Richard asks…

Why is propylthiouracil used to treat hyperthyroidism?

What is its effect on metabolic rate?

Helen answers:

Propylthiouracil, or PTU, actually suppresses thyroid hormone. It treats the hyperthyroidism directly, and it thereby slows metabolic rate.

It is used despite the high rate of side effects because it causes a remission of Grave’s disease about half of the time and so about half of people with Grave’s diseases who use it, can go off of it and need no further treatment.

Laura asks…

Has anyone had a thyroid taken out? Does it leave a horrible scar on your neck? Should I go noninvasive?

They have medicine that can just kill my thyroid. I have to have it taken out or killed. Medicine is not working for me, bad side effects. Thank you

Helen answers:

I have thyroid disease. It runs in my family and I have several members with thyroid problems, including thyroid cancer and Grave’s Disease. Unless you have thyroid cancer or Grave’s Disease, usually removing or killing off your thyroid isn’t a good idea. It’s true that although Grave’s Disease can be corrected with medication, sometimes that doesn’t work and you do end up having to have your thyroid killed off or removed. If that is what is going on with you, be forewarned, you will need to be on medication for the rest of your life after your thyroid is killed off or removed because your body will no longer be getting the correct thyroid hormones it needs and you will then become what is called Hypothyroid. You will need to be on thyroid hormone replacement such as Armour Thyroid, Synthroid, Levothyroxine, Levoxyl, Levothroid, Unithroid, Cytomel or Thyrolar. Without thyroid hormone replacement you will become very ill and could have some serious, if not life threatening problems.

When taking thyroid hormone replacement many people need T3, the active form of thyroid hormone, to feel well because their bodies won’t convert T4 (the thyroid hormone that is in most thyroid hormone replacement medications) into T3. While controversial, some studies have shown that patients have improvement in overall symptoms when they add T3 to their treatment. Many patients favor T4+T3 therapy, versus T4 alone. If someone is taking Synthroid or another Levothyroxine drug like Levoxyl, Levothroid, or Unithroid (all only have T4), I always recommend they ask their doctor about adding Cytomel (the brand name for synthetic T3) to their treatment if their doctor refuses to prescribe Armour. Or they could have their doctor add compounded, time-released T3, or have their doctor switch them to Thyrolar (a synthetic T4+T3 drug). But the overall best is Armour Thyroid, a natural desiccated thyroid drug. Also there are two other brands of natural thyroid medication called Westhroid and Nature-throid which also have the combination of all the T hormones, including T4 and T3. Armour contains all the hormones your thyroid normally produces such as T1, T2, T3, T4, T5, etc. Natural thyroid medication like Armour, Westhroid and Naturethroid are the only thyroid medications that do have all the naturally occurring hormones. It is always better to try and replicate what your body does naturally and that’s why Armour works so well.

Get a second opinion from a doctor that is not in the same medical group. But, your doctor probably is correct, you probably do need to have your thyroid killed off or removed. I know someone who had her thyroid removed due to cancer. She was left with an ugly scar going across her neck and she is such a beautiful girl that it’s a shame she has that ugly scar. I would read up on all the pros and cons of having your thyroid removed vs. Having it killed off and see which is a better option for you. Do some online research using Google. Sit down and ask your doctor questions about your treatment options.

I highly recommend you get the book, “Living Well with Hypothyroidism” by Mary J. Shomon. Its easy reading and you will learn a lot about your disease, as this book covers not just hypothyroidism, but also thyroid cancer, Grave’s Disease and other thyroid problems. The woman who wrote it, Mary J. Shomon, had her thyroid removed. This book saved my life because it taught me all about how to manage my thyroid disease so I would feel my best. You can buy this book on Amazon.com for as little as $1.47 used or you can buy it in a book store. If the book store doesn’t have it, have them order it for you.

William asks…

Is this Autoimmune Hepatitis?

About this time last year i was diagnosed hepatitis A. I didn’t have it for that long, i think it went away quicker than most, but a few mouths ago i noticed i would get a slight pain in my right abdomen area every so often(but i put it down to relapse symptoms) The pain its self isn’t that bad it doesn’t last very long either…most of the time i barely notice it. About a few days ago i have been getting very itchy all over. I don’t appear to have a rash of any kind. It’s not a constant itch either, it comes and goes…especially when i think about it (like now lol)
My eyes are kinda yellow…i don’t know if they even went back to normal when i had hepatitis last.
The thing is, now i am not sure whether i am itchy because i am thinking about it, or is it a symptom of something

Helen answers:

Autoimmune Hepatitis

Autoimmune Disease
Symptoms
Diagnosis
Treatment
Side Effects
Other Treatments
Hope through Research
Points to Remember
For More Information

Autoimmune hepatitis affects
the liver.
Autoimmune hepatitis is a disease in which the body’s immune system attacks liver cells. This causes the liver to become inflamed (hepatitis). Researchers think a genetic factor may predispose some people to autoimmune diseases. About 70 percent of those with autoimmune hepatitis are women, most between the ages of 15 and 40.

The disease is usually quite serious and, if not treated, gets worse over time. It’s usually chronic, meaning it can last for years, and can lead to cirrhosis (scarring and hardening) of the liver and eventually liver failure.

Autoimmune hepatitis is classified as either type I or II. Type I is the most common form in North America. It occurs at any age and is more common among women than men. About half of those with type I have other autoimmune disorders, such as type 1 diabetes, proliferative glomerulonephritis, thyroiditis, Graves’ disease, Sjögren’s syndrome, autoimmune anemia, and ulcerative colitis. Type II autoimmune hepatitis is less common, typically affecting girls ages 2 to 14, although adults can have it too.

