radiation - JASE Medical

Sepsis – A Medical Emergency

According to the CDC

  • At least 1.7 million adults in America develop sepsis.
  • At least 350,000 adults who develop sepsis die during their hospitalization or are discharged to hospice.
  • 1 in 3 people who dies in a hospital had sepsis during that hospitalization
  • Sepsis, or the infection causing sepsis, starts before a patient goes to the hospital in nearly 87% of cases.

What is sepsis?

Sepsis is an extreme medical emergency in response to an infection that has triggered an immune response that causes extensive inflammation throughout your body. This can lead to tissue damage, organ failure and even death. Sepsis occurs when an infection in the body weakens the immune system, and the body stops fighting the infection. At the same time your body stops fighting the infection, your body develops blood clots, leading to reduced flow to organs. This leads organ failure and in some instances even death.

Many different types of infections can trigger sepsis, which is a medical emergency. The quicker you receive treatment, the better your outcome will be. Most cases of sepsis start as a bacterial infection. Some cases of sepsis are from viral or fungal infections.

Symptoms of sepsis

The symptoms of sepsis are specific across populations, and can appear differently in children compared to adults- but can include:

  • Fever and chills
  • Very low body temperature
  • Peeing less than usual
  • Fast heartbeat
  • Nausea and vomiting
  • Diarrhea
  • Fatigue or weakness
  • Blotchy or discolored skin
  • Sweating or clammy skin
  • Confusion, change in mental status
  • Shallow breathing

Sepsis complications-if not treated or treatment started late

  • Kidney failure
  • Dead tissue (gangrene) on fingers and toes, leading to amputation
  • Lung, brain, or heart damage
  • A higher risk of infections over time
  • Sepsis can be deadly in between 25% and 40% of cases.

Risk Factors for Sepsis

Anyone can get sepsis, however the following groups more at risk for developing sepsis:

  • Over 65- as we age our immune systems weaken
  • Infants, very young children, pregnant women
  • People with indwelling catheters, along with respiratory devices, ports and IV sites-these are all entry points for infection.
  • Severe, open injuries- or extensive burns
  • Chronic conditions such as diabetes. Poorly controlled blood sugars feed infection. Other risk factors include cancer, lung disease, immune system disorders, and kidney disease.
  • Dementia and Alzheimer’s patients are unable to express discomfort or pain and are at risk for urinary tract infections-which can lead to sepsis if not treated.
  • Recently hospitalized or recent surgery
  • On steroid therapy- steroids weaken immune system

Sepsis is most commonly associated with the following types of infections:

Note: Sepsis is NOT contagious

  • Lung infections (like pneumonia)
  • Urinary tract infections
  • Skin infections (especially burns)
  • Infections of the digestive system

Prevent infections by

  • Practicing good hygiene- hand washing, keep infected wounds covered, wear gloves during dressing changes.
  • Take care of chronic conditions- especially immune system disorders
  • Diabetics are prone to infections- keep blood sugars under control
  • In the case of Alzheimer’s and dementia patients monitor urine for obvious signs of urinary tract infection.

Prevent sepsis by:

  • Monitoring any lung, urinary tract, wound or gastrointestinal infections and getting appropriate antibiotic therapy (if indicated) started before symptoms of sepsis emerge.

According to the NIH:

  • A single oral dose of the antibiotic azithromycin can reduce the risk of postpartum sepsis and death among women who deliver vaginally by one-third, according to a large multi-country clinical trial funded by the National Institutes of Health. Azithromycin is one of the antibiotics in the Jase case- use only on the instruction of your care provider.

If sepsis is suspected

Seek emergency care immediately

Sepsis symptoms can develop and deteriorate rapidly

The sooner an intervention is started the higher your chance of survival. If sepsis symptoms are mild, you may be sent home with oral antibiotics. Two antibiotics that may be prescribed are supplied in the Jase case- azithromycin and ciprofloxacin.

If sepsis symptoms are severe, you will be admitted to the hospital, given IV fluids, blood pressure monitored, given vasopressors (to constrict blood vessels, which in turn raises blood pressure) and antibiotics along with other supportive therapy.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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3 Medicines That Could Save Your Life Following a Nuclear Blast

As the Russian-Ukraine war escalates, with no end in sight, the threat of nuclear war is ever present. At different times both sides have brought up the possibility of a “limited nuclear war.

