A Peek Into Thyroid Disorders

Thyroid

Words: Dr Rajgopal NIDAMBOOR

The major glands of the endocrine [hormone secretion] system, which produce one or more specific hormones, in our body, are the hypothalamus, the pituitary gland, the thyroid gland, the parathyroid glands, the islets of the pancreas, the adrenal glands, the testes, and the ovaries, in men and women respectively. Not all organs that secrete hormones, or hormone-like substances, may be considered part of the endocrine system. In pregnancy, for instance, the placenta performs the role of an endocrine gland, without compromising on its other functions.

The key function of the endocrine glands is to secrete hormones directly into the bloodstream. Hormones are chemical substances that influence the activity of another part of the body, otherwise known as the target site. Hormones serve as messengers; they control and co-ordinate activities throughout the body. To manage endocrine functions, however, the secretion of each hormone needs to be regulated within specific limits. By doing this, the body is able to sense whether ‘more’ or ‘less’ of a given hormone is required.

Any malfunction of the endocrine system, or gland, can lead to imbalance of health. Let’s look at one such ‘popular’ panorama — the thyroid gland. 

A small gland, measuring about two inch, the thyroid gland lies just below the Adam’s apple in the neck. The gland is shaped like a butterfly, and weighs less than an ounce. The gland is generally not seen or felt. It is seen and felt only when it becomes enlarged due to a condition called goitre. A physician or therapist can, of course, feel it quite easily. As for most of us, what may be apparent, in the condition, is a prominent bulge below, or across, the Adam’s apple.

The thyroid gland secretes thyroid hormones. These hormones control the body’s chemical functions, or the tempo at which they function. This is, in simple terms, called the metabolic rate. The hormones influence metabolism in two ways: they stimulate almost every tissue in the body to produce proteins; and, they also increase our cells’ use of oxygen.

Thyroid hormones regulate a host of vital body functions, including the heart and respiratory rate too. What they also determine is the rate at which calories are burned, aside from maintenance of skin function, physical growth, heat production, fertility, and digestion.

There are two principal thyroid hormones — viz., T4 [thyroxine] and T3 [triiodothyronine].

The thyroid gland needs iodine, from food and water, to produce the two thyroid hormones. Iodine is trapped by the thyroid gland and is processed into thyroid hormones. When the hormones are being used, a small amount of iodine is released. It returns to the thyroid gland and is recycled — to produce more thyroid hormones.

Interestingly, the thyroid gland releases marginally less thyroid hormones when it is exposed to high levels of iodine transported through the blood stream. Any malfunction of the two hormones can lead to thyroid disease.

Hyperthyroidism

Hyperthyroidism, or thyrotoxicosis, is the syndrome that results from an excess of circulating thyroid hormones [T4 and/or T3]. The syndrome which results in a vast majority of cases of thyroid hyperfunction falls into two broad groups: 1. Graves’ disease — characterised by toxic goitre and increase in the number of thyroid cells — which predominantly affects women; and, 2. Plummer’s disease, encompassing overactive, or single and/or multiple nodules of the thyroid gland.

In other words, hyperthyroidism is an abnormality of the thyroid gland in which the secretion of the thyroid hormone is usually increased. Also, the gland is no longer under the regulatory control of hypothalamic-pituitary centres in the brain. The disorder is characterised no less by a typical extra-metabolic state.

Hyperthyroidism may present with the following signs and symptoms: weight loss, tremulousness, elevated plasma levels of the thyroid hormones, and sometimes exophthalmos [protrusion of one or both eyeballs]. The disorder may also progress to severe weakness, wasting, extremely high fever states, and other manifestations of ‘thyroid storm’ — a life-threatening augmentation of the disorder.

It is, perhaps, rare for a new-born to have hyperthyroidism, or neonatal Graves’ disease. The condition may, however, occur if the mother has Graves’ disease during pregnancy, or has undergone treatment for the condition before pregnancy.

In Graves’ disease, the woman’s body produces antibodies that stimulate the thyroid gland to produce increased blood levels of thyroid hormone. The antibodies may cross the placenta and affect the foetus. In the affected new-born, the metabolic rate may often be too high. This is accompanied by a heart rate that is rapid; also, breathing may be just as quick. The new-born is irritable; paradoxically, there may be excessive appetite with little, or no, weight gain.

Signs & Symptoms 

Almost all the systems in the body may be affected by hyperthyroidism — however, the most important signs and symptoms relate themselves to the cardiovascular and neuropsychiatric symptoms.

The appearance and general behaviour of the patient may also clinch the diagnosis — the patient often presents with a wide-eyed, hollow-cheeked, agitated, restless, trembling countenance with rapid, bounding carotid artery pulsations. Other symptoms include loss of weight, fatigue, nervousness, excessive sweating and lack of tolerance for heat, palpitation, breathing difficulty, weakness, diarrhoea, or increased frequency of bowel movements.

