Common Chronic Diseases (NCD’s)

CHRONIC DISEASES

Dr. Anaswara dev No Comments

I. Lifestyle Disorders

  1. Metabolic Disorders – Type 2 Diabetes, Obesity
  2. Brain – Atheroscleroma, Stroke, Alzheimer’s, Dementia
  3. Heart – Coronary Heart Disease, Hypercholesterolemia, Hypertension
  4. Lung- COPD, Asthma
  5. Digestive system – Peptic ulcer, GERD, IBS
  6. Kidney – Kidney failure
  7. Uterus – PCOD
  8. Bone – Osteo Arthritis, Osteoporosis
  9. Cancer
  10. Psychiatry – Depression – Suicide

II. Autoimmune Disorders

  1. Thyroid – Grave Disease, Hashimoto’s Thyroiditis
  2. Pancreas – Type 1 Diabetes
  3. Digestive disorder – Celiac disease
  4. Adrenal gland – Addison’s Disease
  5. Bone- Rheumatoid Arthritis, Rheumatic Fever
  6. Glands – Dryness – Sjogren’s syndrome
  7. Muscles and nerves – Myasthenia gravis
  8. Nerve – Multiple Sclerosis
  9. Skin – Psoriasis, Systemic Lupus Erythematosis
  10. Blood – Pernicious anaemia

III. Common chronic diseases

  1. Hair Fall
  2. Infertility
  3. Kidney Stone
  4. Polyp
  5. Peptic Ulcer
  6. Pimples/Acne
  7. Shoulder Pain
  8. Thyroid Disease

I. Lifestyle Disorder

  1. Metabolic Disorder – 1a. Type 2 Diabetes, 1b. Obesity

Metabolism – The process of making energy from food from the food we eat.

Metabolic Disorder – When metabolism gets disturbed by chemical reactions in the body gets disrupts.

Metabolic Syndrome – It is a cluster of conditions that exist together. It increases the risk of Heart disease, stroke, and Type 2 Diabetes.

This condition includes

  1. High blood pressure
  2. High Blood sugar
  3. Excess body fat around the waist
  4. Abnormal cholestrol or triglyceride level.

1a. Diabetes

If you have diabetes, it means you have too much glucose in your blood

Chronic diabetes conditions include type 1 diabetes and type 2 diabetes.
Potentially reversible diabetes conditions include
1. Prediabetes
when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes. This can be treated with our diet chart alone.
2. Gestational diabetes
Which occurs during pregnancy but may resolve after the baby is delivered. If persist after delivery then you require our treatment.

3. Type 2 Diabetes

With Type 2 Diabetes, the body continues to produce insulin, although insulin production by the body may significantly decrease over time. The pancreas produces either not enough insulin, or the body is unable to recognize the insulin and use it properly. When there isn’t enough insulin or the insulin is not used as it should be, glucose can’t get into the body’s cells to be used as energy. This glucose then builds up in the blood. Your kidneys are forced to work overtime to filter and absorb the excess sugar. If your kidneys can’t keep up, the excess will start excreting into your urine along with fluids drawn from your tissues. This triggers more frequent urination, which may leave you dehydrated. As you drink more fluids to quench your thirst, you’ll urinate even more.3.

We can give treatment depends on the stage of the disease.
Early symptoms of diabetes, especially type 2 diabetes, can be subtle or seemingly harmless — if you have symptoms at all. Over time, however, you may develop diabetes complications, even if you haven’t had diabetes symptoms.
Symptoms
•Excessive thirst and increased urination
•Fatigue
•Weight loss
•For women, bladder, and vaginal infections are especially common.