We have never been so close to nuclear war- even during the cold war we weren’t this close.

The number of nuclear warheads in use is staggering. It is estimated that there are 12,705 nuclear warheads worldwide. These warheads are spread out between only 9 countries- U.S., Russia, France, China, the UK, Pakistan, India, Israel, and North Korea, Hopefully, cooler heads will prevail, and we will soon see a de escalation of tensions.

Preventing exposure-be prepared

Unfortunately, if a nuclear war is fought in Ukraine the radioactive fallout will travel through wind currents and eventually reach the United States. Some of the radioactivity will have dissipated, but a lot wont.

It is always better to prevent exposure to radioactive materials and fallout than to have to deal with the health effects of radiation exposure.  In previous posts I outlined precautions and preparation tips to help you mitigate and decrease your exposure to radioactive fallout.

In this post, we will discuss three of the more common medicines available in the event of a nuclear blast. Whether the drug is over the counter or prescription, it is highly advised to only take as directed by health officials and in the proper amount. Even OTC meds have serious side effects if not taken as directed.

The three we will discuss are: Potassium iodide, Prussian Blue and EDTA.

Potassium iodide (KI)

(Over the counter, however, seek care provider guidance on how and when to take)

The thyroid gland cannot tell the difference between stable and radioactive iodine.  KI acts to block radioactive iodine from being taken into the thyroid gland, it can help protect this gland from injury. Ingesting iodide tablets (KI) flood the thyroid gland and can protect the thyroid gland from absorbing the radioactive iodine from a nuclear incident.

It is also important to know what KI cannot do. KI cannot protect parts of the body other than the thyroid from radioactive iodine. KI cannot protect the body from any radioactive elements other than iodine. If radioactive iodine is not present, then taking KI is not protective.

How to take potassium iodide

Only take potassium iodide if state or local health authorities suggest you do so. During an emergency, health officials will send out an announcement. Your health department will then tell you when it’s OK to take potassium iodide. They’ll also tell you when you can stop the medication.

Excerpt from FDA recommendations:

How much potassium iodide (KI) should I take?

The FDA has approved two different forms of KI—tablets and liquid—that people can take by mouth after a nuclear radiation emergency. Tablets come in two strengths, 130 milligram (mg) and 65 mg. The tablets are scored so they may be cut into smaller pieces for lower doses. Each milliliter (mL) of the oral liquid solution contains 65 mg of KI.  According to the FDA, the following doses are appropriate to take after internal contamination with (or likely internal contamination with) radioactive iodine:

  • Adults should take 130 mg (one 130 mg tablet OR two 65 mg tablets OR two mL of solution). Children who are adult size (greater than or equal to 150 pounds) should take the full adult dose, regardless of their age.
  • Women who are breastfeeding should take the adult dose of 130 mg.
  • Children between 3 and 18 years of age should take 65 mg (one 65 mg tablet OR 1 mL of solution).
  • Infants and children between 1 month and 3 years of age should take 32 mg (½ of a 65 mg tablet OR ½ mL of solution). This dose is for both nursing and non­nursing infants and children.
  • Newborns from birth to 1 month of age should be given 16 mg (¼ of a 65 mg tablet or ¼ mL of solution). This dose is for both nursing and non­nursing newborn infants.
  • NOTE: Newborn infants should only be given potassium iodide under the direction of a healthcare provider. Their underdeveloped thyroid is at risk for developing low thyroid. Thyroid function tests are indicated after iodide has been administered and the radioactive event has passed.

Medical conditions in which taking potassium iodide may be harmful:

Taking KI may be harmful for some people because of the high levels of iodine in this medicine.

You should not take KI if:

  • you know you are allergic to iodine (If you are unsure about this, consult your doctor.
  • A Seafood or shellfish allergy does not necessarily mean that you are allergic to iodine.
  • Certain skin disorders (such as dermatitis herpetiformis or urticaria vasculitis).
  • People with thyroid disease (for example, multinodular goiter, Graves’ disease, or autoimmune thyroiditis)

Food and Drug interactions

There are no known food or drug interactions when taking potassium iodide

Side Effects of potassium iodide

When taken as directed KI has few side effects.

