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Nutrition Related Disease/ Hyperthyroidism

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&nbspNutritionRelated Disease/ Hyperthyroidism

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Abstract

Objective:&nbspThisresearch paper will discuss on hyperthyroidism and how it is relatedto nutrition. Additionally, it will highlight causes, treatment, anddietary recommendations that can be used to manage hyperthyroidism.The last section will incorporate an interview in question and answerformat.

KeyWords:Hyperthyroidism, thyroid hormones, homeostatic, Graves’ disease,diet, nutrients

Hyperthyroidismis a condition caused by the overproduction of thyroxin in thethyroid glands. Thyroid hormones regulate the rate of metabolism inthe body. The pituitary glands control the rate of production ofthyroid hormones. Hyperthyroidism causes acceleration of the body`smetabolism processes. Some of the identifiable signs ofhyperthyroidism include increased weight loss, irregular heartbeat,sweating and agitation. Hyperthyroidism can also be caused by certaindietary supplements such as iodine. Taking excess supplemental iodineor consuming a diet that is extremely rich in iodine can increaseone’s susceptibility to hyperthyroidism. This research paper willdiscuss on hyperthyroidism and how it is related to nutrition.Additionally, it will highlight causes, treatment, and dietaryrecommendations that can be used to manage hyperthyroidism.

Backgroundinformation about the disease

Feedbackmechanisms control the normal secretion of thyroid hormones. Thesemechanisms involve the interaction of several stimulating andinhibiting factors. They comprise of two parts of the brain, thehypothalamus, and pituitary gland. Thyrotropin-releasing hormone(TRH) stimulates the release of thyroid-stimulating hormone (TSH) 1.Elevated levels of thyroid hormones in circulation stimulate thehypothalamus to reduce the levels of TRH it secretes hence thesynthesis of TSH is also reduced. The homeostatic mechanism can bedisturbed at any level, either the pituitary, thyroid gland or themuscles. Iodine is a necessary element in the synthesis of thyroidhormones.

Hyperthyroidismcan cause a sudden increase in heart beat hence causing atrialfibrillation and heart failure. This complication can be reversed bythe use of beta blockers and other anti-arrhythmia medications. Untreated hyperthyroidism can lead to osteoporosis. Excessive amountsof thyroid hormones interfere with the amounts of calcium stored inthe body. Calcium is responsible for ensuring healthy bones andteeth. Its deficiency results in brittle and fragile bones. Afterhyperthyroidism treatment, patients can be at the risk of thyrotoxiccrisis 1.This refers to a sudden intensification of the symptoms ofhyperthyroidism. This can lead to very high fever, a rapid increasein heart rate and even delirium. In such an occurrence patients areadvised to seek immediate medical attention. The doctors will ensurestabilization of heart rate and reduction of fever.

Causesand types of the disease

Theprimary known cause of Hyperthyroidism is the Graves’ disease. Thisis an autoimmune disorder and causes the over-stimulation of thethyroid gland. In this condition, the antibodies that are supposed toattack xenobiotics mistakenly attack the thyroid gland. Graves’disease can be acquired genetically 2.Consequently, women tend to be more susceptible to the diseasecompared to their makes counterparts. Secondly, if the thyroid glandis inflamed, it can result in leaking of hormones in a medicalcondition called thyroiditis. Tumors of the ovaries, testis, thyroidglands or the pituitary gland can cause increased release ofthyroxine. Another cause of hyperthyroidism is Plummer’s’disease. This is the hyperfunctioning of the thyroid nodules (toxicadenoma). One or more adenomas produce too much thyroxine.

Whentaking the history of patients, the doctor should be keen on theirmedical history. This is because Graves’ disease is a risk factorfor hyperthyroidism and is gene linked. Hence, if the patient has arelative or family member with the condition doctors can eliminateother diseases and thus make a proper diagnosis. Since there aredisparities based on sex, women should keep a close track of theirthyroid hormone levels. Patients with Graves’ disease in theirfamily history should also get their thyroid hormone levels checkedduring clinical visits. Lastly, people who are using iodinesupplement should also keep track of the levels of thyroid hormonesin their bodies.

Thetypes of hyperthyroidism can be classified based on the primarycauses. Goiter is the common term used to refer to enlarged thyroidglands. Diffuse toxic goiter is a type of hyperthyroidism that isrelated to Graves’ disease. In this types, the thyroid glandbecomes diffusely hyperplastic and excess amounts thyroid hormone isproduced. The second type is toxic multi-nodular goiter which isrelated to Plummer’s’ disease. It can be genetically related. Itis associated with toxic or non-toxic. The last type is the toxicadenoma which is signaled by the presence of a functional tumor inthe thyroid gland 3.These adenomas are follicular. They are described as cold, warm orhot based on their based functioning capabilities. Thyroid adenomais different from multi-nodular goiter in that it arises from asingle cell. Multinodular goiter results from the hyperplasticresponse of the thyroid gland to a particular stimulus, for example,iodine deficiency.

Treatmentand pharmaceutical recommendation

Methodsused in the management or treatment of hyperthyroidism depend on thepatients’ age, the related cause, personal choice and the severityof the disorder. The methods include radioactive iodine, medicationsand surgery. If radioactive iodine is taken via the mouth, it isabsorbed by the thyroid gland and causes the shrinkage of the thyroidgland 3.The symptoms will be subsidized within three to six months.Radioactive iodine has proven to be useful and efficient as long thepatient use medication to replace thyroxine.

