David asks…

Does anyone know Hypheractive thyroid? whats the medication?

Helen answers:

Hyperthyroidism occurs when the thyroid gland makes too much thyroid hormone. Excess thyroid hormone can cause symptoms such as tiredness, weight loss, increased heart rate, heat intolerance, sweating, irritability, anxiety, muscle weakness, and thyroid enlargement.

An autoimmune disorder called Graves’ disease is the most common cause of hyperthyroidism. Other causes include growths in the thyroid gland (thyroid nodules), inflammation of the thyroid gland (thyroiditis), and taking too much thyroid replacement hormone to treat an underactive thyroid (hypothyroidism).

Hyperthyroidism can be treated with medication, radioactive iodine, or with surgery. In most cases, treatment brings thyroid function back to normal. However, lifelong follow-up with a health professional is needed to closely monitor thyroid hormone levels.

Antithyroid medications for hyperthyroidism

Brand Name Chemical Name
Tapazole methimazole
Propyl-Thyracil or PTU propylthiouracil

How It Works
Antithyroid medications cause your thyroid gland to make less thyroid hormone.

Why It Is Used
Antithyroid medication works more quickly than radioactive iodine therapy. It also does not permanently damage your thyroid gland.

You may take antithyroid medication before you have radioactive iodine treatment or surgery in order to bring your metabolism to normal, to make you feel better, or to reduce the chances of more serious problems.

You may also take antithyroid medications if you have Graves’ ophthalmopathy and are going to be treated with radioactive iodine therapy. If you take antithyroid medication before you have radioactive iodine treatment, it may prevent your Graves’ ophthalmopathy from getting worse.

How Well It Works
Antithyroid medications do not always start working right away. Usually, symptoms get better or go away 1 to 8 weeks after you start taking the medicine. It may take as long as 6 months for your thyroid hormone levels to be normal.

Antithyroid medications work best if you have mild hyperthyroidism, if this is the first time you are being treated for Graves’ disease, if you are younger than 50, or if your thyroid gland is only swollen a little bit (small goiter).

Antithyroid medication may or may not make your hyperthyroidism permanently go away. Hyperthyroidism goes away in about 30% to 50% of people after they take antithyroid medication for 1 or 2 years.1

If your hyperthyroidism comes back after you have stopped taking the medication, you can try taking antithyroid medication again. However, your doctor may recommend radioactive iodine treatment, because radioactive iodine is more likely to permanently cure your hyperthyroidism.

In some cases, one type of antithyroid medication works better than the other.

Methimazole is chosen most often because it can be given once a day, has fewer side effects, and is less expensive.
If you are pregnant, propylthiouracil is safer than methimazole.
If you have severe hyperthyroidism, propylthiouracil may work better than methimazole.

Side Effects
Side effects of antithyroid medications include:

Rash and itching.
Joint aches.
Liver problems (hepatitis). Signs of liver problems are yellow eyes or skin, dark urine, severe tiredness, or pain in your belly.
Low white blood cell count, which can make it hard for your body to fight infection. If you have a low white blood cell count, you may become sick easily and experience symptoms such as fever, chills, and a sore throat.
Call your doctor right away if you have any signs of side effects. Side effects can be serious, but they usually go away after you stop taking the medication.

What To Think About
If you take antithyroid medication for a long time, you may develop hypothyroidism, which means your body is making too little thyroid hormone.

It is very important to take antithyroid medications at the same time every day.

Your doctor will have to check your thyroid hormone levels frequently to make sure you are taking the right amount of medication. If your thyroid hormone levels are too low, your doctor may prescribe a small amount of thyroid medication to take along with your antithyroid medication.

Your hyperthyroidism is most likely to come back (relapse) within 6 months after you start medication, but it can also come back years later.2 This makes it very important to have regular check-ups with your doctor.

If you are pregnant, your doctor will recommend that you take the smallest effective dose of antithyroid medication. After your baby is born, you can safely breast-feed while taking antithyroid medications.

Children may be hard to treat with antithyroid medication because they grow so fast and it is hard to know how much medication to give them.

Nancy asks…

what is thyroid?

My doctor looked at my neck, and said, she never noticed my neck before. lol But now I have to be tested for enlarged thyroid. What does that mean?
so if it’s enlarged, does it slow my energy?

Helen answers:

Hi There,

I suffer from a hyper thyroid which means overactive. There is also the conidition of a hypo thyroid which is underactive.

I have sent you a clip (read below)from a website. This doesn’t mean you have a thyroid problem ….I would certainly wait to find out what your tests results will turn up. There are many websites on the thyroid. Try googling you will get lots of information.

Thyroid problems are one of the most common ailments that can affect the human body. Thyroid is an endocrine gland and produces essential hormones like thyroxin. Hormones produced by thyroid gland are very crucial for the metabolism of the body. Hypothyroidism, hyperthyroidism, and tumors are the most common thyroid problems. Symptoms associated with thyroid problems appear slowly and is therefore often misdiagnosed.