Some of the more common side effects are:

  • Skin rashes
  • Inflammation of the salivary glands
  • GI upset

Prussian Blue (COMMON BRAND NAME(S): Radiogardase

(By prescription only)

Note- Do NOT ingest Prussian blue pigment sold commercially, this practice is dangerous and potentially harmful.

Prussian blue is a pill that may be used in a radiation emergency to help remove radioactive cesium and thallium from the body. Prussian blue traps radioactive cesium and thallium in the intestines and keeps them from being reabsorbed by the body. Prussian blue decreases the half-life of cesium by 33% and from 3.8 to 2.2 days for thallium, The rate of cesium and thallium elimination is proportional to the dose and duration of Prussian blue.

Prussian blue comes in capsule form, and can be taken with or without food, however it is advised to take with food to stimulate secretion of cesium or thallium.

Treatment should be initiated as soon as possible after contamination is suspected. Even when delayed, treatment is effective and should not be withheld.

Dosage:

For oral dosage form (capsules):

For cesium poisoning:

  • Adults and teenagers—3 grams (6 capsules) three times a day.
  • Children 2 to 12 years of age—1 gram (2 capsules) three times a day.
  • Children younger than 2 years of age—Use and dose must be determined by your doctor.

For thallium poisoning:

  • Adults and teenagers—3 grams (6 capsules) three times a day.
  • Children 2 to 12 years of age—1 gram (2 capsules) three times a day.
  • Children younger than 2 years of age—Use and dose must be determined by your doctor.

Notify your care provider before taking if:

  • You are pregnant or nursing.
  • Have any allergic reactions to Prussian blue coloring in foods or medications.
  • Arrhythmia (heart rhythm problem) or
  • Electrolyte imbalance—Use with caution. May make these conditions worse.
  • Blockage of the intestines or constipation
  • Stomach or bowel problems—May increase risk for constipation.
  • Liver disease—May not work properly in patients with this condition

Treatment may last 30 days or longer.

Food and Drug interactions

There are no known food interactions.

The absorption of many drugs decreases when Prussian blue is added. Some of these are:

Side effects that you should report to your doctor or health care professional as soon as possible:

  • Skin rash, itching or hives, swelling of the face, lips, or tongue
  • Fast, irregular heartbeat
  • Muscle pain or weakness, cramps

Mild side effects:

  • blue colored stools
  • constipation
  • upset stomach

EDTA

A prescription medicine, given by injection into the vein (intravenously) or into the muscle (intramuscularly) when used to treat radiation and lead poisoning. It is also found in pill form.

In addition to treating poisonings by radioactive materials such as plutonium, thorium, uranium, and strontium, EDTA is used to treat lead poisoning and brain damage caused by lead poisoning.

EDTA has many other uses, from treating calcium deposits in the eye (eyedrops) to high calcium levels in the blood (hypercalcemia) and treating heart rhythm problems.

Drug and food interactions

Allergy to EDTA has been reported, however no interactions with food

Drugs: There are 21 known drug interactions with EDTA

Side effects

  • EDTA is safe when used as a prescription medicine, as eye drops, and in small amounts as a preservative in foods.
  • EDTA can cause abdominal cramps, nausea, vomiting, diarrhea, headache, low blood pressure, skin problems, and fever.
  • It is UNSAFE to use more than 3 grams of EDTA per day, or to take it longer than 5 to 7 days. Too much can cause kidney damage, dangerously low calcium levels, and death.

Special Precautions and Warnings(From RX List website):