In the Advanced Stage
•Blurred vision

High levels of blood sugar pull fluid from your tissues, including the lenses of your eyes. This affects your ability to focus.
Left untreated, diabetes can cause new blood vessels to form in your retina — the back part of your eye — and damage established vessels. For most people, these early changes do not cause vision problems. However, if these changes progress undetected, they can lead to vision loss and blindness.
•Slow-healing sores or frequent infections
•Tingling hands and feet
Excess sugar in your blood can lead to nerve damage. You may notice tingling and loss of sensation in your hands and feet, as well as a burning pain in your arms, hands, legs and feet.
•Red, swollen, tender gums
Diabetes may weaken your ability to fight germs, which increases the risk of infection in your gums and in the bones that hold your teeth in place. your teeth may become loose, or you may develop sores or pockets of pus in your gums — especially if you have a gum infection before diabetes develops.
Take your body’s hints seriously
If you notice any possible diabetes signs or symptoms, contact your doctor. The earlier the condition is diagnosed, the sooner treatment can begin. Diabetes is a serious condition. But with your active participation and the support of our health care team, you can manage diabetes while enjoying an active, healthy life.

1b. Obesity

It is a condition in which there is excessive accumulation of fat. there is an increase in body weight of 10-20% above the normal. When excessive calories are taken in any form then they are stored as Fat.

Body Mass Index – BMI – weight in Kg/ height in metre square.

In young adults – the value of BMI – 19 -25

In middle-aged and elderly – 21 – 27

BMI of 25 – 30 is overweight

Above 30 -35 – Mild obesity

Above 40 – sever obesity

Two types

  1. Trunkal obesity – fat deposition in the abdomen
  2. Fat deposition seen in buttocks and limbs

Other classification

  1. Primary – no underlying cause
  2. Secondary – due to other diseases

Aetiology

  1. Age and food intake
  2. Socio-economic
  3. Excessive consumption of food
  4. Anxiety and depression
  5. Endocrine disease
  6. Genetic
  7. Lack of physical activity
  8. Disorders like Cushing syndrome and hypothyroidism
  9. Alcohol intake

Pathology

Obesity develops due to imbalance in energy intake and energy expenditure. An obese person has both fat and non-fat masses. If obesity develops from childhood there is increased fat cell and adipose tissue. Fat is deposited as subcutaneous tissue, buttock, abdomen, thigh, shoulders etc.

Obesity leads to impairment of CHO intolerance, increased serum cholesterol level, increase in BP, atherosclerosis. It is associated with increased energy expenditure, lower respiratory quotient and insulin resistant. Obese subjects spend more energy than normal subjects so they restrict physical activity and in turn, lead to accumulation of fat.

Clinical features

Middle-aged persons are usually affected. More in females. The male-female ratio is 1:5. Multi parity is associated with obesity. Main symptoms are Sluggishness, exertional dyspnoea, angina, arthralgia of knee and hip.

Complication

Ill effects – Varicose vein, Falls, Accidents, OA, Skin – recurrent bacterial infection, Menstrual irregularities

CVS- Hypertension, angina, stroke

Respiratory – Respiratory failure

Abdomen- Hernia, gall bladder stone

Metabolic complication – DM,

Psychological – depression

CA of colon, breast, prostate and uterus are common.

2. Brain – 2a. Atherosclerosis, 2b. Stroke, 2c. Alzheimer’s, 2d. Dementia

3. Heart – 3a. Coronary Heart Disease, 3b. Hypercholesterolemia, 3c. Hypertension

4. Lung- 4a. COPD, 4b. Asthma

3c. Systemic hypertension (High BP)

High blood pressure occurs due to excessive force exerted against the arterial wall as the heart pumps blood.

Systolic Blood pressure – Pressure of blood in arteries when the heart pumps.

Diastolic Blood pressure – Pressure of blood in arteries when the heart is filling,

It is defined as an elevation of BP values above generally accepted normal., i.e. chronic increase of systolic BP above 140mm of hg.  Or diastolic BP above 90mm of Hg.

Elevation of systolic bp without diastolic bp increase is called Systolic hypertension.