Under active thyroid or hypothyroidism is mainly caused due to Hashimoto’s thyroiditis. This thyroid problem is found commonly in women. The cause of it is mistaken identity. In it, the antibodies attack the thyroid gland. Obesity, lack of interest, sensitivity to heat and cold, and memory loss are some of the common symptoms associated with hypothyroidism. Those diagnosed with hypothyroidism have low level of thyroxine. Treatment is mainly in the form of thyroid hormone pill. The medication is often a life- long commitment, with varying doses.

In hyperthyroidism, the level of thyroxine is very high and is caused mainly due to Grave’s disease. Middle-aged women are more prone to this thyroid problem. Weight loss, abnormal heartbeat, fatigue, unusual bowel movements, nervousness, and irritability are the common symptoms. Since the symptoms appear late, it is often misdiagnosed. Bulging of eyes and double vision are symptoms found in some patients. Radioactive iodine is the main treatment given for hyperthyroidism. In this treatment, a part of thyroid gland is destroyed to reduce the amount of thyroxine produced. An under active thyroid is the main side effect caused by this treatment. Medications used to treat thyroid problems mainly slow down the activity of the thyroid gland. Drugs for hyperthyroidism often have serious side effects.

Lumps or thyroid nodules are mostly harmless. However, certain lumps are cancerous. A ‘fine needle aspiration biopsy’ done in doctor’s office is the most common method used to detect whether a lump is cancerous or not. If the nodule is cancerous, then surgical removal is the only option.

George asks…

rai-131 side affects?

Helen answers:

Radioactive iodine is both beta and gamma emitter. It is used both in treatment of grave’s disease and in thyroid cancer.
The beat radiation has a short range(about 2mm) and ordinarily doesnt come out of the body. It has enough energy to kill the hyperfuntioning thyroid in graves disease and the thyroid cancer cells when present.
The gamma rays emitted is of high energy and can travel out of ur body and affect people near you.
The side effects of I131 depends on the dose administered..
For graves disease-typically 10mCi or less is administered
For cancer thyroid – From 100 mCi to cumulative dose of 1000mCi can be administered.
Side effects with 10 mCi include
1.Hypothyroidism (delayed)
2.Pain in salivary glands(very rarely)
3.Pain in the neck and increased release of thyroid hormones (at about a week)
4.Increase in prominence of ur eye balls if already having eye disease and smoking
5.Any potential claim of any other side effect is scientifically not proven yet

Doses for cancer
1.Potential to reduce fertility (Not abolish)
2.Pain in the salivary glands and dryness of mouth in the long term
3.Abdominal pain
4.Cancer (It has not been proven consistently that radioiodine can cause cancer. However many claim that there is slightly increased incidence of gastro-esophageal cancers among patients who recieved radioiodine.
This is more a fear than science because no other agent has been as effective as I131 in treating thyroid cancer.
And a last word, if proper precautions like staying away from your kid for prescribed period of time (usually a week) is not practised, there is a risk of the child getting some radiation dose.

Mandy asks…

Hyperthyroidism – can anyone tell me what my appointment with an NHS specialist will entail?


I’ve been diagnosed with hyperthyroidism (that’s an OVER active thyroid), and have been given an appointment with a specialist at an NHS hospital. I understand that the purpose of the appointment is to see how my thyroid gland is responding to the carbimazole that I’ve been prescribed, and to find out the cause of the hyperthyroidism (for which I’m going for a blood test before the appointment).

What I want to know is whether anyone knows, preferably from experience, what tests will be done by the specialist. I’ve found conflicting information – somewhere it says I will have to swallow a pill and go back the next day for a scan, somewhere else is says that I will have an injection in my neck with some radioactive stuff before a scan. I really want to know what to expect – my doctor has been very vague about the procedure, presumably because he doesn’t know.

Any experience or knowledge of the diagnoses and treatment process for hyperthyroidism would be greatly appreciated – I’m kind of in the dark about it all at the moment, only having been told to keep taking the carbimazole.

Helen answers:

I’m not in England and it sounds like things are done differently there than they are here (Illinois). Here, you would not be put on carbimazole until after the cause of your hyperthyroidism had been determined to be Graves’ disease, because it’s not an appropriate treatment otherwise.

I can tell you what all the treatments and tests for hyperthyroidism are, as well as some of the tests the endocrinologist will probably do.