  • Pregnancy and breast-feeding: EDTA seems to be safe when used in food amounts. The safety of larger amounts is unknown.
  • Asthma: Nebulizer solutions containing disodium EDTA as a preservative can cause the breathing tubes to narrow in some people with asthma. The size of the dose determines the amount of the narrowing.
  • Heart rhythm problems: EDTA might make heart rhythm problems worse.
  • Diabetes: EDTA might interfere with blood sugar control because it can interact with insulin.
  • Low calcium levels in the blood (hypocalcemia): EDTA can decrease serum calcium levels, making hypocalcemia worse.
  • Low potassium (hypokalemia): EDTA can bind with potassium and increase the amount of potassium that is flushed out in the urine. This might cause potassium levels to drop too low, especially in people who have low levels to begin with. If you have this problem, don’t use EDTA.
  • Low magnesium levels in the blood (hypomagnesemia): EDTA can bind with magnesium and increase the amount of magnesium that is flushed out in the urine. This might cause magnesium levels to drop too low, especially in people who have low levels to begin with. If you have this problem, don’t use EDTA.
  • Liver problems and hepatitis: EDTA might make liver disease worse. Avoid using EDTA if you have a liver condition.
  • Kidney problems: EDTA can harm the kidney and might make kidney disease worse. EDTA doses should be reduced in patients with kidney disease. Avoid using EDTA if you have severe kidney disease or kidney failure.
  • Seizures (epilepsy): There is some concern that EDTA might increase the risk of seizure in people with epilepsy or in people who tend to have seizures. EDTA can cause severe decreases in blood levels of calcium, and this can cause a seizure.

 

- Brooke Lounsbury, RN

Medical Content Writer

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Hashimotos Thyroiditis Part 2

Tips to manage Hashimoto’s

  • Health risks of not treating Hashimoto’s adequately
  • Lifestyle/stress reduction tips to manage energy and emotional ups and downs
  • How to naturally increase biologically active T3
  • Diet strategies to help heal
  • Nutritional supplements that can aid in recovery and optimal health
  • How to advocate for yourself in the healthcare field when dealing with Hashimoto’s

Health risks of not treating Hashimoto’s adequately

  • May cause impaired carbohydrate metabolism leading to an increase in type 1 and type 2 diabetes- A study that examined hospitalized patients between the years of 2001 and 2010, the Endocrinology and Diabetology Department in Bydgoszcz concluded : “Conclusions: Carbohydrate metabolism disorders in the form of type 1 diabetes connected with an autoimmune process, as well as type 2 diabetes connected with the increase of the insulin resistance, occurred in average of half of the patients with Hashimoto’s thyroiditis.”
  • Cognitive decline/brain fog, inability to focus, – Hashimoto’s thyroiditis is an inflammatory disease (hence the “itis” at the ending of thyroiditis) This extends to brain tissue, where brain inflammation can cause a multitude of problems.
  • Fertility issuesAn unregulated thyroid condition of any kind can lead to lack of or incomplete implantation or early miscarriage. Thyroid disorders in men can affect sperm quality and motility
  • Higher risk of heart disease and high cholesterol

A large study in Demark over a period of 7 years revealed that   individuals with mild hypothyroidism who were not treated had an 83% increased risk of developing heart problems as compared with individuals with normal thyroid function or hypothyroidism that was treated. 

High cholesterol – Low thyroid function negatively affects lipid metabolism, leading to an increase LDL, the “bad cholesterol.”

Lifestyle/stress reduction tips to manage energy and emotional ups and downs

Hashimoto’s disease can have you feeling great one day and totally exhausted the next. Even when optimally managed, excess stress, either emotional or physical can leave one feeling exhausted for days. It is important to maintain good diet, adequate exercise, avoid stress as much as possible and keep a consistent schedule.

  • Remove/reduce sugar from the diet as much as possible, replace with fiber rich fruits. Sugar can place a tremendous burden on the body, flooding cells with insulin to deal with excess glucose in the bloodstream. This can set off a cascade of reactions that challenge thyroid regulation and can affect fat cell receptors and metabolism.
  • Make time for exercise-Make sure you are getting at least 15 minutes of brisk walking in a day. However, don’t overdo any physical activity. This can cause adrenal fatigue, cortisol overload and other stressors that can create a cascading downward spiral resulting in an overload on thyroid function.
  • Plan your days, but don’t over plan. Make time in your schedule to eat a healthy diet, exercise and get good quality sleep. In addition, make relationships and community a priority. Healthy relationships help carry life’s burdens and reduce stress hormones.
  • Get adequate, good quality sleep- The body repairs, heals and detoxifies during sleep. Good quality sleep is vital for Hashimoto patients. Aim for at least 7 hours of shut eye.
  • Keep stress at a minimum. Overactive adrenals, cause by stress can lead to thyroid dysfunction, diabetes, heart disease and more. Nurture and maintain supportive relationships. Avoid news and media if it negatively affects you. Take up a hobby. Hobbies have proven to reduce stress and calm the mind.

