drooling, defective teeth, tendency to obesity and cretinism which is a congenital abnormal condition marked by physical stunting and mental deficiency.
Larynx (Laryngeal, Voice Box)
The short passageway shaped like a triangle that is just below the pharyx in the neck.
Magnesium
An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.
Metabolism (Metabolic, Metabolize, Metabolizes, Metabolizing)
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds. Also defined as the sum total of changes in an organism in order to achieve a balance (homeostasis): Catabolic burns up, anabolic stores and builds up; the sum of their work is metabolism.
Microgram (mcg, Micrograms, ug)
0.000001 or a millionth of a gram.
Mineral (Minerals)
Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.
Osteoporosis
A disease in which bone tissue becomes porous and brittle. The disease primarily affects postmenopausal women.
Pituitary (Pituitary Gland)
The pituitary gland is a small (half-inch), bean-shaped organ that hangs down from the lower center of the brain on a stalk attached to another gland, the hypothalamus. Weighing less than one gram, the pituitary gland is often called the "master gland" since it controls the secretion of hormones by other endocrine glands. It regulates many body activities, and is partitioned into front and back lobes. The front lobe is stimulated by the hypothalamus, and produces any one of six different hormones that in turn stimulate the thyroid, adrenal and reproductive glands, and also breast milk production.
Prognosis
A prediction (estimate) of the future course and outcome of a disease and an indication of the likelihood of recovery from that disease.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Selenium
An essential element involved primarily in enzymes that are antioxidants. Three selenium- containing enzymes are antioxidant peroxidases and a fourth selenium-containing enzyme is involved in thyroid hormone production. The prostate contains a selenium-containing protein and semen contains relatively large amounts of selenium. Clinical studies show that selenium is important in lowering the risk of several types of cancers. In combination with Vitamin E, selenium aids the production of antibodies and helps maintain a healthy heart. It also aids in the function of the pancreas, provides elasticity to tissues and helps cells defend themselves against damage from oxidation.
Sodium
An essential mineral that our bodies regulate and conserve. Excess sodium retention increases the fluid volume (edema) and low sodium leads to less fluid and relative dehydration. The adult body averages a total content of over 100 grams of sodium, of which a surprising one-third is in bone. A small amount of sodium does get into cell interiors, but this represents only about ten percent of the body content. The remaining 57 percent or so of the body sodium content is in the fluid immediately surrounding the cells, where it is the major cation (positive ion). The role of sodium in the extracellular fluid is maintaining osmotic equilibrium (the proper difference in ions dissolved in the fluids inside and outside the cell) and extracellular fluid volume. Sodium is also involved in nerve impulse transmission, muscle tone and nutrient transport. All of these functions are interrelated with potassium.
Subclinical
Pertaining to a disease or condition: Not manifesting characteristic clinical symptoms, that is, not detectable through examination and/or having no symptoms; the period of time when a potential disease is still potential, and a functional imbalance or tendency has not caused any organic disruption. Those years of poor digestion, heartburn, and the
systematic suppression of upper intestinal function by adrenalin stress have not yet become overt gastritis, ulcers, or IBS.
Thyroid (Thyroid Gland)
The thyroid gland is an organ with many veins, anchored around the front of the throat near the voice box. It is essential to normal body growth in infancy and childhood. It absorbs iodine from the diet and releases thyroid hormones - iodine-containing compounds that help govern the rate of the body's metabolism (its total life processes), affecting body temperature, and regulating protein, fat and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor. To a high degree, metabolism is regulated by the hormone thyroxine, which can be made by the thyroid if enough organic iodine is available. An enlarged thyroid gland that is not cancer is sometimes called goitre.
Thyroiditis (Chronic Thyroiditis, Hashimoto's Thyroiditis)
Inflammation of the thyroid; there are several forms of thyroiditis, including chronic or Hashimoto's thyroiditis (also called autoimmune or chronic lymphocyctic thyroiditis), subacute thyroiditis, and painless or postpartum thyroiditis. Thyroiditis often results in hypothyroidism.
Thyrotoxicosis (Graves Disease, Graves' Disease)
Also known as Graves' disease, is a disorder of excess thyroid hormone production. It is usually linked to an enlarged thyroid gland and bulging eyes (exophthalmos).
Thyroxin (T4)
A thyroid hormone also prepared synthetically, for treatment of hypothyroidism and myxedema.
Trachea
The cartilage tube that brings air from the larynx to the two bronchi that enter the lungs. It is lined with mucous membranes and ciliated epithelia.
Last updated: Sep 28, 2009
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