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Autoimmune Disease
One job of the immune system is to protect the body from viruses, bacteria, and other living organisms. Usually, the immune system does not react against the body’s own cells. However, sometimes it mistakenly attacks the cells it is supposed to protect. This response is called autoimmunity. Researchers speculate that certain bacteria, viruses, toxins, and drugs trigger an autoimmune response in people who are genetically susceptible to developing an autoimmune disorder.

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Symptoms
Fatigue is probably the most common symptom of autoimmune hepatitis. Other symptoms include

enlarged liver

jaundice

itching

skin rashes

joint pain

abdominal discomfort

fatigue
spider angiomas (abnormal blood vessels) on the skin

nausea

vomiting

loss of appetite

dark urine

pale or gray colored stools

People in advanced stages of the disease are more likely to have symptoms such as fluid in the abdomen (ascites) or mental confusion. Women may stop having menstrual periods.

Symptoms of autoimmune hepatitis range from mild to severe. Because severe viral hepatitis or hepatitis caused by a drug—for example, certain antibiotics—has the same symptoms, tests may be needed for an exact diagnosis. Your doctor should also review and rule out all your medicines before diagnosing autoimmune hepatitis.

Betty asks…

Hypothyroidism and Levothyroxine?

I was diagnosed with hypothyroidism a week ago, and put on Levothyroxine as a result. I’m very excited to have more energy and just feel better in general, but I understand that weight loss is also a common side effect of this medication. Can anyone share their weight loss experiences, i.e. how much weight per week or per month that you have lost? I’m just trying to figure out what to expect. Thanks so much!

Helen answers:

Levo does not work that fast. Weight loss is NOT a side effect. Weight gain comes from the disease & the meds hopefully stops most of us from gaining more.

You need testing for thyroid ANTIBODIES as well as TSH. TSH ‘norm’ should be .3 – 3 (w/ most feeling best at < 2) but, for diagnosis, may not mean much if ANTIBODIES are present which is indicative of Hashimoto’s Autoimmune Thyroiditis (cycles between HYPER & HYPO at start)…it is the main cause of eventual HypOthyroidism but worse (…OR Graves Disease – HypERthyroid from beginning).

You will have to INSIST they test for the antibodies. They can code so that ins will pay.

WARNING: Doctors seem not to want to find/treat thyroid disease. You may have to go to more than one doctor before you get the right tests, interpretation, and treatment. Best wishes.

Ck these:
http://thyroid.about.com/bio/Mary-Shomon-350.htm
http://www.stopthethyroidmadness.com/
http://www.thyrophoenix.com/index.html
http://thyroid.about.com/cs/newsinfo/l/blguidelines.htm

ALWAYS GET COPIES OF YOUR LABS.

God bless you

Lizzie asks…

thyroid problem.. please help?

my mother aged 69.. is suffering from thyroid problem. please let me know best treatment available in medical and also in alternate medicine and if any other type of treatment if available. how much time does it takes to fully recover. and is full cure there.

Helen answers:

Hi,
I am a med student and we just covered this in pharmacology and endocrine lecures. It all depends on which type of thyroid problem she has.
Possible thyroid problems are hypofunction: caused by any number of things: not enough secretion of TRH (thyroid releasing hormone) from the hypothalamus, undersecretion of TSH (thyroid stimulating hormone) from the pituitary, TSH receptor destruction from Hashimoto’s Thyroiditis, or insufficent iodine uptake (normally in salt).
Hyperfunction: over secretion of TRH, TSH, toxic multinodular goiter (not as bad as it sounds), adenoma (one of the easiest cancers to treat), or graves disease (an autoimmune disease where antibodies bind to the TSH receptors in the thyroid and cause over secretion).
Treatments are as follows: (These are the only FDA approved ones)
For Hypofunction: (unfortunately not curable, just very manageable with treatment)

synthetic T4: called levothyroxine (aka: synthroid), takes 4-6 weeks for maximum action, but results in stable levels.

Synthetic T3: called cytomel, takes 3-6 days for max action, but not as stable levels of thyroid hormones.

For Hashimoto’s it is often necessary to titrate the doses up and down weekly untill there is a stable period (which can last weeks to years, this is a life long process).

For Hyperfunction: Most cases are curable others are manageable.

Thionamides (destroy thyroid cells):
Tapezole and PTU are the two drugs used. Takes a few weeks to have max effect because of stored thyroid hormone. Only on it for a few weeks to a month or so depending on severity.
Tapezole is first line. (Mostly for Graves Disease)

Radioactive Iodine (RAI-131): Very good treatment
Overactive cells take up the iodine and are destroyed, but the normal cells are not effected. It is normally a one time pill NOT chemo therapy (no really bad side effects). No studies have shown increased risk of future cancer with this. It is very safe and effective. (For everything else)

Surgery: not used commonly anymore because of complications and RAI-131 effectiveness. It is only used in people who have really large goiters which obstruct swollowing or cause significant discomfort, or people who refuse RAI-131. Can cause other problems like hypofunction if too much is taken out, or if a parathyroid gland is removed too it may cause calcium problems (affecting bones and kidneys).

Beta Blockers: when not contrindicated (you mother is not taking another drug which may interact with it) is used with other treatments to lessen the symptoms caused by hyperthyroidism: tachycardia, hypertension, and others.

Hope this helps

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