How to naturally increase biologically active T3

T3, the biologically active thyroid form can be increased by:

  • Supplementing diet with selenium and zinc rich foods. A rich source of selenium can be found in Brazil nuts- you only need 1-2 a day, Zinc is found in shellfish, nuts, meats, legumes. If supplementing with either selenium or zinc consult your care provider. Selenium toxicity can cause kidney failure and heart attack or heart failure, zinc toxicity symptoms are nausea, dizziness, vomiting and can lead to copper deficiency and a decrease in HDL (good) cholesterol.
  • Adding healthy fats to your diet– flax, avocado, raw unsalted seeds, and nuts. These foods aid in helping cell receptors take up thyroid hormone.
  • Moderate exercise– Walking, jogging, swimming, tennis, biking, hiking in moderation helps overall thyroid function.
  • Liver detoxification– The liver is involved in the conversion of thyroid hormone and regulation. Some foods that can help detoxify the liver are onions, beetroot, apples, turmeric, leafy greens, tea and in moderation, coffee.
  • Add sea vegetables to your diet. Iodine is a key factor in thyroid function; however, iodine supplementation can be tricky. Too much or too little can negatively affect thyroid dysfunction. Sea salt and iodized salt in moderation along with adding kelp and seaweed powder to your meal can help provide iodine needed supplementation.
  • Drink plenty of good quality, fluoride free water- Filter your water, and if fluoridated use a filter that removes fluoride. Fluoride has an electrical affinity stronger than iodine and will bond to the tyrosine molecule (Thyroid hormone is comprised of tyrosine and iodine) This reduces the amount of thyroid hormone in the body.

 

Diet strategies to help heal

It is believed that impaired gastrointestinal tract (gut dysbiosis) and intestinal permeability are the main cause of Hashimotos. To learn more check out Dr Isabella Wentz book on Hashimotos Thyroiditis- the root cause. This book is a wealth of information to educate and empower anyone dealing with Hashimoto’s.

  • As stated above, avoid simple carbohydrates. Breakfast should include a quality high protein item and fruit or vegetable if desired. Some quality high protein foods are cold water fish (salmon, sardines, and tuna for example) grass fed and finished meats, eggs, and poultry.
  • Increase leafy greens and vegetables such as carrots, turnips,celery
  • Drink twice body weight in ounces of quality water.
  • Add healthy fats to your diet. Healthy fats include butter (no margarine) flax, raw, unsalted nuts and seeds, avocados, olive oil and cold-water fish such as salmon.
  • Add a digestive enzyme right before meals if you experience stomach issues.
  • Eat soy in moderation- Soy, if paired with iodine deficiency can inhibit thyroid function. Check ingredient labels on every packaged food item, including salad dressings, protein bars, ice cream etc. for added soy. Most nutritionists advise to limit soy, not cut it out completely.
  • Cruciferous vegetables- cabbage, broccoli, cauliflower, brussel sprouts etc. if eaten in excess can suppress thyroid function. These foods are packed with nutrition. Don’t cut them out completely, just don’t eat in excess.
  • Supplement with probiotics and fermented foods- Gut health-restoring the gut microbiome- is a large part of healing and managing Hashimoto’s
  • Do a trial run of going gluten free- It takes about 3 weeks for the body to adjust to a gluten free diet. Many report relief in digestive symptoms and less body aches after stopping gluten. In a select population, gluten consumption can trigger an immune reaction. This is because gluten contains a protein (gliadin) that resembles transglutaminase, an enzyme of the thyroid. In gluten sensitivity or celiac disease, the immune system mistakenly attacks the thyroid.
  • Some people react to casein which is found in cow milk, yogurt, some cheeses and supplements. Casein is very structurally similar to gluten(gliadin) and some people have a negative reaction to it, just like gluten.

Nutritional supplements that can aid in recovery and optimal health

Important-Check with your healthcare provider before taking supplements- many supplements can interact with medications you are currently taking

  • Selenium works in synergy with vitamin E to form active T3
  • Zinc- helps repair intestinal walls and stabilizes immune system.
  • Vitamin D with K2 (K2 aids calcium absorption to bones instead of going to arteries where calcium can build up, leading to heart attack and stroke.)
  • Vitamin C with bioflavonoids
  • Magnesium citrate
  • Iron in the form of ferritin- if iron deficient
  • Iodine
  • B complex (look for the methylated form of B12)
  • Probiotics
  • Betain with Pepsin- a natural gastric acid- many Hashimoto sufferers have low stomach acid
  • Digestive enzymes- hel break down fats, carbohydrates and protein. Many diagnosed with Hashimotos have problems digesting food.