When both values increase cardiovascular morbidity and mortality also increase. An individual above 50 pulse pressure is a better predictor of complication. (Systolic Bp minus Diastolic BP)

  1. Exact normal – 120/80
  2. At age of 20 years – 140/90
  3. At age of 50 years – 160/95
  4. At age of 75 years – 170/105

Stages of hypertension

Stage SBP DBP
Stage 1-

 

140-159 90- 99
Stage II 160 – 179 100 – 109
Stage III 180 – 209 110- 119
Stage IV Above 210 Above 120

 

Classification

  1. Essential HT
  2. Secondary HT

Essential HT – the evident organic cause is not present

Factors are

  • Neurological factors
  • Salt sensitivity and intake
  • Renal hormones
  • Age
  • Sex – Males
  • Genetic factors
  • Physical inactivity
  • Obesity
  • Sleep apnoea
  • Hypercholesterolemia
  • Alcohol consumption
  • Smoking
  • DM
  • Psychological stress
  • Foetal factors

4. Digestive system – 4a. Peptic ulcer, 4b. GERD, 4c.IBS

5. Kidney – Kidney failure

6. Uterus – PCOD

7. Bone – 7a. Osteo Arthritis, 7b. Osteoporosis

8. Osteoarthritis (OA)

It is the most common type of arthritis. It is also known as:

  • degenerative joint disease
  • degenerative arthritis
  • wear-and-tear arthritis OA is a disease of ageing.

Other risk factors for OA include:

  • obesity
  • a job that puts stress on the joints
  • joint injury
  • joint malformation

Causes and Symptoms of Osteoarthritis

OA is caused by a breakdown in the cartilage that covers the joints. The protective tissue is damaged by age and repeated motion. This increases the friction as the bones of the joint rub against each other. It can also cause damage to the bone.

The most common symptoms of OA are pain and stiffness. OA can occur in any joint. However, the most commonly affected joints are in the:

  • hands
  • knees
  • hips
  • spine

Over time, OA can cause:

  • pain
  • swelling
  • stiffness
  • limited range of motion

OA is different than Rheumatoid arthritis (RA). RA is an autoimmune disorder. The body’s immune system attacks joint tissue. This leads to swelling and pain.

9. Cancer

10. Psychiatry – Depression – Suicide

II. Autoimmune Disorders

2.Pancreas – Type 1 Diabetes
Type 1 Diabetes occurs in people under the age of 20 but may occur at any age.
Here the insulin-producing cells of the pancreas (called beta cells) are destroyed by the immune system. They produce no insulin and must use insulin injections to control their blood sugar. Here you have to be on insulin and we can give you symptomatic treatment.

5a.Rheumatoid Arthritis

It’s a chronic inflammatory disorder that typically affects the small joints in your hands and feet. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body’s tissues. In addition to causing joint problems, rheumatoid arthritis sometimes can affect other organs of the body — such as the skin, eyes, lungs, and blood vessels.

It can occur at any age, but usually begins after age 40 & Common in women.

Signs and symptoms of rheumatoid arthritis may include:

  • Tender, warm, swollen joints ( smaller joints first)
  • Morning stiffness that may last for hours
  • Firm bumps of tissue under the skin on your arms (rheumatoid nodules)
  • Fatigue, fever and weight loss

Over time, rheumatoid arthritis can cause joints to deform and shift out of place.

5b. Rheumatic Fever

Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever. Strep throat and scarlet fever are caused by an infection with group A streptococcus bacteria.

Rheumatic fever is most common in 5- to 15-year-old children, though it can develop in younger children and adults.

Rheumatic fever can cause permanent damage to the heart, including damaged heart valves and heart failure. Treatments can reduce tissue damage from inflammation, lessen pain and other symptoms, and prevent the recurrence of rheumatic fever.

The symptoms may also change during the course of the disease. Rheumatic fever signs and symptoms — which result from inflammation in the heart, joints, skin or central nervous system — may include:

  • Fever
  • Painful and tender joints — most often the ankles, knees, elbows or wrists; less often the shoulders, hips, hands, and feet
  • Pain in one joint that migrates to another joint
  • Red, hot or swollen joints
  • Small, painless nodules beneath the skin
  • Chest pain
  • Heart murmur
  • Fatigue
  • Flat or slightly raised, painless rash with a ragged edge (erythema marginatum)
  • Jerky, uncontrollable body movements (Sydenham chorea or St. Vitus’ dance) — most often in the hands, feet, and face
  • Outbursts of unusual behaviour, such as crying or inappropriate laughing, that accompanies Sydenham chorea

Call your doctor about fever in the following situations:

  • Newborns up to 3 months old with a fever of 100.4 F (38 C) taken rectally
  • Children ages 3 to 6 months with a temperature of 102 F (38.9 C) or higher
  • Children ages 6 months to 2 years with a fever of 102 F (38.9 C) or higher that doesn’t respond to medication or lasts more than one day
  • Children ages 2 to 17 years with a fever of 102 F (38.9 C) or higher (taken rectally for children younger than 3 and orally for children older than 3) that doesn’t respond to medication or lasts more than three days

III. Other Common chronic diseases

Hair Fall

50 to 100 hair loss per day is normal but new hair grows at the same time. Hair loss occurs when this cycle of hair growth and shedding is disrupted or when the hair follicle is destroyed and replaced with scar tissue.

Common  Causes

  • Family history (heredity)
  • Stress
  • Hormonal changes like Thyroid Disorders
  • Medical conditions like Cancer, Skin disorders like Lichen planus, Lupus, Sarcoidosis, etc
  • Medications –  used for cancer, arthritis, depression, heart problems, high blood pressure and birth control. Intake of too much vitamin A may also cause hair loss.
  • Certain Hairstyling and Treatments
  • Unhygienic  measures in scalp care

Types:

Gradual thinning on top of head.

Circular or patchy bald spots(Alopecia Areata)

It occurs when the body’s immune system attacks hair follicles. usually affects just the scalp, but it sometimes also occurs in beards or eyebrows. In some cases, your skin may become itchy or painful before the hair falls out.

Sudden loosening of hair. A physical or emotional shock can cause hair to loosen. Handfuls of hair may come out.

Full-body hair loss. Some conditions and medical treatments, such as chemotherapy for cancer, can result in the loss of hair all over your body. The hair usually grows back.

Patches of scaling that spread over the scalp. This is a sign of ringworm. It may be accompanied by broken hair, redness, swelling and, at times, oozing.

Hair-pulling disorder. This condition also called trichotillomania. Affects people who have an irresistible urge to pull out their hair,

kidney stones

Kidney stones (renal lithiasis, nephrolithiasis) are small, hard mineral deposits that form inside your kidneys. The stones are made of mineral and acid salts.
Location
Kidney stones can affect any part of your urinary tract — from your kidneys to your bladder.
Cause
No definite, single cause, although several factors may increase your risk.
• Kidney stones form when your urine contains more crystal-forming substances ( calcium, oxalate and uric acid) than the fluid in your urine can dilute.
• At the same time, your urine may lack substances that prevent crystals from sticking together,
• Stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.
Types of kidney stones
Knowing the type of kidney stone helps determine the cause and may give clues on how to reduce your risk of getting more kidney stones. Types of kidney stones include:
• Calcium stones. Most kidney stones are calcium stones, usually in the form of calcium oxalate. Oxalate is a naturally occurring substance found in food. Some fruits and vegetables, as well as nuts and chocolate, have high oxalate levels. Your liver also produces oxalate. Dietary factors, high doses of vitamin D, intestinal bypass surgery and several metabolic disorders can increase the concentration of calcium or oxalate in urine. Calcium stones may also occur in the form of calcium phosphate.
• Struvite stones. Struvite stones form in response to an infection, such as a urinary tract infection. These stones can grow quickly and become quite large, sometimes with few symptoms or little warning.
• Uric acid stones. Uric acid stones can form in people who don’t drink enough fluids or who lose too much fluid, those who eat a high-protein diet, and those who have gout. Certain genetic factors also may increase your risk of uric acid stones.
• Cystine stones. These stones form in people with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria).
• Other stones. Other, rarer types of kidney stones also can occur.
Symptoms
A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter — the tube connecting the kidney and bladder. At that point, you may experience these signs and symptoms:
• Severe pain in the side and back, below the ribs
• Pain that spreads to the lower abdomen and groin
• Pain that comes in waves and fluctuates in intensity
• Pain on urination
• Pink, red or brown urine
• Cloudy or foul-smelling urine
• Nausea and vomiting
• Persistent need to urinate
• Urinating more often than usual
• Fever and chills if an infection is present
• Urinating small amounts of urine
Passing kidney stones can be quite painful, but the stones usually cause no permanent damage.
Increasing in intensity of pain — shifting to a different location as the stone moves through your urinary tract.
When to see a doctor
Make an appointment with your doctor if you have any signs and symptoms that worry you.
Seek immediate medical attention if you experience:
• Pain so severe that you can’t sit still or find a comfortable position
• Pain accompanied by nausea and vomiting
• Pain accompanied by fever and chills
• Blood in your urine
• Difficulty passing urine

Homeopathic preventive treatment t- to reduce your risk of recurrent kidney stones if you’re at increased risk of developing them again.

