The Healthy Thyroid: What you can do to prevent and alleviate thyroid imbalance. Patsy Westcott

the available treatments, including medications, surgery and radiotherapy, and explains how they work, including their pros and cons. It also covers the debate over newer – and the revival of older – forms of treatment, and how you can work with your doctor to find the treatment that is right for you.

      Chapter 6 covers the different ways you can help yourself, such as by paying attention to what you eat, making sure you get the right amount of exercise and managing stress, as well as how to come to terms psychologically with having thyroid disease.

      Chapter 7 looks at how complementary therapies can help you manage your thyroid problems. These therapies are much more widely accepted now than when the first edition of this book was written, and many doctors and healthcare practitioners now acknowledge the part these therapies can play alongside conventional medical treatment.

      Chapter 8 is devoted to thyroid eye disease, a particularly devastating condition about which too little is known, even now, and includes the still controversial issue of how it should be treated.

      Chapter 9 describes how thyroid problems can affect you at different points in the female reproductive cycle, and includes important new information on how thyroid problems can affect menstruation, fertility, pregnancy and life after childbirth.

      Chapter 10 looks at the problems that may be caused by thyroid disease at around the menopause and as we get older.

      Chapter 11 investigates some of the major issues in thyroid disease and the advances made in our current understanding of the disorder, as well as takes a peek into the future at possible new treatments.

      Finally, there is a glossary of terms relevant to thyroid disorders, and a list of books, websites and organizations that may prove helpful.

      The more you know about the way your body works, the better able you will be to help yourself if something goes wrong. The objective of this book is to provide the information you need to help yourself, to work with your doctor to get the best treatment for your problems, and to feel more in control of your body and your life – something that women with thyroid problems often feel they have lost.

      This book does not intend to tell you what to do or replace medical advice. There is a great deal of controversy surrounding thyroid problems – how they come about and how they should be dealt with. The main areas of debate have been outlined in this volume to give you an idea of what different experts think so that you can make up your own mind about how to live with your thyroid problems.

       CHAPTER TWO Understanding Thyroid Problems

      To better understand what can go wrong with your thyroid, it is necessary to know something about how the gland works. This chapter attempts to reveal why we have a thyroid gland, and looks at the way the thyroid interacts with other systems of the body, including the immune system.

      

      The thyroid is one of 10 glands that make up the endocrine (hormonal) system. From the moment we are conceived until the time of our death, our bodies are under the influence of a cocktail of hormones produced by this system. As this system is so finely tuned, when anything happens to disturb its delicate balance, the repercussions ricochet throughout the rest of the body.

      The hormones produced by glands are chemical messengers that are carried around the bloodstream to act on cells and tissues that are often far from their site of origin. Their job is to ensure that we have the correct concentrations of metabolites – vital nutrients (such as sugars and fats), vitamins and minerals (such as calcium, sodium, potassium and iodine), enzymes and other factors essential to life – in the bloodstream.

      Each gland has a specific function, but also works with the other glands to keep our body in a state of chemical balance (homoeostasis). One recent, exciting discovery is that not only do hormones interact with each other, but they also exchange messages with other chemicals produced by the brain and nervous system. Research is beginning to uncover more and more links between these major interacting systems, and to throw more light on the way hormones and chemicals produced by the nervous and immune systems work together. This, in turn, is helping to clarify the connection between mind and body as reflected by a diverse number of conditions, including thyroid disease.

      Key Sites

      The glands themselves are situated at key locations throughout the body (see Figure 2.1). Together they produce over 50 different hormones – so-called ‘mighty molecules’ – that have widespread effects on us from cradle to grave. As hormones cannot be stored in large quantities in the glands, the brain programmes their manufacture by means of a complex biochemical cycle that uses a series of checks and balances to ensure that hormone levels are maintained according to your body’s needs.

      In addition to the endocrine glands themselves, other organs contain pockets of glandular tissue that produce hormones. One of these is the hypothalamus, a region of the brain that is both part of the nervous system and a gland.

      Not surprisingly, with such a complicated system, things can go wrong. Broadly speaking, when a gland ceases to function as it should, it results in two categories of problems: the gland becomes underactive and produces too few hormones; or it becomes overactive and produces too many.

      Balancing the Body

      The whole endocrine system is controlled by a series of ‘feedback loops’, which slow or stop a gland from working when enough hormone has been produced, and turn it back on again when more is needed – like a central-heating thermostat (see Figure 2.2). If the blood levels of any of the essential chemicals are low, special sensory cells are able to pick up a signal that

       Fig 2.1 The endocrine system

       Figure 2.2 The pituitary gland and the hypothalamus in the brain work together to produce a hormone that stimulates the thyroid. The thyroid gland draws iodine from the blood in order to make T3 and T4. Sensors in the TSH-secreting cells of the pituitary detect rising levels of thyroid hormones and quell further secretion. When levels fall, the pituitary releases more TSH, which stimulates the thyroid to start making more hormones.

      prompts them to release hormone. This hormone, in turn, acts on other cells to release more of the needed chemical into the bloodstream. When enough chemical has been produced, the sensory cells switch the system off, which stops further hormone release. In this way, the body’s chemical balance is constantly maintained.

      The system is exquisitely sensitive: food, exercise, stress, illness, changes in body chemistry such as a shortage or excess of certain nutrients, pregnancy, ageing, even the time of day or year, can affect the balancing mechanism and, with it, the amount of hormones our glands secrete.

      Most hormones act only on specific tissues and not all the cells in the body. They do this by latching on to structures called ‘receptors’, which lie studded about the surface of or within cells, rather like a key fits into a lock. This enables hormones to be transported around the bloodstream to specific locations. Receptors are also important because, as we shall see, if the wrong chemical – such as an autoimmune antibody – attaches itself to a receptor, like a thief using a master key to get into your house, it can cause havoc and destruction.

      The Thyroid Gland

      The thyroid is a small, soft, butterfly-shaped gland that weighs just 15–20 g (¹/₂–³/₄ oz) and is about the size of a plum, yet it is also the largest pure endocrine gland in the body. It lies across the front of the windpipe (trachea) just below the larynx, or voice box (see Figure 2.3). Its two lobes, or