When I was first found to have thyrotoxicity (thyrotoxcity means having too much thyroid hormone, as opposed to hyperthyroidism, which means having too much thyroid hormone because of an overactive thyroid- hyperthyroidism is a type of thyrotoxicity) by a low TSH and high fT4, my endocrinologist first ran bloodwork for thyroid antibodies to see if I had autoimmune thyroid disease. These came back negative (in about 80% of cases they are positive, which suggests Hashitoxicosis or Graves). I then had an iodine uptake scan. The iodine can be given either in a pill or by injection. There are two types of iodine given, and they give different quality of pictures. My endocrinologist wanted I-23 because it is better for seeing cancers. That one is the pill. I took the pill, and came back a few hours later and lay in a pretty uncomfortable position for about 40 minutes while pictures were taken. These pictures are to show how much iodine the thyroid used- if it is true hyperthyroidism, the thyroid will be using more iodine than normal, and if it is not, it will be using normal, or below normal amounts of iodine. In my case it was way below normal, which meant that my high levels of thyroid hormones were because my thyroid had released all of its stores of hormone, and not because it was producing a lot of hormone (that is the case for about 15% of people with thyrotoxicity). The other purpose of the picture is to see if the whole thyroid is using thyroid hormone evenly, or if there are specific areas making a lot of hormone- are there thyroid nodules? Are there cold or hot spots of lower or greater activity?

If the test shows nodules that might be cancerous, you will have a biopsy and/or an ultrasound.

If you have hyperthyroidism caused by Graves’ disease (which is the cause in about 70% of cases), then there are three treatment options.

Option 1: Medication, either carbimazole or methimazole, or PTU. These drugs have the huge advantage that sometimes they cause remission and the patient no longer needs any treatment. They have the huge disadvantage of major potential side effects, including stopping your marrow from making blood, so you will need frequent monitoring.

Option 2: Radioactive iodine. Given at about 1000x the dose for testing, and about 1/1000th the dose for cancer, radioactive iodine (typically in a pill) is given because the thyroid uses iodine, and this will kill off a lot of the thyroid. Typically this either gives you enough thyroid left to function normally, or leaves you hypothyroid, necessitating treatment for hypothyroidism. Occasionally this doesn’t work.

Option 3: Surgery. If for some reason the other two options are not good options (most commonly because the patient is pregnant), a thyroidectomy may be performed, wherein the thyroid is removed, and then the patient is put on thyroid replacement hormones.

I’m probably running way too long.

Anyways, if you have thyrotoxicity that is not hyperthyroidism, then the treatment is usually monitoring and symptom relief if it’s subacute thyroiditis (about 15% of cases).

The endocrinologist is probably going to want to see what symptoms you have. He (or she) will feel your neck to see if your thyroid is enlarged, and whether it’s tender. He’ll probably want to see if you have a tremor, by asking you to stick your arms out and seeing how much they shake. Mine also asked me to stick my tongue out- I hadn’t realized until that moment that I had a tremor in my tongue too. He’ll probably want to know about weight loss. He’ll want to know what your pulse is- a resting pulse above 100 or so means he might want to put you on a medication to protect your heart.
Hopefully, your endocrinologist will want to go over the result of your blood work and explain what kind of thyrotoxicity he thinks you have, and why he thinks that, or maybe, if the tests don’t show why, then to give one or three guesses as to what might be going on.

Sandy asks…

eating disorder.????????????/?

I cant control my eating. I eat day n night. HELP. no matter what I do I cant stop. I try starving my self but I end up eating tons of food and I know eat healthy but I don’t have anything health at my house besides apple. WTH. HELP ME PLEASE HOW TO STOP EATING

Helen answers:

According to your other question, you have a thyroid disorder that the doctors are considering removing your thyroid for. That speeds up metabolism tremendously. It is healthy to eat a lot while you have active hyperthyroidism. Worry about the diet after you recover.

And while I’m at it: assuming you have Grave’s you have three choices for treatment.

Option 1 that most doctors would try first in a younger person is medication. The disadvantage of medications for Grave’s disease is that they all have potential side effects. The huge big advantage is that they send Grave’s disease into remission more than half the time and then you don’t need any further medication.

Option 2 that some doctors will not allow if you are a child, is radioactive iodine to destroy your thyroid. There are two downsides to this option. The common problem is that it frequently leaves people with some hypothyroidism and you have to take thyroid medication for the rest of your life- but the medications for hypothyroidism are much much easier to dose and have very little side effects so that’s not too bad. The other issues is that, in children only really, it may cause mutations and might maybe later down the line cause cancer. If you are pregnant you absolutely cannot have radiation; if you are a teen the risk may still be too high. If you are an adult, the risk is close to nonexistant and this is a good option.

Option 3 is to surgically remove the thyroid. This is rarely done first, but usually only after one or both of the other options have failed, or a person has become ineligible for them. This leaves the person hypothyroid and needing thyroid medication for life. The surgery can potentially damage the parathyroid glands, which is a big problem. And unfortunately it is even still possible to accidentally leave a little thyroid tissue behind and so the success rate is only slightly better than option 2.

I suggest that you go with medication or radiation first, depending on your age. And the hunger will decrease dramatically.

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