Goitre is also classical in a majority of cases, where a Parkinsonian-type tremor is often associated. Common eye signs may encompass a prominent stare. Most patients have a rapid pulse. This may be due to sinus tachycardia [rapid beating of the heart], or atrial fibrillation, in which the normal rhythmical contractions of the cardiac atria are replaced by rapid irregular twitching of the muscular wall.

Hypothyroidism

Hypothyroidism is a condition caused by diminished production of thyroid hormone. It leads to clinical signs of thyroid insufficiency — like low metabolic rate, obesity, drowsiness, and sometimes myxoedema [hypothyroidism characterised by a relatively hard swelling of the subcutaneous tissue].

The causes of hypothyroidism may also be secondary to disorders of the hypothalamus and/or pituitary gland with diminished secretion of the thyroid stimulating hormone [TSH]. It may also be caused because of the primary failure of the thyroid gland, owing to idiopathic agenesis [unknown cause and/or absence, failure of formation, or imperfect development of the gland], or atrophy [wasting].

Signs & Symptoms

Symptoms of hypothyroidism are often present for years before a diagnosis is made. This may also be due to the fact that symptoms are frequently non-specific and vague, with the additional possibility of their presence being attributed to non-specific causes.

Hypothyroidism is a disease that predominantly affects females; it occurs in the slightly older age group, peaking through the fifth and sixth decades of one’s life. While a general sense of tired feeling, lethargy, and physical and mental sluggishness are common, patients may also present with muscular pain, menstrual problems, hair loss, impaired hearing, loss of sensation, constipation, and angina, including cardiac failure. Most commonly, the diagnosis of the disorder is made almost accidentally.

Hypothyroidism affects every organ, or tissue, of the body — this is the unique feature of the disease. The difficulty too is the presentation of the disease is often subject to variation — although the characteristic gruff voice, puffy eyes, gross features, and sluggishness of expression and movement are often trademark signs.

Hypothyroid patients have a typically characteristic dry, scaly, cold and thickened skin — they may also present with a ‘strawberries-and-cream’ facial appearance; in other words, a pale countenance. The lips are often thin and coloured light purple; a foul odour from the mouth is also common. Scalp hair may be coarse, or brittle, and there may also be bald spots. The pulse is often slow; blood pressure may be slightly low. Sometimes, it may be normal, or also elevated. There may be electroencephalograph [EEG] changes.

As far as myxoedema is concerned, it may present with neurological symptoms — the symptom complex may include carpal tunnel syndrome, polyneuritis, slurred speech and ataxia, or lack of muscular co-ordination, muscle cramps and stiffness, besides loss of muscle tone. Another characteristic that may be noticed is a delay in the relaxation phase of the ankle jerk, which your physician may elicit. The disorder may also include anaemia, alongside weird psychiatric features — ‘myxoedema madness.’

It should be borne in mind that hypothyroidism in the new-born often leads to poor growth and delayed mental milestones too. This can eventually lead to mental retardation. The most common cause of hypothyroidism in the new-born is complete absence, or underdevelopment, of the thyroid gland. Oddly, the new-born has no symptoms. It’s only later that the classical symptoms of lethargy, poor appetite, constipation, a hoarse cry, and umbilical hernia — a bulging of the abdominal contents where the umbilicus penetrates the abdominal wall — and, slow growth are noticed. The infant may develop crude facial features and a swollen tongue later.

It goes without saying that early treatment can prevent mental retardation.

There is a blood test that is performed in the hospital on the new-born — to measure thyroid hormone levels.

The treatment of choice, in conventional medicine, is thyroid hormone.

Ayurveda 

Thyroid gland disorders are a growing worldwide health issue. Thyroid hormone regulates the metabolic rate of the body. Failure of thyroid hormone to maintain metabolic rate mainly produces hyperthyroidism, or hypothyroidism. Thyroid disorders are characterised by physical and mental abnormality. There is no exact correlation of thyroid gland in Ayurveda. But the Ayurvedic system of medicine is futuristic and it doesn’t emphasise on naming the disease. It rather insists on understanding the constitutional status of a disease and adopting appropriate treatment principles. The main action of thyroid hormone is to act as a spark to start-up body metabolism at the cellular level. In Ayurveda, it can be correlated with the actions of agni. The agni located in the jathara [digestive fire] is responsible for digestion and absorption of the food. The bhutagni is responsible for transformation of heterogeneous substances to homogenous substances. The dhatwagni [the agni located in the body tissues], along with bhutagni, are responsible for metabolism. Also the symptoms of hypothyroidism and hyperthyroidism can be correlated with imbalanced doshas. These concepts of Ayurveda could be considered to understand thyroid disorders from the Ayurveda perspective.  As modern treatment has many adverse effects, it is important to understand thyroid disorders from the Ayurvedic perspective to provide safe and effective Ayurvedic management.

