Irritability? Insatiable appetite? Racing pulse? Unusual weight loss or weight gain? Perhaps it’s time you got your Thyroid checked
I hadn’t seen my friend Jo for six months. I knew that she hadn’t been well, but when we met up at the Byron
Bay Blues Festival, I was shocked by her changed appearance.
Jo had always been slim but now, at 31, she was rake-thin. Once brighteyed and raring to go, her mood had changed to jittery and anxious. The base of her neck was visibly thick and puffy, and she had a big, bulging left eye. When I stole a secret look at her in profile, my friend was still lovely. But front on, I barely recognised this startled, crazy-looking woman.
“I noticed my eye getting bigger every day,” she said, explaining what eventually drove her to seek help.
Suspecting a thyroid problem, her doctor ordered a blood test and then sent Jo to a specialist. Her symptoms – which included uncontrollable shaking, heart palpitations, excessive weight loss, hot flushes and an insatiable appetite – pointed to a hyperactive (ie, overactive) thyroid.This is an autoimmune disorder also known as Graves’ disease. “I was also going to the toilet a lot,” says Jo. “These things had developed gradually – I hadn’t thought of them as anything other than a bit strange.”
Fortunately for Jo, 18 months after the diagnosis her “bulge eye” retreated into its socket and her thyroid gland returned to a near-normal size.
Yet, in a strange twist of fate, not long after I met up with Jo at the festival I developed a persistent, uncontrollable – albeit subtle – case of the shakes. It was noticeable enough to raise my physiotherapist’s concern during a regular visit. A series of tests and an ultrasound revealed that my own thyroid was also
hyperactive. It was only with hindsight that I realised many niggling health concerns I had dismissed as insignificant were symptoms of the disease – intolerance of heat (it was summer, after all); hair loss (well, we all lose around 100 hairs a day); an increased appetite; an inability to relax; a lighter-than-usual period;
and frequent trips to the bathroom. Straightaway, my doctor put me on propylthiouracil, or PTU, an antithyroid medication.
It turns out that Jo and I are far from alone. It’s estimated that more than 200,000 Australians will develop hyperactive thyroid disease. It strikes most sufferers in their 30s or 40s, and seems to run in families. The disease most commonly afflicts women, at a rate of ten females to every male.
The thyroid is a small, butterflyshaped gland that sits at the base of the neck and produces hormones that control metabolism, height and brain development in foetuses. In Graves’ disease, antibodies attack the thyroid, causing it to produce too much thyroid hormone.This makes the body shift into top gear with an elevated metabolism, and the thyroid swells in size – a condition called goitre. In about 40% of cases,
antibodies also attack the eye muscles, causing distinctive “googly” eyes. “The actor Marty Feldman had thyroid eye disease,” says Professor Jack Wall, a thyroid eye disease specialist at Nepean
Hospital in Penrith, NSW.
For most sufferers, eye problems will subside after three months, but it can take up to three years. “There can also be puffiness, redness, swelling around the eye, wateriness, itchiness and grittiness,” says Wall. “In some cases, eye muscle damage can cause double vision.”Damage can be permanent.
What is the exact cause of autoimmune disease of the thyroid gland? Experts are unsure, but believe something in a patient’s genetic make-up is triggered by environmental factors such
as stress or infection. “There’s no doubt there’s an inherited component,” says Professor Creswell Eastman, founding head of endocrinology and diabetes at Sydney’s Westmead Hospital.
Treatment is a two-step process. In most cases, doctors can slow hormone production via a course of drugs over 12 to 18 months. If this doesn’t work, options include removing most of the thyroid gland surgically and a thyroid ablation (or destruction) using one or more doses of radioactive iodine (RAI).
Says Professor Eastman, “Each form of therapy is satisfactory, but none ideal.”
Jo came off medication and was put back on it three times before doctors finally declared she was in remission. Since my diagnosis, my mother and sister and two friends have been diagnosed with thyroid problems. My mother and sister have both been diagnosed as hypoactive, the opposite problem to mine (see box, previous page).
As for me, for the first time in seven years I have stopped taking medication – my last two blood tests showed my hormone levels to be within the normal range. Around 25% of people with Graves’ disease will go into remission. I live in hope that one day, like my friend Jo, this will happen to me.
Tackling the problem
1 | List your symptoms. Are you always hungry? Have you lost weight in recent months without any effort? Write
down any changes you’ve noticed.
2 | What you can try. Take your temperature first thing in the morning. A temperature consistently below 36.5C is a
possible indicator of low thyroid function.
3 | Check with your family. Diseases of the thyroid tend to run in families. Ask parents, siblings and cousins whether they know of any relatives who’ve been afflicted.
4 | Have a thyroid stimulating hormone (TSH) test. This is a simple blood test that your GP can request. High
levels of TSH suggest low thyroid activity; low levels indicate an overactive thyroid.
5 | Treatment. People with confirmed low thyroid activity are normally prescribed synthetic thyroxine, a hormone replacement. An overactive thyroid can be treated using three options: anti-thyroid drugs, radioiodine therapy and surgery.
www.thyroid.org.au
