Living with Thyroid Disfunction
Ali Hussain* knew something did not seem right with his health. He was only 25, yet his body was quickly going through some very unusual changes. He had suddenly dropped over 30 pounds in a matter of months. Hussain noticed his hands would tremble, and he was constantly shaky and nervous.
He would sweat profusely and feel his heart beat uncontrollably as if he had just run a marathon, even during minimal activity such as sitting or lying down. All these red flags led him to consult his primary physician who ran some blood work and determined the cause. Hussain was informed that his thyroid gland was overactive and releasing too many thyroid hormones. His body was suffering from an autoimmune process called Graves’ disease and had been thrown off its natural rhythm. He needed to go see a specialist, immediately.
Hussain had never even heard of this small H-shaped endocrine organ in his throat. Consisting of two side lobes connected by a bridge in the middle called isthmus, the thyroid gland is no more than four or five centimeters in length, sits low on the front of the windpipe below one’s Adam’s apple, and secretes several hormones that influence the function of many of the body’s most important organs such as the heart, brain, liver, kidneys, muscles, and skin. It also is supposed to help regulate one’s body temperature and energy levels, which had gone haywire for Hussain. Also known as hyperthyroidism, it usually begins slowly but in some young patients like Hussain, these changes can be very abrupt.
His doctor referred him to an endocrinologist, someone who specializes in the endocrine system and the body’s hormones. After running more detailed blood tests, the endocrinologist confirmed Hussain had hyperthyroidism and offered him only one solution: to destroy his thyroid cells completely.
“I was not given any other option back then due to the severity of my condition,” the now 43-year-old Hussain shares. “I couldn’t go on living with those symptoms and made the only choice I had, which was to go ahead with the recommended treatment. I was given a one-time radioactive iodine pill that killed off the function of my thyroid gland for good,” he says.
Iodine is a necessary mineral for proper function of the thyroid gland, which then produces thyroid hormones with it. The thyroid is rich with blood vessels and uses a pump-like mechanism to move iodine into its cells, where it is concentrated as iodide. The thyroid gland is the only tissue in the body that takes up and holds onto iodine.
As in Hussain’s case, the radioactive iodine (RAI) used for treatment is administered orally, usually in a small capsule that is taken one time only. Once swallowed, the radioactive iodine gets into the blood stream and is quickly taken up by the overactive thyroid cells. According to the American Thyroid Association (ATA), the radioactive iodine that is not taken up by the thyroid cells disappears from the body within days. It may take anywhere from a few weeks to a few months for RAI to destroy the cells that have absorbed it. The result is that the thyroid shrinks in size, and the level of thyroid hormone in the blood goes down.
Although the treatments with RAI are generally safe and effective, it does produce radiation. Patients must do their best to avoid radiation exposure to others, particularly to pregnant women and young children. ATA reports that radioactive iodine has been used to treat hyperthyroidism in patients for over 60 years, and in the United States more than 70 percent of adults who develop hyperthyroidism are treated with radioactive iodine. Without the body’s ability to make thyroid hormones anymore, a common side effect of RAI treatment is hypothyroidism or an underactive thyroid, which lasts lifelong and cannot be cured.
“For the last 18 years, I have lived with an extremely slow metabolism and had to deal with weight gain,” shares Hussain, a father of two. “I need to exercise longer and harder to increase my heart rate compared to the average healthy person.”
Aside from the weight gain and feeling cold a majority of the time, Hussain has not had to deal with many other symptoms. However, for 34-year-old Reem Ahmad,* dealing with hypothyroidism has been a different experience. At age 21, she also was diagnosed with hyperthyroidism and underwent RAI therapy to deactivate her thyroid cells. She then developed hypothyroidism but has suffered more side effects than Hussain, such as fatigue, emotional imbalance, digestive problems, dry skin, and severe leg cramps.
“Looking back, I would have liked to have done more research and maybe have gotten another opinion,” she says. “I was given the option to take medicine for a year to try and possibly bring levels to normal, but I decided to go with radioactive iodine treatment instead,” Ahmad recalls.