 Polyp

 Pimples/ Acne

Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. Acne usually appears on your face, neck, chest, back and shoulders.

Acne signs and symptoms vary depending on the severity of your condition:

  • Whiteheads (closed plugged pores)
  • Blackheads (open plugged pores — the oil turns brown when it is exposed to air)
  • Small red, tender bumps (papules)
  • Pimples (pustules), which are papules with pus at their tips
  • Large, solid, painful lumps beneath the surface of the skin (nodules)
  • Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)

 

 Shoulder Pain

Common is Rotator cuff (a group of 4 muscles that stabilize the shoulder) injuries– range from mild to severe.

3 Types

  1. Tendinitis is an injury caused by overuse of the rotator cuff. This causes it to become inflamed. Tennis players who serve overhead and painters who reach upward to paint may commonly experience this injury. This is why the condition may also be referred to as swimmer’s shoulder, pitcher’s shoulder, or tennis shoulder.
  2. Bursitis is another common rotator cuff injury. It is caused by inflammation of the bursa, which is fluid-filled sacs in the rotator cuff that aid in motion. This typically occurs after an injury or degenerative damage to the rotator cuff.
  3. Rotator cuff strains or tears are caused by overuse or acute injury. The tendons that connect muscles to bones can overstretch (strain) or tear, partially or completely. The same can be true for rotator cuff muscles. For example, a baseball pitcher who frequently uses the rotator cuff to throw would experience this type of injury. Untreated tendonitis commonly causes these injuries

The rotator cuff can also strain or tear after a fall, a car accident, or another sudden injury. These injuries typically cause intense and immediate pain.

Risk Group

  1. Acute injuries are the result of previous injuries. These can be caused by lifting objects that are too heavy, falling, or breaking the collarbone. Young people are more likely to experience this type of rotator cuff injury
  2. Degenerative injuries are due to long-term overuse. People most at risk for these injuries include:
  • athletes, particularly tennis players, baseball players, rowers, and wrestlers
  • people with jobs that require repetitive lifting, such as painters and carpenters
  • people above 40 years of age.

Symptoms

Not all rotator cuff injuries cause pain. Because some are the result of degenerative conditions, the rotator cuff could be damaged for months or years before symptoms start to appear.

Common rotator cuff injury symptoms include:

  • avoiding certain activities because they cause pain
  • difficulty achieving full range of shoulder motion
  • difficulty sleeping on the affected shoulder
  • pain or tenderness when reaching overhead
  • pain in the shoulder, especially at night
  • progressive weakness of the shoulder
  • trouble reaching behind the back
  • Pain is different for each person.
  • A shoulder injury that lasts longer than six months indicates a very large tear or significant loss of function and strength in the arm.

Thyroid Diseases

Your thyroid is a small, butterfly-shaped gland situated at the base of the front of your neck, just below your Adam’s apple. Hormones produced by the thyroid gland — triiodothyronine (T3) and thyroxine (T4) — have an enormous impact on your health, affecting all aspects of your metabolism. They maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate, and help regulate the production of proteins.Your thyroid also produces calcitonin, a hormone that helps regulate the amount of calcium in your blood.

