Pathophysiology of Hyperthyroidism

7/15/2019 Pathophysiology of Hyperthyroidism

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the disease state in humans and in vertebratescaused by insufficient production of thyroid

hormone by the thyroid gland.



Early symptoms Poor muscle tone (muscle hypotonia) Fatigue Cold intolerance, increased sensitivity to cold Depression Muscle cramps and joint pain Carpal Tunnel Syndrome Goiter Thin, brittle fingernails Thin, brittle hair Paleness Osteoporosis Decreased sweating

Dry, itchy skin Weight gain and water retention Bradycardia (low heart rate – less than sixty beats per minute) Constipation



Late symptoms Slow speech and a hoarse, breaking voice –

deepening of the voice can also be noticed

Dry puffy skin, especially on the face Thinning of the outer third of the eyebrows (sign of

Hertoghe) Abnormal menstrual cycles

Low basal body temperature



Less common symptoms Impaired memory Impaired cognitive function (brain fog) and

inattentiveness A slow heart rate with ECG changes including low

voltage signals. Diminished cardiac output and decreased contractility.

Reactive (or post-prandial) hypoglycemia Sluggish reflexes Hair loss Anemia caused by impaired haemoglobin synthesis

(decreased EPO levels), impaired intestinal iron and folate absorption or B12 deficiency from perniciousanemia

Difficulty swallowing



About three percent of the general population ishypothyroidic. Factors such as iodine deficiency orexposure to Iodine-131 can increase that risk. There are anumber of causes for hypothyroidism. Iodine deficiency is

the most common cause of hypothyroidism worldwide. Iniodine-replete individuals hypothyroidism is generallycaused by Hashimoto's thyroiditis, or otherwise as aresult of either an absent thyroid gland or a deficiency in

stimulating hormones from the hypothalamus or pituitary.



Thyroid hormone replacement therapy generallymaintains normal thyroid hormone levels unless

treatment is interrupted or discontinued.



II. ANATOMY

&PHYSIOLOGY



The thyroid glands are found on the trachea.The main hormone produced is called thyroxine. This hormone controls the growth

and development of animals. Iodine isrequired for its production.

Lack of thyroxine causes deformation and retardation. The glands swell if not enoughhormone is produced – this is called goitre inhumans.



These are located on either side of the thyroid. They produce two hormones: Parathormone and Calcitonin.These hormones control the level of calcium,magnesium and phosphate in the body.

Thymus

A very small gland located on the neck. Has someinvolvement in the production of lymphocytes, whichare involved in immune response.



Normal Thyroid



Hypothyroidism



Hyperthyroidism







IV. NURSING DIAGNOSIS



Imbalanced Nutrition: More than Body Requirementsrelated to a slowed metabolic rate resulting in weight gain

Activity Intolerance related to weakness and apathysecondary to a decreased metabolic rate resulting in anincreased heart rate and shortness of breath with activity

Constipation related to decreased peristalsis secondary toslowed metabolic rate and activity intolerance, resultingin decreased frequency of stools and painful defecation

Hypothermia related to slowed metabolic rate resultingin subnormal body temperature



V. NURSING INTERVENTIONS



The patient with hypothyroidism experiencesdecreased energy and moderate to severelethargy. As a result, the risk for

complications from immobility increases. A major role of the nurse is assisting with

care and hygiene while encouraging the patient to participate in activities within established tolerance levels to prevent the complications of immobility.



The nurse closely monitors the patients ital signsand cognitive level to detect the following:

Deterioration of physical and mental status

Signs and symptoms indicating that treatment has resulted in the metabolic rate exceeding theability of the cardiovascular and pulmonarysystems to respond.

Continued limitations or complications of myxedema



The patient often experiences chilling and extreme intolerance to cold, even if the

room feels comfortable or hot to others. Extra clothing and blankets are provided, and the patient is protected from drops

Use of heating pads and electric blanket is

avoided because of the risk of peripheral vasodilation, further loss of body heat, and vascular collapse.



The patient with moderate to severehypothyroidism may experience severeemotionally actions to changes in appearance

and body image and the frequent delay indiagnosis. As hypothyroidism is treated successfully and symptoms subside, the patient may experience depression and guilt as a result of the progression and severity of symptoms that occurred.

The nurse informs the patient and family that the symptoms and inability to recognize them

are common and part of the disorder itself.



