Your Questions Answered

Q: ... I was wondering whether Stem Cell therapy could be a possible mean for treatment? -Asaph

Stem cell therapy is a possible mean for treatment. The Free University of Belgium have been able to use stem cells to grow a functioning, implantable thyroid gland which even produced the hormones it was meant to. However, this development is still under study.

Q: ... is hyper/hyopthyroidism common at any age? Or is there any lifestyle that will increase the risk of getting them? -Sakinah

No specified age, but thyroid disorders do tend to occur more in women. This is because women are more prone to physical and emotional stress which burdens the thyroid glands. Older women tend to develop the disorder during menopause.

Overworking is a lifestyle that will increase the risk of getting the disorders.

Thus, it is important to rest well and sleep for at least 8 hours a day :*

Q: ... A question since this really bothered me. Do you think by drinking coffee everyday, it would increase the chance of having this disorder? So would you say the food cause the disorder? or it really just depends on individual? -Lynn

If you do not suffer from either of the disorders, it's fine to drink coffee everyday. The foods proposed for thyroid health are mainly advise for those with the disorders. This is because many of them are unaware that when taking medication in the morning, they aren't suppose to consume caffeine within an hour from taking their medication.
Food does not cause the disorder however, do take note on balance and moderation. One of the functions of the thyroid gland is to destroy toxins from fish, eggs, cheese and so on but when too much is consumed, it puts strain on the gland. Other factors such as overworking will increase the chance of having this disorder.
Ultimately, it depends on an individual's thyroid gland limits.

What is the thyroid?

The thyroid is a gland and it is one of the largest in the endocrine system (system of glands which secretes different types of hormones to maintain homeostasis, stable & constant condition of properties such as water/ pH).

Thyroid gland;
- When normal-sized, you can't feel it
- Rich with blood vessels
- Important nerves for voice quality passes it
- Secretes thyroid hormones responsible for:

1. Metabolism
2. Growth & Development
3. Regulating body temperature

Adequate amounts of thyroid hormones are crucial during early stages of brain development.

What are thyroid disorders?

There are 2 types of thyroid disorders; HYPERthyroidism & HYPOthyroidism.

HYPERthyroidism is caused by having too much thyroid hormones wherelse HYPOthyroidism is caused by having too little thyroid hormones.

What causes these 2 types of thyroid disorders?

HYPERthyroidsim

Cause(s)	Explanation
Graves’ Disease	Thyroid is overstimulated*
Toxic Adenomas	Nodules** developing in the thyroid gland and then secreting thyroid hormones, upsetting the body's chemical balance; some goiters^ may contain several of these nodules.
Subacute thyroiditis	Inflammation of the thyroid, causing the gland to "leak" excess hormones, resulting in temporary hyperthyroidism (weeks to months).
Pituitary gland malfunctions or cancerous growths in the thyroid gland	Rare

*aggresive
**fluid-filled lumps formed within thyroid
^thyroid swelling

HYPOthyroidism

Cause(s)	Explanation
Hashimoto's thyroiditis	In this autoimmune* disorder, the body attacks thyroid tissue. The tissue eventually dies and stops producing hormones.
Removal of the thyroid gland (surgically or chemically destroyed)
Exposure to excessive amounts of iodide	Cold and sinus medicine(s), heart medicine ‘amiodarone’, or certain contrast dyes given before some X-rays expose too much iodine.
Lithium (drug)	Causes HYPOthyroidism as well.

*immune response against its own cells & tissues due to failure to recognise its own constituent parts

What are the symptoms of thyroid disorder?

1) Muscle & Joint aches

2) Neck discomfort/ enlargement

Visual signs of a goiter. Hoarse voice (impt nerves for voice quality passes there).

3) Hair loss

HYPOthyroidism, hair becomes brittle & coarse. Worse for HYPERthyroidism.

4) Constipation

May be long-term.

5) Menstrual cycle irregularities & issues with fertility
HYPOthyroidism, heavier & painful periods. HYPERthyroidism, lighter & infrequent menstrual cycles. 

6) Hereditary

7) Problems with cholesterol

8) Depression & anxiety

HYPOthyroidism, depression. HYPERthyroidism, anxiety or panic disorders. Depression unresponsive to antidepressant is a sign of the disorder.

9) Issues with weight management

HYPOthyroidism, difficulty losing weight.

10) Fatigue

What is the biochemistry behind the disease?

Grave's disease > thyroid hormone is over stimulated (HYPERthyroidism)


The pituitary gland secretes thyroid-stimulating hormone (TSH),  triiodothyronine (T₃) and thyroxine (T₄), which are primarily responsible for regulation of metabolism. They will bind to the thyroid-stimulation hormone receptor (TSHR) to produce thyroid hormones.