Anothertreatment is the use of anti-thyroid medication. The drug reduces thesymptoms of hyperthyroidism by preventing excess production ofthyroid hormone. Drugs used in the treatment of hyperthyroidisminclude propylthiouracil and methimazole 4.Both medications are capable of clearing the problem permanently forsome people. However, these drugs can cause severe liver damage. Betablockers are used in hyperthyroidism to reduce heart rate.

Thelast option in treating hyperthyroidism is surgery. This isrecommended for patients who cannot tolerate anti-thyroid drugs orcannot take radioactive thyroid. Thyroidectomy involves the removalof most of the thyroid gland. However, there is the risk destructionof the vocal cords and parathyroid glands. Additionally, the patientwill require lifetime treatment with levothyroxine to ensure supplyof thyroid hormone to the body. In case the parathyroid glands aredamaged, the patient will need medication to keep the levels ofcalcium in blood healthy. This treatment procedure cannot beperformed on pregnant patients. Scientists recommend the use ofmethimazole, which is a drug used to stop the thyroid gland fromproducing hormones 4.It is more recommended because it has few cases of liver damagecompared to propylthiouracil.

Dietaryrecommendation

Sincepatients suffering from hyperthyroidism usually loose experiencemuscle wasting, they are advised to eat nutritious foods with highconcentrations of calcium and sodium. Hyperthyroidism can result insignificant loss of bone strength, hence causing osteoporosis,patients should take vitamin D and calcium supplements. Hyperthyroidism results in the depletion of nutrients which need tobe replaced 5. Vitamins are essential in the buildup of the immune system. Thesevitamins can be obtained from fruits and vegetables.

Individualssuffering from hyperthyroidism should avoid excess iodine. Patientsare advised to avoid stimulants like caffeine and refined sugar sincethey may cause aggregation of the symptoms of hyperthyroidism.Patients should also reduce their intake of red meat, whole milk,fried foods, confectionaries and processed foods6.In hyperthyroidism, the body has accelerated rate of metabolism. Adiet plan for patients with hyperthyroidism would include restrictionto iodine and addition of foods that suppress thyroid hormones likekale, soybeans, broccoli and turnips. This ensures a continuoussupply of calories to replace the ones lost due to excess metabolism.Patients are advised to eat whole grain foods.

Natural,synthetic or herbal supplements can be used in hyperthyroidism. Oneof the natural supplement is fish. Fish contains high levels ofomega-3 fatty acids and is also an excellent source of protein.Omega-3 helps ensure balance in the endocrine system. Brazil nuts area source of selenium which helps balance thyroid levels 7.Herbal supplements that can be used in hyperthyroidism includebugleweed which can be used to reduce heart rate which is a symptomof hyperthyroidism. Synthetic supplements for calcium, vitamin D,selenium, omega-3 fatty acids and other nutrients should be given.

Conclusion

Inconclusion, hyperthyroidism is a disorder that leads to increasedmetabolic rate hence depletion of nutrients and weight loss. Dietcannot be used solely as a means to cure this disease. Remedies forHypothyroidism include medication, radioactive iodine and surgery.However, it is essential to stick to a diet provided by a dietician.Lastly, one should have adequate information on the kind of foods toeat and the ones to avoid when suffering from hyperthyroidism.

References

  1. Leung, Angela M., and Lewis E. Braverman. &quotIodine-induced thyroid dysfunction.&quot&nbspCurrent Opinion in Endocrinology, Diabetes and Obesity&nbsp19.5 (2012): 414-419.

  2. Hebrant, Aline, et al. &quotGenetic hyperthyroidism: hyperthyroidism due to activating TSHR mutations.&quot&nbspEuropean Journal of Endocrinology&nbsp164.1 (2011): 1-9.

  3. Ross, Douglas S. &quotRadioiodine therapy for hyperthyroidism.&quot&nbspNew England Journal of Medicine&nbsp364.6 (2011): 542-550.

  4. Bahn, Rebecca S., et al. &quotHyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists.&quot&nbspThyroid&nbsp21.6 (2011): 593-646.

  5. Varela, Luis, et al. &quotHypothalamic pathway mediates thyroid hormone‐induced hyperphagia in hyperthyroidism.&quot&nbspThe Journal of pathology&nbsp227.2 (2012): 209-222.

  6. Duntas, Leonidas H. &quotSelenium and the thyroid: a close-knit connection.&quot&nbspThe Journal of Clinical Endocrinology &amp Metabolism&nbsp95.12 (2010): 5180-5188.

  7. Vadiveloo, Thenmalar, et al. &quotThe Thyroid Epidemiology, Audit, and Research Study (TEARS): the natural history of endogenous subclinical hyperthyroidism.&quot&nbspThe Journal of Clinical Endocrinology &amp Metabolism&nbsp96.1 (2011): E1-E8.

Interviewquestions and answers

Question1interviewees name

AnswerMary

Question2 age

Answer45

Question3 medical condition

Answerhyperthyroidism

Question4 medications in use

AnswerMary does not take any medication now because she had radioactiveiodine treatment done eight weeks ago. The treatment did not work soshe is considering surgery.

Question5 could it have been treated using the dietary control?

Answerno.

Question6 does controlling their diet now make a difference in their currenthealth status and quality of life?

Answerno.

Question7 have they received instructions on a diet from a registereddietitian?

Answerno.