Because most hypothyroidism treatment takes place at home, the patient and familyrequire information and instruction that will enable them to monitor the patients condition

and response to therapy. The nurse instructs the patient about the

desired actions and side effects of meditations about how and when to take

prescribe medications. The nurse provides written instructions and

guidelines for the patient and family.



The patient with hypothyroidism and myxedema need considerable follow-upand healthcare.

Assistance the nurse reinforces theimportance of continued thyroid hormonereplacement and periodic follow-up and instructs the patient and family members

about the signs of over medication and under medication.



V. MEDICATIONS



Hypothyroidism is traditionally treated with thyroid hormone replacement therapy (either synthetic ornatural). Thyroid replacement therapy could includetaking levothyroxine (T 4 ), liothyronine (T 3 ), or acombination product that contains both T 4 and T 3. All o

these treatments work in the body like thyroxine, thehuman hormone that is normally produced by thethyroid gland, and subsequently converted to T 3, theactive hormone.



The purpose of treatment is to replace the thyroid hormonethat is lacking. Levothyroxine is the most commonly used medication. Doctors will prescribe the lowest dose that effectively relieves symptoms and brings the TSH level to anormal range. If you have heart disease or you are older,your doctor may start with a very small dose.

Lifelong therapy is required unless you have a conditioncalled transient viral thyroiditis.

You must continue taking your medication even when your

symptoms go away. When starting your medication, yourdoctor may check your hormone levels every 2 - 3 months. After that, your thyroid hormone levels should bemonitored at least every year.



Do NOT stop taking the medication when you feel better.Continue taking the medication exactly as directed by yourdoctor.

If you change brands of thyroid medicine, let your doctorknow. Your levels may need to be checked.

Some dietary changes can change the way your bodyabsorbs the thryoid medicine. Talk with your doctor if youare eating a lot of soy products or a high-fiber diet.

Thryoid medicine works best on an empty stomach and when taken 1 hour before any other medications. Do NOT take thyroid hormone with calcium, iron, multivitamins,alumin hydroxide antacids, colestipol, or other medicinesthat bind bile acids, or fiber supplements.



MEDICAL MANAGEMENT

(HYPOTHYROIDISM)



Treatment

Treating Overt Hypothyroidism.

Patients with overt hypothyroidism, indicated by clearsymptoms and blood tests that show high TSH (generally10 mU/L and above) and low thyroxine (T4) levels, must have thyroid replacement therapy.

Treating Subclinical or Mild Hypothyroidism.

Considerable debate exists about whether to treat patients with subclinical hypothyroidism (slightly higherthan normal TSH levels, normal thyroxine levels, and noobvious symptoms). Some doctors opt for treatment and others opt for simply monitoring patients.



It is not clear if the benefits of treating subclinical hypothyroidismoutweigh the risks and potential complications. Doctors who do not advocate treatment argue that thyroid levels can vary widely, and

subclinical hypothyroidism may not persist. In such cases,overtreatment leading to hyperthyroidism is a real risk.

There is reasonable evidence and consensus to recommend treatment for subclinical hypothyroidism in the presence of other factors, including:

High total or LDL cholesterol levels Blood tests that show autoantibodies indicating a future risk for Hashimoto's thyroiditis or other forms of other autoimmune hypothyroidism Blood tests that show TSH levels greater than 10 mU/LGoiter Pregnancy

Female infertility associated with subclinical hypothyroidism



Treatment is optional in patients with subclinical hypothyroidism who have no obvious symptoms and normal cholesterol levels. Some doctors feel that treating

this group of patients will prevent progression to overt hypothyroidism and future heart disease, as well asincrease a patient's sense of well-being. However, theevidence to support treatment of this patient group is not nearly as strong. Many doctors recommend against

treatment and suggest that these patients should simplyhave lab tests every 6 - 12 months.

Suppressive Thyroid Therapy.

Suppressive thyroid therapy involves takinglevothyroxine in doses that are high enough to blockthe production of natural TSH but too low to causehyperthyroid symptoms. It may be used for patientswith large goiters or thyroid cancer.



Treatment of Special Cases

Treating the Elderly and Patients with Heart Disease.

Thyroid dysfunction is common in elderly patients, with most having subclinical hypothyroidism. There is no evidence that this condition poses any great harm in this population, and most doctors recommend treating only high-risk patients.

Elderly patients, particularly people with heart conditions,usually start with very low doses of thyroid replacement,since thyroid hormone may cause angina or even a heart attack. Patients who have heart disease must take lower-than-average maintenance doses. Doctors do not recommend treatment for subclinical hypothyroidism in most elderly patients with heart disease. Such patients should be closelymonitored, however.



