Hoping to raise awareness of thyroid issues
About thyroid disorders
Endocrinologist Annabel Fountain explains more about thyroid disorders:
Q: What is hyperthyroidism?
A: Overactive thyroid is when the thyroid gland makes too much triiodothyronine, T3, and thyroxine, T4. These hormones speed up your metabolism. People lose weight, are very hungry, feel hot and sweaty, can have itchy skin and loose bowels (even diarrhoea). They can also have issues with anxiety and sleeplessness and feel their heart racing even when they’re not exercising. It can be caused by a single thyroid nodule making too much hormone, or by an autoimmune process involving antibodies that stimulate the thyroid to make too much hormone. This is called Graves’ disease. The antibodies present in Graves’ disease sometimes also cause problems with the muscles around the eyes, causing swelling or double vision. This is known as Graves’ opthalmopathy. Treatment of hyperthyroidism is with antithyroid drugs, radioactive iodine ablation or surgery.
Q: And hypothyroidism?
A: Underactive thyroid is when the gland does not make enough T3 and T4. People can gain weight, feel cold, lethargic, sleepy, depressed and constipated. The cause can also be an autoimmune process with antibodies that cause destruction of the thyroid. This is called Hashimoto’s disease. Radiation therapy for other cancer diagnoses (eg leukaemia, lymphoma) or surgical removal of the thyroid also cause hypothyroidism. The treatment of hypothyroidism, whatever the cause, is the same: medication to replace the low hormone levels.
Q: Are they serious conditions?
A: Thyroid disease is generally common worldwide. It tends to be more common in women than men and increases with age. Local statistics are not collected but in my opinion there are no unusual trends in its prevalence in Bermuda. Mild to moderate thyroid dysfunction is not life-threatening and certainly very treatable with medical therapy in the majority of cases. Severe thyroid dysfunction can have untoward effects. Thyroid cancer is very treatable with 98 per cent [having a] five-year survival rate and 97 per cent a ten-year survival rate. Compare this with breast cancer where the five-year survival rate is 99 per cent and the ten-year rate is 83 per cent, or bowel cancer with a five-year survival rate of 65 per cent and a ten-year survival of 58 per cent.
Maxene Mathias was dripping with sweat, her heart and pulse racing.
Terrified, she took a taxi to the hospital where her condition was given a name: thyroid storm.
The 28-year-old had only learnt she had hyperthyroidism days earlier. Lying in a bed at King Edward VII Memorial Hospital, it felt like she was fighting for her life.
“I did feel like I was going to die. My heart rate was so high, I was dripping in sweat and I couldn’t breathe [although] anxiety is probably to blame for that because my oxygen saturation was 100 per cent,” said Ms Mathias, who hopes her story will draw attention to Thyroid Awareness Month.
“[A thyroid storm] happens when you’re producing way too many hormones and it basically shuts the body down. Thyroid storms are very rare. Usually people who [have thyroid problems] have them addressed; thyroid storms usually happen when people are untreated or under-treated.”
She first noticed something was off about a year ago.
“Since about January I hadn’t been feeling well,” Ms Mathias said. “In February, one of my eyes became larger than the other. I was prone to ‘selfies’ and suddenly noticed it in a picture. People tried to reassure me that it wasn’t that bad, that I should just leave it alone.”
The problem was Graves’ ophthalmopathy. The autoimmune inflammatory disorder can appear before, after or at the same time as other signs of hyperthyroidism. Its symptoms include upper eyelid retraction, lid lag, swelling, redness, conjunctivitis and bulging eyes.
Ms Mathias was under a great deal of stress at the time, and chalked her eye problems up to that. In August, things came to a head.
“I had a stressful few months — a lot going on — so I thought I just had to work on that. I went to the eye doctor and got glasses and he figured out that I had hyperthyroidism. Only a few days later, I was in hospital with a suspected thyroid storm.
“My resting pulse was 188; it should be between 70 and 90. My heart was beating rapidly. It was summer, so of course it was hot, and I was dripping with sweat — Graves’ patients are intolerant to heat. It was my thyroid. I was in hospital for four days to get my thyroid stabilised and my pulse regulated. I’m still trying to get it regulated.”
Ms Mathias’s concern is that there could be others unknowingly walking around with thyroid problems.
“With Graves’ you can suffer anxiety, a racing heartbeat and hair loss and these were things I had been dealing with for years. So many people here just chalk it up to hereditary problems, they don’t think about it or, they attribute it to stress. Graves’ amplifies the thyroid indicators, but I think the symptoms are so common they could be overlooked — mood swings, anxiety, depression. People have so much on their plates these days, it’s hard to sit down and say, ‘Maybe something else is happening here’. I don’t want to scare people, but they should be aware that their body could be trying to give them a signal.
“I used to have bouts where I’d feel lightheaded, I’d pass out — I dismissed them as not having enough dinner that day. I couldn’t breathe, I was hyperventilating. It was one of the scariest things I’ve ever been through. I just hope I can help by sharing my story.”
She’s since been on medication to control her hyperthyroidism. Specialists Annabel Fountain and Catherine Siddle and her GP George Shaw “have really helped”, Ms Mathias added.
Because of the Graves she’s not eligible for the radioactive iodine treatment sometimes offered when people with thyroid problems do not have cancer.
“I’m seeing if I can medicate it into remission,” she said. “[Such experiences] make you wonder if you’re being overly sensitive or if there’s something wrong; that’s why it appealed to me to say something. I feel like so many other people, women in particular, might have some symptoms and dismiss them as being nothing. And I want them to get help, especially before it gets really bad.
“It’s crazy how the thyroid goes overlooked and forgotten about, but it can make or break you very quickly. I have not met anyone [with hyperthyroidism].
“I would love to find out how others are coping. I’ve been looking on Facebook. There’s a lot of support groups there and it was great to know it was not just me.
“People look at thyroid problems and say, ‘Oh you’re just tired or lazy’, but I think it’s important people know there are chronic conditions attached that people have to manage.”
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