In Grave's disease, the body produces antibodies to the TSHR, resulting in the overproduction of the thyroid hormones.

They are 

• Thyroid stimulating immunoglobulins: act as long acting thyroid stimulants, activating the cells in a longer and slower way than TSH, leading to an elevated production of thyroid hormone.

• Thyroid growth immunoglobulins: bind directly to the TSH receptor and have been implicated in the growth of thyroid follicles.

• Thyrotrophin Binding-Inhibiting Immunoglobulins: inhibit the binding of TSH with its receptor. Some will actually act as if TSH itself is binding to its receptor, thus inducing thyroid function.

The autoantibodies produced in Graves' disease are not subject to negative feedback and will continue to be produced and bind to TSHR even when thyroid hormone levels rise too high. This results in hyperthyroidism, or an abnormally strong release of hormones from the thyroid gland.

Many factors can affect a person's susceptibility to Graves' disease, although the mechanism of initiation remains unknown.

Could one prevent this metabolic disorder?

Yes, thyroid disorder(s) can be prevented by having a diet which contains food promoting thyroid health and as well as keeping off food which threatens it.

Food for Promoting Thyroid Function (especially for those with HYPERthyroidsim)

Seaweed Almost 0 calories, low in fat, and contains high concentrations of minerals. Helps to prevent growth of tumors.	Rich in iodine (helps in manufacturing thyroid hormones).     Reduces cholesterol. Those with hypothyroidism face increased blood cholesterol level, thus, seaweed reduces effects.
Coconut Oil  Processed hydrogenated vegetable oils are to blame for many modern diseases. Easy to ingest, can be used as a spread, cooking or just taken in raw.	Stimulates thyroid hormone production & metabolism.             Contains saturated fat (promotes thyroid function).             Helps in weight loss (for those with hypothyroidism).             Reduces cholesterol. Those with hypothyroidism face increased blood cholesterol level, thus, coconut oil reduces effects.
Shellfish	Simply rich in iodine.

Food for Suppressing Thyroid Function (especially for those with HYPOthyroidism)

Fermented Soy Foods	Strong suppressor of thyroid hormones (more effective than anti-thyroid drugs).
Raw Cruciferous Vegetables	Suppressor of thyroid hormones.             Contain goitrogens that interfere with iodine uptake.
Millet Bajra (millet) has high fat content, thus, having a high nutritional content. This grain food is used to feed poultry.	Cooking may lessen its antithyroid effects.

Food To Avoid For Thyroid Health

Gluten-containing Grains	Contains anti-thyroid antibodies.
Unfermented Soy	Rich in concentrated isoflavones & genistein (contribute to autoimmune thyroid disease).
Coffee	Contain goitrogens that interferes with iodine uptake.

What are the current cures?

Surgery

1) Lobectomy

Removal of the lobe.

2) Near-total thyroidectomy

Removal of a large part of the thyroid.

3) Total thyroidectomy

Removal of the whole thyroid.

4) Lymphadenectomy

Removal of lymph nodes.

Radiation Therapy

Use of high-energy x-rays or other types of radiation to kill cancer cells or to inhibit their growth.

1) External radiation therapy

Uses a machine to externally send radiation toward the cancer cells.

2) Internal radiation therapy 

Uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed internally or near the cancer.

Radiation therapy(s) are given depending on the type and stage of the cancer being treated.

Chemotherapy

Uses drugs to kill the cancer cells or to inhibit their growth.

Thyroid Hormone Therapy

Removes hormones or blocks their action.

Targeted Therapy

Uses drugs to kill specific cancer cells without harming normal cells. 

e.g. Tyrosine kinase inhibitor (TKI) therapy is a type of targeted therapy that blocks signals needed for tumors to grow.

Thyroid Surgery (Thyroidectomy)

How does it affect individuals with the disease?

An interview with a individual suffering from the disease will help us better understand his/ her situation.

Name: D'silva Beatrice (Monisha's mother)

Age: 53

Occupation: Library Shelving Assistant

Thyroid Disorder: HYPOthyroidism

Since: 2003

What made you visit the doctor?

"Tightness around the neck region. Wake up suddenly, light-headed, unbalanced, heart palpitations, dizziness. Unable to sleep every night because of neck tightness."

As stated in 'What are the symptoms of thyroid disorder?', heart palpitations is a sign of a thyroid disorder. However, it is usually seen in HYPERthyroidism (unusual for this case). Furthermore, the tightness around the 'tightness' around the neck was a sign of an enlarged thyroid gland.

How were you diagnosed with the disorder?