Treating Newborns and Infants with Hypothyroidism. Babies born with hypothyroidism (congenital hypothyroidism) should be treated with levothyroxine(T4) as soon as possible to prevent complications. Earlytreatment can help improve IQ and other developmental

factors. However, even with early treatment, mild problems in mental functioning may last into adulthood. In general, children born with milder forms of hypothyroidism will fare better than those who have

more severe forms.



Treatment During Pregnancy and for Postpartum Thyroiditis. Women who have hypothyroidism before becoming pregnant

may need to increase their dose of levothyroxine during pregnancy. Women who are first diagnosed with overthypothyroidism during pregnancy should be treated immediately, with quick acceleration to therapeutic levels.

Although not well proven, doctors often recommend treating patients diagnosed with subclinical hypothyroidism while pregnant. There are no risks to the developing baby when the pregnant woman takes appropriate doses of thyroid hormones.The pregnant woman with hypothyroidism should be monitored

regularly and doses adjusted as necessary. If postpartumthyroiditis develops after delivery, any thyroid medicationshould be reduced or temporarily stopped during this period.



Treatment of Hypothyroidism and Iodide Deficiency.

People who are iodide deficient may be able to betreated for hypothyroidism simply by using iodized salt.In addition to iodized salt, seafood is a good source.Except for plants grown in iodine-rich soil, most other

foods do not contain iodine. The current RDA for iodideis 150 micrograms for both men and women, with anupper limit of 1,100 micrograms to avoid thyroid injury.



Hyperthyroidism





Hyperthyroidism is the term for overactive tissue withinthe thyroid gland, resulting in overproduction and thus an

excess of circulating free thyroid hormones: thyroxine (T 4 ),triiodothyronine(T 3 ), or both. Thyroid hormone isimportant at a cellular level, affecting nearly every type of tissue in the body.

Thyroid hormone functions as a stimulus to metabolismand is critical to normal function of the cell. In excess, it both overstimulates metabolism and exacerbates the effect of the sympathetic nervous system, causing "speeding up" of various body systems and symptoms resembling an

overdose of epinephrine (adrenaline). These include fast heart beat and symptoms of palpitations, nervous systemtremor and anxiety symptoms, digestive systemhypermotility (diarrhea), and weight loss.



weight loss (often accompanied by an increased

appetite) anxiety intolerance to heat hair loss

muscle aches weakness fatigue hyperactivity Irritability Apathy depression polyuria and sweating.



The major causes in humans are:Graves' disease (the most common etiology with 70-

80%) Toxic thyroid adenoma

Toxic multinodular goitre



Hyperthyroidism is generally treatable and carriesa good prognosis. Most patients lead normal lives

with proper treatment. Thyroid storm, however, canbe life threatening and can lead to heart, liver, orkidney failure.



II. ANATOMY

&PHYSIOLOGY



The thyroid glands are found on the trachea.The main hormone produced is called thyroxine. This hormone controls the growth

and development of animals. Iodine isrequired for its production.

Lack of thyroxine causes deformation and retardation. The glands swell if not enoughhormone is produced – this is called goitre inhumans.



These are located on either side of the thyroid. They produce two hormones: Parathormone and Calcitonin.These hormones control the level of calcium,magnesium and phosphate in the body.

Thymus

A very small gland located on the neck. Has someinvolvement in the production of lymphocytes, whichare involved in immune response.



Normal Thyroid



Hypothyroidism



Hyperthyroidism



III. PATHOPHYSIOLOGY



Hyperthyroidism

Grave'sDisease(most

commoncause)

autoimmunecondition

abnormalstimulation of

the thyroidgland bythyroid

stimulatingantibodies

Goitercytokine-mediated

activation of fibroblasts inorbital tissue

behind the eyeball

exopthalmos(opthalmopathy)

paralysis of extraocular

muscle

optic nervedamage

visual loss inability toclose lids

cornealulceration

multinodulargoiter

adenoma of thyroid

ingestion of excessive

thyroidhormone

too muchingestion of

iodine-containing

agents

-increaseoxygen

consumption

-increase useof metabolic

fuels

-increasesympathetic

CNS activity

hypermetabolic state

nervousness,irritability,

restlessness,anxiety,

wakefulness

weight losstachycardia,palpitation,shortness of

breath

increasedcardiac output

excessivesweating, thinhair, silky skin

decreasemuscle toneand reflexes

musclecramps

heatintolerance

incrased GImotility

diarrhea



IV. NURSING DIAGNOSIS



Imbalanced Nutrition: Less than Body Requirementsrelated to accelerated metabolic rate resulting in weight loss and decreased energy levels