  • Geeta K Varma and Jatved J Pawar, “A Review on Ayurvedic Perspective of Thyroid Disorders,” International Journal of Development Research, Vol 6, Issue 8, August 2016 [8916-8919]. 

Homeopathy

Homeopathy is the medicine of minimal dose, vital stimulation, vital reaction, or auto-regulation. Example: the stimulus required to cause reaction in individuals who have become ‘oversensitive’ by illness is seldom material. The human body, as you know, manufacturers only fifty to a hundred millionth of a gram of thyroid hormone each day. Yet a ‘small’ excess or reduction, as you’ve read, in this already ‘minuscule’ amount can affect your health.

Homeopathy considers thyroid disorders as a result of autoimmune glandular dysfunction. It provides a better chance of ‘cure,’ because the treatment is patient-specific, based on the individual’s constitution — not just the disorder by its name alone.

Homeopathic treatment is on its own useful. It can also be used as a supportive therapy for regulating thyroid problems — be it hypothyroidism, or hyperthyroidism. Homeopathic treatment is safe and has no side-effects. The best part also is — individuals on multiple medications can take homeopathic remedies as adjuvant with better treatment outcomes.

Conventional [allopathic] treatment of thyroid disorders relies primarily on drugs and surgery. Homeopathic treatment, on the other hand, is aimed to improve thyroid function naturally. Homeopathic remedies work by stimulating the body’s own healing capacity. They encourage the body to reactivate hormone secretions, replenish and reinstate thyroid physiology [function], while helping to healing the body.

A recent study suggests that the estimated number of people with undiagnosed thyroid disease worldwide may be 15 per cent. Statistics indicate that over 150 million people in India may have undiagnosed thyroid problems — women are seven times more likely than men to suffer from thyroid complications. The risk is evidenced to increase with age — more so, in individuals having a family history of thyroid disorders.

In an interesting study, the homeopathic remedy, Thyroxine 30X, was placed in water containing tadpoles. The study showed the ‘morphogenesis’ of tadpoles into frogs was slowed down for tadpoles who were exposed to the homeopathic doses, when compared to tadpoles that were given placebo [dummy pill]. The outcome makes sense from a homeopathic perspective, because thyroid hormone in crude [material] doses speeds up morphogenesis. What makes the study fascinating is the outcome has been replicated in other lab studies and the results have been consistent.

  • Delpaul M, Razlog R, and Greenfield R. “The Effect of Ultra-High Dilutions of Thyroxine on the Morphogenesis of Xenopus laevis Tadpoles,” Alternative and Integrative Medicine [2018], 7: 273.

Nutrition

It is recommended that thyroidal problems are best treated by a medical professional/therapist. It may, however, be mentioned that, for long, native societies have used the kelp variety of seaweeds to treat iodine deficiency. Kelp is rich in iodine; besides, it is loaded with minerals and B-vitamins, an additional benefit. Studies suggest that iodine, which is naturally present, in kelp capsules, or tablets, are progressively assimilated by the body, unlike iodine solutions that are said to cause allergic reactions. Iodine, as you may know, is involved in the regulation of basal metabolic rate [BMR], oxygen uptake into cells and glucose utilisation. Kelp is said to be a useful remedy not only in thyroidal affections, but also for the bad effects of radiation exposure and/or radiation sickness.

Yet another safe therapy for thyroidal affections is the use of natural sea salts — which are, generally, consumed in comparatively small amounts. Hence, they do not cause any unpleasant effects. It may also be emphasised that the addition of iodine is fundamental to treating thyroidal infections that a person may suffer from. In the event iodine supplementation is advised, kelp — the herbal product from the sea — would be nature’s best medicine and tonic.

Note: It is best to avoid certain foods in hypothyroidism — cabbage, turnips, Brussel sprouts, soybean and peanuts — because they are known to interfere with iodine absorption. They should not be taken with kelp capsules, or tablets.

Dr RAJGOPAL NIDAMBOOR, PhD, is a wellness physician-writer-editor, independent researcher, critic, columnist, author and publisher. His published work includes hundreds of newspaper, magazine, web articles, essays, meditations, columns, and critiques on a host of subjects, eight books on natural health, two coffee table tomes and an encyclopaedic treatise on Indian philosophy. He is Chief Wellness Officer, Docco360 — a mobile health application/platform connecting patients with Ayurveda, homeopathic and Unani physicians, and nutrition therapists, among others, from the comfort of their home — and, Editor-in-Chief, ThinkWellness360. 

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