"The doctor thought it was depression at first, until I was sent for a Thyroid Panel Test (blood test). When I took the antidepressants, all that improved was my sleep. I could still feel the tightness so when I visited the doctor the second time, he sent me for the test."

As stated in 'What are the symptoms of thyroid disorder?', depression is a symptom of a thyroid disorder. In this case, the patient was wrongly diagnosed at first but because she visited the doctor the 2nd time, the doctor knew it might be thyroid.

Are you receiving treatment/ medication?

"Yes, I've to take 1 tablet of Thyroxine every morning 1/2 to 1 hour before breakfast. I've to go for check-up every 6 months to check, my t3 levels? (unsure)"

Low hormones of T3 (triiodothyrodine) levels is a cause HYPOthyroidism. The regular check-ups is to ensure hormone levels are maintained with the supplied medication.

What were the changes in lifestyle you had to make?

"Well, the doctor didn't tell me to avoid any food. The medication is for life and I can't seem to lose weight although I don't eat much."

References

Your Questions Answered

GeekoSystem, 2012. Stem Cells Used To Grow Functioning, Implantable Thyroid Gland. [online] Available at: <http://www.geekosystem.com/stem-cell-thyroid/>

Health and Care, 2010. Women are more prone to thyroid disease. [online] Available at: <http://healthandcare.in/women-are-more-prone-to-thyroid-disease/>

What is the thyroid?

WebMD, 2010. The Thyroid (Human Anatomy): Picture, Function, Definition, Location in the Body, and More. [online] Available at: <http://women.webmd.com/picture-of-the-thyroid> [Accessed July 2013].

The Washington Endocrine Clinic, (n.d).Thyroidology. [online] Available at: <http://www.washingtonendocrineclinic.com/Thyroid-Care.html> [Accessed July 2013].

What are thyroid disorders?

WebMD, 2013. Understanding thyroid problems - The Basics. [online] Available at: <http://women.webmd.com/guide/understanding-thyroid-problems-basics> [Accessed July 2013].

Diseaseaday, 2008. Graves disease - Why Some People Are Hyper Active For A Reason. [online] Available at: <http://www.diseaseaday.com/graves-disease/>  [Accessed July 2013].

Wikipedia, 2007. Thyroid nodule. [online] Available at: <https://en.wikipedia.org/wiki/Thyroid_nodule> [Accessed July 2013].

What are the symptoms of thyroid disorder?

Shomon, M. (n.d). Top 10 Signs that You May Have a Thyroid Problem. [online] Available at: <http://thyroid.about.com/cs/basics_starthere/a/10signs.htm> [Accessed July 2013].

What is the biochemistry behind the disease?

Breedlove, M. (n.d). Grave's Disease. [online] Available at: <http://www.bio.davidson.edu/Courses/Immunology/Students/Spring2003/Breedlove/GravesDisease.html> [Accessed July 2013].

Wikibooks, 2012. Structural Biochemistry/ Graves Disease. [online] Available at: <http://en.wikibooks.org/wiki/Structural_Biochemistry/Graves_Disease> [Accessed July 2013].

Could one prevent this metabolic disorder?

Seaweed Pete, 2012. Seaweed Benefits. [online] Available at: <http://www.seaweedpete.com/seaweed-benefits-2/> [Accessed July 2013].

Hope, M., 2012. Why I Love Coconut Oil. [online] Available at: <http://myblessedlife.net/2012/05/why-i-love-coconut-oil.html> [Accessed July 2013].

Oxford Advanced Learner's Dictionaries, (n.d). Shellfish. [online] Available at: <http://oald8.oxfordlearnersdictionaries.com/dictionary/shellfish> [Accessed July 2013].

Diabetes Mine, 2008. Nutition Sites & (Actually Useful) Food Tips. [online] Available at: <http://www.diabetesmine.com/2008/09/nutrition-sites-actually-useful-food-tips.html> [Accessed July 2013].

Shri Lal Mahal, (n.d). Millet. [online] Available at: <http://www.shrilalmahal.org/millet.html> [Accessed July 2013].

Nourished Kitchen, 2009. Foods to Promote Thyroid Health. [online]. Available at: <http://nourishedkitchen.com/foods-thyroid-health/> [Accessed July 2013].

What are the current cures?

National Cancer Institute, (n.d). Treatment Option Overview. [online] Available at: <http://www.cancer.gov/cancertopics/pdq/treatment/thyroid/Patient/page4#Keypoint26> [Accessed July 2013].

Thyroid Surgery (Thyroidectomy)

Nucleus Medical Media, 2012. Thyroid Surgery (Thyroidectomy). [video online] Available at: <http://www.youtube.com/watch?v=0h5jM7eN6j4> [Accessed July 2013].