Thyroid Disease

Hypothyroidism & Hyperthyroidism

If you suffer from palpitations, tremors, temperature intolerance, and anxiety, or if you are excessively tired, fatigued, and experience unexplained weight changes, you may have a thyroid problem.  The thyroid gland is responsible for thyroid hormone production. The thyroid hormone regulates the function of other organ systems such as the cardiovascular and nervous systems.

Causes

Excessive or underproduction of thyroid hormone could affect metabolism, heart rate, blood pressure, and the menstrual cycle in women.  There are several conditions that cause hyperthyroidism and hypothyroidism; some of which are autoimmune and genetic whereas others are inflammatory, infectious, or related to pregnancy.

Hypothyroidism

Hypothyroidism is a low thyroid hormone state, which is characterized by low energy, difficulty in losing weight, constipation, depression, hair loss, dry skin, brittle nails, and abnormal menstrual cycles in women.

Hypothyroidism is more common in women, but can be seen in men and the most prevalent cause is autoimmune.  Patients who develop autoimmune hypothyroidism produce antibodies that attack an enzyme called Thyroid Peroxidase, which is Important in thyroid hormone production. This leads to underproduction of the thyroid hormone.

In other cases of hypothyroidism, a viral or bacterial infection can lead to temporary hypothyroidism, which is a self-limited condition or may need only supportive treatment.

Women with a history of multiple miscarriages should have their thyroid evaluated as hypothyroidism could be the cause of fetal loss. A small percentage of patients with hypothyroidism may have a problem converting the T4 hormone to the T3 hormone and may need a combination treatment. Sometimes multiple autoimmune conditions can occur concomitantly so careful evaluation is important.

Hyperthyroidism

In the case of hyperthyroidism, some etiologies are self-limited but others may require treatment as uncontrolled hyperthyroidism can lead to heart rhythm abnormalities and osteoporosis.

Treatment Options

Treatment options for hyperthyroidism include radioactive iodine, surgery, and anti-thyroid medications called Thionamides.  At NorCal Endocrinology & Internal Medicine, we have the expertise to assess the etiology of the thyroid function abnormalities and determine the best course of action, a decision which is made with the patient after weighing the benefits and risks of each treatment modality.

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