Activity Intolerance related to exhaustion secondary toaccelerated metabolic rate resulting in inability to performactivity without shortness of breath and significant increases in heart rate

Hyperthermia related to accelerated metabolic rateresulting in fever, diaphoresis, and reported heat intolerance

Impaired Social Interaction related to extreme agitation,hyperactivity, and mood swings resulting in inability torelate effectively with others



V. NURSING INTERVENTIONS



Rapid movement of food through thegastrointestinal tract may result tonutritional imbalance and further

weight loss. Highly seasoned foods and stimulants

such as coffee, tea, cola, and alcohol arediscouraged to reduce the area.

High calorie, high protein foods areencouraged.



The patient needs reassurance that the emotional reactions being experience are a result of thedisorder and that with effective treatment thosesymptoms will be controlled.

Use a calm, unhurried approach with the patient.

Stressful experiences are minimized; therefore,if hospitalized, the patient is not placed in aroom with very ill or talkative patients.

The environment is kept quite and uncluttered.

The nurse encourages relaxing activities if theydo not overestimate the patient.



The patient is likely to experience changes inappearance, appetite and weight.

The nurse conveys and understanding of the patients concern about these problems and assists

the patient to develop effective coping strategies. If changes in appearance are very disturbing to

patient, mirrors maybe covered or removed.

The nurse reminds the family members and

personnel to avoid bringing these changes to the patient’s attention.

The nurse explains to the patient and family that most of these changes are expected to disappearwith effective treatment.



The patient finds a normal roomtemperature too warm because of an

exaggerated metabolic rate and increased heat production.

The nurse maintains the environment at a

cool, comfortable temperature and changes bedding and clothing as needed.



The nurse closely monitors the patient with

hyperthyroidism for signs and symptomsthat maybe indicative of thyroid storm. Anti-thyroid medications maybe prescribe to

reduce thyroid hormone levels.

Propranolol and digitalis maybe prescribe totreat cardiac symptoms.



The nurse teaches the patient how and when to take prescribe medication, and provides instructionsabout the essential role of the medication and broader therapeutic plan.

The nurse provides a written plan for the patient touse at home

The nurse identifies adverse effects that should bereported if they occur.

The nurse also advises the patient to avoid stressful situations that may precipitate thyroid storm.



The nurse reinforces to the patient and familythe importance of long-term follow-up becauseof the risk for hypothyroidism afterthyroidectomy or treatment with anti-thyroid

medications or radioactive iodine.The nurse also assesses the patient for changes

indicating return to normal thyroid function and signs and symptoms of hyperthyroidism and

hypothyroidism.The nurse reminds the patients and family about

the importance of health promotion activitiesand recommended health screening.



VI. MEDICAL MANAGEMENT



Radioiodine is considered the treatment of choice forhyperthyroidism, but in some situations, methimazole

therapy is preferred, such as in cats with pre-existingrenal insufficiency.

Methimazole blocks thyroid hormone synthesis, and controls hyperthyroidism in more than 90% of cats that tolerate the drug. Unfavorable outcomes are usually dueto side effects such as gastrointestinal (GI) upset, facial

excoriation, thrombocytopenia, neutropenia, or liverenzyme elevations; warfarin-like coagulopathy ormyasthenia gravis have been reported but are rare.

S i l P d



Surgical Procedure Surgery - this involves surgically removing thethyroid gland (thyroidectomy). It may be an option for patients who cannot tolerate anti-thyroid medications,or those who do not wish to receive radioactive iodinetherapy. Patients will subsequently require thyroxinetreatment to make sure their blood levels of thyroid

hormones are adequate.

The operative procedure to treat hyperthyroidism isknown as a near total thyroidectomy

It is performed under general anesthesia.

The surgeon makes an incision in the skin lines acrossthe front of the neck and carefully exposes the thyroid gland.

Precautions are taken to identify, isolate, and protect



fy, , pimportant structures in the area of the thyroid gland. Twoare particularly important:

1. The laryngeal nerve, which is vital for the proper function of the larynx or voice box, iscarefully identified and protected from traumaduring this procedure.

2. The four small parathyroid glands, which areembedded in thyroid tissue and produce ahormone necessary for maintenance of blood calcium levels, are also identified and preserved.

Most of the thyroid gland is removed.

