02 Jun 2011
By: JONATHAN LIAUTRAKUL
The production of the thyroid hormone by the thyroid gland, a small butterfly-shaped gland at the base of the neck which helps regulate the body’s energy use, is a lesson in moderation.
Too little of the hormone produced and one faces bouts of depression, tiredness and high blood pressure. Five to 10 in 100 people globally face this condition, called hypothyroidism.
Too much and the body’s metabolism speeds up, causing the body’s systems to teeter into a “storm” of instability that can lead to death. This condition, called hyperthyroidism, is less common, affecting five in 1,000 people worldwide.
So prompt treatment of thyroid problems is important, a message highlighted in International Thyroid Awareness Week last week.
Both men and women are vulnerable to thyroid disorders, though women are more susceptible to them and their complications, said Dr Ho Su Chin, an endocrinologist who practises at Mount Elizabeth and Parkway East medical centres.
For months, Madam L.L. Goh (right) suffered a series of mystifying and uncomfortable symptoms.
She lost weight even though she was not on a diet. During walks, she perspired excessively, her heart rate raced and her neck swelled slightly.
Her annual company health check in October 2009 showed that her thyroid hormone level was high and that she might have a thyroid problem.
The 56-year-old human resources and administrative manager was encouraged by her family to see a doctor, who referred her to Dr Chia Su-Ynn, Dr Ho’s colleague.
Through a scan, Madam Goh was found to have two thyroid nodules which were benign and had caused the overproduction of hormones. The nodules were left as they were and she went on oral medication.
Since then, the swelling and her symptoms of hyperthyroidism have subsided.
Married with a daughter, 35, and a son, 27, she said: “It is fortunate I discovered the condition early.”
For those who refuse to have treatment or are unaware of their conditions, dangers abound. If, for example, a person has an infection, it could tip the balance of the body, said Dr Ho.
“If there is another medical condition – like a heart attack, stroke or pneumonia – or after a surgery, it can push the person into a thyroid storm or thyroid crisis,” she said.
A thyroid storm happens when the patient develops severe signs and symptoms arising from excessive amounts of thyroid hormones.
High fever, diarrhoea, liver inflammation and an irregular heart beat can occur. In serious cases, the patient may lose consciousness, lapse into coma, or even die.
By then, treatment may be too late to reverse the infection or the excessive hormones produced, said Dr Ho.
The thyroid can also underproduce hormones. This often occurs in patients with a family history of thyroid problems, or who are above the age of 50.
Babies may also develop hypothyroidism at birth and have to take thyroxine, the hormone produced by the gland, for the rest of their lives, said Dr Chia.
Common causes include auto-immune disorders like Hashimoto’s thyroiditis, a common condition when the body attacks the thyroid.
If left untreated, the patient’s metabolic rate will fall to a critical level and he will lose consciousness as a result. Myxedema coma, a state of deterioration of bodily functions that may prove fatal, may also happen.
Fortunately, both thyroid storm and myxedema coma are rare, added Dr Adoree Lim, a registrar at the department of endocrinology at the Singapore General Hospital.
Dr Lim advised: “A thyroid patient must have regular follow-ups with his doctor and comply with the treatment recommended. Additionally, it is important to maintain a healthy lifestyle, no matter what condition one is diagnosed with.”
On foods to avoid, Dr Chia said: “Those with hyperthyroidism should avoid food containing high amounts of iodine because it activates the thyroid gland. Seaweed-based products and seafood like shrimps should be avoided until the thyroid hormone levels have stabilised.”
Thyroxine cannot work properly when it comes in contact with food containing iron and calcium, like dairy products. So patients with hypothyroidism who are on thyroxine treatment should avoid such food, Dr Chia added.
Email: jonliau@sph.com.sg
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