Hyperthyroid Disorders

Lesson 8: Accompanying Conditions and Complications

Hypothyroidism and other Treatment Related Conditions

Several conditions can occur as a result of aggressive treatment for hyperthyroidism. These include hypothyroidism, other autoimmune diseases, salivary gland damage and hypoparathyroidism. In this section, students will learn about these conditions and their symptoms. Many other disorders, including cancer, are also associated with treatment for hyperthyroidism. Space restricts this discussion to the following treatment consequences.

Hypothyroidism
Hypothyroidism primarily occurs as a result of radioiodine ablation and total thyroidectomy although it may also occur after partial thyroidectomy. A mild form of hypothyroidism, which can be temporary, also occurs in approximately 20 percent of patients who avoid using aggressive treatment.

Symptoms of hypothyroidism include abdominal pain and distention, constipation, digestive disturbances, palpitations, increased diastolic blood pressure, cold intolerance, decreased drug metabolism, edema, anemia, diminished hormone secretion, decreased bone resorption, joint pain, memory impairment, depression, headache, muscle pain, leg cramps, restless leg syndrome, increased lipid levels, cardiac problems, obstructive sleep area, peripheral neuropathy, dry skin, acne, decreased sweating, infection, slow wound healing, slow speech, thickened tongue, hoarse voice, hearing loss, weakness, lethargy, weight gain, and malabsorption.

In summary, hypothyroidism affects all of the bodily symptoms, impairing their function. Untreated, hypothyroidism can progress to a condition of myxedema coma, which has a mortality rate of 60 percent. Certain hypothyroid symptoms can precipitate myxedema coma, including low blood sugar, low blood sodium, narcotics, sedatives, tranquilizers and cold weather. Predominant symptoms include hypothermia with temperatures falling as low as 80 degrees and unconsciousness. Typical hypothyroid features, such as coarse dry, puffy skin, and swollen features are usually seen. In patients with total thyroid failure, myxedema coma can develop after six weeks without thyroid replacement hormone.

Hypothyroidism following surgery may improve or resolve, whereas hypothyroidism resulting from radioiodine ablation tends to worsen over time, frequently progressing to autoimmune thyroid failure. It’s important for patients to have regular thyroid function tests so that the optimal type and dose of replacement hormone can be prescribed. For proper absorption of thyroid replacement hormone, it should be taken on an empty stomach at least two hours apart from other medications including calcium supplements. Patients consulting naturopaths may be prescribed digestive enzymes and essential oils to help facilitate absorption.

Other Autoimmune Diseases
Patients with one autoimmune disorder such as Graves’ disease are more likely to develop a second autoimmune disease than other people. The risk is increased in patients who have radioiodine ablation because of the persistent immune system stimulation. The most common disorders to occur include fibromyalgia, which is more likely to occur in individuals who become permanently hypothyroid, atrophic gastritis, pernicious anemia and celiac disease, which is a condition of gluten intolerance.

Salivary Gland Destruction
The salivary glands are frequently injured by radioiodine used for thyroid ablation. This impairs secretion of salivary gland juices, which hinders digestion and causes a mild condition of mouth dryness, which, in turn, contributes to dental problems, especially increased cavities.

Hypoparathyroidism
The parathyroid glands can be damaged by radioiodine and during thyroidectomy surgery resulting in a condition of transient or permanent hypoparathyroidism. The parathyroid glands secrete parathyroid hormone or PTH. PTH, along with the thyroid hormone calcitonin and vitamin D, regulates blood calcium levels. In hypoparathyroidism, blood calcium levels are low, which causes symptoms of tetany, muscle spasms, tingling lips, and bone loss.

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