The surgeon usually leaves about 3 to 8 grams, which isless the 0.3 ounces of thyroid tissue.

The procedure generally takes several hours.



The incision usually heals well and is usually not evennoticeable

Surgical Care

Thyroidectomy is no longer the recommended first-linetherapy for hyperthyroid Graves disease. However, a recent retrospective cohort

studyjavascript:showcontent('active','references'); showed that one-third of all patients electing surgery as definitivemanagement did so without a specific indication, and the patient satisfaction with the decision for surgery asdefinitive management of Graves disease was high. Surgeryis a safe alternative therapeutic option in patients who arenoncompliant with or cannot tolerate antithyroid drugs,have moderate-to-severe ophthalmopathy, have largegoiters, or refuse or cannot undergo radioiodine therapy.

Thyroidectomy may be appropriate in the presence of a



Thyroidectomy may be appropriate in the presence of athyroid nodule that is suggestive of carcinoma.

In certain cases (eg, in pregnant patients with severe

hyperthyroidism), thyroidectomy may be indicated becauseradioactive iodine and antithyroid medications may becontraindicated.

It generally is reserved for patients with large goiters

with or without compressive symptoms. It also may be indicated in patients who refuseradioiodine as definitive therapy or in those in whom theuse of antithyroid drugs and/or radioiodine does not control hyperthyroidism.

Surgery provides rapid treatment of Graves diseaseand permanent cure of hyperthyroidism in most patients,and it has "negligible mortality and acceptable

morbidity" by experienced surgeons.

Ophthalmopathy



Ophthalmopathy

Near-total thyroidectomy has little, if any, effect on the course of

ophthalmopathy.

If ophthalmopathy is severe but inactive, orbital decompressionmay be performed. Reducing proptosis and decompressing the

optic nerve can be achieved by transantral orbital decompression.The major adverse effect is postoperative diplopia, which maynecessitate a second surgery on the extraocular muscles to correctthe problem.

Rehabilitative (extraocular muscle or eyelid) surgery is oftenneeded. Eyelid surgery (eg, severance of the Müller muscle, scleral or palatal graft insertion) can be performed to improve exposurekeratitis.



VII. MEDICATIONS



Hyperthyroidism can be treated using medicine,radiation, or surgery. Many factors, such as the person's

age and the severity and type of hyperthyroidism, areimportant in determining which treatment is best. The

two main types of medicines used to treat hyperthyroidism are antithyroid drugs and beta-

blockers.



Antithyroid drugs, such as methimazole (MMI orTapazole) and propylthiouracil (PTU), work bydecreasing the production of thyroid hormone. Both are very effective, but methimazole isgenerally preferred because of a rare risk of serious side effects with PTU. The illustrationshows that some hormone is made, but the thyroid

becomes much less efficient. When taken faithfully, these drugs are usually very effective incontrolling hyperthyroidism within a few weeks.



For pregnant women, PTU is the preferred drug during the first trimester. After the first trimester, methimazole is preferred.

For patients with sustained forms of

hyperthyroidism, such as Graves' disease or toxic nodular

goiter, anti-thyroid medications are often

used. The goal with this form of drug therapyis to prevent the thyroid from producinghormones.



Very rarely, patients treated with these medicationscan develop liver inflammation or a deficiency of white blood cells therefore, patients takingantithyroid drugs should be aware that they must stop their medication and call their doctor promptly

if they develop yellowing of the skin, a high fever, orsevere sore throat. The main shortcoming of antithyroid drugs is that the underlyinghyperthyroidism often comes back after they arediscontinued. For this reason, many patients withhyperthyroidism are advised to consider atreatment that permanently prevents the thyroid gland from producing too much thyroid hormone.

Cont’d



Rash itching or fever (but these are

uncommon)



MMI is usually preferred over PTU because it reverses hyperthyroidism more quickly and has fewer side effects. MMI requires an

average of 6 weeks to lower T4 levels tonormal and is often given before radioactiveiodine treatment. MMI can be taken once perday.



PTU blocks the conversion of T4 to T3 in non-thyroid tissue, but it does not reverse

hyperthyroidism as rapidly as MMI. PTU must be taken two to three times per the day.



PTU used to be the drug of choice during pregnancybecause it is thought to have a lower risk of causingbirth defects. But experts now recommend that PTU be

given during the first trimester only. This is becausethere have been rare cases of liver damage in peopletaking PTU. After the first trimester, women should switch to methimazole for the rest of the pregnancy.