The rate at which T-4 and T-3 are released is controlled by your pituitary gland and your hypothalamus — an area at the base of your brain that acts as a thermostat for your whole system. Here’s how the process works:

The hypothalamus signals your pituitary gland to make a hormone called thyroid-stimulating hormone (TSH). Your pituitary gland then releases TSH — the amount depends on how much T-4 and T-3 are in your blood. If you don’t have enough T-4 and T-3 in your blood, your TSH will rise; if you have too much, your TSH level will fall. Finally, your thyroid gland regulates its production of hormones based on the amount of TSH it receives. If the thyroid gland is diseased and is releasing too much thyroid hormone on its own, the TSH blood level will remain below normal; if the diseased thyroid gland cannot make enough thyroid hormone, the TSH blood level will remain high.

1. Goiter

Goitre is a noncancerous enlargement of the thyroid gland. The most common cause of goitre worldwide is an iodine deficiency in the diet. Goitre is often caused by (and a symptom of) hyperthyroidism where iodized salt provides plenty of iodine. Goitre can affect anyone at any age, especially in areas of the world where foods rich in iodine are in short supply. However, goitres are more common after the age of 40 and in women, who are more likely to have thyroid disorders. Other risk factors include family medical history, certain medication usage, pregnancy, and radiation exposure. When hypothyroidism isn’t treated, signs and symptoms can gradually become more severe. Constant stimulation of your thyroid gland to release more hormones may lead to an enlarged thyroid (goitre)

There might not be any symptoms if the goitre is not severe. The goitre may cause one or more of the following symptoms if it grows large enough, depending on the size:

  • swelling/tightness in the neck
  • breathing and/or swallowing difficulties
  • coughing or wheezing

2. Hypothyroidism

(underactive thyroid) is a condition in which your thyroid gland doesn’t produce enough of certain important hormones.
Which inturn upsets the normal balance of chemical reactions in your body
Causes
• Autoimmune disease – People who develop a particular inflammatory disorder known as Hashimoto’s thyroiditis suffer from the most common cause of hypothyroidism. Autoimmune disorders occur when your immune system produces antibodies that attack your own tissues.
• Treatment for hyperthyroidism – People who produce too much thyroid hormone (hyperthyroidism) are often treated with radioactive iodine or anti-thyroid medications to reduce and normalize their thyroid function.
• Thyroid surgery -Removing all or a large portion of your thyroid gland can diminish or halt hormone production.
• Radiation therapy – Radiation used to treat cancers of the head and neck can affect your thyroid gland and may lead to hypothyroidism.
• Medications – A number of medications can contribute to hypothyroidism. One such medication is lithium, which is used to treat certain psychiatric disorders.
• Emotional stress.
Less often, hypothyroidism may result from one of the following:
• Congenital disease.
• Pituitary disorder.
• Pregnancy.
• Iodine deficiency.
signs and symptom
• Fatigue
• Weight gain
• Increased sensitivity to cold
• Constipation
• Dry skin
• Unexplained weight gain
• Puffy face
• Hoarseness
• Muscle weakness
• Elevated blood cholesterol level
• Muscle aches, tenderness and stiffness
• Pain, stiffness or swelling in your joints
• Heavier than normal or irregular menstrual periods
• Thinning hair
• Slowed heart rate
• Depression
• Impaired memory.
Advanced hypothyroidism, known as myxedema, is rare, but when it occurs it can be life-threatening. Signs and symptoms include low blood pressure, decreased breathing, decreased body temperature, unresponsiveness and even coma. In extreme cases, myxedema can be fatal.
Hypothyroidism in infants
Initially, babies born without a thyroid gland or with a gland that doesn’t work properly may have few signs and symptoms. When newborns do have problems with hypothyroidism, they may include:
• Yellowing of the skin and whites of the eyes (jaundice). In most cases, this occurs when a baby’s liver can’t metabolize a substance called bilirubin, which normally forms when the body recycles old or damaged red blood cells.
• Frequent choking.
• A large, protruding tongue.
• A puffy appearance to the face.
As the disease progresses, infants are likely to have trouble feeding and may fail to grow and develop normally. They may also have:
• Constipation
• Poor muscle tone
• Excessive sleepiness
When hypothyroidism in infants isn’t treated, even mild cases can lead to severe physical and mental retardation.
Hypothyroidism in children and teens
In general, children and teens who develop hypothyroidism have the same signs and symptoms as adults do, but they may also experience:
• Poor growth, resulting in short stature
• Delayed development of permanent teeth
• Delayed puberty
• Poor mental development
you’re at an increased risk if you:
• Are a woman older than age 60
• Have an autoimmune disease
• Have a close relative, such as a parent or grandparent, with an autoimmune disease
• Have been treated with radioactive iodine or anti-thyroid medications
• Received radiation to your neck or upper chest
• Have had thyroid surgery (partial thyroidectomy)
• Have been pregnant or delivered a baby within the past six months