Feeling lethargic and dealing with mood swings has not been easy for Ahmad. She does her best to keep her stress levels to a minimum as her health is easily affected by excessive stress. Patients with hypothyroidism are required to take a thyroid hormone supplement once a day to normalize hormone levels.
Nebal Alazawi, a dietician from southern Indiana currently pursuing her master’s in health administration, has worked with clients who suffer from hypothyroidism. She has seen them deal with depression and moodiness, especially the women.
“Exercise is a must to help regulate the hormones,” the mother-of-three advises. “Although it will not change the dosage of medicine required for hypothyroidism, it can help reduce stress and increase a patient’s energy levels,” says Alazawi.
As a board-certified endocrinologist, her husband, Dr. Hisham Allababidi, sees patients with thyroid function disorder on a daily basis. He completed his fellowship in endocrinology from Wayne State University in Detroit in 2002 and sees, on average, one-fourth of his daily patients with some type of thyroid disease.
“Hypothyroidism is more common than hyperthyroidism,” notes Dr. Allababidi. “I also happen to see more female than male patients with thyroid dysfunction,” he adds.
Before starting any treatment, Dr. Allababidi first determines what may be the cause of the thyroid not functioning properly. Some causes may include an autoimmune disease (Hashimoto disease for some hypothyroidism cases), inflammation of the thyroid (thyroiditis), taking certain cancer medications, too much or too little iodine in the body, being born with congenital thyroid disease, hereditary genes, radiation treatment, and surgery on the thyroid gland or damage to the pituitary gland.
“We also have to look at the severity of the thyroid dysfunction, the patient’s age and weight, and any other medical conditions he/she may have,” Dr. Allababidi continues. “If you have a family history of thyroid disease, it is important to get regular screenings done. Also those patients with diabetes should also get their thyroid hormone levels checked often,” he suggests.
Dr. Allababidi states that there is nothing specific that links thyroid disease and certain foods and herbs intake. However, Sajida Mohiuddin,* who was diagnosed with hypothyroidism at age 24, disagrees.
“I have noticed that when I am on a low-carbohydrates and high-protein diet, my energy levels are higher and my symptoms seem to be much less,” says the grade-school teacher and mother of two. “Since being diagnosed, I have been doing my own research for the last ten years to discover how my diet may affect my thyroid function,” Mohiuddin says.
She tries to avoid high-fiber foods, like beans and cabbage, and caffeine during the day. Mohiuddin steers clear of starting her morning off with fruits for breakfast. She feels sugar does not mix well with her thyroid function. Hypothyroidism has also caused her to gain weight, so she makes sure to exercise regularly. She even feels that her thyroid dysfunction may have had something to do with her fertility issues.
“It was actually my fertility specialist that found my thyroid hormone levels to be off,” says Mohiuddin. “I was having trouble conceiving as well as losing a lot of hair and had put on 30 pounds in one year. Something was definitely not right.”
Mohiuddin has learned to adjust her lifestyle according to her health. She stays on top of her medication and regulates her diet well. She even incorporates homeopathic medicine to help her thyroid function.
“Hypothyroidism is not necessarily dangerous,” says Mohiuddin. “For me, it was a blessing to discover it, as it has taught me to eat better and be more aware of my sensitivities to certain foods. It has also helped regulate my appetite and make me appreciate good health.”
If a person suspects having thyroid dysfunction or has a strong family history of it, Mohiuddin recommends not ignoring any abnormal symptoms and consulting one’s doctor right away.
“You know your body best. When you need medical attention, accept it and get the proper care from a professional,” she advises. “This body is a gift from God, and we must do our best to take care of it.”
Tayyaba Syed has written for numerous publications and been featured on NPR and Radio Islam. She teaches and volunteers with the youth in various communities. Tayyaba lives in Illinois with her husband and two kids.
* Names have been changed at the request of the interviewees to maintain privacy.