 

How to advocate for yourself in the healthcare field when dealing with Hashimoto’s

Dealing with thyroid disorders can be a complicated and complex health issue. Many diseases mimic others- Some heart diseases may have undiagnosed thyroid function. This also is common with depression, anxiety, and other mental health disorders. Some medications can affect thyroid function. Diabetics have a higher incidence of thyroid disorders.

Educating yourself and seeking a health professional who understands  thyroid disorders is vital to overall wellbeing.

At the very minimum, request a TSH and free T4 lab if hypothyroid is suspected.

Keep a journal of food, activity, mood and physical symptoms that you have recorded for a week or so before your appointment. Include physical signs of hypothyroid you may be having. This will enable your care provider to provide the best care possible.  

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Keeping you informed and safe.

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Hashimotos Thyroiditis Part 1

Part 1 will cover

  • Hashimoto’s description
  • Prevalence of Hashimoto’s
  • Symptoms of low thyroid (Is it Hashimotos?)
  • Other not as common hypothyroid conditions
  • Lab tests to diagnose Hashimoto’s
  • Medications to treat low thyroid/Hashimotos

Part 2 will cover:

Tips to manage Hashimoto’s along with medications such as

  • Health risks of not treating Hashimoto’s adequately
  • Lifestyle/stress reduction tips to manage energy and emotional ups and downs
  • How to naturally increase biologically active T3
  • Diet strategies to help heal
  • Nutritional supplements that can aid in recovery and optimal health
  • How to advocate for yourself in the healthcare field when dealing with Hashimoto’s

Description

Hashimoto’s thyroiditis is an autoimmune disease that affects the thyroid. An autoimmune disease is a condition in which the body’s immune system mistakes its own healthy tissues as foreign and attacks them. Most autoimmune diseases cause inflammation of the affected tissue. In the case of Hashimoto’s thyroiditis, the thyroid gland is inflamed and attacked by the body’s immune system.

Note: any word with “itis” at the end indicates inflammation. (Arthritis, bursitis, conjunctivitis for example)

Over 90% of hypothyroid cases are Hashimoto’s.

Other causes of low thyroid are:

 (Excerpt from American Thyroid Association)

  • Pituitary gland disorder/damage-The pituitary, the “master gland,” tells the thyroid how much hormone to make. When the pituitary is damaged by a tumor, radiation, or surgery, it may no longer be able to give the thyroid instructions, and the thyroid may stop making enough hormone.
  • Medicines-Medicines such as amiodarone, lithium, interferon alpha, and interleukin-2 can prevent the thyroid gland from being able to make hormone normally. These drugs are most likely to trigger hypothyroidism in patients who have a genetic tendency to autoimmune thyroid disease.
  • Too much or too little iodine. The thyroid gland must have iodine to make thyroid hormone. Iodine comes into the body in food and travels through the blood to the thyroid. Keeping thyroid hormone production in balance requires the right amount of iodine. Taking in too much iodine can cause or worsen hypothyroidism.
  • Surgical removal of part or all of the thyroid gland due to nodules or cancer
  • Radiation treatment-Patients with Hodgkin’s disease, lymphoma, or cancers of the head or neck are treated with radiation. All these patients can lose part or all of their thyroid function.
  • Congenital hypothyroidism (hypothyroidism that a baby is born with). A few babies are born without a thyroid or with only a partly formed one. A few have part or all their thyroid in the wrong place (ectopic thyroid). In some babies, the thyroid cells or their enzymes don’t work right.
  • Rare disorders that infiltrate the thyroid. In a few people, diseases deposit abnormal substances in the thyroid and impair its ability to function. For example, amyloidosis can deposit amyloid protein, sarcoidosis can deposit granulomas, and hemochromatosis can deposit iron.