3. Hyperthyroidism

Hyperthyroidism (overactive thyroid) is a condition in which your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body’s metabolism significantly, causing sudden weight loss, a rapid or irregular heartbeat, sweating, and nervousness or irritability.

Causes
A number of conditions, including Graves’ disease, toxic adenoma, Plummer’s disease (toxic multinodular goitre) and thyroiditis, can cause hyperthyroidism.

How it all works

Reasons for too much thyroxine (T-4)

Normally, your thyroid releases the right amount of hormones, but sometimes it produces too much T-4. This may occur for a number of reasons, including:

  • Graves’ disease. Graves’ disease, an autoimmune disorder in which antibodies produced by your immune system stimulate your thyroid to produce too much T-4, is the most common cause of hyperthyroidism. Normally, your immune system uses antibodies to help protect against viruses, bacteria and other foreign substances that invade your body. In Graves’ disease, antibodies mistakenly attack your thyroid and occasionally attack the tissue behind your eyes (Graves’ ophthalmopathy) and the skin, often in your lower legs over the shins (Graves’ dermopathy). Scientists aren’t sure exactly what causes Graves’ disease, although several factors — including a genetic predisposition — are likely involved.
  • Hyperfunctioning thyroid nodules (toxic adenoma, toxic multinodular goiter, Plummer’s disease). This form of hyperthyroidism occurs when one or more adenomas of your thyroid produce too much T-4. An adenoma is a part of the gland that has walled itself off from the rest of the gland, forming noncancerous (benign) lumps that may cause an enlargement of the thyroid. Not all adenomas produce excess T-4, and doctors aren’t sure what causes some to begin producing too much hormone.
  • Thyroiditis. Sometimes your thyroid gland can become inflamed for unknown reasons. The inflammation can cause excess thyroid hormone stored in the gland to leak into your bloodstream. One rare type of thyroiditis, known as subacute thyroiditis, causes pain in the thyroid gland. Other types are painless and may sometimes occur after pregnancy (postpartum thyroiditis).
  • Sudden weight loss, even when your appetite and the amount and type of food you eat remain the same or even increase
  • Rapid heartbeat (tachycardia) — commonly more than 100 beats a minute — irregular heartbeat (arrhythmia) or pounding of your heart (palpitations)
  • Increased appetite
  • Nervousness, anxiety and irritability
  • Tremor — usually a fine trembling in your hands and fingers
  • Sweating
  • Changes in menstrual patterns
  • Increased sensitivity to heat
  • Changes in bowel patterns, especially more frequent bowel movements
  • An enlarged thyroid gland (goiter), which may appear as a swelling at the base of your neck
  • Fatigue, muscle weakness
  • Difficulty sleeping
  • Skin thinning
  • Fine, brittle hair

Older adults are more likely to have either no signs or symptoms or subtle ones, such as an increased heart rate, heat intolerance and a tendency to become tired during ordinary activities. Medications called beta blockers, which are used to treat high blood pressure and other conditions, can mask many of the signs of hyperthyroidism.

Graves’ ophthalmopathy

Sometimes an uncommon problem called Graves’ ophthalmopathy may affect your eyes, especially if you smoke. In this disorder, your eyeballs protrude beyond their normal protective orbits when the tissues and muscles behind your eyes swell. This pushes the eyeballs forward so far that they actually bulge out of their orbits. This can cause the front surface of your eyeballs to become very dry. Eye problems often improve without treatment.

Signs and symptoms of Graves’ ophthalmopathy include:

  • Protruding eyeballs
  • Red or swollen eyes
  • Excessive tearing or discomfort in one or both eyes
  • Light sensitivity, blurry or double vision, inflammation, or reduced eye movement.

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