Beta-blockers, such as atenolol, are oftenstarted as soon as the diagnosis of hyperthyroidism is made. While beta-blockersdo not reduce thyroid hormone production,

they can control many of the bothersomesymptoms, such as rapid heart rate, tremors,anxiety, and heat intolerance. Once thehyperthyroidism is under control (byantithyroid drugs, surgery, or radioactiveiodine), the beta-blocker is stopped.



Destroying the thyroid with radiation, called radioiodine ablation, is a permanent way toresolve hyperthyroidism. The amount of radiationused is small and does not cause cancer. This is themost widely used treatment in the United States.

Radioiodine is given in liquid or capsule form, and it works by attacking and destroying much of thethyroid tissue. This takes about 6 to 18 weeks. People with severe symptoms, older adults, and people with heart problems should first be treated

with an antithyroid drug to control symptoms. Most patients who receive radioiodine develophypothyroidism and need to take thyroid hormonesupplements for the rest of their lives.



Sometimes, after apparently successful treatment,the condition returns and further treatment isneeded.

About 20 percent of those who use radioiodinetreatment require a second dose. These peopleusually have severe hyperthyroidism or a verylarge goiter.

Occasionally, people whose hyperthyroidism iscaused by Graves' disease may find that their eyesymptoms worsen after therapy.



People who undergo this therapy should avoid close physical contact, especially with youngchildren and pregnant women, for three toseven days after treatment because of the possibility of exposing them to low doses of radiation. This can be difficult for parents of young children. Patients will need to see their

clinician on a regular basis after treatment tohave thyroid hormone levels checked and monitor for hypothyroidism or recurrent hyperthyroidism.



VIII. DIAGNOSTIC

PROCEDURES



Hypo t h y r o i d i sm

&

Hype r t h y r o i d i sm





The TSH (or Thyroid Stimulating Hormone) assay has been recognized as

an exquisitely sensitive indicator of thyroid status.



The T4 (or Thyroxin) assay complements

the TSH assay, and is used to confirm athyroid disorder when suggested by anabnormal TSH.

The T3 (or Triiodothyronine) assay is

another assay which is used in thediagnosis of thyroid disorders.

T3



The T3 Resin Uptake assay is used in calculatingthe Free Thyroxin Index (FTI).

Autoantibodies of clinical interest in thyroid disease include thyroid-stimulating antibodies

(TSAb), TSH receptor-binding inhibitoryimmunoglobulins (TBII), antithyroglobulinantibodies (Anti-Tg Ab) and the antithyroid peroxidase antibody (Anti-TPO Ab).

Other Tests



Similar in its use for evaluating a breast

mass, ultrasound can be used to assess athyroid nodule.

Fine Needle Aspiration (FNA) has becomethe single-most important step in theevaluation of a thyroid nodule.

Fine Needle Aspiration



The thyroid glands' ability to concentrate iodineand certain radioactive isotopes has beenexploited in a nuclear imaging technique knownas the thyroid scan.



X. DIET



No foods have been shown in clinical studies toimprove or worsen the symptoms of

hyperthyroidism. However, that doesn't meanyou shouldn't pay attention to what you eat. Ahealthy, well-balanced diet is important forthose with hyperthyroidism -- both during and after treatment. It should include things likeruits, vegetables, and lean proteins, with limited

amounts of foods high in fat and cholesterol.



Healthcare providers generally advise their patients to follow good dietary habits followingtreatment for hyperthyroidism. The reason isthat considerable weight gain is common withthis condition. One study showed an averageweight gain of about 12 pounds (5.4 kg) in people followed for up to two years after

hyperthyroidism treatment.



Graves' disease

Preexisting obesity Previous weight loss as a result of

hyperthyroidism

Hypothyroidism following treatment.



The good news is that research has also shownthat this weight gain can be minimized by following sensible dietary habits. If you have anoveractive thyroid, you should strive to eat awell-balanced diet and control your weight.

A well-balanced diet can help you feel betterand can be a positive step in dealing with

hyperthyroidism. It can also help decrease yourchances of developing heart disease or certaintypes of cancer.



Eat a heart-healthy diet. This diet should include foodssuch as:

Fruits, vegetables, grains, and fat-free or low-fat milk and milk products

Lean meats, poultry, fish, beans, eggs, and nuts. Limit foods with saturated fats, trans fats, cholesterol,

sodium (salt), and added sugars.

Get regular physical activity for at least 30 minutes aday on most days of the week.

Limit your intake of alcohol.



END

-To God be the Glory-

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Pathophysiology of Hyperthyroidism