Prevalence of Hashimoto’s

  • Most common in women– The American Thyroid Association (ATA) estimates that five to eight women are affected with Hashimoto’s for every one man. The ATA also estimates that one in eight women will be affected with Hashimoto’s or another thyroid disorder at some point in their lives.
  • Runs in families (genetic predisposition)
  • Affects about 5 percent of the US population
  • It is suspected that it is underdiagnosed

Symptoms

The onset of Hashimoto’s disease can be difficult to diagnose. As thyroid hormones are released in the bloodstream from  antibodies attacking the thyroid, transitory (temporary)hyperthyroidism (high thyroid) results.

Early symptoms can mimic hyperthyroid. This condition presents as an elevated T3 (the biologically active form of thyroid) and elevated T4, along with suppressed TSH. This condition is called thyrotoxicosis (Hashitoxicosis). This phase can last for 1-2 months, however in rare cases this phase can last for 2 or more years.

 Early-temporary symptoms can include

  • Anxiety
  • Nervousness
  • Diarrhea
  • Sleeplessness
  • Mood swings and muscle weakness.

 As the disease progresses (the autoimmune attack continues) thyroid production decreases, resulting in hypothyroidism (Hashimoto’s thyroiditis).

Symptoms of low thyroid are:

  • Dry skin,
  • Hair loss,
  • Constipation,
  • Depression,
  • Intolerance to cold,
  • Low energy
  • Brain fog,
  • Heavy menstruation,
  • Unexplained weight gain.
  • Muscle aches and cramps

Your care provider will take a thorough physical history (which includes checking for enlarged thyroid gland) and medical history along with a family history and your symptoms.

Lab tests for Hashimoto’s

TSH – The pituitary gland produces this hormone which stimulates the thyroid gland to produce thyroid hormone

Free T4– Free T4 is thyroid hormone not bound to protein, it is freely flowing in bloodstream.

Thyroid peroxidase antibodies (TPOAb) – Thyroid peroxidase (TPO) antibodies are a type of thyroid antibody. Thyroid peroxidase is an enzyme which helps to make thyroid hormones (T3, T4 and TSH). The body’s immune system makes antibodies in response to non-self proteins. These non-self proteins are called antigens.

Thyroglobulin antibodies (TGAb) Thyroglobulin antibodies (Tg Ab) are another type of thyroid antibody. Thyroglobulin is a protein made by thyroid cells. It helps to make thyroid hormones. Thyroglobulin antibodies (Tg Ab) are made when the body attacks it’s own thyroglobulin. Thyroglobulin antibodies can be raised in Hashimoto’s thyroiditis  They are also raised in 10-15% of the general population.

You may be diagnosed with Hashimoto’s disease if your TSH is high, your free T4 is low, and your TPO Ab is elevated. High TPO Ab is the key marker because it is present in over 90% of those with Hashimoto’s. TG Ab is present in about 60-80% of cases.

Total T3- as symptoms dictate

  • Low T3 levels may mean you have hypothyroidism,
  • T3 test results are often compared with T4 and TSH test results to help diagnose thyroid disease.

Reverse T3-as symptoms dictate

Reverse T3 is created by the body from T4. Your body can convert T4 into the ACTIVE thyroid hormone T3 or the inactive thyroid called reverse T3.  Reverse T3 slows metabolism to conserve energy during times of extreme stress and inflammation.

Treatment

Hashimoto’s requires a multi prong approach. Along with medication, and lifestyle/stress management, diet and supplements can go a long way to achieve optimum health.  Diet, lifestyle and supplements will be covered in part 2.

Medications

Note: A word about generic and label medications- Though the names are different, generic and brand-name drugs work the same. According to the FDA, generic drugs are just as effective as their branded counterparts. Drug makers must prove that generic medications can be substituted for brand-name drugs and offer the same benefits as their brand-name counterparts

Levothyroxine – also known as Synthroid Euthyrox, Unithroid,  Tirosint. and Levoxyl– These medications use only T4 hormone as primary ingredient.

One advantage to generic levothyroxine, unlike Synthroid is it does not contain corn. This is invaluable for anyone with an allergy or sensitivity to corn.

Armour thyroid- Desiccated thyroid- made from bovine thyroid hormone- contains both T4 and T3

  Cytomel – (generic name is liothyronine) – A manmade T3 hormone

There are many other brands of thyroid medications, however the above represents the majority of medications.

- Brooke Lounsbury, RN

Medical Content Writer

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